Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure

Chen, Chen; Li, Xiao; Sun, Lisha; Cao, Sha; Kang, Y. R.; Li, Hong; Liang, Yutong; You, Guiying; Zhang, Qing

doi:10.1002/ehf2.12380

Cited by 57 publications

(81 citation statements)

References 26 publications

(47 reference statements)

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“…Four studies were rated to have a low RoB [27,29,31,32]. Three out of the eight studies were rated to have a high RoB [26,28,33], and the other studies were rated to have an unclear RoB [30]. Random sequence generation was reported in five studies [27,29,[31][32][33].…”

Section: Study Quality Appraisalmentioning

confidence: 99%

“…Three out of the eight studies were rated to have a high RoB [26,28,33], and the other studies were rated to have an unclear RoB [30]. Random sequence generation was reported in five studies [27,29,[31][32][33]. However, three studies did not report how the allocation sequence was generated [27,29,33].…”

Section: Study Quality Appraisalmentioning

confidence: 99%

“…Random sequence generation was reported in five studies [27,29,[31][32][33]. However, three studies did not report how the allocation sequence was generated [27,29,33]. Blinding of participants and personnel was lacking in the majority of the studies [26][27][28]32,33].…”

Section: Study Quality Appraisalmentioning

confidence: 99%

“…However, three studies did not report how the allocation sequence was generated [27,29,33]. Blinding of participants and personnel was lacking in the majority of the studies [26][27][28]32,33]. However, the blinding of patients and healthcare personnel could have been especially difficult in mobile phone-based interventions.…”

Section: Study Quality Appraisalmentioning

confidence: 99%

“…As shown in Table 1, eight RCTs with a total of 2534 patients were included in this systematic review. Seven studies were conducted in the United States and Europe [26][27][28][29][30][31][32], as well as one in China [33]. Of the patients, 1331 were allocated to the intervention group and 1203 to the control group.…”

Section: Study Settings and Patient Characteristicsmentioning

confidence: 99%

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Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis

Son

Lee

2020

IJERPH

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Mobile phone-based interventions are increasingly used to prevent adverse health outcomes in heart failure patients. However, the effects of mobile phone-based interventions on the health outcomes of heart failure patients remain unclear. Our review aims to synthesize the randomized controlled trials (RCT) of mobile phone-based interventions for heart failure patients and identify the intervention features that are most effective. Electronic searches of RCTs published from January 2000 to July 2019 were conducted. Primary outcomes included all-cause mortality, readmission, emergency department visits, length of hospital stays, and quality of life. Secondary outcomes were self-care behaviors, including medication adherence and other clinical outcomes. A total of eight studies with varying methodological quality met the inclusion criteria and were analyzed. Voice call intervention was more frequently used compared with telemonitoring and short message services. Our meta-analysis showed that voice call interventions had significant effects on the length of hospital stays. However, no significant effects on all-cause mortality, readmission, emergency department visits, or quality of life were found. Compared to other mobile phone-based interventions, voice calls were more effective in reducing the length of hospital stay. Future studies are needed to identify which features of mobile phone-based intervention most effectively improve health outcomes.

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Section: Study Quality Appraisalmentioning

confidence: 99%

Section: Study Quality Appraisalmentioning

confidence: 99%

Section: Study Quality Appraisalmentioning

confidence: 99%

Section: Study Quality Appraisalmentioning

confidence: 99%

Section: Study Settings and Patient Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis

Son

Lee

2020

IJERPH

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Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission

