Medically reviewed by Susan Kerrigan, MD and Marianne Madsen
Both heart disease and diabetes are chronic conditions that require round-the-clock care. Two new devices aim to make living with these conditions a little easier – via remote monitoring.
Innovation at the American College of Clinical Pharmacy
Two different devices were the focus of the American College of Clinical Pharmacy’s 2020 virtual annual meeting point: KardiaMobile’s personal ECG (electrocardiogram) monitor and Livongo’s RDMP (remote diabetes monitoring program). The two devices were tested in separate studies. Both led to impressive results, and could change the way diabetes and heart disease are managed.
Mobile ECG Detects Life-Threatening Arrhythmias
KardiaMobile’s ECG monitor was tested in a 2019-2020 study of 53 patients enrolled at three community pharmacies in Iowa. Pharmacists studied patients’ QTc intervals (an electrocardiogram representation of ventricular depolarization and repolarization) using 30-second ECG measures taken on the device. All patients in the study were taking medications known to prolong their QTc interval. A long QTc interval can lead to arrhythmias, which in turn can cause fainting, seizures or even death.
Recordings from the device alerted pharmacists to potential long QT syndrome in six of the patients. Three of them had their medications adjusted.
Lead study author James Hoens, PharmD, of the University of Iowa College of Pharmacy, said the new technology could help pharmacists prescribe heart medications with more accurate judgement.
“With this easy technology, we’ve got the ability for a pharmacist in 30 seconds to determine somebody’s QTc interval at the time they are processing this prescription. It’s put a totally new tool in the pocket of the pharmacist to help them with their professional judgment,” said Hoens.
Better Glycemic Control, Medication Adherence
Livongo’s remote diabetes management program, which includes a cellular-enabled glucose meter, test strips and interactive coaching, was tested in a study of 870 diabetic patients. 479 patients were used as controls, and were not included in the program. The patients in the program were given Livongo’s glucose meter and unlimited test strips.
As the patients took blood glucose readings, the data was uploaded to the cloud, processed by an algorithm, and returned to the patient – this time, with helpful tips on how to improve their glucose levels.
After two years of participation in the study, patients’ medication adherence increased from 77% to 80%, but patients not enrolled in the study saw a decline in their medication adherence levels – from 78% to 69%. Furthermore, the patients in the Livongo program saw a 1 mg/dL decrease in blood glucose each month.
“We were pretty astonished to see this real difference at two years of medication adherence,” said Bimal Shah, MD, MBA, CMO of product and analytics at Livongo and a cardiologist at Duke University School of Medicine.
“We know that only about a third of people with diabetes are adherent to their medications on an ongoing basis. This is a huge opportunity to promote better glucose control and better diabetes management.”