Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND More than 37 million people throughout the world are diagnosed with heart failure that is a growing burden on the health sector. Cardiac rehabilitation aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. However, cardiac rehabilitation programs have poor compliance and adherence. Telerehabilitation may be a solution to overcome some of these challenges to cardiac rehabilitation and making it more individualized. As part of the Future Patient Telerehabilitation program, a digital toolbox with the aim of enabling HF patients to monitor and evaluate their own current status has been developed and tested via data from a questionnaire (patient reported outcomes) that the patient has answered every other week (patient -reported outcomes) for one year. OBJECTIVE The aim of this sub-study is to evaluate the changes in quality of life and well-being for heart failure patients participating in the FPT Program over the course of one year. METHODS In total, 140 patients were enrolled in the Future Patient Telerehabilitation program and randomized into either the telerehabilitation group (n=70) or the control group (n=70). The patients in the telerehabilitation group answered patient reported outcomes that consisted of three components: Questions regarding the patients’ sleep patterns using the Spiegel Sleep Questionnaire. Measurements of physical limitations, symptoms, self-efficacy, social interaction and quality of life were assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ). In addition, five additional questions regarding psychological well-being were developed by the research group. Of the 70 patients in the TR group, 56 answered the PRO questionnaire and completed the program, and it is these 56 patients who constitute the population for this study. RESULTS The changes in scores during one year of the study were examined using one-sample Wilcoxon signed-rank tests with a hypothesized median being 0. There were statistically significant differences in the scores in most of the slopes and intersections of the scores from the dimensions from the KCCQ and in the slopes of the patients’ overall well-being (p < 0.05). Only one dimension, the symptom stability, showed a decrease in scores over a one-year period. CONCLUSIONS The overall well-being of heart failure patients increased during one year of participating in a telerehabilitation program. There was a statistically significant increase in clinical and social well-being and quality of life during the one-year intervention period. The increase in the scores over time may indicate that the patients became more aware of their own symptoms and became better equipped to cope with disease in their everyday lives. These results suggest that patient-reported-outcome questionnaires may be used as a tool for patients in a telerehabilitation program that can both monitor and guide the patients in mastering their own symptoms CLINICALTRIAL ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918