scholarly journals The role of the novel MyAlgos e-medicine Platform in promoting patient-centered self-care management in patients with atrial fibrillation: The emPOWERD trial

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
C Lazaridis ◽  
D Mouselimis ◽  
C Bakogiannis ◽  
A Tsarouchas ◽  
A Antoniadis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Care Management ◽  
Digital Health ◽  
Self Care ◽  
The Mean ◽  
Control Version ◽  
To Receive

Abstract Funding Acknowledgements Type of funding sources: None. Background The emergence of digital health has revolutionized most aspects of healthcare. Meanwhile, atrial fibrillation (AF) remains the most common sustained arrhythmia associated with high morbidity and impaired quality of life. Patient-perceived treatment burden can be further optimized by digital health interventions utilizing smartphone technology.  The MyAlgos platform is an integrated software system designed to enhance the remote management and communication between the patient and the healthcare practitioner. The mobile application encourages patient self-management through educational modules and tools to improve medication adherence. The web-based platform allows the health care practitioner to receive live updates on patient status and design personalized self-care management plans. Purpose  To investigate whether the use of the MyAlgos platform by AF patients is safe and improves the quality of self-care, quality of life (QoL), and hospitalization rate. Methods We designed a single-center, randomized, controlled, prospective, open-label, pilot study to compare the effect of the use of the full-feature MyAlgos platform version versus a stripped-down control version of the platform on the QoL, medication adherence and hospitalization rate in patients with paroxysmal AF.  The full version of the e-medicine platform includes active patient education, communication with the medical team, medication reminders as well as the full record of clinically significant data such as heart rate and blood pressure. Specialized algorithms monitor patient data and alert physicians for potential AF episodes. The control version only allows the recording of patient’s heart rate. Results A total of 80 patients with paroxysmal AF were randomized in a 1:1 ratio to receive either the full or the control version of the MyAlgos Platform. The mean age of all patients, 53 (66%) male, was 58.1 ± 9.1 years. Hypertension and diabetes were present in 47 (59%) and 7 (9%) respectively. At baseline, the majority of patients had AF-related symptoms classified as European Heart Rhythm Association (EHRA) I (45%) or EHRA II (24%), while the mean Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) score was 70.1 ± 17.0.  Between the two groups, there were no statistically significant differences in the baseline characteristics of the participants. Conclusion The emPOWERD trial will provide data on the impact of a novel e-medicine platform on the QoL, medication adherence and hospitalizations of patients with paroxysmal AF. We anticipate better outcomes for the subjects receiving the full version of the MyAlgos platform, allowing it to positively affect the further management of paroxysmal AF. Abstract Figure. The MyAlgos e-medicine Platform

scholarly journals The Atrial Fibrillation Health Literacy Information Technology System: Pilot Assessment (Preprint)

2017 ◽  
Author(s):  
Jared W Magnani ◽  
Courtney L Schlusser ◽  
Everlyne Kimani ◽  
Bruce L Rollman ◽  
Michael K Paasche-Orlow ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Information Technology ◽  
Heart Rate ◽  
Medication Adherence ◽  
Patient Activation ◽  
Patient Centered ◽  
The Mean ◽  
Relational Agent

BACKGROUND Atrial fibrillation (AF) is a highly prevalent heart rhythm condition that has significant associated morbidity and requires chronic treatment. Mobile health (mHealth) technologies have the potential to enhance multiple aspects of AF care, including education, monitoring of symptoms, and encouraging and tracking medication adherence. We have previously implemented and tested relational agents to improve outcomes in chronic disease and sought to develop a smartphone-based relational agent for improving patient-centered outcomes in AF. OBJECTIVE The objective of this study was to pilot a smartphone-based relational agent as preparation for a randomized clinical trial, the Atrial Fibrillation Health Literacy Information Technology Trial (AF-LITT). METHODS We developed the relational agent for use by a smartphone consistent with our prior approaches. We programmed the relational agent as a computer-animated agent to simulate a face-to-face conversation and to serve as a health counselor or coach specific to AF. Relational agent’s dialogue content, informed by a review of literature, focused on patient-centered domains and qualitative interviews with patients with AF, encompassed AF education, common symptoms, adherence challenges, and patient activation. We established that the content was accessible to individuals with limited health or computer literacy. Relational agent content coordinated with use of the smartphone AliveCor Kardia heart rate and rhythm monitor. Participants (N=31) were recruited as a convenience cohort from ambulatory clinical sites and instructed to use the relational agent and Kardia for 30 days. We collected demographic, social, and clinical characteristics and conducted baseline and 30-day assessments of health-related quality of life (HRQoL) with the Atrial Fibrillation Effect on Quality of life (AFEQT) measure; self-reported medication adherence with the Morisky 8-item Medication Adherence Scale (MMAS-8); and patient activation with the Patient Activation Measure (PAM). RESULTS Participants (mean age 68 [SD 11]; 39% [12/31] women) used the relational agent for an average 17.8 (SD 10.0) days. The mean number of independent log-ins was 19.6 (SD 10.7), with a median of 20 times over 30 days. The mean number of Kardia uses was 26.5 (SD 5.9), and participants using Kardia were in AF for 14.3 (SD 11.0) days. AFEQT scores improved significantly from 64.5 (SD 22.9) at baseline to 76.3 (SD 19.4) units at 30 days (P<.01). We observed marginal but statistically significant improvement in self-reported medication adherence (baseline: 7.3 [SD 0.9], 30 days: 7.7 [SD 0.5]; P=.01). Assessments of acceptability identified that most of the participants found the relational agent useful, informative, and trustworthy. CONCLUSIONS We piloted a 30-day smartphone-based intervention that combined a relational agent with dedicated content for AF alongside Kardia heart rate and rhythm monitoring. Pilot participants had favorable improvements in HRQoL and self-reported medication adherence, as well as positive responses to the intervention. These data will guide a larger, enhanced randomized trial implementing the smartphone relational agent and the Kardia monitor system.

