Abstract
Objective: Evaluate feasibility of using a visualized symptom monitoring tool for patients with heart failure (HF) in a large academic medical center using mixed methods. Introduction: Patients with HF are frequently hospitalized with symptoms such as shortness of breath, fatigue, and swelling, and commonly report persistent symptoms one week after discharge. Many of these hospitalizations are preventable, emphasizing the need for improved methods for symptom monitoring and management. Methods: Quantitative summaries of ten symptoms were measured with the Patient-Reported Outcomes Measurement Information System-29 among patients with HF at baseline, 2, 4, 6, and 8 weeks with automated email follow-up. Symptom summary reports with visualizations previously developed using user-centered design were displayed at each time point to and showed changes in symptoms over time. Qualitative exit interviews were conducted with patients and healthcare professionals and were coded using directed content analysis. Results: 65 participants completed all baseline surveys, and over half (n = 35, 54%) completed at least one follow-up survey (recruitment and follow-up ongoing). Based on mean PROMIS T-scores with a population mean of 50.0, participants reported highest symptom burden for: physical function (36.9 ± 9.0), fatigue (56.9 ± 12.0), and anxiety (55.4 ± 10.0). Interviews with patients (n = 18) and healthcare professionals (n = 5) highlighted that the tool was helpful for understanding health status and prompting communication, which might depend on patient agency. Suggestions for improvement included offering paper copies of symptom reports and follow-up phone calls (Table). Conclusions: Participants found the tool useful for understanding symptoms and prompting communication with the healthcare team. Future work should consider providing actionable symptom summaries to support patient agency and providing multiple options for format and follow-up.
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