Assessment of Heart Failure Patients' Interest in Mobile Health Apps for Self-Care: Survey Study.

BackgroundHeart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders.ObjectiveThe objective of this study was to ascertain heart failure patients' interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app.MethodsIn the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board-approved questionnaires. The survey measured patients' interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients' health-related quality of life through patient-reported outcomes.ResultsParticipants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (P<.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (P<.05).ConclusionsThe majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology

Would You Prescribe Mobile Health Apps for Heart Failure Self-care? An Integrated Review of Commercially Available Mobile Technology for Heart Failure Patients

Treatment of chronic diseases, such as heart failure, requires complex protocols based on early diagnosis; self-monitoring of symptoms, vital signs and physical activity; regular medication intake; and education of patients and caregivers about relevant aspects of the disease. Smartphones and mobile health applications could be very helpful in improving the efficacy of such protocols, but several barriers make it difficult to fully exploit their technological potential and produce clear clinical evidence of their effectiveness. App suppliers do not help users distinguish between useless/dangerous apps and valid solutions. The latter are few and often characterised by rapid obsolescence, lack of interactivity and lack of authoritative information. Systematic reviews can help physicians and researchers find and assess the 'best candidate solutions' in a repeatable manner and pave the way for well-grounded and fruitful discussion on their clinical effectiveness. To this purpose, the authors assess 10 apps for heart failure self-care using the Intercontinental Marketing Statistics score and other criteria, discuss the clinical effectiveness of existing solutions and identify barriers to their use in practice and drivers for change

A Review of Current Heart Failure Apps

Background: Heart disease is the second leading cause of death in Canada, with tremendous economic impacts on the healthcare system. Currently, there are several smartphone based heart failure (HF) apps available for patients. These apps provide information to patients regarding HF, and how to monitor and manage their condition. This review describes the current literature on HF apps, and describes the features offered by these apps. Methods and Results: Peer-reviewed literature was searched and revealed only a limited number of studies (8) related to HF apps, including HeartMapp, SUPPORT-HF and CardioManager.  A Google-based grey literature search was conducted, and Google Play and the Apple Store were also searched to identify additional HF-related apps. These searches revealed several other HF-related apps (total 11), the features of which are described in the current review. Conclusion: This review will help healthcare providers select apps for themselves and recommend HF apps to their patients that provide the most suitable disease and management information and monitoring capability. The insight will also help software developers design apps in the future that will provide better support to patients with HF and help the healthcare providers monitor their condition better

Identifying Medication Management Smartphone App Features Suitable for Young Adults With Developmental Disabilities: Delphi Consensus Study

Background: Smartphone apps can be a tool to facilitate independent medication management among persons with developmental disabilities. At present, multiple medication management apps exist in the market, but only 1 has been specifically designed for persons with developmental disabilities. Before initiating further app development targeting this population, input from stakeholders including persons with developmental disabilities, caregivers, and professionals regarding the most preferred features should be obtained. Objective: The aim of this study was to identify medication management app features that are suitable to promote independence in the medication management process by young adults with developmental disabilities using a Delphi consensus method. Methods: A compilation of medication management app features was performed by searching the iTunes App Store, United States, in February 2016, using the following terms: adherence, medication, medication management, medication list, and medication reminder. After identifying features within the retrieved apps, a final list of 42 features grouped into 4 modules (medication list, medication reminder, medication administration record, and additional features) was included in a questionnaire for expert consensus rating. A total of 52 experts in developmental disabilities, including persons with developmental disabilities, caregivers, and professionals, were invited to participate in a 3-round Delphi technique. The purpose was to obtain consensus on features that are preferred and suitable to promote independence in the medication management process among persons with developmental disabilities. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively. Results: A total of 75 responses were received over the 3 Delphi rounds—30 in the first round, 24 in the second round, and 21 in the third round. At the end of the third round, cumulative consensus was achieved for 60% (12/20) items in the medication list module, 100% (3/3) in the medication reminder module, 67% (2/3) in the medication administration record module, and 63% (10/16) in the additional features module. In addition to the medication list, medication reminder, and medication administration record features, experts selected the following top 3 most important additional features: automatic refills through pharmacies; ability to share medication information from the app with providers; and ability to share medication information from the app with family, friends, and caregivers. The top 3 least important features included a link to an official drug information source, privacy settings and password protection, and prescription refill reminders. Conclusions: Although several mobile apps for medication management exist, few are specifically designed to support persons with developmental disabilities in the complex medication management process. Of the 42 different features assessed, 64% (27/42) achieved consensus for inclusion in a future medication management app. This study provides information on the features of a medication management app that are most important to persons with developmental disabilities, caregivers, and professionals

Evaluation of a mobile application for heart failure telemonitoring

Q2Adequate adherence to treatment is indispensable in preventing adverse consequences in heart failure patients. Such adherence can be managed through heart failure clinics and various methods of follow-up. In recent years, the use of telemonitoring has shown promising benefits in supporting clinicians' follow-up, as well as contributing to patients' self-care. This article presents the development and evaluation of a telemonitoring application for heart failure, through a Web-based interface for clinicians and a mobile application for patients. The application was evaluated through a 6-month pilot observational descriptive study in 20 outpatients with reduced ejection fraction and two nurses, in the context of a heart failure clinic. A technological acceptance questionnaire was applied to all patients and nurses at the end of the study period. In use, the application generated 64 real-time alerts for early decision-making to prevent complications, and 91% of patients did not present hospital readmissions. Such results, along with high user acceptance, show potential utility of the application as an effective complementary strategy for follow-up of patients with heart failure.Revista Internacional - Indexad

Does Use of a Mobile App and Telephone Support Promote Improved Self-Care of Heart Failure?

