Patients can now manage heart failure at home safely, thanks to a wearable device that allows them to administer treatment themselves. The mini-pump delivers furosemide, a diuretic medication, directly under the skin in a manner similar to devices already used for diabetes. For people with heart failure, whose condition often leads to fluid retention in the legs and lungs, this marks a significant shift away from repeated hospital stays for intravenous therapy.
The device is designed for patients whose fluid buildup is not adequately controlled by oral diuretics. Until now, such patients would typically be admitted to hospital for intravenous furosemide, with an average stay of nine to ten days. With the new wearable pump, individuals can receive the same medication at home, self-administering the treatment without the need for constant clinical supervision. The approach places the management of a potentially serious condition directly in the hands of patients, giving them greater independence and reducing the disruption caused by prolonged hospitalisation.
Trial shows safety and effectiveness at home
The findings come from the SUBCUT HF II trial, led by the University of Glasgow and involving 172 heart failure patients across 20 hospitals in the United Kingdom. The study compared patients using the wearable pump with those receiving standard care — typically intravenous furosemide in hospital. Results showed that patients in the device arm recovered at similar rates and were no more likely to become unwell than those receiving conventional treatment. Importantly, the device was found to be safe for home use, with no additional risk to patients.
A striking outcome of the trial was the reduction in time spent in hospital. Patients who began treatment with the wearable device were discharged approximately two days later — about five days earlier than the typical UK stay for furosemide treatment. This has major implications for both patient quality of life and the strain on the National Health Service, where heart failure accounts for around 90,000 hospital admissions in England each year, making it one of the leading causes of avoidable hospitalisations.
The study was co-led by Dr Ross Campbell, clinical senior lecturer at the University of Glasgow and consultant cardiologist at the Queen Elizabeth University Hospital, and Professor Mark Petrie, professor of cardiology at the University of Glasgow.
Expert view: a new chapter in heart failure care
Dr Ross Campbell, co-lead author of the study, said: “This study has shown that we can successfully and safely manage patients with heart failure in their own home and, moreover, that patients are able to administer treatment themselves.”
Heart failure in the UK: a growing burden
Heart failure affects an estimated 920,000 people in the UK, with around 200,000 new diagnoses each year. The British Heart Foundation reported a 21% rise in diagnoses since 2020, reaching a record 785,000 in March 2024. These numbers are projected to nearly double by 2040, driven by an ageing population and better survival rates after heart attacks. The condition occurs when the heart cannot pump blood efficiently, leading to symptoms such as shortness of breath and fluid retention in the legs and lungs.
Remote monitoring and wearable technology
The SUBCUT HF II trial is part of a broader trend toward using wearable devices and remote monitoring to improve heart failure management. The National Institute for Health and Care Excellence has recommended algorithm-based technologies such as HeartLogic and TriageHF, which work with cardiac implantable electronic devices. These systems have shown significant reductions in hospitalisations — HeartLogic by 72% and TriageHF by 58%. Studies also suggest that remote monitoring can be cost-effective: one analysis found it could be viable at a willingness-to-pay threshold of £20,000 per quality-adjusted life year, with the main cost driver being healthcare resource utilisation. Another study calculated an incremental cost-effectiveness ratio of £11,432 from a healthcare perspective in the UK.
Wearable devices have also demonstrated potential in predicting heart failure hospitalisations, with some allowing prediction six-and-a-half to 32 days in advance. The integration of artificial intelligence is a key area of development, enabling the analysis of large datasets from wearables for more accurate predictions and personalised treatment adjustments. However, the use of such technologies raises ethical considerations, including patient autonomy, data privacy and security, equity and accessibility, and the risk of over-reliance on technology.
Related innovations in heart failure care
Dr Campbell and colleagues at the University of Glasgow have also been involved in research using artificial intelligence to interpret echocardiogram images from handheld ultrasound devices, which could speed up heart failure diagnosis. At St Bartholomew’s Hospital, a pioneering stem cell treatment for advanced heart failure is under investigation, using a patient’s own bone marrow cells to promote repair and regeneration of heart tissue. Another approach, known as “rapid titration”, involves giving patients larger doses of heart failure drugs at the start of treatment and has been shown to significantly reduce deaths and hospital readmissions in international trials.
The Queen Elizabeth University Hospital in Glasgow, where Dr Campbell practices, has been a hub for cardiac innovation, including the introduction of rapid point-of-care cardiac testing and the use of ambulatory ECG patch monitors for faster diagnosis of atrial fibrillation.