Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial

2020 ◽  
pp. 1357633X1989926 ◽  
Author(s):  
Lucía M Yanicelli ◽  
Carla B Goy ◽  
Viviana del C González ◽  
Gerardo N Palacios ◽  
Ernesto C Martínez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Usual Care ◽  
Treatment Adherence ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Heart Failure Patients ◽  
Home Telemonitoring

Introduction The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients. Methods A randomized clinical trial that compares the efficacy of a home telemonitoring system –intervention group versus usual care control group – among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients’ self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period. Results 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence ( p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients ( p = 0.03) and a worsened self-care in the control group ( p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided. Discussion This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels. Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093

scholarly journals Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I

2013 ◽  
Vol 21 (spe) ◽  
pp. 20-28 ◽  
Author(s):  
Cláudia Motta Mussi ◽  
Karen Ruschel ◽  
Emiliane Nogueira de Souza ◽  
Alexandra Nogueira Mello Lopes ◽  
Melina Maria Trojahn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Self Care ◽  
Home Visits ◽  
Decompensated Heart Failure ◽  
Control Group ◽  
Phone Calls

OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group). After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and P<0.001), respectively; the adhesion to the treatment, measured and compared between the groups, was significantly higher in the intervention group (P=0.001). CONCLUSION: the strategy of home visits to patients who were recently hospitalized with decompensated heart failure was effective in improving the outcomes assessed and its implementation deserves to be considered in Brazil aiming at avoiding unplanned hospitalizations. NCT-01213862

scholarly journals A Novel Intelligent Two-Way Communication System for Remote Heart Failure Medication Uptitration (the CardioCoach Study): Randomized Controlled Feasibility Trial (Preprint)

2017 ◽  
Author(s):  
Christophe JP Smeets ◽  
Valerie Storms ◽  
Pieter M Vandervoort ◽  
Pauline Dreesen ◽  
Julie Vranken ◽  
...  
Keyword(s):  
Heart Failure ◽  
Usual Care ◽  
Information Exchange ◽  
Intervention Group ◽  
Feasibility Trial ◽  
Control Group ◽  
Care Providers ◽  
Converting Enzyme Inhibitors ◽  
Number Of Patients

BACKGROUND European Society of Cardiology guidelines for the treatment of heart failure (HF) prescribe uptitration of angiotensin-converting enzyme inhibitors (ACE-I) and β-blockers to the maximum-tolerated, evidence-based dose. Although HF prognosis can drastically improve when correctly implementing these guidelines, studies have shown that they are insufficiently implemented in clinical practice. OBJECTIVE The aim of this study was to verify whether supplementing the usual care with the CardioCoach follow-up tool is feasible and safe, and whether the tool is more efficient in implementing the guideline recommendations for β-blocker and ACE-I. METHODS A total of 25 HF patients were randomly assigned to either the usual care control group (n=10) or CardioCoach intervention group (n=15), and observed for 6 months. The CardioCoach follow-up tool is a two-way communication platform with decision support algorithms for semiautomatic remote medication uptitration. Remote monitoring sensors automatically transmit patient’s blood pressure, heart rate, and weight on a daily basis. RESULTS Patients’ satisfaction and adherence for medication intake (10,018/10,825, 92.55%) and vital sign measurements (4504/4758, 94.66%) were excellent. However, the number of technical issues that arose was large, with 831 phone contacts (median 41, IQR 32-65) in total. The semiautomatic remote uptitration was safe, as there were no adverse events and no false positive uptitration proposals. Although no significant differences were found between both groups, a higher number of patients were on guideline-recommended medication dose in both groups compared with previous reports. CONCLUSIONS The CardioCoach follow-up tool for remote uptitration is feasible and safe and was found to be efficient in facilitating information exchange between care providers, with high patient satisfaction and adherence. CLINICALTRIAL ClinicalTrials.gov NCT03294811; https://clinicaltrials.gov/ct2/show/NCT03294811 (Archived by WebCite at http://www.webcitation.org/6xLiWVsgM)

scholarly journals A Supportive-Educational Intervention for Heart Failure Patients in Iran: The Effect on Self-Care Behaviours

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Vahid Zamanzadeh ◽  
Leila Valizadeh ◽  
A. Fuchsia Howard ◽  
Fatemeh Jamshidi
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Educational Intervention ◽  
Cultural Context ◽  
Intervention Group ◽  
Self Care ◽  
Educational Interventions ◽  
Control Group ◽  
Heart Failure Patients ◽  
To Receive

