The Acceptability of a Palliative Care Mobile Application for Older Adults with Heart Failure and Caregivers (Preprint)

2021 ◽  
Author(s):  
Jennifer Paola Villalobos ◽  
Sheana Salyers Bull ◽  
Jennifer Dickman Portz

BACKGROUND Digital health provides opportunities for patients with advanced heart failure and their caregivers to engage in palliative care, but is relatively underexplored. OBJECTIVE To test the acceptability and usability of Convoy-Pal, a mobile palliative care solution for older adults and their family and informal caregivers, i.e., their “social convoy”. METHODS Convoy-Pal includes tablet based and smart watch tools facilitating self-management and access to palliative care resources. Older adults and convoy caregivers completed an acceptability and usability interview via Zoom including open ended questions and the Mobile Application Rating Scale: User Version (uMars). Descriptive analysis was conducted to summarize the results of open-ended feedback and self-reported acceptability and usability. RESULTS Overall, the feedback from users was good (uMars M=3.96, out of 5). Open ended feedback from the interviews included improving graphs and adding monitoring features. CONCLUSIONS Convoy-Pal is perceived acceptable with good usability for both older adults and their caregivers.

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kavita Radhakrishnan ◽  
Christine Julien ◽  
Matthew O'Hair ◽  
Thomas Baranowski ◽  
Grace Lee ◽  
...  

Introduction: Poor self-management of heart failure (HF) has contributed to poor health outcomes with an annual loss of $32 billion. Our innovative sensor controlled digital game (SCDG) integrates data from weight scale and physical activity sensors to trigger rewards, progress, changes in avatar’s health status and feedback based on HF individuals’ real-time behaviors (Fig1). Hypothesis: Weight monitoring and physical activity by participants receiving both the SCDG app and sensors will be higher than participants receiving only the sensors (CG). Methods: English-speaking HF adults aged >55 years, own a smartphone, and walk unassisted were recruited from cardiac settings in Texas. Both SCDG and CG participants were given ‘Withings’ activity tracker and smart weight scale sensors to track behaviors for 12 weeks. Physical activity goal was tailored to the participant’s ability. Results: In early results over six weeks on 12 participants (58% women, white, and 65+ years age), the mean days with weight monitoring in the SCDG group was 34 and 27 in the CG. Daily average steps were 2195 (53% of goal) in SCDG group and 3187 in CG (75% of goal). 100% of participants found the SCDG easy and enjoyable to play. Study adaptations in response to the COVID19 crisis will allow us to present results on 30 participants at conference time. Conclusion: SCDG had trends of higher weight monitoring but lower physical activity among older adults with HF. Participants in the study continue to engage in weight-monitoring and physical activity even during the COVID19 crisis. This presents opportunities to tailor digital health interventions to remotely motivate self-management behaviors.


2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling

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


2021 ◽  
Author(s):  
Yohanca Maria Diaz-Skeete ◽  
David McQuaid ◽  
Adewale Samuel Akinosun ◽  
Idongesit Ekerete ◽  
Natacha Carragher ◽  
...  

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


2017 ◽  
Vol 11 (5) ◽  
Author(s):  
Jennifer R. Riggs ◽  
Alex Reyentovich ◽  
Mathew S. Maurer ◽  
John A. Dodson

2016 ◽  
Vol 22 (8) ◽  
pp. S56
Author(s):  
Mahesh A. Chandrasekhar ◽  
Ruiz George ◽  
Kathryn A. Walker ◽  
Hunter Groninger

Author(s):  
Bradi B. Granger ◽  
James A. Tulsky ◽  
Brystana G. Kaufman ◽  
Robert M. Clare ◽  
Kevin Anstrom ◽  
...  

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