Background Heart failure is a complex disease and a growing global epidemic. Symptoms and multiple comorbidities contribute to the overwhelming burden of heart failure, and support people make an important contribution to self-care. Effective self-care maintenance behaviors along with confidence and support can help people living with heart failure to effectively self-manage the disease. Purpose This project aimed to determine if use of a mobile app with telephone support calls was an effective intervention to promote improved self-care of heart failure and caregiver contribution to self-care of heart failure compared to the standard of care where the intervention was not used. Methods This project used a quantitative quasi-experimental pretest-posttest design with a non-equivalent control group. Participants included people with heart failure and support people. The pretest and posttest were conducted to measure the effectiveness of a 90-day intervention compared to the standard of care. The evidence-based 90-day intervention, used a mobile app to track daily weight and heart failure symptoms with structured telephone support calls, aimed to improve self-care of and caregiver contribution to self-care of heart failure. This project was guided by the situation-specific theory of heart failure self-care. Results Thirty-five people completed the 90-day project period. While the small sample size and non-normally distributed variables likely contributed to a lack of significant results comparing the intervention to the standard of care, results within groups were interesting. Control group participants (n = 17) made no significant improvements from pretest to posttest in self-care maintenance, management, or confidence. However, intervention group participants (n = 18) made significant improvements from pretest to posttest in self-care management, t(10) = -2.031, p = 0.035, and confidence, t(17) = -3.766, p = 0.001. Examining the level of use of the app in intervention group households, participants in low-level use households (n = 10) made significant improvement from pretest to posttest in self-care confidence, z = -2.214, p = 0.018, while participants in high-level use households (n = 8) made significant improvements from pretest to posttest in self-care management, z = -1.826, p = 0.034, and confidence, z = -2.214, p = 0.014. Conclusions The intervention resulted in significantly improved self-care management and confidence for intervention group participants and improvement above adequate (70%) in self-care maintenance, management, and confidence for high-level users of the app. The results of this project validated the theory and the literature on evidence-based interventions to promote heart failure self-care. This intervention could be applied in practice as part of an individualized care plan to promote self-care of heart failure and caregiver contribution to self-care of heart failure

Building Bridges for “Palliative Care-in-Place”: Development of a mHealth Intervention for Informal Home Care

Funding: The study has received funding under the project Help2Care-PAL: Support the caregiver in palliative care, funded by Fundação “LaCaixa”. This work is also funded by national funds through FCT—Fundação para a Ciência e a Tecnologia, IP (UIDB/05704/2020 and UIDP/05704/2020) and under the Scientific Employment Stimulus—Institutional Call—[CEECINST/00051/2018].In Palliative Care (PC), family and close people are an essential part of provision of care. They assume highly complex tasks for which they are not prepared, with considerable physical, psychological, social and economic impact. Informal Caregivers (ICs) often falter in the final stage of life and develop distress, enhancing emotional burden and complicated grief. The lack of available and accessible in-person counselling resources is often reported by ICs. Online resources can promote early access to help and support for patient-IC dyads in palliative care. The primary aim of this research is to co-design, develop and test the feasibility of the Help2Care-PAL mHealth app that addresses the needs of ICs of palliative patients cared for at home. This Digital Health Intervention (DHI) in palliative care will be used for education, symptom management, communication and decision-making, to enhance Quality of Life (QoL) of patients and ICs, fostering anticipatory grief and the reach and efficiency of services.info:eu-repo/semantics/publishedVersio

Engagement with consumer smartwatches for tracking symptoms of individuals living with multiple long-term conditions (multimorbidity)::A longitudinal observational study

INTRODUCTION: People living with multiple long-term conditions (multimorbidity) (MLTC-M) experience an accumulating combination of different symptoms. It has been suggested that these symptoms can be tracked longitudinally using consumer technology, such as smartphones and wearable devices. AIM: The aim of this study was to investigate longitudinal user engagement with a smartwatch application, collecting survey questions and active tasks over 90 days, in people living with MLTC-M. METHODS: ‘Watch Your Steps’ was a prospective observational study, administering multiple questions and active tasks over 90 days. Adults with more than one clinician-diagnosed long-term conditions were loaned Fossil® Sport smartwatches, pre-loaded with the study app. Around 20 questions were prompted per day. Daily completion rates were calculated to describe engagement patterns over time, and to explore how these varied by patient characteristics and question type. RESULTS: Fifty three people with MLTC-M took part in the study. Around half were male ( = 26; 49%) and the majority had a white ethnic background (n = 45; 85%). About a third of participants engaged with the smartwatch app nearly every day. The overall completion rate of symptom questions was 45% inter-quartile range (IQR 23–67%) across all study participants. Older patients and those with greater MLTC-M were more engaged, although engagement was not significantly different between genders. CONCLUSION: It was feasible for people living with MLTC-M to report multiple symptoms per day over 3 months. User engagement appeared as good as other mobile health studies that recruited people with single health conditions, despite the higher daily data entry burden