scholarly journals Self-care management, knowledge, self-efficacy for medication and Quality of Life in chronic heart failure patients

2021 ◽  
Vol 7 (1) ◽  
pp. 4
Author(s):  
Elpida Kroustalli ◽  
Constantinos H Papadopoulos ◽  
Ioannis Vasileiadis ◽  
Athena Kalokairinou ◽  
Sotirios Kiokas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Medication Adherence ◽  
Self Efficacy ◽  
Care Management ◽  
Nyha Class ◽  
Self Care ◽  
Knowledge Test ◽  
Heart Failure Patients

Background: The management of Heart Failure (HF) is the cornerstone for the appropriate therapy and the knowledge obtained concerning the disease is known to affect self-care behaviours. Aim: The aim was to test the association between self-care management, knowledge, self-efficacy for medication and quality of life in chronic HF patients.Material and Method: A cross-sectional study was conducted and four questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFK), Minnesota Living with Heart Failure (HMLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9). Multiple linear regression analysis was performed to identify independently associated variables with study subscales.Results: The sample consisted of 122 Heart Failure patients (102 men-20 women) with mean age 67.1 years (SD=12.3). Scores on Fluid and sodium management, Physical activity and recognition of deteriorating symptoms were  significantly greater  as compared with scores on Adhering to recommendations (p<0.001), indicating that the needs concerning Adhering to recommendations were greater.  Linear regression analyses showed that score on knowledge-test and New York Heart Association (NYHA) class were predictive of medication adherence factors. Better knowledge was associated with better medication adherence, while worse scores were found in subjects with NYHA class III or IV as compared to those with NYHA class I or II. Additionally, Knowledge and years of Education were associated with Self-care behaviour factors (β=0.44, SE=0.08, p<0.001). Conclusions: Patients at a higher level of HF knowledge show better adherence to the Medication. Self-care behavior and life quality are improved.

scholarly journals Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 418-429
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Care Management ◽  
Controlled Trial ◽  
Self Care ◽  
Fluid Restriction ◽  
Symptom Recognition ◽  
Patients With Heart Failure ◽  
Randomised Controlled

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).

scholarly journals The impact of the acceptance of illness on the quality of life of patients with atrial fibrillation

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
B Jankowska-Polanska ◽  
D Kasperczak ◽  
N Swiatoniowska-Lonc ◽  
J Polanski
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Heart Rhythm ◽  
Well Being ◽  
Supraventricular Arrhythmia ◽  
Heart Rhythm Disorders ◽  
The Mean ◽  
Acceptance Of Illness ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. AF and the complications associated with it interfere with the physical, mental and social well-being of a person, thus affecting the quality of life. An important factor affecting the quality of life of patients with AF is the acceptance of illness (AI). In spite of the large problem related to this subject, the analysis of the relation between the acceptance of illness and the quality of life of patients with AF is insufficient. The aim of the study was to assess the impact of the acceptance of illness on the quality of life of patients with AF. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess the acceptance of illness and Arrhythmia-Specific questionnaire In Tachycardia and Arrhythmia (ASTA) to assess quality of life. Results. The majority of patients were secondary educated (64.27%), lived in a city (78.58%), were inactive (57.15%), were hospitalized 3-5 times (42.85%), had a cardiostimulator (23.80%) or underwent ablation (22.62%) during the last year. The average result of the acceptance of illness was 27.67 ± 7.70. 48.8% of patients had a high level of the acceptance of illness, 38.09% average, and 13.11% did not accept their illness. The mean result of quality of life for the whole studied group was (ASTA III) 25.64 ± 8.64. As regards the severity of symptoms (ASTA II) the mean result was 17.15 ± 5.89. Correlation analysis showed that the higher the level of the acceptance of illness the higher the quality of life (r = 0.640; p = 0.002) and lower the severity of AF symptoms (r=-0.51, p &lt; 0.001). Conclusions. Patients with AF present a moderate level of disease acceptance and quality of life. The acceptance of illnessis the independent predictor and significantly increases quality of life of patients with AF.

