scholarly journals A Hospital-Community-Family–Based Telehealth Program for Patients With Chronic Heart Failure: Single-Arm, Prospective Feasibility Study (Preprint)

2018 ◽  
Author(s):  
Xiaorong Guo ◽  
Xiang Gu ◽  
Jiang Jiang ◽  
Hongxiao Li ◽  
Ruoyu Duan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Vegetable Intake ◽  
Mobile App ◽  
Text Messages ◽  
Ease Of Use ◽  
Care Plan ◽  
Self Management ◽  
Number Of Patients ◽  
Hierarchical Management

BACKGROUND An increasing number of patients with chronic heart failure (CHF) are demanding more convenient and efficient modern health care systems, especially in remote areas away from central cities. Telehealth is receiving increasing attention, which may be useful to patients with CHF. OBJECTIVE This study aimed to evaluate the feasibility of a hospital-community-family (HCF)–based telehealth program, which was designed to implement remote hierarchical management in patients with CHF. METHODS This was a single-arm prospective study in which 70 patients with CHF participated in the HCF-based telehealth program for remote intervention for at least 4 months. The participants were recruited from the clinic and educated on the use of smart health tracking devices and mobile apps to collect and manually upload comprehensive data elements related to the risk of CHF self-care management. They were also instructed on how to use the remote platform and mobile app to send text messages, check notifications, and open video channels. The general practitioners viewed the index of each participant on the mobile app and provided primary care periodically, and cardiologists in the regional central hospital offered remote guidance, if necessary. The assessed outcomes included accomplishments of the program, usability and satisfaction, engagement with the intervention, and changes of heart failure–related health behaviors. RESULTS As of February 2018, a total of 66 individuals, aged 40-79 years, completed the 4-month study. Throughout the study period, 294 electronic medical records were formed on the remote monitoring service platform. In addition, a total of 89 remote consultations and 196 remote ward rounds were conducted. Participants indicated that they were generally satisfied with the intervention for its ease of use and usefulness. More than 91% (21/23) of physicians believed the program was effective, and 87% (20/23) of physicians stated that their professional knowledge could always be refreshed and enhanced through a library hosted on the platform and remote consultation. More than 60% (40/66) of participants showed good adherence to the care plan in the study period, and 79% (52/66) of patients maintained a consistent pattern of reporting and viewing their data over the course of the 4-month follow-up period. The program showed a positive effect on self-management for patients (healthy diet: <italic>P</italic>=.046, more fruit and vegetable intake: <italic>P</italic>=.02, weight monitoring: <italic>P</italic>=.002, blood pressure: <italic>P</italic>&lt;.001, correct time: <italic>P</italic>=.049, and daily dosages of medicine taken: <italic>P</italic>=.006). CONCLUSIONS The HCF-based telehealth program is feasible and provided researchers with evidence of remote hierarchical management for patients with CHF, which can enhance participants’ and their families’ access and motivation to engage in self-management. Further prospective studies with a larger sample size are necessary to confirm the program’s effectiveness.

scholarly journals A Hospital-Community-Family–Based Telehealth Program for Patients With Chronic Heart Failure: Single-Arm, Prospective Feasibility Study

10.2196/13229 ◽  
2019 ◽  
Vol 7 (12) ◽  
pp. e13229 ◽  
Author(s):  
Xiaorong Guo ◽  
Xiang Gu ◽  
Jiang Jiang ◽  
Hongxiao Li ◽  
Ruoyu Duan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Vegetable Intake ◽  
Mobile App ◽  
Text Messages ◽  
Ease Of Use ◽  
Care Plan ◽  
Self Management ◽  
Number Of Patients ◽  
Hierarchical Management

Background An increasing number of patients with chronic heart failure (CHF) are demanding more convenient and efficient modern health care systems, especially in remote areas away from central cities. Telehealth is receiving increasing attention, which may be useful to patients with CHF. Objective This study aimed to evaluate the feasibility of a hospital-community-family (HCF)–based telehealth program, which was designed to implement remote hierarchical management in patients with CHF. Methods This was a single-arm prospective study in which 70 patients with CHF participated in the HCF-based telehealth program for remote intervention for at least 4 months. The participants were recruited from the clinic and educated on the use of smart health tracking devices and mobile apps to collect and manually upload comprehensive data elements related to the risk of CHF self-care management. They were also instructed on how to use the remote platform and mobile app to send text messages, check notifications, and open video channels. The general practitioners viewed the index of each participant on the mobile app and provided primary care periodically, and cardiologists in the regional central hospital offered remote guidance, if necessary. The assessed outcomes included accomplishments of the program, usability and satisfaction, engagement with the intervention, and changes of heart failure–related health behaviors. Results As of February 2018, a total of 66 individuals, aged 40-79 years, completed the 4-month study. Throughout the study period, 294 electronic medical records were formed on the remote monitoring service platform. In addition, a total of 89 remote consultations and 196 remote ward rounds were conducted. Participants indicated that they were generally satisfied with the intervention for its ease of use and usefulness. More than 91% (21/23) of physicians believed the program was effective, and 87% (20/23) of physicians stated that their professional knowledge could always be refreshed and enhanced through a library hosted on the platform and remote consultation. More than 60% (40/66) of participants showed good adherence to the care plan in the study period, and 79% (52/66) of patients maintained a consistent pattern of reporting and viewing their data over the course of the 4-month follow-up period. The program showed a positive effect on self-management for patients (healthy diet: P=.046, more fruit and vegetable intake: P=.02, weight monitoring: P=.002, blood pressure: P<.001, correct time: P=.049, and daily dosages of medicine taken: P=.006). Conclusions The HCF-based telehealth program is feasible and provided researchers with evidence of remote hierarchical management for patients with CHF, which can enhance participants’ and their families’ access and motivation to engage in self-management. Further prospective studies with a larger sample size are necessary to confirm the program’s effectiveness.

