Heart disease remains one of the greatest causes of death and suffering in our community today. Recurrent events among patients transitioning home after a hospital admission represent a significant, and possibly preventable, portion of the total health and economic burden. Programs to support patients in this transition have been shown to improve outcomes, but patient engagement in traditional forms of these programs remains low.
Our study team have developed a program called “Total Cardiac Care Plus”. The TCC+ app provides patients with information about the management of heart disease and medication reminders. It records activity and comes with a graduated exercise program. Patients are also provided with a blood pressure monitor and weight scales that are paired to the phone. All these measurements are uploaded wirelessly. Patients can track their own progress over time.
The measurements are also monitored by doctors on the research team who will contact the patient and their treating health care provider if there are any concerning trends, to help organise an early review. The aims of the TCC+ Program are to encourage healthy behaviours by educating and empowering patients, and to monitor patients at home to detect early signs of deterioration before they require readmission to hospital.
Through this translational project, we hope to demonstrate that the TCC+ program can help patients by: educating patients and helping them to keep track of their own heart disease; enabling greater levels of physical activity, and remotely monitoring their progress at home to detect early signs of deterioration and facilitate clinical review, which in turn will result in improved transitional care and reduced clinical complications.