Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study

Background Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities. Objective The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study. Methods This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English. Results Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn’t realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving. Conclusions Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.

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Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study (Preprint)

10.2196/preprints.28139 ◽

2021 ◽

Author(s):

Myra Schmaderer ◽

Jennifer N Miller ◽

Elizabeth Mollard

Keyword(s):

Heart Failure ◽

Health Care ◽

Care Delivery ◽

Health Care Team ◽

Mobile App ◽

Care Team ◽

Management Tool ◽

Self Management ◽

Mhealth Intervention ◽

Phone Calls

BACKGROUND Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities. OBJECTIVE The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study. METHODS This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English. RESULTS Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn’t realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving. CONCLUSIONS Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.

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DENTAL HYGIENISTS AS ESSENTIAL MEMBERS OF THE HEALTH CARE TEAM

Odontología Activa Revista Científica ◽

10.26871/oactiva.v1i2.150 ◽

2018 ◽

Vol 1 (2) ◽

pp. 73

Author(s):

Jacqueline Juhl

Keyword(s):

Health Care ◽

Oral Health ◽

Care Delivery ◽

Cost Effective ◽

Economic Loss ◽

The United States ◽

Health Care Team ◽

Care Team ◽

Oral Disease ◽

Dental Hygienists

Despite the advances in dental sciences, innovative oral health programs, and efforts dedicated by oral health professionals,globally, unmet oral disease, and the economic loss it causes, is growing. In the present, oral health care delivery systemsurgently need improvement. The introduction of dental hygienists as essential members of the health care team can contributeto improved and cost-effective health care outcomes. This paper provides definitions of dental hygienists from both, aninternational and the United States (U.S.) and describes their education, functions, and contributions to the health care team.

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An Effective Model of Diabetes Care and Education: Revising the AADE7 Self-Care Behaviors®

The Diabetes Educator ◽

10.1177/0145721719894903 ◽

2020 ◽

Vol 46 (2) ◽

pp. 139-160 ◽

Cited By ~ 13

Author(s):

Keyword(s):

Health Care ◽

Diabetes Management ◽

Management Education ◽

Self Care ◽

Position Statement ◽

Health Care Team ◽

Care Team ◽

Self Management ◽

Health Related ◽

Problem Solve

Purpose The AADE7 Self-Care Behaviors® (AADE7) is a robust framework for self-management of diabetes and other related conditions, such as prediabetes and cardiometabolic diseases. It is the position of the American Association of Diabetes Educators (AADE) that, at the cornerstone of diabetes self-management education and support, the AADE7 is the framework for achieving behavior change that leads to effective self-management through improved behavior and clinical outcome measures. The AADE7 model guides the health care team in effective person-centered collaboration and goal setting to achieve health-related outcomes and improved quality of life. Continued research and evidence are critical to expand this model and broaden its application to other chronic conditions. Given the advances in the science of diabetes management, as well as in diabetes self-management education and support, AADE has evaluated the AADE7 within the framework of these advances, including the digital and dynamic health care landscape. Conclusion This revised position statement blends the updates in research and AADE’s vision and expansion beyond diabetes to refresh the AADE7 framework. This revision reflects the perspectives of all members of the health care team as they problem solve with individuals who are at risk for or who have diabetes and related conditions to achieve healthier outcomes.

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‘Who is on your health-care team?’ Asking individuals with heart failure about care team membership and roles

Health Expectations ◽

10.1111/hex.12447 ◽

2016 ◽

Vol 20 (2) ◽

pp. 198-210 ◽

Cited By ~ 17

Author(s):

Kori A. LaDonna ◽

Joanna Bates ◽

Glendon R. Tait ◽

Allan McDougall ◽

Valerie Schulz ◽

...

Keyword(s):

Heart Failure ◽

Health Care ◽

Health Care Team ◽

Care Team

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An Effective Model of Diabetes Care and Education: The ADCES7 Self-Care Behaviors™

The Science of Diabetes Self-Management and Care ◽

10.1177/0145721720978154 ◽

2021 ◽

Vol 47 (1) ◽

pp. 30-53

Author(s):

◽

Leslie Kolb

Keyword(s):

Health Care ◽

Diabetes Care ◽

Diabetes Management ◽

Management Education ◽

Self Care ◽

Position Statement ◽

Health Care Team ◽

Care Team ◽

Self Management ◽

Problem Solve

Purpose The ADCES7 Self-Care Behaviors™ (ADCES7) is a robust framework for self-management of diabetes and other related conditions, such as prediabetes and cardiometabolic diseases. It is the position of the Association of Diabetes Care and Education Specialists (ADCES) that at the cornerstone of diabetes self-management education and support, the ADCES7 is the framework for achieving behavior change that leads to effective self-management through improved behavior and clinical outcome measures. The ADCES7 model guides the health care team in effective person-centered collaboration and goal setting to achieve health-related outcomes and improved quality of life. Continued research and evidence are critical to expand this model and broaden its application to other chronic conditions. Given the advances in the science of diabetes management as well as diabetes self-management education and support, ADCES has evaluated the ADCES7 within the framework of these advances, including the digital and dynamic health care landscape. Conclusion This revised position statement blends the updates in research and ADCES’s vision and expansion beyond diabetes to refresh the ADCES7 framework. This revision reflects the perspectives of all members of the health care team as they problem solve with individuals who are at risk for or who have diabetes and related conditions to achieve healthier outcomes.

