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The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies
BACKGROUND: Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015755/ https://www.ncbi.nlm.nih.gov/pubmed/35357311 http://dx.doi.org/10.2196/33839 |
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author | Bezerra Giordan, Leticia Tong, Huong Ly Atherton, John J Ronto, Rimante Chau, Josephine Kaye, David Shaw, Tim Chow, Clara Laranjo, Liliana |
author_facet | Bezerra Giordan, Leticia Tong, Huong Ly Atherton, John J Ronto, Rimante Chau, Josephine Kaye, David Shaw, Tim Chow, Clara Laranjo, Liliana |
author_sort | Bezerra Giordan, Leticia |
collection | PubMed |
description | BACKGROUND: Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote monitoring interventions using nonapp types of mobile technologies to transmit data to health care providers, rarely focusing on supporting patient self-management of heart failure. OBJECTIVE: This study aims to systematically review the evidence on the effect of heart failure self-management apps on health outcomes, patient-reported outcomes, and patient experience. METHODS: Four databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for studies examining interventions that comprised a mobile app targeting heart failure self-management and reported any health-related outcomes or patient-reported outcomes or perspectives published from 2008 to December 2021. The studies were independently screened. The risk of bias was appraised using Cochrane tools. We performed a narrative synthesis of the results. The protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42020158041). RESULTS: A total of 28 articles (randomized controlled trials [RCTs]: n=10, 36%), assessing 23 apps, and a total of 1397 participants were included. The most common app features were weight monitoring (19/23, 83%), symptom monitoring (18/23, 78%), and vital sign monitoring (15/23, 65%). Only 26% (6/23) of the apps provided all guideline-defined core components of heart failure self-management programs: education, symptom monitoring, medication support, and physical activity support. RCTs were small, involving altogether 717 participants, had ≤6 months of follow-up, and outcomes were predominantly self-reported. Approximately 20% (2/10) of RCTs reported a significant improvement in their primary outcomes: heart failure knowledge (P=.002) and self-care (P=.004). One of the RCTs found a significant reduction in readmissions (P=.02), and 20% (2/10) of RCTs reported higher unplanned clinic visits. Other experimental studies also found significant improvements in knowledge, self-care, and readmissions, among others. Less than half of the studies involved patients and clinicians in the design of apps. Engagement with the intervention was poorly reported, with only 11% (3/28) of studies quantifying app engagement metrics such as frequency of use over the study duration. The most desirable app features were automated self-monitoring and feedback, personalization, communication with clinicians, and data sharing and integration. CONCLUSIONS: Mobile apps may improve heart failure self-management; however, more robust evaluation studies are needed to analyze key end points for heart failure. On the basis of the results of this review, we provide a road map for future studies in this area. |
format | Online Article Text |
id | pubmed-9015755 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-90157552022-04-19 The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies Bezerra Giordan, Leticia Tong, Huong Ly Atherton, John J Ronto, Rimante Chau, Josephine Kaye, David Shaw, Tim Chow, Clara Laranjo, Liliana JMIR Cardio Review BACKGROUND: Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote monitoring interventions using nonapp types of mobile technologies to transmit data to health care providers, rarely focusing on supporting patient self-management of heart failure. OBJECTIVE: This study aims to systematically review the evidence on the effect of heart failure self-management apps on health outcomes, patient-reported outcomes, and patient experience. METHODS: Four databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for studies examining interventions that comprised a mobile app targeting heart failure self-management and reported any health-related outcomes or patient-reported outcomes or perspectives published from 2008 to December 2021. The studies were independently screened. The risk of bias was appraised using Cochrane tools. We performed a narrative synthesis of the results. The protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42020158041). RESULTS: A total of 28 articles (randomized controlled trials [RCTs]: n=10, 36%), assessing 23 apps, and a total of 1397 participants were included. The most common app features were weight monitoring (19/23, 83%), symptom monitoring (18/23, 78%), and vital sign monitoring (15/23, 65%). Only 26% (6/23) of the apps provided all guideline-defined core components of heart failure self-management programs: education, symptom monitoring, medication support, and physical activity support. RCTs were small, involving altogether 717 participants, had ≤6 months of follow-up, and outcomes were predominantly self-reported. Approximately 20% (2/10) of RCTs reported a significant improvement in their primary outcomes: heart failure knowledge (P=.002) and self-care (P=.004). One of the RCTs found a significant reduction in readmissions (P=.02), and 20% (2/10) of RCTs reported higher unplanned clinic visits. Other experimental studies also found significant improvements in knowledge, self-care, and readmissions, among others. Less than half of the studies involved patients and clinicians in the design of apps. Engagement with the intervention was poorly reported, with only 11% (3/28) of studies quantifying app engagement metrics such as frequency of use over the study duration. The most desirable app features were automated self-monitoring and feedback, personalization, communication with clinicians, and data sharing and integration. CONCLUSIONS: Mobile apps may improve heart failure self-management; however, more robust evaluation studies are needed to analyze key end points for heart failure. On the basis of the results of this review, we provide a road map for future studies in this area. JMIR Publications 2022-03-31 /pmc/articles/PMC9015755/ /pubmed/35357311 http://dx.doi.org/10.2196/33839 Text en ©Leticia Bezerra Giordan, Huong Ly Tong, John J Atherton, Rimante Ronto, Josephine Chau, David Kaye, Tim Shaw, Clara Chow, Liliana Laranjo. Originally published in JMIR Cardio (https://cardio.jmir.org), 31.03.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on https://cardio.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Review Bezerra Giordan, Leticia Tong, Huong Ly Atherton, John J Ronto, Rimante Chau, Josephine Kaye, David Shaw, Tim Chow, Clara Laranjo, Liliana The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title | The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title_full | The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title_fullStr | The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title_full_unstemmed | The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title_short | The Use of Mobile Apps for Heart Failure Self-management: Systematic Review of Experimental and Qualitative Studies |
title_sort | use of mobile apps for heart failure self-management: systematic review of experimental and qualitative studies |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015755/ https://www.ncbi.nlm.nih.gov/pubmed/35357311 http://dx.doi.org/10.2196/33839 |
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