Adherence to self-care in patients with heart failure in the HeartCycle study
Authors Stut W, Deighan C, Cleland J, Jaarsma T
Received 13 May 2015
Accepted for publication 17 July 2015
Published 19 August 2015 Volume 2015:9 Pages 1195—1206
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Qian Ding
Peer reviewer comments 3
Editor who approved publication: Dr Johnny Chen
Wim Stut,1 Carolyn Deighan,2 John G Cleland,3 Tiny Jaarsma4
1Philips Research Europe, Eindhoven, the Netherlands; 2The Heart Manual Department, NHS Lothian, Edinburgh, UK; 3National Heart and Lung Institute, Royal Brompton and Harefield Hospitals Imperial College, London, UK; 4Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
Purpose: The purpose of this study was to evaluate a novel online education and coaching program to promote self-care among patients with heart failure. In this program, education and coaching content is automatically tailored to the knowledge and behavior of the patient.
Patients and methods: The evaluation of the program took place within the scope of the HeartCycle study. This multi-center, observational study examined the ability of a third generation telehealth system to enhance the management of patients recently (<60 days) admitted to the hospital for worsening heart failure or outpatients with persistent New York Heart Association (NYHA) Functional Classification III/IV symptoms. Self-reported self-care behavior was assessed at baseline and study-end by means of the 9-item European Heart Failure Self-care Behavior scale. Adherence to daily weighing, blood pressure monitoring, and reporting of symptoms was determined by analyzing the system’s database.
Results: Of 123 patients enrolled, the mean age was 66±12 years, 66% were in NYHA III and 79% were men. Self-reported self-care behavior scores (n=101) improved during the study for daily weighing, low-salt diet, physical activity (P<0.001), and fluid restriction (P<0.05). Average adherence (n=120) to measuring weight was 90%±16%, to measuring blood pressure was 89%±17% and to symptom reporting was 66%±32%.
Conclusion: Self-reported self-care behavior scores improved significantly during the period of observation, and the objective evidence of adherence to daily weight and blood pressure measurements was high and remained stable over time. However, adherence to daily reporting of symptoms was lower and declined in the long-term.
Keywords: lifestyle, patient adherence, telehealth, e-coaching
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