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Medical-Legal Partnership in Primary Care: Moving Upstream in the Clinic

American Journal of Lifestyle Medicine ◽

10.1177/1559827617698417 ◽

2017 ◽

Vol 13 (3) ◽

pp. 282-291 ◽

Cited By ~ 6

Author(s):

Elizabeth Tobin Tyler

Keyword(s):

Primary Care ◽

Health Care ◽

Affordable Care Act ◽

Care Delivery ◽

Health Care Team ◽

Food Assistance ◽

Care Team ◽

Vulnerable Patients ◽

Populations At Risk ◽

The Social

Medical-legal partnership (MLP) is a health care delivery innovation that embeds civil legal aid expertise into the health care team to address health-harming legal needs for vulnerable populations at risk for poor health. The MLP approach focuses on prevention by addressing upstream structural and systemic social and legal problems that affect patient and population health. Because many unmet legal needs affect health (such as residing in substandard housing; wrongful denial of government income supports, health insurance, or food assistance; family violence; and barriers to care based on immigration status), lawyers are important members of the health care team. This review describes the MLP approach to addressing the social determinants of health, examines its benefits for improving the delivery of primary care for vulnerable patients and populations, and explores new opportunities for MLP in primary care with the advent of systems reforms driven by the Affordable Care Act.

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Web-Based Self-Management Guide for Kidney Transplant Recipients (The Getting on With Your Life With a Transplanted Kidney Study): Protocol for Development and Preliminary Testing (Preprint)

10.2196/preprints.13420 ◽

2019 ◽

Author(s):

Daniela Massierer ◽

Ruth Sapir-Pichhadze ◽

Vanessa Bouchard ◽

Kaberi Dasgupta ◽

Nicolas Fernandez ◽

...

Keyword(s):

Health Care ◽

Focus Groups ◽

Needs Assessment ◽

Kidney Transplant ◽

Health Care Team ◽

Care Team ◽

Self Management ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Web Based

BACKGROUND Although it is well known that compared with dialysis, kidney transplantation improves the quality of life (QoL) of patients with end-stage renal disease, posttransplant recovery of physical health and other aspects of QoL remain well below age- and sex-matched norms. In addition, most transplant recipients are not physically active even years after the transplant and face several barriers to engaging in physical activity (PA). This is of concern as low levels of PA in transplant recipients has been associated with increased risk of mortality and poor graft function. Optimization of QoL needs a team approach involving the patients and the members of the health care team. While members of the health care team are focused on optimizing the biological responses to transplant, patients may have few or no tools at their disposal to engage in behaviors that optimize QoL. To accomplish the need of supporting these patients in the self-management of their condition and to facilitate engagement with PA, new tools tailored to this population are required. OBJECTIVE The aim of this protocol study is to develop a Web-based, patient-centered self-management intervention to promote a healthy lifestyle, increase daily PA, and improve QoL in kidney transplant recipients. METHODS We will use the Obesity-Related Behavioral Intervention Trials model for developing behavioral treatments for chronic diseases to guide the proposed project. We will follow a modified version of the iterative 10-step process that was used to develop educational material for people with multiple sclerosis. The development of the intervention will occur in partnership with patients and a multidisciplinary team of clinicians and researchers. A comprehensive needs assessment including data from our pilot study, literature review, and focus groups will be conducted. The focus groups will be conducted with 6 to 10 participants for each type of stakeholders: patients and professional experts to identify areas of concerns of kidney transplant recipients that are appropriate to address through self-management. The areas of concern identified through the assessment needs will be included in the website. RESULTS This study has received funding from the Kidney Foundation of Canada for 2 years (2018-2020) and was recently granted ethics approval. Investigators have begun conducting the needs assessment described in step 1 of the study. The study is expected to be completed by the end of 2020. CONCLUSIONS This will be the first comprehensive, evidence- and experience-based self-management program for kidney transplant recipients. Once the intervention is developed, we anticipate improvements in patient experience, shared decision making, daily PA, QoL, and, in future studies, improvements in health outcomes and demonstrations of cost savings in posttransplant care. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/13420

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Treatment Considerations and the Role of the Clinical Pharmacist Throughout Transitions of Care for Patients With Acute Heart Failure

Journal of Pharmacy Practice ◽

10.1177/0897190016645435 ◽

2016 ◽

Vol 30 (4) ◽

pp. 441-450 ◽

Cited By ~ 9

Author(s):

Elizabeth B. McNeely

Keyword(s):

Heart Failure ◽

Health Care ◽

Health Care Costs ◽

Health Care Team ◽

Care Team ◽

Transitions Of Care ◽

Clinical Pharmacists ◽

Care Plans ◽

Increased Risk ◽

Care Costs

Heart failure is associated with increased risk of morbidity and mortality, resulting in substantial health-care costs. Clinical pharmacists have an opportunity to reduce health-care costs and improve disease management as patients transition from inpatient to outpatient care by leading interventions to develop patient care plans, educate patients and clinicians, prevent adverse drug reactions, reconcile medications, monitor drug levels, and improve medication access and adherence. Through these methods, clinical pharmacists are able to reduce rates of hospitalization, readmission, and mortality. In addition, care by clinical pharmacists can improve dosing levels and adherence to guideline-directed therapies. A greater benefit in patient management occurs when clinical pharmacists collaborate with other members of the health-care team, emphasizing the importance of heart failure treatment by a multidisciplinary health-care team. Education is a key area in which clinical pharmacists can improve care of patients with heart failure and should not be limited to patients. Clinical pharmacists should provide education to all members of the health-care team and introduce them to new therapies that may further improve the management of heart failure. The objective of this review is to detail the numerous opportunities that clinical pharmacists have to improve the management of heart failure and reduce health-care costs as part of a multidisciplinary health-care team.

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