Would You Prescribe Mobile Health Apps for Heart Failure Self-care? An Integrated Review of Commercially Available Mobile Technology for Heart Failure Patients

Treatment of chronic diseases, such as heart failure, requires complex protocols based on early diagnosis; self-monitoring of symptoms, vital signs and physical activity; regular medication intake; and education of patients and caregivers about relevant aspects of the disease. Smartphones and mobile health applications could be very helpful in improving the efficacy of such protocols, but several barriers make it difficult to fully exploit their technological potential and produce clear clinical evidence of their effectiveness. App suppliers do not help users distinguish between useless/dangerous apps and valid solutions. The latter are few and often characterised by rapid obsolescence, lack of interactivity and lack of authoritative information. Systematic reviews can help physicians and researchers find and assess the ‘best candidate solutions’ in a repeatable manner and pave the way for well-grounded and fruitful discussion on their clinical effectiveness. To this purpose, the authors assess 10 apps for heart failure self-care using the Intercontinental Marketing Statistics score and other criteria, discuss the clinical effectiveness of existing solutions and identify barriers to their use in practice and drivers for change.

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Smartphone Ownership and Interest in Mobile Health Technologies for Self-care Among Patients With Chronic Heart Failure: Cross-sectional Survey Study (Preprint)

10.2196/preprints.31982 ◽

2021 ◽

Author(s):

Jonathan W Leigh ◽

Ben S Gerber ◽

Christopher P Gans ◽

Mayank M Kansal ◽

Spyros Kitsiou

Keyword(s):

Heart Failure ◽

African American ◽

Mobile Health ◽

Self Care ◽

Minority Population ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Self Monitoring ◽

Health Technologies ◽

Mhealth Apps

BACKGROUND Heart failure (HF) is a highly prevalent chronic condition that places a substantial burden on patients, families, and health care systems worldwide. Recent advances in mobile health (mHealth) technologies offer great opportunities for supporting many aspects of HF self-care. There is a need to better understand patients’ adoption of and interest in using mHealth for self-monitoring and management of HF symptoms. OBJECTIVE The purpose of this study is to assess smartphone ownership and patient attitudes toward using mHealth technologies for HF self-care in a predominantly minority population in an urban clinical setting. METHODS We conducted a cross-sectional survey of adult outpatients (aged ≥18 years) at an academic outpatient HF clinic in the Midwest. The survey comprised 34 questions assessing patient demographics, ownership of smartphones and other mHealth devices, frequently used smartphone features, use of mHealth apps, and interest in using mHealth technologies for vital sign and HF symptom self-monitoring and management. RESULTS A total of 144 patients were approached, of which 100 (69.4%) participated in the study (63/100, 63% women). The participants had a mean age of 61.3 (SD 12.25) years and were predominantly Black or African American (61/100, 61%) and Hispanic or Latino (18/100, 18%). Almost all participants (93/100, 93%) owned a cell phone. The share of patients who owned a smartphone was 68% (68/100). Racial and ethnic minorities that identified as Black or African American or Hispanic or Latino reported higher smartphone ownership rates compared with White patients with HF (45/61, 74% Black or African American and 11/18, 61% Hispanic or Latino vs 9/17, 53% White). There was a moderate and statistically significant association between smartphone ownership and age (Cramér V [ΦC]=0.35; P<.001), education (ΦC=0.29; P=.001), and employment status (ΦC=0.3; P=.01). The most common smartphone features used by the participants were SMS text messaging (51/68, 75%), internet browsing (43/68, 63%), and mobile apps (41/68, 60%). The use of mHealth apps and wearable activity trackers (eg, Fitbits) for self-monitoring of HF-related parameters was low (15/68, 22% and 15/100, 15%, respectively). The most popular HF-related self-care measures participants would like to monitor using mHealth technologies were physical activity (46/68, 68%), blood pressure (44/68, 65%), and medication use (40/68, 59%). CONCLUSIONS Most patients with HF have smartphones and are interested in using commercial mHealth apps and connected health devices to self-monitor their condition. Thus, there is a great opportunity to capitalize on the high smartphone ownership among racial and ethnic minority patients to increase reach and enhance HF self-management through mHealth interventions.

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Contribution of mobile health applications to self-management by consumers: review of published evidence

Australian Health Review ◽

10.1071/ah15162 ◽

2016 ◽

Vol 40 (5) ◽

pp. 591 ◽

Cited By ~ 13

Author(s):

Kevin Anderson ◽

Lynne M. Emmerton

Keyword(s):

