Habits Heart 应用程序在心力衰竭管理中用于患者参与：试点可行性随机试验。

Habits Heart App for Patient Engagement in Heart Failure Management: Pilot Feasibility Randomized Trial.

机构信息

Cardiology Division, Massachusetts General Hospital, Boston, MA, United States.

University of California, Irvine, School of Medicine, Irvine, CA, United States.

出版信息

JMIR Mhealth Uhealth. 2021 Jan 20;9(1):e19465. doi: 10.2196/19465.

DOI:10.2196/19465

PMID:33470941

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7857947/

Abstract

BACKGROUND

Due to the complexity and chronicity of heart failure, engaging yet simple patient self-management tools are needed.

OBJECTIVE

This study aimed to assess the feasibility and patient engagement with a smartphone app designed for heart failure.

METHODS

Patients with heart failure were randomized to intervention (smartphone with the Habits Heart App installed and Bluetooth-linked scale) or control (paper education material) groups. All intervention group patients were interviewed and monitored closely for app feasibility while receiving standard of care heart failure management by cardiologists. The Atlanta Heart Failure Knowledge Test, a quality of life survey (Kansas City Cardiomyopathy Questionnaire), and weight were assessed at baseline and final visits.

RESULTS

Patients (N=28 patients; intervention: n=15; control: n=13) with heart failure (with reduced ejection fraction: 15/28, 54%; male: 20/28, 71%, female: 8/28, 29%; median age 63 years) were enrolled, and 82% of patients (N=23; intervention: 12/15, 80%; control: 11/13, 85%) completed both baseline and final visits (median follow up 60 days). In the intervention group, 2 out of the 12 patients who completed the study did not use the app after study onboarding due to illnesses and hospitalizations. Of the remaining 10 patients who used the app, 5 patients logged ≥1 interaction with the app per day on average, and 2 patients logged an interaction with the app every other day on average. The intervention group averaged 403 screen views (per patient) in 56 distinct sessions, 5-minute session durations, and 22 weight entries per patient. There was a direct correlation between duration of app use and improvement in heart failure knowledge (Atlanta Heart Failure Knowledge Test score; ρ=0.59, P=.04) and quality of life (Kansas City Cardiomyopathy Questionnaire score; ρ=0.63, P=.03). The correlation between app use and weight change was ρ=-0.40 (P=.19). Only 1 out of 11 patients in the control group retained education material by the follow-up visit.

CONCLUSIONS

The Habits Heart App with a Bluetooth-linked scale is a feasible way to engage patients in heart failure management, and barriers to app engagement were identified. A larger multicenter study may be warranted to evaluate the effectiveness of the app.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03238729; http://clinicaltrials.gov/ct2/show/NCT03238729.

摘要

背景

由于心力衰竭的复杂性和慢性特征，需要使用简单易用的患者自我管理工具。

目的

本研究旨在评估一款专为心力衰竭设计的智能手机应用的可行性和患者参与度。

方法

心力衰竭患者被随机分为干预组（安装了 Habits Heart App 的智能手机和蓝牙链接秤）和对照组（纸质教育材料）。所有干预组患者在接受心脏病专家标准心力衰竭管理的同时，接受有关应用程序可行性的访谈和密切监测。在基线和最终就诊时，评估亚特兰大心力衰竭知识测试、生活质量调查（堪萨斯城心肌病问卷）和体重。

结果

共纳入 28 名心力衰竭患者（射血分数降低：15/28，54%；男性：20/28，71%，女性：8/28，29%；中位年龄 63 岁），82%的患者（N=23；干预组：12/15，80%；对照组：11/13，85%）完成了基线和最终就诊（中位随访 60 天）。在干预组中，有 2 名完成研究的 12 名患者因疾病和住院而在研究入组后不再使用该应用程序。在其余 10 名使用该应用程序的患者中，有 5 名患者平均每天至少与该应用程序交互 1 次，有 2 名患者平均每两天与该应用程序交互 1 次。干预组患者平均每人有 56 次不同的会话，每次会话持续 5 分钟，每人记录 22 次体重，共记录了 403 次屏幕视图（每位患者）。应用程序使用时间的长短与心力衰竭知识（亚特兰大心力衰竭知识测试评分；ρ=0.59，P=.04）和生活质量（堪萨斯城心肌病问卷评分；ρ=0.63，P=.03）的改善呈直接正相关。应用程序使用时间与体重变化的相关性为 ρ=-0.40（P=.19）。对照组中只有 11 名患者中的 1 名在随访时保留了教育材料。