Despite major scientific advances, heart
failure continues to be a common and costly condition, and each year more than
1 million people are admitted to an inpatient setting for acute heart failure.
There is an urgent need for low-cost solutions to reduce morbidity in heart
failure.
Several studies have shown that
self-monitoring can improve quality of life in heart failure patients.
Self-monitoring includes daily tracking of symptoms, weight, and exercise. Accurate
self-monitoring, feedback and self-efficacy (an individual’s belief in their
ability to perform a specific behavior) are essential components of the
self-regulation cycle and are critical for managing heart failure.
ManageHF4Life is
a mobile application designed to promote self-monitoring and self-management of
heart failure. Behavior change interventions that focus on self-regulation are
particularly well suited for automation. The use of technology can decrease the
burden of self-monitoring and enhance self-regulatory efforts. Cyclical
processes of goal setting, behavior change, and goal assessment can be easily
tracked, charted, reviewed and automated.
Aim 1:
Determine the impact of a self-monitoring mobile heart failure application on
(1) self-management, (2) quality of life, and (3) hospital admission in
ambulatory heart failure patients.
Aim 2: Determine
the extent to which passive pre-clinical measurements predict symptoms of
clinical worsening of heart failure.
Aim 3: Develop a notification message system for the mobile
application to improve self-management of heart failure via patient participant
feedback.
All patients
enrolled in the 2 phases of research will be greater than 45 years old and have
a left ventricular ejection fraction <40%. Patients will be excluded for any
of the following: unstable coronary syndromes within the 8 weeks of enrollment,
primary valvular heart disease, primary myocardial disease, pericardial
disease, uncorrected thyroid disease, advanced renal disease (dialysis or
creatinine >4.0 mg/dL), end-stage heart failure (hospice candidate), active
cancer, pulmonary fibrosis, discharge to a setting other than home, or
requirement for chronic inotropic therapy.