Health Policy ◽

Mobile Health ◽

Self Care ◽

Chronic Health Conditions ◽

Health Conditions ◽

Self Management ◽

Self Monitoring ◽

Australian Health ◽

Health Apps ◽

Mobile Health Apps

Objective The aim of the present study was to review the contribution of mobile health applications (‘apps’) to consumers’ self-management of chronic health conditions, and the potential for this practice to inform health policy, procedures and guidelines. Methods A search was performed on the MEDLINE, Cochrane Library, ProQuest and Global Health (Ovid) databases using the search terms ‘mobile app*’, ‘self-care’, ‘self-monitoring’, ‘trial’, ‘intervention*’ and various medical conditions. The search was supplemented with manual location of emerging literature and government reports. Mapping review methods identified relevant titles and abstracts, followed by review of content to determine extant research, reports addressing the key questions, and gaps suggesting areas for future research. Available studies were organised by disease state, and presented in a narrative analysis. Results Four studies describing the results of clinical trials were identified from Canada, England, Taiwan and Australia; all but the Australian study used custom-made apps. The available studies examined the effect of apps in health monitoring, reporting positive but not robust findings. Australian public policy and government reports acknowledge and support self-management, but do not address the potential contribution of mobile interventions. Conclusions There are limited controlled trials testing the contribution of health apps to consumers’ self-management. Further evidence in this field is required to inform health policy and practice relating to self-management. What is known about the topic? Australian health policy encourages self-care by health consumers to reduce expenditure in health services. A fundamental component of self-care in chronic health conditions is self-monitoring, which can be used to assess progress towards treatment goals, as well as signs and symptoms of disease exacerbation. An abundance of mobile health apps is available for self-monitoring. What does this study add? A limited number of randomised control trials have assessed the clinical impact of health apps for self-monitoring. The body of evidence relating to current and long-term clinical impact is developing. Despite endorsing self-care, Australian health policy does not address the use and potential contribution of mobile health apps to health care. What are the implications? Widespread and sustained use of validated mobile health apps for chronic health conditions should have potential to improve consumer independence, confidence and burden on health services in the longer term. However, a significant body of scientific evidence has not yet been established; this is mirrored in the lack of acknowledgement of health apps in Australian health policy referring to consumers’ self-management.

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An Innovative Mobile Health Intervention to Improve Self-care in Patients With Heart Failure

Case Medical Research ◽

10.31525/ct1-nct04262544 ◽

2020 ◽

Author(s):

Keyword(s):

Heart Failure ◽

Mobile Health ◽

Self Care ◽

Health Intervention ◽

Patients With Heart Failure

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

10.2196/preprints.26185 ◽

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

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Mobile Health Applications to Support COVID-19 Self-management: Review and Evaluation

Applied Health Information Technology ◽

10.18502/ahit.v2i2.7992 ◽

2021 ◽

Author(s):

Sahar Khenarinezhad ◽

Ehsan Ghazanfari Savadkoohi ◽

Leila Shahmoradi

Keyword(s):

Mobile Health ◽

Mobile Apps ◽

Healthcare Providers ◽

Vital Signs ◽

Complete Information ◽

Self Management ◽

Management Measures ◽

Management Procedures ◽

Mobile Health Applications ◽

Health Applications

Aim: During the epidemic and with an increase in coronavirus (COVID-19) disease prevalence, emergency care is essential to help people stay informed and undertake self-management measures to protect their health. One of these self-management procedures is the use of mobile apps in health. Mobile health (mHealth) applications include mobile devices in collecting clinical health data, sharing healthcare information for practitioners and patients, real-time monitoring of patient vital signs, and the direct provision of care (via mobile telemedicine). Mobile apps are increasing to improve health, but before healthcare providers can recommend these applications to patients, they need to be sure the apps will help change patients' lifestyles. Method: A search was conducted systematically using the keywords "Covid-19," "Coronavirus," "Covid-19, and Self-management" at the "Apple App Store". Then we evaluated the apps according to MARS criteria in May 2020. Results: A total of 145 apps for COVID-19 self-management were identified, but only 32 apps met our inclusion criteria after being assessed. The overall mean MARS score was 2.9 out of 5, and more than half of the apps had a minimum acceptability score (range 2.5-3.9). The "who academy" app received the highest functionality score. Who Academy, Corona-Care and First Responder COVID-19 Guide had the highest scores for behavior change. Conclusion: Our findings showed that few apps meet the quality, content, and functionality criteria for Covid-19 self-management. Therefore, developers should use evidence-based medical guidelines in creating mobile health applications so that, they can provide comprehensive and complete information to both patients and healthcare provider.

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The prevalence and sociodemographic predictors of mobile health applications ownership among cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24046 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24046-e24046

Author(s):

Gideon T Dosunmu ◽

Kobina Kwantsin Hagan ◽

Chike Udoye ◽

Moh'd M. Khushman

Keyword(s):

Cancer Survivors ◽

Mobile Health ◽

Employment Status ◽

Limited Resources ◽

Health Apps ◽

Sociodemographic Predictors ◽

Mobile Health Applications ◽

Mobile Health Apps ◽

Growing Population ◽

Health Applications

e24046 Background: The transition of cancer patients from patients to survivors is challenging. Cancer survivors often experience chronic physical, social and mental health needs which remain largely unmet. Due to the growing population of cancer survivors and limited resources available to address their needs, mobile health applications (apps) have emerged to help cancer patients in assuming their new role as survivors. Here, we explored the prevalence and sociodemographic predictors of mobile health apps ownership among Cancer Survivors in the United States using a nationally representative sample. Methods: Data from cycles 1 (2017) and 2 (2018) of the 5th edition of the Health Information National Trends Survey (HINTS 5) was reviewed. Descriptive statistics was used to evaluate the sociodemographic characteristics and the prevalence of mobile health apps ownership among cancer survivors. Univariate logistic regression models were used to explore the relationship between sociodemographic predictors and mobile health apps ownership. Results: We identified 1,097 (weighted estimate of 44,666,781) individuals who self-reported having been diagnosed with cancer in the . Of these, 57.39% were females, 79% were whites, 47.18% had 2 or more medical comorbidities, 63.7% were unemployed and about 50% were aged 65 or more. Prevalence of mobile health apps ownership was 44.82%. Among all the sociodemographic variables; educational level (p = 0.015), income (p = 0.014) and employment status (p < 0.005) were predictors of mobile health apps ownership among cancer. Conclusions: Cancer survivors are digitally connected and can be approached through mobile health apps. In our study, the prevalence of mobile health apps ownership in cancer survivors was 44.8%. Educational level, income and employment status were identified as predictors of mobile health apps ownership. Due to the growing population of cancer survivors and limited resources available to address their needs, efforts to address barriers of mobile health apps adoption and utilization should be encouraged.

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