Using a mobile app to enhance the uptake of survivorship care plans (SCP) for adolescent and young adult survivors of childhood cancer.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 74-74
Author(s):  
Lisa Schwartz ◽  
Dava Szalda ◽  
Alexandra M Psihogios ◽  
Elizabeth Shea Ver Hoeve ◽  
Lauren Daniel ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Mobile App ◽  
Text Messages ◽  
Adolescent And Young Adult ◽  
Care Plan ◽  
Self Management ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

74 Background: Survivorship self-management, including adherence to survivorship care plans (SCPs), is variable, especially among adolescents and young adults (AYA). Methods:The present study describes the development of a mobile application (app) for AYA survivors (AYA STEPS), which strives to improve survivorship self-management via a combined texting self-management program (THRIVE 2.0) and an electronic survivorship care plan generator (Smart-ALACC [Smart-Adult Living After Childhood Cancer], hosted on Oncolink.org). Results: AYA STEPS was developed by modifying an existing disease management app, LSTCare. The main feature of the app is the delivery of two-way text messages that are tailored to an individual’s SCP. The messages are designed to enhance uptake of the SCP with information, strategies for adherence, motivational messages, and appointment reminders. Patients may also text back with questions. The SCP and its related text information are customized based on input of patient characteristics and treatment history, such as age, time off treatment, and type of treatment (e.g., anthracycline chemotherapy, mediastinal radiation, cranial radiation). The app also houses a copy of the complete SCP document. The SCP is generated, via patient or provider, via an electronic platform that incorporates patient demographic information, cancer diagnosis, and cancer treatments received with checklist of options. Feedback on the app was provided by AYA ages 15 to 21 via a focus group (n = 5) and interviews (n = 5), through which qualitative data were collected. AYA reported high acceptability of a mHealth intervention to improve self-care as cancer survivors, especially the inclusion of tailored content from an individualized SCP as text messages. They also reported the app as feasible to download and maintain on their phones. Conclusions: We are about to begin a RCT that will test adherence to SCP for those who received the app and the SCP versus the SCP alone. We will report details of the app and the launch of the RCT. We expect high acceptability and feasibility with measured benefit to receiving the self-management app.

scholarly journals The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Hang Ding ◽  
Rajiv Jayasena ◽  
Sheau Huey Chen ◽  
Andrew Maiorana ◽  
Alison Dowling ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Chronic Heart Failure ◽  
Patient Compliance ◽  
Controlled Trial ◽  
Care Program ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Management Recommendations

BACKGROUND Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. OBJECTIVE This study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). METHODS We conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. RESULTS A total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; <i>P</i>=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; <i>P</i>=.005). CONCLUSIONS ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691

scholarly journals USABILITY ASSESSMENT OF A SENSOR-CONTROLLED DIGITAL GAME FOR OLDER ADULTS WITH HEART FAILURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S892-S892 ◽  
Author(s):  
Kavita Radhakrishnan ◽  
Christine Julien ◽  
Matthew O’Hair ◽  
Catherine Fournier ◽  
Grace Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Game Design ◽  
Training Session ◽  
Ease Of Use ◽  
Self Management ◽  
Digital Game ◽  
Usability Assessment ◽  
Central Texas ◽  
Knowledge Content

Abstract The inability of older persons with heart failure (HF) to self-manage has contributed to poor health outcomes. Our team from nursing, digital game design, and mobile computing developed an innovative sensor-controlled digital game (SCDG) called ‘Heart Mountain’ to offer a portable, and enjoyable tool to facilitate engagement in HF self-management. We installed the SCDG application, which featured older adult game avatars on the participants’ smartphones. The SCDG utilized data from an activity tracker and weight scale to trigger game rewards, knowledge content and messages based on participants’ real-time behaviors. In this study we assessed the usability of a SCDG prototype with 10 HF older adults in Central Texas. Observations on the usability of the SCDG app by older adults were noted on a usability heuristics checklist. Acceptance and satisfaction were collected by an open-ended survey guided by Intrinsic Motivation Inventory after a week of playing the game. Participants (60% males, 60% white, ages 63-84) were able to play the game and use the devices after a training session that lasted for 15 minutes. We will present results on participants’ ease of use of the SCDG app, satisfaction with the knowledge content, quizzes and rewards features of the SCDG, and perceptions on acceptance and satisfaction with the SCDG for heart failure self-management. Our project will generate insights on designing digital gaming solutions that are acceptable to older adults and can be applied to improve self-management of chronic diseases like heart failure.

