Enhanced Self Care with Mobile Technology to Reduce Readmission in Congestive Heart Failure: A Pilot Study

Abstract

Introduction: While people with congestive heart failure (CHF) are living longer, they often have limited ability to engage in treatment plans and self-management at home, thus resulting in increased hospitalizations. The use of novel digital technologies for improving self-management has been recommended for reducing CHF related hospitalizations. Objective: This pilot study compared a patient-centered enhanced self-care (ESC) intervention using a mobile system called “HeartMapp (HM)” (ESC HM) with an active wait listed control (WLC) group who received CHF education in reducing hospitalization rate and improving CHF outcomes. A total of 18 participants who met the inclusion criteria were block randomized to ESC HM (n=9) and active WLC group (n=9), both using similar mobile platform. Participants were followed for 30-days to examine the number of hospitalization and secondary outcomes including self-care, quality of life, and CHF knowledge. Results: Results showed that none of the participants randomized to ESC HM (n=9) were hospitalized during the study period of 30-days compared to two participants, both men (11%) in the WLC group. Additionally, clinically meaningful improvement in self-care management (t=3.38; p=0.006) and self-care confidence (6.7 vs 1.8; t=2.53; p=0.028) were observed in ESC HM group. Knowledge significantly improved in the ESC HM group while declined in the WLC group (t=2.37; p=0.037). Quality of life score declined by 2 points in the ESC HM group, while the WLC group score declined by 8 points (p=.08). Conclusion: Preliminary results of the pilot study demonstrated feasibility and potential efficacy of reducing hospitalization and improving CHF self-care; thus, warranting further evaluation in a well-designed large clinical trial.