Smartphone-Based Remote Monitoring for Chronic Heart Failure: Mixed Methods Analysis of User Experience From Patient and Nurse Perspectives.

It was done at one centre in one part of London, so the findings may not apply to other services. There was no comparison group of patients who did not use remote monitoring, and no prescription data were analysed, so changes in vital signs cannot be attributed to the app or to medication adherence. Patients were not required to give feedback, so the comments may reflect the views of those who chose to submit them. Four of 83 onboarded patients were excluded because they used the platform for fewer than 3 months, including 2 who dropped out and 2 who died. The follow-up was only 3 months, and remote monitoring use can decline over time. The app was studied only in patients with reduced ejection fraction, not preserved ejection fraction. Vital signs were self-measured and could vary day to day and within the same day.

The supplied text lists author disclosures: CB receives educational and consultancy honoraria from AstraZeneca, Vifor, Novartis, Omron and Boehringer Ingelheim; CP receives educational honoraria from AstraZeneca and Boehringer Ingelheim. It does not state who funded the work.

Do not read the lower blood pressure and heart rate as proof that the app improved adherence or caused better outcomes. There was no non-monitoring comparison group, no prescription data were analysed, and the app combined self-measurement, messaging, symptom reporting and e-learning, so the effect of any single component cannot be separated.