Remote dielectric sensing (ReDS) technology noninvasively assesses lung congestion, but its value in primary care remains unknown. This study aimed to evaluate the feasibility of a ReDS-guided heart failure (HF) management programme in primary care.The 1-month programme, including ReDS measurements, a decision-support algorithm for diuretic adjustments, follow-up, and support for patient symptom monitoring, was provided to 18 patients with HF (mean age 81 years, mean ReDS values 33.6 ± 6.0 indicating optimal volume status) in one rural primary care centre. The feasibility areas of acceptability, demand, implementation, practicality, and limited efficacy were evaluated in a mixed-methods study. Data were collected from 18 patients with HF and two healthcare professionals (HCPs) at baseline and 1-month follow-up. Acceptability: Patients found the programme satisfactory, while HCPs expressed uncertainty about using the algorithm for patients with deviating ReDS values but no worsening symptoms. Demand: Patients recognized the potential to prevent hospitalizations. Healthcare professionals perceived higher demand in rural settings. Practicality: The ReDS technology was found practical and easy to use. Implementation: Fidelity was partial, with algorithm-recommended clinical actions not always implemented. Limited efficacy: Self-care improved with a medium effect size and N-terminal pro-B-type natriuretic peptide (NT-proBNP), with a small effect size. No adverse events were reported.Our study demonstrates the feasibility of a ReDS-guided HF management programme, which may enable early detection of subclinical congestion and improve outcomes for patients with HF in primary care settings. Further effort is necessary to refine the algorithm and improve its fidelity.

Thorough consideration of user experiences and the weighing of advantages and disadvantages are essential when implementing new technology in clinical practice. This article describes a primary care nurse's experience using two technologies to monitor lung congestion in six patient cases: a remote dielectric sensing device for non-invasive lung fluid measurement and a portable handheld ultrasound device. Both can support decision-making when assessing lung congestion in heart failure patients. However, technical difficulties and interpretational complexities are inherent in their use. Balancing these advantages and disadvantages and finding effective strategies to address challenges is crucial for successful clinical implementation.

Aims This study aimed to explore effects of exergaming and medical yoga on exercise capacity, fatigue, shortness of breath, health-related quality of life, depression, and anxiety in patients with heart failure.Methods and results A randomized sub-study with a 3-month intervention and outcomes measures at baseline, 3, 6, and 12 months. Participants were recruited from heart failure clinics in Sweden. Treatment effects in change of outcomes were tested in an analysis of mixed-effects models with repeated measures. Change in outcomes was the dependent variable. The independent fixed-effect parameters were treatment group, time, and the interaction between treatment group and time. In total, 104 patients (37% women, mean age 71 +/- 12, 48% in New York Heart Association Class II and 42% in III) were randomized to exergaming (n = 35), medical yoga (n = 33), or an active control group (n = 36). No statistically significant differences were found between these three groups on any of the outcome measures. Exergaming significantly improved exercise capacity, fatigue, shortness of breath, and physical health-related quality of life and medical yoga improved symptoms of fatigue and emotional health-related quality of life. The control group did not change on the exercise capacity, symptoms, health-related quality of life, or depressive or anxiety symptoms. The well-being score in patients in the control group significantly decreased at 3 months.Methods and results A randomized sub-study with a 3-month intervention and outcomes measures at baseline, 3, 6, and 12 months. Participants were recruited from heart failure clinics in Sweden. Treatment effects in change of outcomes were tested in an analysis of mixed-effects models with repeated measures. Change in outcomes was the dependent variable. The independent fixed-effect parameters were treatment group, time, and the interaction between treatment group and time. In total, 104 patients (37% women, mean age 71 +/- 12, 48% in New York Heart Association Class II and 42% in III) were randomized to exergaming (n = 35), medical yoga (n = 33), or an active control group (n = 36). No statistically significant differences were found between these three groups on any of the outcome measures. Exergaming significantly improved exercise capacity, fatigue, shortness of breath, and physical health-related quality of life and medical yoga improved symptoms of fatigue and emotional health-related quality of life. The control group did not change on the exercise capacity, symptoms, health-related quality of life, or depressive or anxiety symptoms. The well-being score in patients in the control group significantly decreased at 3 months.Conclusion Both exergaming and medical yoga demonstrated positive impacts on outcomes when compared with a control group. Exergaming, characterized by its elevated physical intensity, exerted effects primarily on physical health, while medical yoga, as a mind-body intervention, exhibited influences on emotional well-being.Registration ClinicalTrial.gov: NCT01785121

AimThis paper describes the trajectory during 1 year of four patient-reported outcomes (PROs), namely, sleep, depressive symptoms, health-related quality of life (HrQoL), and well-being, in patients with heart failure (HF), their relationship and the patient characteristics associated with changes in these PROs.Methods and resultsData analyses of PROs from 603 patients (mean age 67 years; 29% female, 60% NYHA II) enrolled in the HF-Wii study. On short term, between baseline and 3 months, 16% of the patients experienced continuing poor sleep, 11% had sustained depressive symptoms, 13% had consistent poor HrQoL, and 13% consistent poor well-being. Across the entire 1-year period only 21% of the patients had good PRO scores at all timepoints (baseline, 3, 6, and 12 months). All others had at least one low score in any of the PROs at some timepoint during the study. Over the 12 months, 17% had consistently poor sleep, 17% had sustained symptoms of depression, 15% consistently rated a poor HrQoL, and 13% poor well-being. Different patient characteristics per PRO were associated with a poor outcomes across the 12 months. Age, education, New York Heart Association, and length of disease were related to two PRO domains and submaximal exercise capacity (6 min test), co-morbidity, and poor physical activity to one.ConclusionIn total, 79% of the patients with HF encountered problems related to sleep, depressive symptoms, HrQoL, and well-being at least once during a 1-year period. This underscores the need for continuous monitoring and follow-up of patients with HF and the need for dynamic adjustments in treatment and care regularly throughout the HF trajectory.