Abstract 17502: Using Patient-Centered Outcomes Research Principles to Develop and Implement a Mobile Heart Failure Self-Care Program

Abstract

Introduction: Patients admitted with decompensated heart failure (HF) are at risk for hospital readmission and poor quality of life. Remote monitoring and mobile health (mHealth) technologies can help prevent hospitalization for community-dwelling patients. We aimed to develop a HF mHealth application to enhance self-care after HF hospitalization. Hypothesis: We hypothesized that 1) a mHealth platform could be designed to increase HF self-care after hospital discharge for a population at high risk for HF readmission and 2) our tool would be user friendly and feasibly deployed. Methods: Intervention development included input from the following stakeholders: patients, clinicians, information technology developers, patient education experts, and mHealth researchers. We recruited 32 inpatient adults with HF and randomized them 1:1 to the mHealth program plus usual HF care or usual care only. Patients discharged to a nursing home, with end-stage HF (e.g. awaiting transplant/ventricular assist device or on palliative inotropes), or without a smart phone were excluded. Feasibility was determined by ease of deployment, duration of participant recruitment, and participant attrition. We measured program usability by how often the application was opened and used by patients. Results: We developed an educational HF mHealth patient self-care tool consisting of daily videos and self-assessments. Of 202 patients screened: 13 were excluded due to discharge to nursing home; 28 were excluded for end-stage HF; 9 were excluded because they did not have a smart phone. We enrolled 32 patients, 14 of which were randomized to receive the program. Mean age was 60 years (range 22-85). There were 53% male and 81% White. Four of 14 (28.6%) did not fully complete the 90-day program. All survey respondents expressed satisfaction with the intervention. Conclusions: We conducted a pilot study of a HF self-care mHealth tool for adults at risk for HF readmission and have determined it to be both feasible and acceptable. Our intervention, although a research prototype, may serve as a novel approach to reduce hospital admission and improve patient ability to manage HF as an outpatient.