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Randomized Controlled Trial
. 2024 Jul 1;13(3):e002753.
doi: 10.1136/bmjoq-2024-002753.

Randomised pilot study comparing a coach to SMARTPhone reminders to aid the management of heart failure (HF) patients: humans or machines

Affiliations
Randomized Controlled Trial

Randomised pilot study comparing a coach to SMARTPhone reminders to aid the management of heart failure (HF) patients: humans or machines

Rahel Eynan et al. BMJ Open Qual. .

Abstract

Ambulatory management of congestive heart failure (HF) continues to be a challenging clinical problem. Recent studies have focused on the role of HF clinics, nurse practitioners and disease management programmes to reduce HF readmissions. This pilot study is a pragmatic factorial study comparing a coach intervention, a SMARTPHONE REMINDER system intervention and BOTH interventions combined to Treatment as USUAL (TAU). We determined that both modalities were acceptable to patients prior to randomisation. Fifty-four patients were randomised to the four groups. The COACH group had no readmissions for HF 6 months after enrolment compared with 18% for the SMARTPHONE REMINDER Group, 8% for the BOTH intervention group and 13% for TAU. Medium-to-high medication adherence was maintained in all four groups although sodium consumption was lower at 3 months for the COACH and combined (BOTH) groups. This pilot study suggests a beneficial effect on rehospitalisation with the use of support measures including coaches and telephone reminders that needs confirmation in a larger trial.

Keywords: Checklists; Chronic disease management; Healthcare quality improvement; Mobile Applications; Outpatients.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Morisky medication adherence score at baseline and 3 months. Height of bars indicates the accumulative per cent of three levels of adherence for each group at both time periods. By 3 months, fewer patients had low scores. TAU, treatment as usual care.

References

    1. Feltner C, Jones CD, Cené CW, et al. . Transitional care interventions to prevent readmissions for people with heart failure. Comparative effectiveness review No.133. (Prepared by the Research Triangle Institute–University of North Carolina Evidencebased Practice Center under Contract No.290-2012- 00008-I). AHRQ Publication No.14-EHC021-EF. Rockville, MD: Agency for Healthcare Research and Quality, 2014. Available: www.effectivehealthcare.ahrq.gov - PubMed
    1. Abouezzeddine OF, Redfield MM. Who has advanced heart failure?: definition and epidemiology. Congest Heart Fail 2011;17:160–8. 10.1111/j.1751-7133.2011.00246.x - DOI - PMC - PubMed
    1. Powell LH, Calvin JE, Richardson D, et al. . Self-management counseling in patients with heart failure: the heart failure adherence and retention randomized behavioral trial. JAMA 2010;304:1331–8. 10.1001/jama.2010.1362 - DOI - PMC - PubMed
    1. Mangla A, Doukky R, Richardson D, et al. . Design of a bilevel clinical trial targeting adherence in heart failure patients and their providers: the congestive heart failure adherence redesign trial (CHART). Am Heart J 2018;195:139–50. 10.1016/j.ahj.2017.09.016 - DOI - PMC - PubMed
    1. van Walraven C, Dhalla IA, Bell C, et al. . Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. CMAJ 2010;182:551–7. 10.1503/cmaj.091117 - DOI - PMC - PubMed

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