scholarly journals Assessment of medication adherence and quality of life among patients with type 2 diabetes mellitus in a tertiary hospital in Kelantan, Malaysia

2021 ◽  
Vol 1 (2) ◽  
pp. 79-86
Author(s):  
Nazmi Liana Azmi ◽  
Nurul Aida Md Rosly ◽  
Hock Chun Tang ◽  
Anis Fariha Che Darof ◽  
Nor Dini Zuki
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Life Questionnaire ◽  
Adherence To Medication ◽  
The Mean

Introduction: Previous studies have reported the relationship between medication adherence and quality of life are interrelated. However, many of the results were found to be conflicting. This study aimed to assess the level and association of medication adherence and quality of life among type 2 diabetes mellitus patients in Raja Perempuan Zainab II Hospital, Kelantan, Malaysia. Materials and methods: A cross-sectional survey was conducted among adult type 2 diabetes mellitus patients on treatment for over 1 year using convenience sampling at outpatient.  Medication Compliance Questionnaire (MCQ) and revised Diabetes Quality of Life Questionnaire (DQOL) instrument were self-administered to eligible subjects. Data were analysed using GNU PSPP version 0.8.5 and reported for descriptive statistics as well as correlation of both parameters. Results: A total of 200 patients were recruited and they were mostly at the age of 40 to 60 years old. The mean (SD) score for MCQ was 26.0 (1.6) with the majority of them were non-adherent (55.0%, n=110). The mean (SD) score for overall revised DQOL instrument was 25.5 (8.9) while each domain of “satisfaction”, “impact” and “worry” had mean (SD) scores of 12.0 (5.0), 7.7 (3.4) and 5.9 (2.7), respectively. The scores obtained were only approximately half of the possible range of scores for QoL. There was no significant correlation between total score of medication adherence and quality of life when tested using Pearson’s correlation (r=-0.083, p=0.240). Independent t-test also demonstrated no significant relationship between medication adherence status and quality of life (p=0.883). Conclusion: Type 2 diabetes mellitus patients in our setting had unsatisfactory adherence but exhibited acceptable quality of life. We observed that both variables were not associated with one another. Further research is warranted to identify potential factors affecting non-adherence to medication.

Abstract 130: Clinically Important Difference in the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Score: Results from the ORBIT-AF Registry

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
DaJuanicia N Simon ◽  
Laine E Thomas ◽  
Emily C O’Brien ◽  
Gregg C Fonarow ◽  
Bernard J Gersh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Important Change ◽  
Operating Characteristics ◽  
Method Of Calculation ◽  
Clinically Important Difference ◽  
The Mean ◽  
The Impact

Background: The Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) survey has recently been validated to measure the impact of atrial fibrillation on patients’ quality of life, but a clinically important difference (CID) in AFEQT score has not been defined. Knowing the CID is needed to interpret the meaningfulness of differences between treatments in clinical trials; or patient populations for quality assessment. Objectives: To calculate CID values in AFEQT in the ORBIT registry. Methods: ORBIT-AF is a US-based outpatient AF registry that measured disease-specific QoL with the AFEQT tool (score range= 0 (worst) to 100) at baseline and at 1 year follow-up. Two anchor-based methods were used to relate changes in AFEQT to clinically important differences in the more established European Heart Rhythm Association (EHRA) measure of functional status. Ranging from 1 (no symptoms) to 4 (disabling), a change of 1 EHRA class was defined as an important change in the anchor. Both the mean change and receiver operating characteristics (ROC) methods were then used to identify CIDs in AFEQT at 1 year follow-up. This was done for both improvement and worsening on the anchor. The mean change method defines a CID as the mean change in AFEQT score among patients with a 1 EHRA class change. The ROC method identifies a CID as the point on the ROC curve that best discriminates patients who experienced an important change in the anchor (≥ 1 EHRA class change) from those who experienced no change. Results: AFEQT was assessed in 2008 AF patients at baseline and 1347 patients at 1 year from 99 US sites participating in ORBIT-AF. CIDs and 95% confidence intervals (CI) corresponding to an improvement in EHRA for the mean change method were 5.4 (3.6, 7.2) AFEQT points and 1.9 (0.4, 9.3) AFEQT points for the ROC method. CIDs corresponding to worsening in EHRA for the mean change method were -4.2 (-6.9,-1.5) AFEQT points and -7.4 (-13.9,-4.6) AFEQT points for the ROC method. Conclusions: Changes in AFEQT as small as 2 points may be clinically relevant, although CIDs vary depending on the method of calculation. The variability suggests identifying a single universal CID to assess improvement in quality of life in AF patients may not be ideal and improvement may relate to the nature of a patient’s symptoms and their baseline level of activity.

