A Hamilton Health Sciences (HHS) cardiologist and her research team are exploring how remote home monitoring can help improve access to care for people experiencing heart failure, a common condition affecting 750,000 Canadians.

Heart failure is when the heart doesn’t function properly or when there’s damage to the structure of the heart. It can be the result of a heart attack or other serious heart conditions such as hypertension. It can also result from obesity, alcohol misuse, or valve disease. The dysfunction is often permanent and can’t be cured, but it can be improved through medications and lifestyle choices.

Lifelong management of heart failure can be challenging, so Dr. Harriette Van Spall and her research team are exploring how to improve access to care. As well as being an HHS cardiologist, Van Spall is a scientist at the Population Health Research Institute of HHS and McMaster University as well as at St. Joseph’s Research Institute, and an associate professor in the Division of
Cardiology at McMaster.

Supporting those with heart failure

More people are surviving cardiac events like heart attacks than ever before and hypertension is not only common but often undertreated. So, the number of people with heart failure is also on the rise.

“We’re not only seeing more people with heart failure but younger people in their 40s and 50s with many years of life at stake,” says Van Spall. “However, the typical patient is an older adult, and many can’t get to centres of excellence. This is why it’s important to provide accessible care and remote support.”

While maintaining a healthy lifestyle through diet and exercise and taking medications as prescribed is important for everyone, it’s essential for people with heart failure. What makes it especially challenging, is that small changes can have large impacts. This means many people with heart failure end up back in hospital with persistent symptoms like fatigue, shortness of breath from fluid in the lungs, and swelling in the abdomen and legs.

“If we can provide effective ongoing support and best medical treatments to those with heart failure, they’re less likely to be re-admitted to hospital,” says Van Spall. “However currently, many don’t get adequate enough care after they’re discharged.”

VICTORY –HF randomized clinical trial

To try and meet this need, Van Spall and her team are currently testing a virtual model of care with a clinical trial called VICTORY-HF. This involves a remote monitoring system where patients regularly track health data from the comfort of their homes, to be reviewed by their care team. Regular remote visits occur between the patient and care team to optimize medical therapy. This 3-year study will include approximately 1,400 participants at sites across Canada, including HHS.

“We want to see if a virtual model with remote monitoring can help patients feel better and ultimately prevent re-admissions to hospital,” says Van Spall. “There’s great potential for a virtual care model to improve access for those who find it challenging to attend regular appointments, and for health-care providers to intervene before health concerns become serious.”

Creating change

Van Spall’s work to improve the lives of those with heart failure has been recognized by the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada. Plus, she’s received prestigious awards for her research from the Canadian Institutes of Health Research and the American Heart Association.

Her successful career has given her the opportunity to pursue equity, diversity, and inclusion improvements within both the research community and cardiology.

She is a strong supporter of women and other under-represented groups in cardiology. She has funded a training program for students from under-represented regions in the world to join her research team. She believes that giving opportunities to a more diverse group of researchers can spur the systematic change needed to find innovative solutions for patients living with cardiovascular disease around the world.

“If we want to make serious advancements in health care, we need the contributions of the best and brightest, regardless of their age, gender, geography, or ethnic background,” says Van Spall. “We must make room at the table for everyone who wants to contribute.”