Background. Chronic heart failure is a major health and social problem. The promotion of self-care behaviours can potentially assist patients to effectively manage this chronic condition and prevent worsening of the disease. Formal personalized educational interventions that provide support and take into consideration the cultural context are needed.Objective. The objective of this research was to evaluate the effect of a supportive-educational intervention on self-care behaviours of heart failure patients in Iran.Methods. This research was a prospective, randomized trial of a supportive-educational intervention. Eighty heart failure patients were randomly assigned to receive the supportive-educational intervention or usual care. The intervention consisted of a one-hour, nurse-led, in-person education session and postdischarge followup by telephone over three months. Data were collected at baseline, one, two, and three months.Results. The control and intervention groups did not differ in self-care scores at baseline (P>0.05). Each of the self-care scores was significantly higher in the intervention group than the control group at 1, 2, and 3 months (P<0.001). There were significant differences in self-care behaviours over the three months, among participants in the intervention group.Conclusion. This study provides support for the effectiveness of a supportive-educational intervention to increase self-care behaviours among Iranian patients suffering from chronic heart failure.

scholarly journals Impact of Self-efficacy Strategies Education on Self-care Behaviors among Heart Failure Patients

2020 ◽  
Author(s):  
Nooshin Peyman ◽  
Fateme Shahedi ◽  
Mahbubeh Abdollahi ◽  
Hassan Doosti ◽  
Zohre Zadehahmad
Keyword(s):  
Heart Failure ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Care ◽  
Educational Interventions ◽  
Control Group ◽  
Heart Failure Patients ◽  
Positive Effects ◽  
The Mean ◽  
And Control

Background: Self-efficacy in self-care behaviors is an effective framework for measuring patients’ degree of ability to perform selfcare behaviors that significantly affect their recovery process and quality of life. This study was designed to investigate the effects of education based on self-efficacy strategies on self-care behaviors in heart failure patients. Methods: A semi-experimental study was conducted on 80 heart failure patients divided into 2 equal groups of test and control. The intervention group received three 60-minute practical and theoretical training sessions based on self-care and self-efficacy strategies, while the control group received the usual care services. Self-care behaviors and self-efficacy were evaluated before training, shortly after training, and 3 months after the training program using the Sullivan self-efficacy questionnaire for heart failure patients and the European self-care behaviors questionnaires. Results: The mean age of the patients was 55.00±8.48 and 51.61±8.51 years in the intervention and control groups, respectively. Women comprised 73.7% (n=59) of the study population. The mean score for the self-care and self-efficacy questionnaires in the experimental group was 23.50±6.58 and 18.57±6.64, correspondingly, before the intervention, which increased to 42.64±6.74 (P<0.014) and 32.29±7.06 (P<0.001), respectively, shortly after the intervention. A significant improvement also occurred at 3 months’ follow-up (P<0.001). Self-care behaviors also revealed a positive correlation with self-efficacy shortly after the intervention (r=0.82, P<0.001) and 3 months after the intervention (r=0.85, P<0.001). Conclusion: The implementation of educational interventions based on self-efficacy strategies could have positive effects on healthpromoting behaviors among heart failure patients.

A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Self Monitoring ◽  
Heart Failure Questionnaire

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

scholarly journals The Effect of Health Literacy Counselling on Self-Care in Women after Mastectomy: a Randomized Clinical Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 39-45
Author(s):  
Masoume Rastegar ◽  
Zohreh Mahmoodi ◽  
Sara Esmaelzadeh Saeieh ◽  
Nasibeh Sharifi ◽  
Kourosh Kabir
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Health Literacy ◽  
Intervention Group ◽  
Self Care ◽  
Essential Element ◽  
World Health ◽  
Control Group ◽  
Fars Province ◽  
The Mean