scholarly journals Does Symptom Recognition Improve Self-Care in Patients With Heart Failure? A Growth Latent Model

2021 ◽  
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Care Management ◽  
Self Care ◽  
Control Group ◽  
Fluid Restriction ◽  
Symptom Recognition ◽  
Patients With Heart Failure ◽  
The Impact

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p&lt;.001) and emergency admission (IRR 4.24; p&lt;.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (&beta;Slope. Assign-ment_group=-.881; p&lt;.001) and in the quality of life (&beta;Slope. Assignment_group=1.739; p&lt;.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.

DIGITAL HEALTH AND SELF-CARE IN PEOPLE WITH INTESTINAL OSTOMIES: AN INTEGRATIVE REVIEW

2021 ◽  
Author(s):  
Nildete Vargas Pozebom ◽  
Karin Viégas
Keyword(s):  
Quality Of Life ◽  
Digital Health ◽  
Self Care ◽  
Scientific Production ◽  
Integrative Review ◽  
National Library ◽  
Medline Database ◽  
Online Databases

Objective: synthesize the scientific production related to digital health in ostomies to promote self-care. Method: integrative review with research in online databases, seeking to answer the following guiding question: What are the digital approaches used to teach self-care to patients with ostomy identified in the publications? Results: six different ways of using digital health to promote self-care in people living with intestinal ostomies were identified. Five were published in the National Library of Medicine (MEDLINE) database and one published in the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Base de Dados de Enfermagem da Biblioteca Virtual em Saúde (BDENF),in the period from 2017 to 2020. Conclusion: the six approaches studied can be used simultaneously in individuals with ostomies and can be considered complementary, as they act in different aspects of the individual’s routine, with the ultimate goal being to improve the quality of life of the person with an intestinal ostomy.

Investigation of the potential relationship between depression, diabetes knowledge and self-care management with the quality of life in diabetic patients – an analytical study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yaser Khajebishak ◽  
Amir Hossein Faghfouri ◽  
Ali Molaei ◽  
Vahid Rahmani ◽  
Samira Amiri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Management ◽  
Self Care ◽  
Diabetic Patients ◽  
Diabetes Knowledge ◽  
Total Quality ◽  
Content Type ◽  
Potential Relationship ◽  
Validated Questionnaire

Purpose This paper aims to investigate the potential relationship between depression, diabetes knowledge and self-care management with quality of life in diabetic patients. Design/methodology/approach This analytical cross-sectional study was conducted on 309 diabetic patients in Tabriz, Iran in 2015-2017. Quality of life was assessed by a validated questionnaire. The Persian version of the Beck Aeron questionnaire was used to assess the depression status. Knowledge and self-care management was evaluated by the health belief model questionnaire. Simple and multiple regression models were used to determine the relationship between the mentioned factors and the quality of life in diabetic patients. Findings Thirty-six per cent of the patients suffered from depression. The mean score of the total quality of life was 33.75 ± 8.72. The scores of the three domains of the quality of life were less than the normal range (“complication of diabetes” domain: 9.93 ± 3.16, “diagnosis, therapy and follow-up” domain: 10.91 ± 3.31, “psycho-social effect of diabetes” domain: 12.93 ± 4.41). The score of “complication of diabetes” score in males was significantly higher than females (p = 0.001). There was a significant relationship between depression (p < 0.001), self-care management (p = 0.019) and two parameters of knowledge (diet: p = 0.006 and diabetes: p = 0.004) with quality of life of diabetic patients. Originality/value The obtained results presented an unfavorable status of knowledge, physical and mental health in diabetic patients and a strong relationship between health-related factors with quality of life. Therefore, it is suggested to hold community-based health-promoting programs to enhance the overall life satisfaction in people with diabetes.

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