Innovative digital therapeutics program shows a reduction in hospitalizations and costs for heart failure patients

MONTREAL, Québec, November 21, 2023 – The CONTINUUM program, a remote patient monitoring and digital therapeutics project led by The Centre hospitalier de l’Université de Montréal (CHUM), helped heart failure outpatients achieve a significant reduction in the number of emergency room visits and/or
hospitalizations and demonstrated a 23% reduction in healthcare costs, according to preliminary results
presented at the American Heart Association’s Scientific Sessions, held November 11–13, 2023, in
Philadelphia, Pennsylvania.¹

There is increasing use of digital health solutions in heart failure, but few studies have demonstrated its
impact on public healthcare systems in North America. Heart failure is on the rise with 750,000 Canadians living with the disease and more than 100,000 receiving a diagnosis each year. 2 Heart failure is one of the top reasons why people in Canada are hospitalized. 2 By 2030, the healthcare costs associated with heart failure in Canada are expected to reach $2.8 billion per year. ²

The three-month randomized controlled trial for heart failure outpatients at risk of hospitalization evaluated the CONTINUUM program versus standard of care alone. This program included: 1. A self-care app via smartphone or tablet where patients entered vital signs, weight, and heart failure symptoms; 2. Remote monitoring of these data by the CHUM's clinical nurses; 3. Digital therapeutics automated medication suggestions sent to the treating medical team; and 4. Heart failure educational modules for patients – all based on Greybox Solutions’ Takecare platform.

The preliminary results show that the number of ER visits and/or hospitalizations (all cause) per patient was 0.19±0.47 for the intervention group and 0.55±0.89 for the control one (P=0.05). Survival analysis showed a trend in favor of the intervention group (95 days (CI95% 87-104) vs 78 days (CI95% 68-89); P=0.08). The total cost of healthcare consumption (hospitalizations + ER visits) in the intervention group was $134,088 CAD vs $174,924 CAD in the control group (+30%). 

“Given the prevalence of heart failure and the seriousness of the condition, there is a real need for innovative solutions that can help improve patient outcomes and quality of life,” says Dr. François Bernard Tournoux, Cardiologist at the CHUM, Associate Professor, University of Montréal, FRQS Clinical Researcher at the CHUM Research Centre and principal investigator of the trial. “The encouraging preliminary results from the CONTINUUM trial support further study in preventing major heart failure events, involving patients as partners in care, all at a reduced cost for the healthcare system.” 

A total of 171 patients were included in the trial. Preliminary results are available for the first 63 patients that completed the study, 32 intervention (INT) and 31 control (CTRL). Patients were similar in age (70±12 vs 69±13y), NYHA class (II 81 vs 87%), patients with ejection fraction <40% (56 vs 48%) and comorbidities such as diabetes (38 vs 45%; INT vs CTRL).

The CONTINUUM program is a partnership between the Centre hospitalier de l’Université de Montréal
(CHUM), the CHUM Research Centre, MEDTEQ+, Greybox Solutions Inc., Mitacs, PROMPT, and
Boehringer Ingelheim (Canada) Ltd./ Ltée. Boehringer Ingelheim (Canada) Ltd. had no role in the design or conduct of the study.

About CHUM
The Centre hospitalier de l’Université de Montreal (CHUM) is an innovative hospital devoted to serving
patients and the Quebec population. The CHUM adopts an integrated approach to health and the
population which is expressed in all aspects of its mission such as, care, teaching, research, management and innovation, as well as in partnership with the patient and citizen (SERGIP). To achieve the objective of continuous improvement in the health of the population, management of the care trajectory and the life trajectory of patients has been implemented using data analyzed by artificial intelligence from genetic and environmental information. In collaboration with other speakers in the health and social services network (RSSS), the CHUM offers the best specialized care and services based on constantly updated scientific knowledge. chumontreal.qc.ca

About Greybox Solutions Inc.
Greybox Solutions Inc., a Montreal-based healthcare technology company, is a pioneer in the development of Digital Therapies (DTx). Integrating a multitude of technologies within its Takecare platform – versatile, accessible and revolutionary – Greybox offers a modern solution to the numerous and complex challenges at the heart of the healthcare system. Creator of a technological solution offering a simple and dynamic alternative for monitoring chronic diseases, Greybox Solutions, in partnership with the Centre Hospitalier de l'Université de Montréal (CHUM) and Boehringer Ingelheim Canada, has clinically demonstrated the effectiveness of its DTx solution in the field of heart failure. Clinical applications are currently being evaluated in the areas of healthcare related to heart disease, lung disease, mental health and newborn care, among others. www.greybox.ca

About MEDTEQ+

MEDTEQ+, a pan-Canadian consortium for industrial research and innovation in healthcare technologies,
aims to accelerate the development of innovative technological solutions to improve people’s health and
quality of life. MEDTEQ+ supports the validation of these technologies, their integration into the healthcare network, their commercialization, as well as their local and international outreach, by bringing together the complementary skills of industrial and institutional partners and healthcare providers. MEDTEQ+ offers support, subsidies, and investment services to innovative companies. Since December 2022, MEDTEQ+ has also been the lead partner in the envisAGE initiative, which aims to catalyze the AgeTech ecosystem and help companies grow and scale in the AgeTech market. MEDTEQ+ relies, among other things, on financial support from the Government of Quebec, the Government of Canada, the private sector, and complementary partners to foster research-industry relationships. www.medteq.ca 

Boehringer Ingelheim (Canada) Ltd.

Boehringer Ingelheim is working on breakthrough therapies that transform lives, today and for generations to come. As a leading research-driven biopharmaceutical company, the company creates value through innovation in areas of high unmet medical need. Founded in 1885 and family-owned ever since, Boehringer Ingelheim takes a long-term, sustainable perspective. More than 53,000 employees serve over 130 markets in the two business units, Human Pharma and Animal Health. The Canadian headquarters of Boehringer Ingelheim was established in 1972 in Montreal, Quebec and is now located in Burlington, Ontario. Boehringer Ingelheim employs approximately 500 people across Canada. Learn more at www.boehringer-ingelheim.com/ca

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MEDIA CONTACTS:

Andrée-Anne Toussaint
Communication Advisor
Centre hospitalier de l’Université de Montréal (CHUM)
Email: andree-anne.toussaint.chum@ssss.gouv.qc.ca
Telephone: 514 890-8000, extension 23675

Anne Coffey 
Corporate Communications  
Boehringer Ingelheim (Canada) Ltd. 
Email: anne.coffey@boehringer-ingelheim.com  
Telephone: 416-526-5388

References

¹ Emmanuel Marier Tetrault NP, et al. The Impact of Remote Patient Monitoring and Digital Therapeutics on Major Clinical Events and Costs in Heart Failure Patients: Early Experience in the Quebec Public Healthcare System.
Presented at the American Heart Association’s Scientific Sessions 2023; 12 November 2023. Available at:
https://doi.org/10.1161/circ.148.suppl_1.12585Circulation. 2023;148:A12585
² Heart and Stroke Foundation. Heart failure in Canada: complex, incurable and on the rise. Available at: Heart failure in Canada complex incurable and on the rise | Heart and Stroke Foundation. Accessed November 2023.