Developing and Implementing an mHealth Heart Failure Self-care Program to Reduce Readmissions: Randomized Controlled Trial

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Abstract

Background

Patients admitted with decompensated heart failure (HF) are at risk for hospital readmission and poor quality of life during the discharge period. Lifestyle behavior modifications that promote the self-management of chronic cardiac diseases have been associated with an improved quality of life. However, whether a mobile health (mHealth) program can assist patients in the self-management of HF during the acute posthospital discharge period is unknown.

Objective

We aimed to develop an mHealth program designed to enhance patients’ self-management of HF by increasing knowledge, self-efficacy, and symptom detection. We hypothesized that patients hospitalized with HF would be willing to use a feasibly deployed mHealth program after their hospital discharge.

Methods

We employed a patient-centered outcomes research methodology to design a stakeholder-informed mHealth program. Adult patients with HF admitted to a large academic hospital were enrolled and randomized to receive the mHealth intervention versus usual care. Our feasibility outcomes included ease of program deployment, use of the clinical escalation process, duration of participant recruitment, and participant attrition. Surveys assessing the demographics and clinical characteristics of HF were measured at baseline and at 30 and 90 days after discharge.

Results

The study period was between July 1, 2019, and April 7, 2020. The mean cohort (N=31) age was 60.4 (range 22-85) years. Over half of the participants were men (n=18, 58%) and 77% (n=24) were White. There were no significant differences in baseline measures. We determined that an educational mHealth program tailored for patients with HF is feasibly deployed and acceptable by patients. Though not significant, we found notable trends including a higher mean quality of life at 30 days posthospitalization among program users and a longer duration before rehospitalization, which are suggestive of better HF prognosis.

Conclusions

Our mHealth tool should be further assessed in a larger comparative effectiveness trial. Our pilot intervention offers promise as an innovative means to help HF patients lead healthy, independent lives. These preliminary data suggest that patient-centered mHealth tools can enable high-risk patients to play a role in the management of their HF after discharge.

Trial Registration

ClinicalTrials.gov NCT03982017; https://clinicaltrials.gov/ct2/show/NCT03982017

Related collections

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Author and article information

Contributors

Amber E Johnson:

ORCID: https://orcid.org/0000-0003-1252-0735

Division of CardiologyDepartment of MedicineUniversity of Pittsburgh200 Lothrop StPittsburgh, PA, 15213United States1 412 648 61011 412 648 6598johnsonae2@upmc.edu

Journal

Journal ID (nlm-ta): JMIR Cardio

Journal ID (iso-abbrev): JMIR Cardio

Journal ID (publisher-id): JCARD

Title: JMIR Cardio

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2561-1011

Publication date Collection: Jan-Jun 2022

Publication date (Electronic): 21 March 2022

Volume: 6

Issue: 1

Electronic Location Identifier: e33286

Affiliations

[1 ] Division of Cardiology Department of Medicine University of Pittsburgh Pittsburgh, PA United States

[2 ] UPMC Heart and Vascular Institute Pittsburgh, PA United States

[3 ] Department of Internal Medicine UPMC Pittsburgh, PA United States

[4 ] Department of Medicine Massachusetts General Hospital Harvard Medical School Boston, MA United States

[5 ] UPMC Community Provider Services Pittsburgh, PA United States

[6 ] Innovative Homecare Solutions of UPMC Pittsburgh, PA United States

[7 ] Division of General Internal Medicine Department of Medicine University of Pittsburgh Pittsburgh, PA United States

Author notes

Corresponding Author: Amber E Johnson johnsonae2@ 123456upmc.edu

Author information

Amber E Johnson https://orcid.org/0000-0003-1252-0735

Shuvodra Routh https://orcid.org/0000-0003-3975-6115

Christy N Taylor https://orcid.org/0000-0002-3707-5562

Meagan Leopold https://orcid.org/0000-0001-8717-0536

Kathryn Beatty https://orcid.org/0000-0002-0846-1085

Dennis M McNamara https://orcid.org/0000-0003-3215-6504

Esa M Davis https://orcid.org/0000-0002-6658-1528

Article

Publisher ID: v6i1e33286

DOI: 10.2196/33286

PMC ID: 8981015

PubMed ID: 35311679

SO-VID: c46df7ad-d1b3-4beb-84be-2e35361cd498

Copyright © ©Amber E Johnson, Shuvodra Routh, Christy N Taylor, Meagan Leopold, Kathryn Beatty, Dennis M McNamara, Esa M Davis. Originally published in JMIR Cardio (https://cardio.jmir.org), 21.03.2022.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on https://cardio.jmir.org, as well as this copyright and license information must be included.

History

Date received : 1 September 2021

Date revision requested : 3 January 2022

Date revision received : 3 February 2022

Date accepted : 16 February 2022

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