Effects of multidisciplinary Internet-based program on management of heart failure

Abstract

Objectives:To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF).Methods:The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results:The treatment group had a high (85%) adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001), amount of exercise (p = 0.001), and quality of life (p = 0.001), and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001), blood pressure (systolic, p = 0.002; diastolic, p < 0.001), frequency of emergency room visit, and length of hospital stay (both p = 0.001).Conclusions:An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.

Patient focused Internet-based approaches to cardiovascular rehabilitation – a systematic review

“…The reasons for the satisfaction included perceived better health and support from healthcare providers. [20] All patients involved in this study felt they were more confident in dealing with their heart failure following the intervention.…”

“…[16] Other factors were that patients felt guilty when they had no exercise to input on a particular day and that the monitors were a nuisance and intrusive. [20] …”

Smart Home with Healthcare Technologies for Community-Dwelling Older Adults

“…The effectiveness of this system for their caregivers was measured (see the report later in this chapter). The University at Buffalo also conducted a pilot study for e-health for patients with heart failure (Tomita et al, 2009). In this project, patients used the Internet and daily recorded their vital signs and health behaviours on a website that were monitored by health professionals.…”

“…All of them increased their exercise duration by 38 minutes on average, and they lost weight of 2.9 pounds on average, decreased in caloric intake by 336 calories, and lowered systolic and diastolic blood pressure by 10 and 5 points, respectively. Similarly, Internet-based technology was used to promote self-management of patients with heart failure (Tomita et al, 2009). In this pilot study (N=40), all participants were 60 years of age or older.…”

“…Home-based technologies may be most effective, if they also promote healthy behaviour and lifestyles for continued community living. Focusing on the situation in the United States, this chapter includes: (1) a description of societal needs for the technology, (2) a summary of current SH status, (3) a review of older adults' perceptions of SH, healthcare technologies and their effectiveness, (4) caregivers' perspectives of the technology, and (5) defining the role of SH with health care technologies in the Model toward Optimal Management for Independent through Technological Adoption (Tomita et al, 2009). The model expands on behavioural medicine to promote healthy behaviours in community-dwelling older adults.…”