Utilisation of Digital Monitoring System for Heart Failure Patients: Experience from a Tertiary Healthcare in Bangladesh

Background: Digital monitoring aims to improve early detection of HF decompensation and prevent readmissions. However, evidence of its effectiveness, particularly from lower- and middle-income countries like Bangladesh, is limited. To evaluate the association between the use of a digital monitoring (DM) platform and healthcare utilization among patients with heart failure (HF) at a tertiary care center in Bangladesh. Methods: We conducted a prospective study at a single tertiary HF clinic between April and October 2024. The study compared outcomes for patients who opted into a DM program (DM group) versus those receiving conventional physical visits (PV group). The primary outcome was all-cause hospitalization. A multivariable logistic regression model was used to adjust for baseline differences between the groups. Results: A total of 1,536 patients were included: 43 in the DM group and 1,490 in the PV group. The DM group was younger, had a higher monthly income, and a lower baseline NYHA classification compared to the PV group. In the unadjusted analysis, the DM group had a significantly lower rate of all-cause hospitalization (10% vs. 40%; p=0.01) and fewer emergency care visits (mean 0.7 vs. 1.3; p=0.001). After adjusting for baseline demographic and clinical differences, participation in the DM program remained associated with lower odds of hospitalization. Conclusions: In this single-center study, participation in a DM program was associated with lower healthcare utilization among HF patients. A randomized controlled trial is required to establish a causal relationship and confirm the benefits of telemonitoring in this population.