A telemedicine initiative targeting patients with heart failure with reduced ejection fraction in the Navajo Nation improved rates of guideline-directed therapy by fivefold.
with reduced ejection fraction across the rural expanse of the Navajo Nation in Arizona and New Mexico significantly increased rates of guideline-directed medical therapy within 30 days of signing them up, results of a clinical trial showed.
Eberly noted the telemedicine initiative was designed after garnering input from the Navajo Nation and tribal elders. "In addition to the significantly high rates of addition of GDMT in the intervention arm, there were also higher rates of increase in doses at 79% vs 23%, and while this was exploratory and a secondary outcome, there were lower heart failure hospitalizations in the intervention arm, and there were very few adverse events in total with no significant differences between the arms," she added. The rate of heart failure hospitalizations was 1.3% in the telemedicine arm vs 4.
Sometimes, the roads are virtually impassable, she said, and for those who can travel, food and a hotel stay add costs."Sometimes those barriers are completely prohibitive," she said.The Indian Health Service has since adopted this GDMT telemedicine initiative at its Gallup and Tohatchi, New Mexico, centers, with plans to expand it to a third center in Arizona, Eberly said, and is exploring ways to target other disease states, again based on input from the tribal community and elders.
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