Effectiveness of the European Society of Cardiology/Heart Failure Association website ‘heartfailurematters.org’ and an e-health adjusted care pathway in patients with stable heart failure: results of the ‘e-Vita HF’ randomized controlled trial
Wagenaar, Kim P.; Broekhuizen, Berna D.L.; Jaarsma, Tiny; Kok, Ilse; Mosterd, Arend; Willems, Frank F.; Linssen, Gerard C.M.; Agema, Willem R.P.; Anneveldt, Sander; Lucas, Carolien M.H.B.; Mannaerts, Herman F.J.; Wajon, Elly M.C.J.; Dickstein, Kenneth; Cramer, Maarten J.; Landman, Marcel A.J.; Hoes, Arno W.; Rutten, Frans H.
(2019) European Journal of Heart Failure, volume 21, issue 2, pp. 238 - 246
(Article)
Abstract
Background: Efficient incorporation of e-health in patients with heart failure (HF) may enhance health care efficiency and patient empowerment. We aimed to assess the effect on self-care of (i) the European Society of Cardiology/Heart Failure Association website ‘heartfailurematters.org’ on top of usual care, and (ii) an e-health adjusted care pathway
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leaving out ‘in person’ routine HF nurse consultations in stable HF patients. Methods and results: In a three-group parallel-randomized trial in stable HF patients from nine Dutch outpatient clinics, we compared two interventions (heartfailurematters.org website and an e-health adjusted care pathway) to usual care. The primary outcome was self-care measured with the European Heart Failure Self-care Behaviour Scale. Secondary outcomes were health status, mortality, and hospitalizations. In total, 450 patients were included. The mean age was 66.8 ± 11.0 years, 74.2% were male, and 78.8% classified themselves as New York Heart Association I or II at baseline. After 3 months of follow-up, the mean score on the self-care scale was significantly higher in the groups using the website and the adjusted care pathway compared to usual care (73.5 vs. 70.8, 95% confidence interval 0.6–6.2; and 78.2 vs. 70.8, 95% confidence interval 3.8– 9.4, respectively). The effect attenuated, until no differences after 1 year between the groups. Quality of life showed a similar pattern. Other secondary outcomes did not clearly differ between the groups. Conclusions: Both the heartfailurematters.org website and an e-health adjusted care pathway improved self-care in HF patients on the short term, but not on the long term. Continuous updating of e-health facilities could be helpful to sustain effects. Clinical Trial registration: ClinicalTrials.gov ID NCT01755988.
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Keywords: Heart failure, Hospitalization, Mortality, Self-care, Telemedicine, Follow-Up Studies, Social Media, Cardiology/methods, Europe, Humans, Male, Telemedicine/methods, Societies, Medical, Quality Improvement, Quality of Life, Female, Aged, Retrospective Studies, Heart Failure/therapy, Health Status, Delivery of Health Care/organization & administration, Cardiology and Cardiovascular Medicine, Journal Article, Research Support, Non-U.S. Gov't, Randomized Controlled Trial, Multicenter Study, Pragmatic Clinical Trial
ISSN: 1388-9842
Publisher: Oxford University Press
Note: © 2018 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
(Peer reviewed)