Kevin Volpp, MD, PhD
Andrea Troxel, ScD
National Heart, Lung, and Blood Institute
Congestive heart failure is a major cause of morbidity, mortality, and cost. Disease management programs have shown promise in improving outcomes but lack firm evidence of effectiveness and scalability.
A team of researchers at the University of Pennsylvania leveraged Way to Health to determine whether remote monitoring of diuretic adherence and weight changes with financial incentives reduces hospital readmissions or death following discharge with heart failure.
The team enrolled 552 patients in the EMPOWER trial. Participants in the intervention arm received digital scales, electronic pill bottles for diuretic medication, and regret lottery incentives conditional on the previous day’s adherence to both medication and weight measurement. They also had the option to invite a support partner who would receive alerts about non-adherence.
There was no significant difference between the intervention and usual care groups for the combined outcome of all-cause inpatient readmission or death. There were 423 readmissions and 26 deaths in the control group and 377 readmissions and 23 deaths in the intervention group.