scholarly journals The development and pilot study of a nurse-led HOMe-based HEart failure self-Management Programme (the HOM-HEMP) for patients with chronic heart failure, following Medical Research Council guidelines

2019 ◽  
Vol 19 (3) ◽  
pp. 212-222 ◽  
Author(s):  
Ying Jiang ◽  
Shefaly Shorey ◽  
Hoang D Nguyen ◽  
Vivien Xi Wu ◽  
Choy Yee Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
Self Care ◽  
Self Management ◽  
Intervention Package ◽  
Pilot Testing ◽  
Study Intervention

Background: Chronic heart failure (CHF) is one of the most common causes of hospital admissions and readmissions. Managing CHF requires a comprehensive treatment plan that consists of medication treatment and behavioural change. However, patients often feel unprepared for their self-management role in the community, especially during the period of transition after discharge from hospital. Therefore, an effective intervention to promote CHF self-management is needed. Aims: This paper describes the development and pilot testing of a multicomponent nursing intervention (i.e. the HOM-HEMP) for a randomised controlled trial to assess its effectiveness in improving self-care behaviour among CHF patients in Singapore. A description of the study intervention is also delineated in detail. Methods: The HOM-HEMP was developed based on the UK Medical Research Council framework for developing and evaluating complex interventions. After the development of the study intervention, a single group pre- and post-repeated measure pilot test was conducted to evaluate the study intervention package for its acceptability and the feasibility of the data collection procedure. Ten participants were recruited through consecutive sampling. All of the participants received the full intervention package with the supplementary mobile application. The data were collected at baseline and immediately after the study intervention (i.e. 6 weeks from baseline). The outcome measures included the Self-Care Heart Failure Index, Cardiac Self-Efficacy Scale, Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale and Short Form of the Social Support Questionnaire. Results: The results from the pilot testing showed that the programme was feasible and potentially effective in improving patient’s self-care management, psychological outcomes and health-related quality of life. Conclusion: A self-management psychosocial education approach is the preferred choice for many patients with chronic diseases. The effectiveness of the HOM-HEMP will next be tested in a full scale randomised control trial.

scholarly journals SELF-MANAGEMENT OF OLDER INDIVIDUALS WITH CHRONIC HEART FAILURE IN JAPAN

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 322-322
Author(s):  
A. Mitsuoka ◽  
H. Hirata
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Self Management ◽  
Older Individuals

scholarly journals Effectiveness of an educational self-management program for outpatients with chronic heart failure

2010 ◽  
Vol 8 (2) ◽  
pp. 140-152 ◽  
Author(s):  
Haruka OTSU ◽  
Michiko MORIYAMA
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Management Program ◽  
Self Management

scholarly journals Assessment of chronic disease self-management in patients with chronic heart failure based on the MCID of patient-reported outcomes by the multilevel model 

2020 ◽  
Author(s):  
Jing Tian ◽  
Jinghua Zhao ◽  
Qing Zhang ◽  
Jia Ren ◽  
Linai Han ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Disease ◽  
Chronic Heart Failure ◽  
Clinical Significance ◽  
Multilevel Models ◽  
Threshold Value ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Low Sodium Diet ◽  
Patient Reported

Abstract Purpose: The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure - PRO measure (CHF-PROM).Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from July 2018. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with β values of CDSM obtained from the multi-level models to further evaluate the clinical significance.Results: Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating (12.39 vs. 9.75) and maintenance of a regular schedule often (10.98 vs. 9.75), and exercise almost every day (11.36 vs. 9.75) reached clinical significance for the overall summary. Avoidance of over-eating (5.88 vs. 4.79) and a regular schedule almost every day (4.96 vs. 4.79) reached clinical significance for the physical scores. Avoidance of over-eating half of the time (5.26 vs. 4.87) and a regular schedule almost every day (5.84 vs. 4.87) demonstrated clinical significance for the psychological scores.Conclusions: This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure.

scholarly journals Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

2020 ◽  
Author(s):  
Jing Tian ◽  
Jinghua Zhao ◽  
Qing Zhang ◽  
Jia Ren ◽  
Linai Han ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Multilevel Models ◽  
Management Strategies ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Self Management ◽  
Converting Enzyme Inhibitors ◽  
Patient Reported ◽  
Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure.Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance.Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains.Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.Trial registration: 2018LL128, January 2, 2018.

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