Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS)

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

Nursing Reports ◽

10.3390/nursrep11020040 ◽

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).

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Self-Care Management Education Through Health Coaching for Heart Failure Patients

The Journal for Nurse Practitioners ◽

10.1016/j.nurpra.2021.09.017 ◽

2021 ◽

Author(s):

Eli Zuraida ◽

Andi Masyitha Irwan ◽

Elly Lilianty Sjattar

Keyword(s):

Heart Failure ◽

Care Management ◽

Management Education ◽

Self Care ◽

Health Coaching ◽

Heart Failure Patients

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The relationship between health literacy and self-care in patients with heart failure

British Journal of Cardiac Nursing ◽

10.12968/bjca.2020.0128 ◽

2021 ◽

pp. 1-10

Author(s):

Katie Nesbitt ◽

Huiyun Du ◽

Paul Nolan ◽

Susie Cartledge ◽

Parichat Wonggom ◽

...

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Patient Group ◽

Care Management ◽

Self Care ◽

Randomised Control Trial ◽

Adequate Health Literacy ◽

Patients With Heart Failure ◽

Literacy Knowledge ◽

The Relationship

Background/Aims Research has shown that health literacy can influence an individual's ability to practise self-care, particularly for patients with heart failure. This study aimed to assess health literacy and its relationship with heart failure knowledge and self-care practices in this patient group. Methods An observational sub-study was conducted with the data from a large randomised control trial that evaluated the relationship between patients' health literacy, general literacy, knowledge of heart failure and self-care. Results A total of 36 participants were recruited, of which 33 (89.9%) had adequate levels of health literacy. Health literacy was positively associated with heart failure knowledge. However, 67.7% of participants with adequate health literacy were found to have inadequate levels of self-care management. Conclusions Health literacy may facilitate better heart failure knowledge, but it does not necessarily lead to improved self-care management in patients with heart failure. This suggest that clinicians need to put more emphasis on translating knowledge into behavioural changes for self-care in this patient group.

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An Analysis of Apps with a Medication List Functionality for Older People with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint)

10.2196/preprints.30674 ◽

2021 ◽

Author(s):

Yohanca Maria Diaz-Skeete ◽

David McQuaid ◽

Adewale Samuel Akinosun ◽

Idongesit Ekerete ◽

Natacha Carragher ◽

...

Keyword(s):

Heart Failure ◽

Mobile Application ◽

Rating Scale ◽

Scientific Evidence ◽

Medication List ◽

Healthcare Informatics ◽

Medication History ◽

Clinic Efficiency ◽

Google Play

BACKGROUND Managing the care of older patients with heart failure (HF) largely centres on medication management. Due to their frequent medication or dosing changes, an app supporting them to keep an up-to-date list of medication could be advantageous. During COVID-19 times, HF outpatients’ consultations are taking place virtually or by phone. An app with the capability to share the medication list with healthcare professionals before consultation could support the clinic efficiency, for example, reducing consultation time. However, the influence of apps on maintaining an up to date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE The objectives of this review are twofold: to review apps with a medication list functionality and to evaluate the quality of the apps included in the review using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS A systematic search of apps was conducted in June 2019 using the Google Play StoreTM and iTunes App StoreTM. The MARS was used independently by four researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS Google play and iOS app stores searches identified 483 potential apps (292 from Android stores and 191 from Apple stores). Six apps met the inclusion criteria. Medisafe app had the highest overall MARS score (4/5) and the medication list & medical records app had the lowest overall score (2.5/5). Five out of the six apps achieved an acceptable quality MARS score (>3.0). Two apps scored the maximum number of features (n=11) according to the IMS Institute for Healthcare Informatics functionality score and two scored the lowest (n=5). The apps had on average 8 functions based on the IMS functionality criteria (range 5 to 11). CONCLUSIONS The quality of current apps with a medication list functionality varies regarding their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality. However, the subjective quality or satisfaction with the apps was poor. Only three apps are based on scientific evidence and have been previously tested. Two apps featured all the IMS Institute for Healthcare Informatics functionalities and half do not provide clear instructions on how to enter medication data, do not display vital parameters data in an easy to understand format and do not guide users on how or when to take their medication. CLINICALTRIAL N/A

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The Influence of Mutuality on Self-Care in Heart Failure Patients and Caregivers: A Dyadic Analysis

Journal of Family Nursing ◽

10.1177/1074840718809484 ◽

2018 ◽

Vol 24 (4) ◽

pp. 563-584 ◽

Cited By ~ 5

Author(s):

Ercole Vellone ◽

Misook L. Chung ◽

Rosaria Alvaro ◽

Marco Paturzo ◽

Federica Dellafiore

Keyword(s):

Heart Failure ◽

Care Management ◽

Self Care ◽

Dyadic Analysis ◽

Heart Failure Patients ◽

Actor Partner Interdependence Model ◽

Partner Effect

Mutuality in patient–caregiver dyad may improve heart failure (HF) patient self-care and caregiver contribution to self-care, but literature is scarce. We evaluated the influence of mutuality and its dimensions on patient–caregiver dyad self-care. A sample of 366 HF patient–caregiver dyads was enrolled. The Actor–Partner Interdependence Model was used to identify the influence of individual patient and caregiver mutuality on their own self-care (actor effect) and on partner self-care (partner effect). The total mutuality score had an actor effect on patient self-care maintenance (i.e., behaviors aimed at maintaining HF stability) and on patient and caregiver self-care confidence. Total score of patient mutuality also had a partner effect on caregiver self-care management (i.e., responses to symptoms of HF exacerbation). Specific mutuality dimensions had different actor and partner effects on patient and caregiver self-care. Interventions to improve mutuality in HF patient–caregiver dyads may influence patient self-care and caregiver contribution to self-care.

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