Heart Health on Achievement 

In collaboration with the American College of Cardiology (ACC), Evidation has launched a nationwide initiative focusing  on the lived experience of individuals with heart failure beyond the clinic walls, to understand their particular needs and sources of value which could improve engagement and outcomes.

Over 1000 people with heart failure and other chronic conditions (as of April 2021) from across 48 states and the District of Columbia have agreed to participate, recruited in less than 1 month from Evidation’s Achievement app.

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Person-Generated Health Data

 PGHD allows us to understand the heart failure lived experience outside the clinic for a wider population, and allows individuals to tell their own story.

Engagement 

Through PGHD, we can identify individuals who could benefit from engagement and nudge them towards evidence supported actions. 

Digital Tools 

We can identify individuals with heart failure that are not being managed well and engage them via digital tools, ultimately improving health outcomes.

Important Insights: As of July 22, 2021


Medication Change

While more than half of the patients actively taking medication to manage their heart health report having never changed either the medications or the dosages they are on, we see a huge range in the rates with which the others report that their medication and the dosages of their medications are changed.

  • Why it matters: Getting on the right medication is really important for long-term management of heart failure and a patient’s quality of life. We tend to see a wide variation in medication change due to different causes such as limited access to medication, knowledge etc. Unfortunately, medications are not one size fits all and there is no one correct medication or dosage for all patients. This means that regularly monitoring patients and adjusting their medications and dosages is a key part of successful long-term management of heart failure.
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Symptoms by Medication Change

We asked patients how their symptoms changed after their most recent medication change. We saw that a change usually had no effect on specific symptoms, but often helped. However, patients on government (Medicaid, TRICARE or military) insurance, the opposite trend was seen - heart failure often results in a reduced ability to exercise, and patients on government insurance told us that their new medications often made this worse.

  • Why it matters: When medications are changed, it is important to monitor if and how symptoms change afterwards. Having a direct connection to patients can help record what symptoms patients are experiencing and facilitate feedback to their doctor, helping them get on the right medications for them.
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Medication Impact on Well-Being

We asked patients how they were feeling overall since their last medication change. We saw that patients who changed their medications more often (e.g. monthly) felt better overall.

  • Why it matters: Finding the right medications for each patient is a big challenge in heart failure, so being in regular contact with your doctor, and regularly updating your medications is a key part of the journey towards well managed heart failure. A direct connection to patients can help track how patients are feeling and nudge them towards healthy choices.
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Symptoms by Socioeconomic Status 

We see that socioeconomics (for example employment status or the type of insurance someone is on) associates strongly with the number of symptoms an individual reports.

  • Why it matters: Socioeconomics have a big influence on access to care and on outcomes in heart failure. Meeting patients where they are, to help them manage their health, is a key part to overcoming these disparities.
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Missing a Dose of Medication

We asked patients how often they miss a dose of their medications and why. The most common reason for occasionally missing a dose was simply because they forgot, but we also saw that many patients reported having trouble paying for medications or tried to stretch their medications to limit costs. In addition, patients who avoided or stopped taking their medications reported having concerns about the medication, experienced side-effects or believed the medications did not work on them.

  • Why it matters: Non-adherence can have serious consequences. In the simplest cases, patients need help managing their medications, but we also need to help patients work with their care team to transition to the best medications for them so that they feel the benefit of taking them.
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Access to Healthcare 

Many heart failure patients experience limitations in access to healthcare. Patients told us that the number one reason for experiencing limitations has been the pandemic.

  • Why it matters: The pandemic has affected us all in so many ways, but for heart failure patients and others with chronic conditions, good access to healthcare has been heavily impacted. Enabling patients to access healthcare through other channels will help alleviate this disparity.
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Trends in Activity 

We compared self-reported trends in overall health with objective behavioral data collected from consumer-grade wearables. It was found that people who reported feeling better tend to have increased their activity levels over the preceding few months.

  • Why it matters: When someone is on a good track, we need objective ways to reinforce that trend. Equally, if someone is off track, we need triggers to reach out to them. This objective Person-Generated Health Data (PGHD) from consumer-grade wearables, enables us to do that.
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Important Insights: As of May 25, 2021


Geographic Reach

474 heart failure participants from across the United States joined the study, representing 48/50 states and a 80:20 mix of urban and rural.

  • Why it matters: Inequalities in access and treatment play a large role in Heart Failure outcomes, it is critical to meet patients where they are, both in their journey and also physically.
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Behaviorgram

Participants shared up to 5 years of retrospective wearable data, in many cases covering their entire heart failure journey: pre-diagnosis, diagnosis, hospitalizations and medication changes, as well as current symptoms and trajectories.

  • Why it matters: Participants are enabling us to understand their entire journey and study the impact of heart failure on their behavior and outcomes over long periods of time. This helps us identify individual personas and trajectories, and derive personalized insights which help that individual engage with their own health. 
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Device Usage

We observe high levels of device usage across demographic, socio-economic and ethnic groups.

  • Why it matters: Low-burden and highly popular mobile technologies enable all patients to have their voice heard. 
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Diagnoses

76% of participants reported being aware of their symptoms prior to diagnosis, and 25% for months or years before their diagnosis. 61%  participants have a connected wearable device, of which 9% participants shared dense (no more than 4 consecutive missing days, no more than 15 days missing in a month) wearable data covering their entire journey all the way to diagnosis.

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Hospitalizations 

89% of participants had been hospitalized at least once, and 24% participants shared dense (no more than 4 consecutive missing days, no more than 15 days missing in a month) wearable data covering their most recent hospitalization.

  • Why it matters: Hospitalization is the major driver of costs associated with heart failure in the United States. This data will enable us to better understand behaviors and identify patients who are likely to be readmitted. 
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Medication Change

11-13% report not regularly taking any medications for their heart failure, and of those that are, 53% participants reported feeling no change or worsening symptoms since last medication change.

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