KNCV is constantly looking for innovative approaches for patient-centered care. Patients with drug resistant tuberculosis (DR-TB) who receive treatment with new drugs or novel regimen need to be monitored throughout the treatment period due to the cardiotoxicity effect of some of these drugs in the regimen.
These events are rare, and the treatment is usually well tolerated, however, such cardiac events may lead to serious consequences and making it difficult to effectively treat a patient. Timely identification and management of these cardiac events are important. That is why regular monitoring of cardiac rhythm by recording of electrocardiogram (ECG) is essential and it is an integral part of active TB drug-safety monitoring and management (aDSM). aDSM provides active and systematic clinical and laboratory assessment of patients while on treatment, and ultimately aim to detect, manage, and report serious adverse events related to the drug toxicities.
In November 2021, the National Tuberculosis Program (NTP) in Kazakhstan, supported by KNCV specialists, started the pilot implementation of personal ECG devices, KardiaMobile for ECG monitoring for DR-TB patients. With this innovative technology, patients receive the opportunity to get their ECG recorded at the convenience of their homes. This is especially important for those who live remotely and experience difficulties reaching the healthcare facility.
The tiny KardiaMobile ECG instrument was originally approved by the Food and Drug Administration in USA as a personal ECG recording device that produces a clinical grade ECG, and is nowadays recognized and accepted by cardiologists around the globe.
The recording of personal ECG and sending it over the internet to the clinician for an immediate interpretation takes a few minutes. In case of developing cardiac rhythm abnormalities, the clinician will adjust the treatment. The KardiaMobile devices paired with smartphones are provided to the patients for the duration of the treatment, and upon completion will be handed over to the new patients.
By 14 February 2022, 30 patients started their treatment at the in-patient department in Almaty. 22 patients have already been discharged from the hospital to continue their treatment at home. All 22 were provided with KardiaMobile and a smartphone. 8 patients will be also discharged soon.
The project aims to enroll up to 90 patients, an such criteria as usability and acceptability of KardiaMobile will be evaluated among patients and healthcare workers. Upon completion of the pilot implementation in 2022, the recommendations for the use of personal ECG devices will be developed.