Women, Younger Patients May Benefit Most with Mobile Integrated Health

A major randomized clinical trial from Columbia Nursing confirms that mobile integrated health (MIH) helps patients with heart failure transition from the hospital to home and is effective in a diverse population with a high burden of disease. 

Professor Ruth Masterson Creber, PhD, co-first author and contact principal investigator of the study, presented the findings March 30 in a Late Breaker Clinical Trial session at the American College of Cardiology’s Annual Scientific Sessions in Chicago. The ACC highlighted the findings in a press release and a news story. 

In the MIGHTy-Heart Trial, Masterson Creber and colleagues at 11 hospitals across two New York City health systems enrolled 2,003 patients hospitalized for heart failure, randomly assigning them to MIH or a phone call from a transitions of care coordinator 48 to 72 hours after discharge. Patients in the MIH group could request in-home visits from paramedics, who assessed their symptoms and home environment and facilitated a live telehealth visit with a physician. 

While there was no difference between the MIH and standard-care groups in the study’s primary endpoint of 30-day readmissions, there were differences for some important subgroups, Masterson Creber and her colleagues found. All-cause hospitalization was 30% less likely for women compared to men in the MIH group, while women assigned to MIH had a 36% lower risk of being readmitted to the hospital for heart failure.  

The researchers also found that patients younger and older than 70 showed equal benefit with MIH, but that younger patients were less likely than older patients to improve with standard care. 

“Patients facing greater social and economic barriers—like financial stress or lack of caregiving support—may gain the most from mobile integrated health,” Masterson Creber notes. “These findings highlight the complexity of tailoring care transitions in heart failure—and reinforce the need for novel care models that deliver high-quality care to all patients.” 

The Patient-Centered Outcomes Research Institute (PCORI) funded the MIGHTy-Heart Trial, and the authors are planning additional analyses to identify other factors that could influence the benefits of MIH in order to improve the MIH program and implement it more widely in the future.