Mobile applications for heart failure self-management: a systematic review (Preprint)

2021 ◽  
Author(s):  
Leticia Bezerra ◽  
Huong Ly Tong ◽  
John J Atherton ◽  
Rimante Ronto ◽  
Josephine Chau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mobile Applications ◽  
Evaluation Studies ◽  
Self Care ◽  
Mobile App ◽  
Emergency Department Visits ◽  
Self Management ◽  
Self Monitoring ◽  
Vital Signs Monitoring ◽  
The Impact

BACKGROUND Heart failure is a common cause of hospitalization and patient self-management is essential to avoid decompensation and readmissions. Mobile applications (apps) seem promising in supporting heart failure self-management. OBJECTIVE This study systematically reviews the evidence on the impact of heart failure self-management apps on health outcomes and patient experience. METHODS Four databases (Medline, Embase, CINAHL, and PsycINFO) were searched for studies published from 2008 to 2020 examining interventions that comprised a mobile app targeting heart failure self-management and reported any health-related outcomes or patient perspectives. Studies were independently screened. We performed a narrative synthesis of results. PRISMA guidelines were followed. The protocol was registered in PROSPERO (CRD42020158041). RESULTS Nineteen articles [4 randomized controlled trials (RCTs)], assessing 16 apps and a total of 930 participants were included. The most common app features were symptom monitoring (14 of 16 apps), weight monitoring (13/16), and vital signs monitoring (12/16). RCTs were small and outcomes were predominantly self-reported. Two RCTs reported significant improvement in self-care scale measures, including ‘self-management’ (p=0.01), ‘self-confidence’ (p=0.03) and ‘self-maintenance’ (p=0.03) Two RCTs reported higher unplanned clinic visits. Mortality and emergency department visits were reported in two RCTs and hospital re-admissions in one RCT, with no significant differences. Engagement with the intervention was poorly reported. The most desirable app characteristics were automated self-monitoring and feedback, data integration and sharing, and personalization. CONCLUSIONS Mobile apps may improve self-care, particularly if enabling automated self-monitoring and personalized feedback, but more robust evaluation studies are needed addressing key endpoints for heart failure.

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 Explorando o uso de aplicativos móveis para autogestão do tratamento em saúde mental: scoping review

2021 ◽  
Vol 11 ◽  
pp. e56
Author(s):  
Maria Do Perpétuo Socorro de Sousa Nóbrega ◽  
Priscila Campos Tibúrcio ◽  
Mariana Coronato Fernandes ◽  
Carla Sílvia Neves da Nova Fernandes ◽  
Célia Samarina Vilaça de Brito Santos ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
Scoping Review ◽  
Mobile Applications ◽  
Psychiatric Illness ◽  
Self Care ◽  
Self Management ◽  
Self Monitoring

Objetivo: mapear a literatura científica produzida sobre aplicativos móveis para a autogestão do tratamento em saúde mental. Método: revisão de escopo realizada em cinco bases em português, inglês ou espanhol em novembro de 2020 com os descritores mental health, mental illness, mental disorder, psychiatric illness, mobile applications, app, self care, self management e self monitoring. Resultados: encontraram-se 46 artigos relacionados, em sua maioria, com desenvolvimento, eficácia, percepção dos usuários ou busca de aplicativos em lojas especializadas e com foco no automonitoramento do humor (13%) ou gestão de doenças mentais, em geral (23,9%). Conclusão: os estudos evidenciaram variedade e eficácia de aplicativos móveis para diferentes transtornos mentais. A construção de novos aplicativos para autogestão em SM deve ser sustentada em evidências, com participação do público e com amostras representativas que, de fato, retratem as expectativas e motivações do usuário para o uso dessas tecnologias na autogestão de seu tratamento.