Introduction: Breast cancer has a high prevalence, constituting a major cause of mortality in women around the world. Health literacy has a vital role in the self-care of chronic diseases such as cancer and is an essential element in the ability of each person to engage with health promotion. The aim of this study was to determine effect of health literacy counselling on selfcare in women after mastectomy. Methods: This study is a randomized, controlled, clinical trial carried out on 72 women with breast cancer after mastectomy in Fars province. The eligible women entered the study using convenience sampling and were then divided into an intervention and a control group through randomized blocks of four. Health literacy questionnaire and self-care questionnaire were distributed among the participants before, immediately after and three weeks following the intervention. Data analysis was performed in SPSS ver.13. Results: The results showed no significant differences between the two groups in terms of their health literacy and self-care scores before the intervention (P=0.299 and 0.059). A comparison of the mean values showed a greater increase in the mean score of health literacy and score of selfcare immediately and three weeks after the intervention in the intervention group compared to the control group. Also, the mean score of the dimensions of self-care in chemotherapy increased over time in the intervention group. Conclusion: The findings of this study confirm the higher effectiveness of counseling with a health literacy approach on overall self-care in chemotherapy and all its dimensions.

Abstract P76: Effect of Patient Activation on Self-Management Behaviors in Heart Failure

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Martha Shively ◽  
Nancy Gardetto ◽  
Mary Kodiath ◽  
Ann Kelly ◽  
Tom Smith
Keyword(s):  
Heart Failure ◽  
Usual Care ◽  
Repeated Measures ◽  
Intervention Group ◽  
Patient Activation ◽  
Self Care ◽  
Self Report ◽  
Self Management ◽  
Significant Group ◽  
Repeated Measures Design

Background Disease management and chronic care models have evidenced success with heart failure (HF) patients but have not fully explored patients' engagement/activation in self- care. Objective Determine efficacy of a patient activation intervention (Heart PACT Program) compared to usual care on activation and self-care management in HF. Methods This study was a 4-year, randomized, 2-group, repeated-measures design (baseline, 3 months, and 6 months). Following consent, 84 patients were stratified by activation level and randomly assigned to usual care (n = 41), or usual care plus the activation intervention (n = 43). The primary outcome variables were patient activation using the Patient Activation Measure (PAM) (Hibbard et al., 2005), and self-care using the Self-Care for Heart Failure Index (SCHFI) (Riegel et al., 2004) and the Medical Outcomes Study (MOS) Specific Adherence Scale. The intervention consisted of individual meetings and phone call follow-up over 6 months based on the patient's level of activation: stage 1 or 2 (low activation), stage 3 (medium), or stage 4 (high) as assessed by the patient's self-report PAM score and brief interview. The leaders collaborated with patients to improve activation and self-management of HF: adhering to medications; monitoring weight, blood pressure, and symptoms; and implementing health behavior goals. Findings Participants were primarily male (99%), Caucasian (77%), and classified as NYHA III (52%). The mean age was 66 years (SD 11). The majority (71%) of participants reported 3 or more comorbid conditions. The intervention group compared to the usual care group showed a significant increase in activation/PAM scores from baseline to 6 months (significant group by time interaction linear contrast, F=16.90, p=.02). Although the baseline MOS mean was lower in the intervention group, results revealed a significant group by time effect (F=9.16, p = .001) with the intervention group improving more over time. There were no significant group by time interactions for the SCHFI. Conclusion Patient activation can be improved through targeted intervention. The patient activation model has the potential to change approaches to tailored patient education for self-management in heart failure.

Effectiveness of Asthma Self-Care Program Through Mobile Line Application (SALA) on Lung Function among Asthma Patients in Angthong Hospital: A Randomized Control Trial

2021 ◽  
Vol 104 (2) ◽  
pp. 264-270
Keyword(s):  
Lung Function ◽  
Usual Care ◽  
Controlled Trial ◽  
Demographic Data ◽  
Intervention Group ◽  
Self Care ◽  
Care Program ◽  
Self Management ◽  
Control Group ◽  
Asthma Patients

