Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial

Yanicelli, Lucía María; Goy, C. B.; González, Viviana Del C; Palacios, Gerardo N; Martínez, Ernesto; Herrera, M. C.

doi:10.1177/1357633x19899261

Cited by 29 publications

(48 citation statements)

References 29 publications

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“…Across the 23 apps, the app was provided via a smartphone in 17 (74%) [ 38 - 54 , 57 , 59 , 63 , 64 ] and via a tablet in 6 (26%) interventions [ 42 , 55 , 58 , 60 - 62 ]. In addition to the app, 35% (8/23) of interventions included telemonitoring (ie, remote monitoring), with transfer of data to health care providers [ 41 , 42 , 46 , 47 , 49 - 51 , 54 ], and 65% (15/23) were solely focused on self-management support [ 38 - 40 , 43 - 45 , 48 , 52 , 53 , 55 , 57 , 58 , 60 - 62 ]. Approximately 9% (2/23) of apps provided patient access to electronic medical records [ 42 , 49 ], and 22% (5/23) of apps allowed direct clinician communication [ 39 , 40 , 42 , 49 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most frequent app features were weight monitoring (19/23, 83%), [ 38 - 42 , 44 , 46 , 47 , 49 - 54 , 57 - 60 , 62 - 64 ], symptom monitoring (18/23, 78%) [ 40 - 42 , 44 , 46 - 55 , 57 - 60 , 62 - 64 ], and vital signs monitoring (blood pressure and heart rate: 15/23, 65%; Figure 2 ; Multimedia Appendix 7 [ 38 - 55 , 57 - 65 ]) [ 38 , 41 , 42 , 44 , 46 , 47 , 49 - 54 , 57 - 60 , 63 , 64 ]. Automated monitoring through external wireless devices (eg, weight scale, blood pressure, and heart rate monitor) was present in 43% (10/23) of apps [ 38 - 40 , 42 , 44 , 47 , 49 - 51 , 54 , 59 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most apps recommended daily monitoring of symptoms and vital signs, and reminders for monitoring were mentioned in 52% (12/23) of interventions [ 38 - 42 , 44 , 47 , 51 , 53 - 55 , 57 ]. Few studies detailed the format or specifics of symptom monitoring except for 22% (5/23) of interventions [ 41 , 46 , 54 , 55 , 62 ], which allowed for the recording of the presence or absence of specific symptoms, with 20% (1/5) of them based on a validated questionnaire [ 54 ] and 60% (3/5) of them also providing symptom severity scales [ 41 , 54 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

“…The 10 included RCTs were small, often underpowered, with main outcomes self-reported, and the results were inconsistent. Approximately 20% (2/10) of RCTs found significant improvements in their primary outcomes: heart failure knowledge [ 43 ] and self-care [ 41 ]. One of the RCTs [ 47 ] reported several primary outcomes, showing improvements in self-care and quality of life.…”

Section: Resultsmentioning

confidence: 99%

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The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies

Bezerra¹,

Tong²,

Atherton³

et al. 2022

JMIR Cardio

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Background Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote monitoring interventions using nonapp types of mobile technologies to transmit data to health care providers, rarely focusing on supporting patient self-management of heart failure. Objective This study aims to systematically review the evidence on the effect of heart failure self-management apps on health outcomes, patient-reported outcomes, and patient experience. Methods Four databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for studies examining interventions that comprised a mobile app targeting heart failure self-management and reported any health-related outcomes or patient-reported outcomes or perspectives published from 2008 to December 2021. The studies were independently screened. The risk of bias was appraised using Cochrane tools. We performed a narrative synthesis of the results. The protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42020158041). Results A total of 28 articles (randomized controlled trials [RCTs]: n=10, 36%), assessing 23 apps, and a total of 1397 participants were included. The most common app features were weight monitoring (19/23, 83%), symptom monitoring (18/23, 78%), and vital sign monitoring (15/23, 65%). Only 26% (6/23) of the apps provided all guideline-defined core components of heart failure self-management programs: education, symptom monitoring, medication support, and physical activity support. RCTs were small, involving altogether 717 participants, had ≤6 months of follow-up, and outcomes were predominantly self-reported. Approximately 20% (2/10) of RCTs reported a significant improvement in their primary outcomes: heart failure knowledge (P=.002) and self-care (P=.004). One of the RCTs found a significant reduction in readmissions (P=.02), and 20% (2/10) of RCTs reported higher unplanned clinic visits. Other experimental studies also found significant improvements in knowledge, self-care, and readmissions, among others. Less than half of the studies involved patients and clinicians in the design of apps. Engagement with the intervention was poorly reported, with only 11% (3/28) of studies quantifying app engagement metrics such as frequency of use over the study duration. The most desirable app features were automated self-monitoring and feedback, personalization, communication with clinicians, and data sharing and integration. Conclusions Mobile apps may improve heart failure self-management; however, more robust evaluation studies are needed to analyze key end points for heart failure. On the basis of the results of this review, we provide a road map for future studies in this area.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies

Bezerra¹,

Tong²,

Atherton³

et al. 2022

JMIR Cardio

View full text Add to dashboard Cite

show abstract

“…There are data to suggest that these programs are successful in managing HF patients. 42 Integrated HF teams can adapt existing telemedicine infrastructure as part of their program or develop new telemedicine programs with the support of their institution.…”

Section: Telemedicinementioning

confidence: 99%