Instrumente zur Messung der Selbstpflege bei Patienten mit Herzinsuffizienz. Ergebnisse einer Literaturanalyse

Pflege ◽  
2008 ◽  
Vol 21 (4) ◽  
pp. 235-251 ◽  
Author(s):  
Jörg Haasenritter ◽  
Eva-Maria Panfil
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Self Management ◽  
Reliabilität Und Validität ◽  
Failure Index

Herzinsuffizienz ist eine häufige Erkrankung, die mit großem Leid für die Betroffenen und hohen Kosten für die jeweiligen Gesundheitssysteme einhergeht. Eine Verbesserung der Selbstpflege soll zu einer Verbesserung der Ergebnisse wie höhere Lebenserwartung, bessere Lebensqualität, geringere Hospitalisationsrate und verminderten Ressourcenverbrauch führen. Um die Effektivität von Interventionen zur Verbesserung der Selbstpflege in Praxis und Forschung zu beurteilen, sind valide und reliable Instrumente zur Messung der Selbstpflege nötig. Ziel der vorliegenden Literaturanalyse ist es, eine Übersicht über die vorhandenen pflegerischen Assessmentinstrumente zur Messung der Selbstpflege bei Herzinsuffizienz zu erstellen und diese in ihrer messtheoretischen Güte zu bewerten. Hierzu wurde in Datenbanken und anschließender Handsuche nach Studien gesucht, in denen Messungen der gesundheitsbedingten Selbstpflege von Patienten mit Herzinsuffizienz durchgeführt wurden. Es konnten fünf Instrumente identifiziert werden: European Heart Failure Self-care Behaviour Scale (EHFScBS); Revised Heart Failure Self-care Behaviour Scale (rHFScBS); Heart Failure Self-Care Inventory (HFS-CI) Self-Management of Heart Failure Scale (SMHF); Self-Care of Heart Failure Index (SCHFI). Jede der besprochenen Skalen besitzt im Hinblick auf die Gütekriterien unterschiedlich ausgeprägt Stärken und Schwächen. Die EHFSCBS, der HFS-CI und der HFSCI können zumindest bedingt für den Einsatz in Forschung in Praxis empfohlen werden. Für alle Instrumente sind aber weitere Überprüfungen im Bereich der Reliabilität und Validität notwendig.

scholarly journals Self-Directed Learning in EFL During Covid-19 Pandemic: Teacher’s Perception and Students’ Learning Autonomy

2021 ◽  
Vol 4 (1) ◽  
pp. 80
Author(s):  
Ni Luh Made Purnia Adi ◽  
Luh Putu Artini ◽  
Luh Gede Eka Wahyuni
Keyword(s):  
Online Learning ◽  
Learning Activities ◽  
Self Management ◽  
Mixed Method Research ◽  
Self Directed Learning ◽  
Self Monitoring ◽  
Teachers Perceptions ◽  
Directed Learning ◽  
The Impact ◽  
Teacher's Perception

Due to the global outbreak of coronavirus disease (COVID-19), new regulations require students to study from home so that students must be able to study independently. This study aimed to analyze teachers' perceptions of self-directed learning (SDL) and SDL components that can be identified from online learning activities assigned by teachers during the COVID-19 pandemic. This research was designed in the form of embedded mixed-method research. An English teacher at a high school was selected as a participant. Furthermore, data were collected through questionnaires, observations, and classification tables. The results showed that: 1) with a score of 4.00, teachers perceive themselves as "knowledgeable" about SDL knowledge, with a score of 3.57, teachers perceive themselves as "expected" or often carry out learning activities that support SDL, with a score of 3.88, teachers assessing the impact of SDL as “influential” on students, 2) components of SDL reflected through online learning activities assigned by the teacher are “developing a sense of belonging to students in learning” and “developing student self-monitoring” and self-management.” Thus, teachers perceive SDL positively, and there are two components of SDL promoted by teachers' online learning activities.

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.

Abstract 17378: “If My Doctors Had Recommended a Mobile App to Me Back Then, I Wouldn't Have Been in This Situation Today”: Identifying the Barriers and Facilitators to the Utilization of mHealth Apps to Improve Self-Care in Patients With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ifeanyi Madujibeya ◽  
Salman Alreshidi ◽  
Adaze Aroh
Keyword(s):  
Heart Failure ◽  
Academic Medical Center ◽  
Self Care ◽  
Mobile App ◽  
Perceived Usefulness ◽  
Intention To Use ◽  
Depth Analysis ◽  
Patients With Heart Failure ◽  
Prior Use ◽  
Mhealth Apps

