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Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring

BACKGROUND: Previous trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs. OBJECTIVES: The objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical m...

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Autores principales: Seto, Emily, Leonard, Kevin J, Cafazzo, Joseph A, Barnsley, Jan, Masino, Caterina, Ross, Heather J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Gunther Eysenbach 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374534/
https://www.ncbi.nlm.nih.gov/pubmed/22328237
http://dx.doi.org/10.2196/jmir.1912
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author Seto, Emily
Leonard, Kevin J
Cafazzo, Joseph A
Barnsley, Jan
Masino, Caterina
Ross, Heather J
author_facet Seto, Emily
Leonard, Kevin J
Cafazzo, Joseph A
Barnsley, Jan
Masino, Caterina
Ross, Heather J
author_sort Seto, Emily
collection PubMed
description BACKGROUND: Previous trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs. OBJECTIVES: The objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical management, and (2) to determine the features that enable successful heart failure telemonitoring. METHODS: Semi-structured interviews were conducted with 22 heart failure patients attending a heart function clinic who had used a mobile phone-based telemonitoring system for 6 months. The telemonitoring system required the patients to take daily weight and blood pressure readings, weekly single-lead ECGs, and to answer daily symptom questions on a mobile phone. Instructions were sent to the patient’s mobile phone based on their physiological values. Alerts were also sent to a cardiologist’s mobile phone, as required. All clinicians involved in the study were also interviewed post-trial (N = 5). The interviews were recorded, transcribed, and then analyzed using a conventional content analysis approach. RESULTS: The telemonitoring system improved patient self-care by instructing the patients in real-time how to appropriately modify their lifestyle behaviors. Patients felt more aware of their heart failure condition, less anxiety, and more empowered. Many were willing to partially fund the use of the system. The clinicians were able to manage their patients’ heart failure conditions more effectively, because they had physiological data reported to them frequently to help in their decision-making (eg, for medication titration) and were alerted at the earliest sign of decompensation. Essential characteristics of the telemonitoring system that contributed to improved heart failure management included immediate self-care and clinical feedback (ie, teachable moments), how the system was easy and quick to use, and how the patients and clinicians perceived tangible benefits from telemonitoring. Some clinical concerns included ongoing costs of the telemonitoring system and increased clinical workload. A few patients did not want to be watched long-term while some were concerned they might become dependent on the system. CONCLUSIONS: The success of a telemonitoring system is highly dependent on its features and design. The essential system characteristics identified in this study should be considered when developing telemonitoring solutions. KEY WORDS:
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spelling pubmed-33745342012-06-13 Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring Seto, Emily Leonard, Kevin J Cafazzo, Joseph A Barnsley, Jan Masino, Caterina Ross, Heather J J Med Internet Res Original Paper BACKGROUND: Previous trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs. OBJECTIVES: The objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical management, and (2) to determine the features that enable successful heart failure telemonitoring. METHODS: Semi-structured interviews were conducted with 22 heart failure patients attending a heart function clinic who had used a mobile phone-based telemonitoring system for 6 months. The telemonitoring system required the patients to take daily weight and blood pressure readings, weekly single-lead ECGs, and to answer daily symptom questions on a mobile phone. Instructions were sent to the patient’s mobile phone based on their physiological values. Alerts were also sent to a cardiologist’s mobile phone, as required. All clinicians involved in the study were also interviewed post-trial (N = 5). The interviews were recorded, transcribed, and then analyzed using a conventional content analysis approach. RESULTS: The telemonitoring system improved patient self-care by instructing the patients in real-time how to appropriately modify their lifestyle behaviors. Patients felt more aware of their heart failure condition, less anxiety, and more empowered. Many were willing to partially fund the use of the system. The clinicians were able to manage their patients’ heart failure conditions more effectively, because they had physiological data reported to them frequently to help in their decision-making (eg, for medication titration) and were alerted at the earliest sign of decompensation. Essential characteristics of the telemonitoring system that contributed to improved heart failure management included immediate self-care and clinical feedback (ie, teachable moments), how the system was easy and quick to use, and how the patients and clinicians perceived tangible benefits from telemonitoring. Some clinical concerns included ongoing costs of the telemonitoring system and increased clinical workload. A few patients did not want to be watched long-term while some were concerned they might become dependent on the system. CONCLUSIONS: The success of a telemonitoring system is highly dependent on its features and design. The essential system characteristics identified in this study should be considered when developing telemonitoring solutions. KEY WORDS: Gunther Eysenbach 2012-02-10 /pmc/articles/PMC3374534/ /pubmed/22328237 http://dx.doi.org/10.2196/jmir.1912 Text en ©Emily Seto, Kevin J Leonard, Joseph A Cafazzo, Jan Barnsley, Caterina Masino, Heather J Ross. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.02.2012. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Seto, Emily
Leonard, Kevin J
Cafazzo, Joseph A
Barnsley, Jan
Masino, Caterina
Ross, Heather J
Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title_full Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title_fullStr Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title_full_unstemmed Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title_short Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
title_sort perceptions and experiences of heart failure patients and clinicians on the use of mobile phone-based telemonitoring
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374534/
https://www.ncbi.nlm.nih.gov/pubmed/22328237
http://dx.doi.org/10.2196/jmir.1912
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