Background: Asthma is a disease that causes a lot of suffering. It becomes a hurdle in everyday life. Asthma self-care program through mobile Line application (SALA) might be a good choice to help resolving this problem. Objective: To evaluate effectiveness of SALA program among asthma patients. Materials and Methods: The present study was a randomized controlled trial. The study sample consisted of 62 participants aged between 20 to 60 years with mild to moderate asthma. The study sample were randomly assigned to intervention plus usual care (intervention group, n=31) or usual care (control group, n=31) by computer generated. SALA program was sent to participants once a week for two months through their mobile phone, drug reminder appointment date for four months. The study period was six months. Clinical record form and Questionnaire were adapted to collect the demographic data and lung function via spirometer as FEV₁, FVC, FEV₁/FVC, PEFR, ACS, knowledge, attitude, and self-management. Mini Asthma Quality of Life (QOL) questionnaire was used to collect the data. Intention to treat (ITT), Repeated ANOVA, and General Linear model were statistical technique used to analyze the data. Results: Data from 60 asthma patients were available for analyses. The baseline characteristics of both groups were not significantly different. There were statistically significant mean differences in between the groups at three and six months. The mean difference in the following variables were FEV₁ 13.83 (5.01 to 22.65) FVC, 13.36 (2.62 to 24.09) FEV₁/FVC, 11.65 (4.8 to 18.49), PEFR 9.85 (0.03 to 19.67), ACS 2.45 (0.62 to 4.27), knowledge 2.64 (0.81 to 4.46), and self-management 4.26 (2.00 to 6.52). Conclusion: SALA improved knowledge, self-management, asthma status, and lung function among asthma patients. Keywords: Asthma, Self-care program, Mobile line application

Abstract 225: A Depression Quality Program and Cardiovascular Disease: Assessing the Impact on Care

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Linda Gordon ◽  
Amanda Malecky ◽  
Andrew Althouse ◽  
Nicole Ansani
Keyword(s):  
Usual Care ◽  
Goal Attainment ◽  
Intervention Group ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Group ◽  
Control Group ◽  
Surrogate Outcome ◽  
The Impact

Background: Data demonstrate an adverse association between depression and coronary artery disease prognosis. Therefore, a depression screening program was initiated in the catheterization (cath) lab. The goals were to improve HEDIS depression compliance rates and determine the impact on clinical outcomes. Methods: Adult patients in an inpatient cath lab from 3 cardiology practices were screened for enrollment in a randomized controlled trial. All cath lab patients received a PHQ-9 depression screener. Those who screened positive for depression (score ≥ 10) were randomized to intervention or usual care. The usual care group received a follow-up phone call to re-administer the PHQ-9 at 6-8 weeks and within 210 days of discharge. The intervention group was administered the PHQ-9 and received intensive education at baseline, 6-8 weeks, and within 210 days of discharge. Education included targeted depression information with a mental health care provider and comprehensive disease management education with a cardiovascular nurse practitioner. Outcomes included: differences in HEDIS depression goal attainment; depression response/remission rates; and cardiovascular goals. Differences between groups were tested using chi-squared tests (categorical variables) and t-tests (continuous variables). Results: Baseline characteristics were similar between control (N=43) and intervention (N=40) groups, with the exception of significantly fewer African American patients in the control group (N=2, 4.7%) vs intervention (N=9, 22.5%). Changes in HEDIS goal attainment show that patients in the intervention group were slightly more likely to be referred to a provider to address depression (95.0% vs 86.0%, p=0.314), or receive meds for depression (65.0% vs 51.2%, p=0.219), but these differences are not statistically significant. More patients in the intervention group refused meds for depression compared to control (15.0% vs. 2.3%, p=0.041); have received blood work (65.0% vs 41.9%, p=0.030); and have received follow-up within 210 days (82.5% vs 46.5%, p<0.001). Treatment adjustment rate was higher in the intervention group compared to control (85.0% vs. 65.1%, p=0.037). Hospital readmission rate was similar between groups (p=0.896) and there was no difference in depression remission or response rates (p=0.426). Further, no differences were seen in cardiovascular surrogate outcome parameters, including cholesterol, A1c, CRP, or BNP between groups; except SGOT was significantly different between groups (-5.0 intervention vs 2.0 control p=0.045). Conclusions: These data demonstrate improvements in attaining a surrogate outcome measure of quality (HEDIS goals); however, this does not appear to translate to a significant clinical impact. Quality measures may need to be continuously reassessed to ensure efficiency and effectiveness of care.

scholarly journals An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients

2015 ◽  
Vol 23 (4) ◽  
pp. 753-768 ◽  
Author(s):  
Sophie Boisvert ◽  
Alexandra Proulx-Belhumeur ◽  
Natalia Gonçalves ◽  
Michel Doré ◽  
Julie Francoeur ◽  
...  
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Self Care ◽  
Theoretical Background ◽  
Nursing Interventions ◽  
Behavioral Strategies ◽  
Heart Failure Patients ◽  
Final Sample ◽  
Critical Components

AbstractObjective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients.Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients).Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints.Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness.

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