Background: Mobile Health applications (mHealth apps) have been demonstrated as an effective strategy for improving self-care abilities in patients with heart failure (HF). However, the uptake of the apps by patients remains low. Little is known about the patient’s perspectives on the factors that influence their uptake of the apps. This study explored HF patients’ perspectives on the barriers and motivators to the uptake and utilization of mHealth apps. Method: Semi-structure interviews and demographic questionnaires were used to gather data from patients with HF (N= 43) recruited from an academic medical center. An in-depth analysis of the interviews was conducted using a deductive thematic approach with the help of qualitative software, Atias.ti version 8. Results: Among the participants ( median age = 62 [35-92] years, mean±SD ejection fraction = 37.3±17, 41.9% female, 70% smartphone owners), 90.7% (n =39) had no prior use of mHealth apps for self-care. The majority of the participants with no prior use of mhealth (79.5%, n = 31), including 64.7% (n= 17) of participants aged 65yrs and above, expressed an intention to use the apps for self-care. All the participants (100%) stated that their healthcare providers (HCP) had never recommended the use of mHealth apps for self-care. Other barriers included lack of knowledge of the apps, the perceived financial cost of mHealth apps or smartphones, concern for privacy, and security of personal information, resistance to the change of previous self-care strategies, and perceived technology incompetence. Motivators to the uptake of mHealth included perceived usefulness of mHealth apps, mHealth apps’ ease of use, and the belief that the use of mHealth apps may alleviate perceived threat to health, and availability of technical support. Conclusion: This study suggests that patients with HF are willing to use mHealth apps to improve their self-care abilities. Thus, the effort to improve patients’ perceptions of mHealth apps’ usefulness and HCP recommendation of the apps are warranted to turn patients' “intention to use” to actual apps usage.

The Impact of Mobile Health use on the Self-Care of Patients with Type 2 Diabetes: A Protocol for a Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Lucija Gosak ◽  
Majda Pajnkihar ◽  
Gregor Štiglic
Keyword(s):  
Type 2 Diabetes ◽  
Family Medicine ◽  
Mobile Applications ◽  
Mobile Application ◽  
Controlled Trial ◽  
Self Care ◽  
The Self ◽  
Control Group ◽  
The Impact

BACKGROUND Chronic diseases are an important public health issue worldwide and affect an individual's quality of life. Due to the alarming rise in type 2 diabetes, healthcare, which was previously largely focused primarily on diagnosis and treatment of the disease, is increasingly focused on prevention and self-care. Patients who adhere to a constant and strict treatment regimen (physical activity, diet, medication) and regularly monitor their health, maintain self-care and health, prevent exacerbation of the disease and prevent complications of diabetes (retinopathy, diabetic feet). Many innovative devices that have become increasingly present in patient health care in recent years, such as mobile applications, are available to patients to maintain consistency in monitoring their health status. Mobile applications make it easier for individuals to monitor their self-care, monitor illness, and make it easier to follow instructions regarding disease control. OBJECTIVE The study aim is to determine the impact of mobile application use on self-care in patients with type 2 diabetes. The aim of the study is also to evaluate and test the usefulness of the forDiabetes application as a tool to improve the self-care of individuals with type 2 diabetes. METHODS We will perform a double-blind randomized controlled trial. The study will include individuals over the age of 18 who have been diagnosed and have regulated type 2 diabetes, who have already received oral treatment and are being treated in family medicine practice. Also, individuals included in the study should not have any acute complications due to the consequences of type 2 diabetes. During the study, they should be able to use an Android or iOS mobile phone and a blood glucose meter. With the help of simple randomization, individuals will be divided into an intervention and a control group. Individuals in the intervention group will use the forDiabetes mobile app to monitor their self-care for type 2 diabetes. Individuals in the control group will not receive a special intervention. Data will be collected using the “Self-care of Diabetes Inventory” questionnaire and a “Brief Illness Perception Questionnaire”. Blood sugar, blood pressure, HbA1c, and weight measurements will be monitored using the calibrated instruments during the study by the nurses employed in family medicine practice. Data will be collected at the beginning of the study and after the patient visit to the family medicine practice. RESULTS The expected results as a result of using the mobile application forDiabetes are the impact on the level of self-care, the impact on the perception of the disease, blood sugar levels, blood pressure, HbA1c, and the measured body weight of the patient. CONCLUSIONS The research contributes to greater visibility and usability of mobile applications for self-care of patients with type 2 diabetes and makes aware of the possible use of innovative methods. CLINICALTRIAL NCT04999189

Abstract 17114: Whose Work is It? Patient Perspectives on Challenges in Heart Failure Self-Management