Rohde,

Rover,

Hoffmann Filho

et al. 2024

JAMA Cardiol

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ImportanceReadmissions after an index heart failure (HF) hospitalization are a major contemporary health care problem.ObjectiveTo evaluate the feasibility and efficacy of an intensive telemonitoring strategy in the vulnerable period after an HF hospitalization.Design, Setting, and ParticipantsThis randomized clinical trial was conducted in 30 HF clinics in Brazil. Patients with left ventricular ejection fraction less than 40% and access to mobile phones were enrolled up to 30 days after an HF admission. Data were collected from July 2019 to July 2022.InterventionParticipants were randomly assigned to a telemonitoring strategy or standard care. The telemonitoring group received 4 daily short message service text messages to optimize self-care, active engagement, and early intervention. Red flags based on feedback messages triggered automatic diuretic adjustment and/or a telephone call from the health care team.Main Outcomes and MeasuresThe primary end point was change in N-terminal pro–brain natriuretic peptide (NT-proBNP) from baseline to 180 days. A hierarchical win-ratio analysis incorporating blindly adjudicated clinical events (cardiovascular deaths and HF hospitalization) and variation in NT-proBNP was also performed.ResultsOf 699 included patients, 460 (65.8%) were male, and the mean (SD) age was 61.2 (14.5) years. A total of 352 patients were randomly assigned to the telemonitoring strategy and 347 to standard care. Satisfaction with the telemonitoring strategy was excellent (net promoting score at 180 days, 78.5). HF self-care increased significantly in the telemonitoring group compared with the standard care group (score difference at 30 days, −2.21; 95% CI, −3.67 to −0.74; P = .001; score difference at 180 days, −2.08; 95% CI, −3.59 to −0.57; P = .004). Variation of NT-proBNP was similar in the telemonitoring group compared with the standard care group (telemonitoring: baseline, 2593 pg/mL; 95% CI, 2314-2923; 180 days, 1313 pg/mL; 95% CI, 1117-1543; standard care: baseline, 2396 pg/mL; 95% CI, 2122-2721; 180 days, 1319 pg/mL; 95% CI, 1114-1564; ratio of change, 0.92; 95% CI, 0.77-1.11; P = .39). Hierarchical analysis of the composite outcome demonstrated a similar number of wins in both groups (telemonitoring, 49 883 of 122 144 comparisons [40.8%]; standard care, 48 034 of 122 144 comparisons [39.3%]; win ratio, 1.04; 95% CI, 0.86-1.26).Conclusions and RelevanceAn intensive telemonitoring strategy applied in the vulnerable period after an HF admission was feasible, well-accepted, and increased scores of HF self-care but did not translate to reductions in NT-proBNP levels nor improvement in a composite hierarchical clinical outcome.Trial RegistrationClinicalTrials.gov Identifier: NCT04062461

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Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Tyler,

Hodkinson,

Planner

et al. 2023

JAMA Netw Open

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ImportanceDischarge from the hospital to the community has been associated with serious patient risks and excess service costs.ObjectiveTo evaluate the comparative effectiveness associated with transitional care interventions with different complexity levels at improving health care utilization and patient outcomes in the transition from the hospital to the community.Data SourcesCENTRAL, Embase, MEDLINE, and PsycINFO were searched from inception until August 2022.Study SelectionRandomized clinical trials evaluating transitional care interventions from hospitals to the community were identified.Data Extraction and SynthesisAt least 2 reviewers were involved in all data screening and extraction. Random-effects network meta-analyses and meta-regressions were applied. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.Main Outcomes and MeasuresThe primary outcomes were readmission at 30, 90, and 180 days after discharge. Secondary outcomes included emergency department visits, mortality, quality of life, patient satisfaction, medication adherence, length of stay, primary care and outpatient visits, and intervention uptake.ResultsOverall, 126 trials with 97 408 participants were included, 86 (68%) of which were of low risk of bias. Low-complexity interventions were associated with the most efficacy for reducing hospital readmissions at 30 days (odds ratio [OR], 0.78; 95% CI, 0.66 to 0.92) and 180 days (OR, 0.45; 95% CI, 0.30 to 0.66) and emergency department visits (OR, 0.68; 95% CI, 0.48 to 0.96). Medium-complexity interventions were associated with the most efficacy at reducing hospital readmissions at 90 days (OR, 0.64; 95% CI, 0.45 to 0.92), reducing adverse events (OR, 0.42; 95% CI, 0.24 to 0.75), and improving medication adherence (standardized mean difference [SMD], 0.49; 95% CI, 0.30 to 0.67) but were associated with less efficacy than low-complexity interventions for reducing readmissions at 30 and 180 days. High-complexity interventions were most effective for reducing length of hospital stay (SMD, −0.20; 95% CI, −0.38 to −0.03) and increasing patient satisfaction (SMD, 0.52; 95% CI, 0.22 to 0.82) but were least effective for reducing readmissions at all time periods. None of the interventions were associated with improved uptake, quality of life (general, mental, or physical), or primary care and outpatient visits.Conclusions and RelevanceThese findings suggest that low- and medium-complexity transitional care interventions were associated with reducing health care utilization for patients transitioning from hospitals to the community. Comprehensive and consistent outcome measures are needed to capture the patient benefits of transitional care interventions.

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Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure

Cited by 57 publications

References 26 publications

Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis

Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis

Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

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