Abstract:Background: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) often coexist and share periods of symptom deterioration. Electronic health (eHealth) might play an important role in adherence to interventions for the self-management of COPD and CHF symptoms by facilitating and supporting home-based care. Methods: In this pilot study, an eHealth self-management intervention was developed based on paper versions of multi-morbid exacerbation action plans and evaluated in patients with bot… Show more
“…Most interventions were designed to address heart failure alone (9/13, 69%) [ 30 , 35 , 40 , 42 , 48 , 52 - 54 , 56 ]. Only 1 intervention was designed for people with both chronic obstructive pulmonary disease and heart failure [ 55 ]. In addition, 3 interventions were designed for people with at least one of multiple conditions; people with heart disease (including heart failure) who had received a mechanical circulatory support device [ 57 ]; people with coronary artery disease, hypertension, or heart failure [ 27 ]; and those with chronic obstructive pulmonary disease or heart failure with a history of hospitalization or who were undergoing major surgery (hip or knee replacement) [ 25 ].…”
Background
The management of heart failure is complex. Innovative solutions are required to support health care providers and people with heart failure with decision-making and self-care behaviors. In recent years, more sophisticated technologies have enabled new health care models, such as smart health ecosystems. Smart health ecosystems use data collection, intelligent data processing, and communication to support the diagnosis, management, and primary and secondary prevention of chronic conditions. Currently, there is little information on the characteristics of smart health ecosystems for people with heart failure.
Objective
We aimed to identify and describe the characteristics of smart health ecosystems that support heart failure self-care.
Methods
We conducted a scoping review using the Joanna Briggs Institute methodology. The MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on identifying articles describing smart health ecosystems that support heart failure self-care. A total of 2 reviewers screened the articles and extracted relevant data from the included full texts.
Results
After removing duplicates, 1543 articles were screened, and 34 articles representing 13 interventions were included in this review. To support self-care, the interventions used sensors and questionnaires to collect data and used tailoring methods to provide personalized support. The interventions used a total of 34 behavior change techniques, which were facilitated by a combination of 8 features for people with heart failure: automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a health care provider, and psychological support. Furthermore, features to support health care providers included data presentation, alarms, alerts, communication tools, remote care plan modification, and health record integration.
Conclusions
This scoping review identified that there are few reports of smart health ecosystems that support heart failure self-care, and those that have been reported do not provide comprehensive support across all domains of self-care. This review describes the technical and behavioral components of the identified interventions, providing information that can be used as a starting point for designing and testing future smart health ecosystems.
“…Most interventions were designed to address heart failure alone (9/13, 69%) [ 30 , 35 , 40 , 42 , 48 , 52 - 54 , 56 ]. Only 1 intervention was designed for people with both chronic obstructive pulmonary disease and heart failure [ 55 ]. In addition, 3 interventions were designed for people with at least one of multiple conditions; people with heart disease (including heart failure) who had received a mechanical circulatory support device [ 57 ]; people with coronary artery disease, hypertension, or heart failure [ 27 ]; and those with chronic obstructive pulmonary disease or heart failure with a history of hospitalization or who were undergoing major surgery (hip or knee replacement) [ 25 ].…”
Background
The management of heart failure is complex. Innovative solutions are required to support health care providers and people with heart failure with decision-making and self-care behaviors. In recent years, more sophisticated technologies have enabled new health care models, such as smart health ecosystems. Smart health ecosystems use data collection, intelligent data processing, and communication to support the diagnosis, management, and primary and secondary prevention of chronic conditions. Currently, there is little information on the characteristics of smart health ecosystems for people with heart failure.
Objective
We aimed to identify and describe the characteristics of smart health ecosystems that support heart failure self-care.
Methods
We conducted a scoping review using the Joanna Briggs Institute methodology. The MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on identifying articles describing smart health ecosystems that support heart failure self-care. A total of 2 reviewers screened the articles and extracted relevant data from the included full texts.
Results
After removing duplicates, 1543 articles were screened, and 34 articles representing 13 interventions were included in this review. To support self-care, the interventions used sensors and questionnaires to collect data and used tailoring methods to provide personalized support. The interventions used a total of 34 behavior change techniques, which were facilitated by a combination of 8 features for people with heart failure: automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a health care provider, and psychological support. Furthermore, features to support health care providers included data presentation, alarms, alerts, communication tools, remote care plan modification, and health record integration.
Conclusions
This scoping review identified that there are few reports of smart health ecosystems that support heart failure self-care, and those that have been reported do not provide comprehensive support across all domains of self-care. This review describes the technical and behavioral components of the identified interventions, providing information that can be used as a starting point for designing and testing future smart health ecosystems.
“…The digital inhalers are primarily designed to improve medication adherence for patients ( Mehta, Jan. 2021 )– ( “Amiko Respiro Inhaler Tracking System Cleared in Europe | Medgadget.” https://www.medgadget.com/, 2021 ). The product, ProAir® Digihaler® ( Figure7 A) from Teva, has secured FDA-approval as the first and only digital inhaler with a built-in sensor and mobile app ( Sloots et al, Jul. 2021 ).…”
Section: Advancements On Dpi Devicesmentioning
confidence: 99%
“… Fig. 7 Examples of digital inhalers wirelessly connecting to a mobile app: A) ProAir® Digihaler® ; B) The Respiro® system attached to an Ellipta DPI; C) Enerzair® Breezhaler® (Adapted from ( Sloots et al, Jul. 2021 , “Novartis receives EC approval for Enerzair® Breezhaler®, including the first digital companion (sensor and app) that can be prescribed alongside a treatment for uncontrolled asthma in the EU,” Novartis.…”
“…Third, previous research do not particularly focus on the effects of eHealth [ 24 ]. The eHealth self-management interventions have been gradually applied in patients with CHF failure, however, the findings are inconsistent [ 15 , 17 ]. Furthermore, little is known at this point about the effectiveness and the affecting factors of this approach.…”
Section: Introductionmentioning
confidence: 99%
“…It includes mobile health technologies or digital technologies for CHF self management (e.g., remote support, virtual reality, online education) [11,12]. eHealth is used to provide tailored information, reminder, decision support and adapt to patients' needs through information and communication technology, so as to conduct self-management more effectively [10,[13][14][15][16].…”
Purpose
The objective of this paper is to design a protocol for a systematic review and meta-analysis on the effectiveness of self-management interventions in patients with chronic heart failure.
Methods
The protocol is developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in PROSPERO (CRD42021246973). Base on the population, intervention, comparator, and outcome (PICO) framework, our research questions are: 1) What are the effects of eHealth self-management interventions on patients with chronic heart failure? 2) What factors of interventions might affect outcomes? The process includes: 1) search strategy and inclusion criteria; 2) data extraction; 3) risk of bias assessment and 4) data analysis. Searching process and data extraction will be guided by Cochrane Handbook for Systematic Reviews of Interventions. We will use Cochrane Risk of Bias tool to assess the risk of bias. The data analysis will be performed using Metafor package in R.
Conclusions
This systemic review will synthesize the current evidence and identify gaps. Findings in the meta-analysis will provide guidance for designing a more effective self-management intervention for patients with chronic heart failure in future.
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