AdHeart

The Project AdHeart – Get involved with your heart: Promotion of therapeutic adherence with a telemonitoring system for people with chronic heart failure is a project developed by CINTESIS, in partnership with Fraunhofer Portugal and FPCEUP. With global funding of around 240 million euros from FCT and POR NORTE, AdHeart aims to develop strategies in the area of non-invasive telemonitoring of heart failure and to assess the impact and conditions of adherence to technology and therapy.

In Portugal, heart failure (HF) affects 380,000 patients and is more deadly than many more common forms of cancer. It represents 1-2% of all health costs in developed countries. 50 to 70% of the economic weight of HF is due to hospitalizations, which have a high intra- and extra-hospital mortality and a marked recurrence rate. They are a central aspect of HF, deteriorating the prognosis and constituting, if repetitive, an indication for heart transplantation. They are preceded by a period of progressive decompensation, which, if not corrected, deteriorates the clinical situation, leading to hospitalization. Invasive telemonitoring (ITM) allows the early detection of signs of decompensation, enabling its correction, and reducing hospitalizations for HF. Although it is a proof of the concept’s validity, the intra-thoracic implantation of hemodynamic sensors is not feasible on a large scale. Alternatively, non-invasive telemonitoring (NITM) may overcome this limitation, however it depends heavily on adherence to technology and therapy. Clinical trials with TMNI have shown low rates of continued adherence to these devices, which is a fundamental barrier. The investigation of technology acceptance and therapeutic adherence strategies is crucial and is the objective of this project.

We will develop two types of strategies: technological and behavioral. HF’s NITM support will be a smartphone. We will assess the impact of the system on adherence to therapy and technology, quality of life and relevant clinical objectives (soft endpoints) through a clinical trial. It will include patients followed by a multidisciplinary HF team, being randomized into 2 groups: one, of control, will maintain the usual health care (standard of care) and the second will additionally use a NITM system for 12 months. Four hospital centers in the North of Portugal will participate.
The study will allow a better understanding of the conditions of adherence to technology and therapeutics, contributing to overcome one of the main barriers to the success of NITM in HF and thus creating conditions so that (as shown for ITM) also NITM can reduce hospitalizations for HF.

The participating entities, U.Porto (Medicine and Psychology) and Fraunhofer, have cooperated since 2015 in NITM’s research in HF, having developed the Smart System for the management of Heart Failure in older adults (SmartBEAT) and proceeded with a more integrated solution of NITM in the Deus ex Machina Project. SmartBEAT will be the technology base for AdHeart. The new behavioral and technological solutions that we will develop will contribute to the improvement of the integrated NITM solution, which we will call SmartBEAT Plus. The continuity of this cooperation is assumed in the present project and is ensured by the participation of all entities in all phases of the study, thus contributing to the coherence and continuity of the proposed program.

FCT and POR NORTE

239,883.06€

187,217.90 €

NORTE-01-0145-FEDER-032069

01/11/2019 to 31/10/2022 ( 36 months )

Fraunhofer Portugal e FPCEUP

José Silva Cardoso (PI), Lia Fernandes, Nuno Borges, Luís Azevedo, Sónia Martins, Roberto Pinto, Carla Sousa, Alexandra Sousa, Aurora Abreu