Abstract 13020: A Pilot Randomized Controlled Trial on a Technology-Based Family-Centered Empowerment Transitional Program Among Heart Failure Patients

Abstract

Introduction: Heart failure is the most common cause of hospital readmission. While the increased acceptance of mobile health, a novel virtual platform, titled Technology-based Family-centered Empowerment (T-FAME) Program was developed to enhance post-discharge outcomes of HF patients. Hypothesis: The T-FAME was more effective than usual care to enhance self-care, perceived control, HRQoL, and family function of post-discharge HF patients . Methods: From Aug2021 to Jan2022, a pilot RCT randomized 60 post-discharge HF patients (mean age=66.4, SD=2.1; NYHA Grade II/III: 70/30%) to T-FAME or usual care. The 12-week nurse-delivered T-FAME comprises an interactive mobile Apps, which allows i) daily self symptom and clinical monitoring with tailored autonomous nurses' feedback , ii) family-centered goal-setting and attainment plan on self-care , iii) personalized drug education, iv) real-time live chat with nurse, v) video-based HF compass for information navigation. The nurse visited the family for three times and conducted the Calgary family assessment and counseling. Outcome evaluation was done by Self-care Heart Failure Index, Self-care Self-efficacy Scale, Control Attitude Scale, Family Functioning Device, and Minnesota Living with Heart Failure Questionnaire at baseline and post-test. The patients and primary caregivers were interviewed for engagement experience in T-FAME. Results: Two-way analysis of covariance showed significant greater improvement of T-FAME group on self-care maintenance (F=4.762,p=0.033, ƞp2=0.08), management (F=18.223,p<0.001,ƞp2=0.249) and symptom perception (F=9.33,p=0.003, ƞp2=0.145). They reported non-significant greater improvement in self-care self-efficacy, perceived control and HRQL with ƞp2=0.048-0.05, indicating almost medium effect in pilot trial. More families receiving T-FAME reported non-problematic family function (50%) than the control group (16.7%) (p=0.013). The qualitative findings indicated T-FAME is highly acceptable to enable proactive person-centered disease monitoring and management. Conclusions: The preliminary health benefits of T-FAME supports its stringent cost-benefit evaluation in full-scale RCT.