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Renee Leverty ◽  
Leslie Chang ◽  
Jose Barcenas ◽  
James James Campbell ◽  
Kirsten Dahlgren ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Behavior Change ◽  
Social Interactions ◽  
Self Care ◽  
Patient Perspectives ◽  
Self Management ◽  
Depth Interviews ◽  
Care Behavior ◽  
Effective Behavior

Introduction: The importance of self-care behaviors in successful heart failure (HF) management is widely recognized. And yet, patient perspectives on strategies to effective carry out the work of behavior change remain relatively unexplored. Methods: From March 2017 to May 2017, we conducted semi-structured, in-depth interviews with 8 HF patients involved in the CONNECT-HF clinical trial and 7 of their respective caregivers. Interviews were audio-recorded and transcriptions were imported to NVivo 11 (Version 11.4.0) for coding and analysis. We used content analysis and a mixed inductive and deductive approach for interpretation of coded text. Results: Patients (n=8) and caregivers (n=7) reported numerous strategies (n=28) for each guideline-based self-care behavior. The over-arching theme contributing to successful, effective behavior change was the value of social support and social interactions in the work of “sticking with it.” Predominant sub-themes included the idea that “knowledge is necessary but not sufficient” for behavior change, and “ building a routine” was critical for life-long self-care to be effective (Table 1). Conclusions: Many of the behavior change barriers and strategies proposed by patients are concepts that are consistent with findings in the field of behavioral economics and have the potential to inform development of effective behavior change tools.

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.

Diabetes self-care in-the-wild

2014 ◽  
Vol 27 (4) ◽  
pp. 397-420 ◽  
Author(s):  
Cristiano Storni
Keyword(s):  
Chronic Disease ◽  
Everyday Life ◽  
Self Care ◽  
Self Management ◽  
Self Monitoring ◽  
Content Type ◽  
In The Wild ◽  
Care Practices

Purpose – The purpose of this paper is to raise issues about the design of personal health record systems (PHRs) and self-monitoring technology supporting self-care practices of an increasing number of individuals dealing with the management of a chronic disease in everyday life. It discusses the results of an ethnographic study exposing to analysis the intricacies and practicalities of managing diabetes “in the wild”. It then describe and discuss the patient-centric design of a diabetes journaling platform that followed the analysis. Design/methodology/approach – The study includes ethnometodological investigation based on in depth interviews, observations in a support group for adults with type 1 diabetes, home visits, shadowing sessions and semi-structured interviews with a series of medical experts (endocrinologists, general practitioners and diabetes nurses). Findings informed the design of a proof-of-concept PHR called Tag-it-Yourself (TiY): a mobile journaling platform that enables the personalization of self-monitoring practices. The platform is thoroughly described along with an evaluation of its use with real users. Findings – The investigation sheds light on a series of general characters of everyday chronic self-care practices, and how they ask to re-think some of the assumptions and connotations of the current medical model and the traditional sick role of the patient – often unreflectively assumed also in the design of personal technologies (e.g. PHR) to be used by patients in clinically un-controlled settings. In particular, the analysis discusses: the ubiquitous nature of diabetes that is better seen as a lifestyle, the key role of lay expertises and different forms of knowledge developed by the patient in dealing with a disease on a daily basis, and the need of more symmetrical interactions and collaborations with the medical experts. Research limitations/implications – Reported discussions suggest the need of a more holistic view of self-management of chronic disease in everyday life with more attention being paid on the perspective of the affected individuals. Findings have potential implications on the way PHR and systems to support self-management of chronic disease in everyday life are conceived and designed. Practical implications – The paper suggests designers and policy makers to look at chronic disease not as a medical condition to be disciplined by a clinical perspective but rather as a complex life-style where the medical cannot be separated by other aspects of everyday life. Such shift in the perspective might suggest new forms of collaborations, new ways of creative evidence and new form of knowledge creation and validation in chronic self-care. Social implications – The paper suggests re-thinking the role of the patient in chronic-disease self-management. In particular, it suggests giving more room to the patient voice and concerns and suggest how these can enrich rather than complicate the generation of knowledge about self-care practices, at least in type 1 diabetes. Originality/value – The paper sheds light on everyday intricacies and practicalities of dealing with a chronic disease. Studies of self-care practices that shed light on the patient perspectives are sporadic and often assume a clinical perspective, its assumptions (e.g. biomedical knowledge is the only one available to improve health outcome, doctors know best) and implications (e.g. compliance, asymmetry between the specialist and the patient).

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