A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure

以患者为中心的移动干预，以促进自我管理并改善慢性心力衰竭患者的治疗结果

基本信息

批准号：
9334682
负责人：
Michael Dorsch
金额：
$ 19.38万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2019-04-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): In the United States, heart failure (HF) is the most common hospital discharge diagnosis among older adults. About 40 percent of patients are readmitted within 1-year following their first admission for HF and hospitalization accounts for approximately 70 percent of the costs of HF management. Previous research shows that case management and telephonic support are effective in reducing HF hospitalizations, but these strategies are costly. As a result, the management of HF patients is evolving from the traditional model of face-to-face follow-up visits toward a proactive real-time technological model of assisting patients with monitoring and self- management while in the community. While several HF studies have implemented technologically-driven disease management programs, results have been mixed. These systems are effective for delivering the monitoring data and alerts to healthcare providers, but they have not been tested for their effectiveness in delivering and modifying patient behavior. This represents a significant gap in knowledge that unless filled will stifle the advancement of self-management science. Therefore, there is a critical need for the development of technologies that effortlessly increase self-monitoring performed by the patient (active monitoring) and monitoring done by external devices (passive monitoring), identify pre-clinical and clinical measurements of worsening HF, and deliver behavioral interventions that promote self-management with an overall goal of reducing HF hospitalizations. The proposed project will determine the impact of a self-monitoring mobile application on self-management, quality of life and hospital admission in ambulatory HF patients, determine the extent to which passive pre- clinical measurements predict symptoms of clinical worsening in HF and develop a notification message system for the mobile application to improve self-management of HF via patient participant feedback. These data will be crucial in further refining our intervention (the mobile application) and serve as the basis for future research that will test the mobile applicatio with a robust push notification system against the usual care in a larger randomized clinical trial This technological approach has positive implications in improving self-management and reducing disease morbidity. It will also foster the introduction of a novel tool and technology tha has the potential to bring about a new paradigm for self-management of common and debilitating chronic health conditions.

描述（由适用提供）：在美国，心力衰竭（HF）是老年人中最常见的医院出院诊断。在HF首次入院后，约有40％的患者在1年内阅读，住院治疗约为HF管理成本的70％。先前的研究表明，案例管理和电话支持可有效减少HF住院治疗，但这些策略成本高昂。结果，HF患者的管理正在从传统的面对面随访访问模型发展为一种积极主动的实时技术模型，该模型在社区中协助患者进行监测和自我管理。尽管几项HF研究已经实施了技术驱动的疾病管理计划，但结果却混合在一起。这些系统可有效地传递监视数据并向医疗保健提供者提供警报，但尚未对其在交付和修改患者行为方面的有效性进行测试。这意味着知识的一个很大的差距，除非填充将坚持自我管理科学的发展。因此，迫切需要开发技术，这些技术毫不费力地增加了患者（主动监测）和外部设备（被动监控）进行的监测，确定令人担忧的HF的临床前和临床测量，并提供行为干预措施，并提供自我管理，从而促进自我管理，从而降低HF住院的整体目标。拟议的项目将确定自我监控的移动应用对卧床HF患者的自我管理，生活质量和住院入院的影响，确定被动预临床测量的程度可以预测HF中临床担忧的症状，并开发通知消息系统，以通过患者参与反馈来改善HF的移动应用程序以改善HF的自我管理。这些数据对于进一步完善我们的干预措施（移动应用）至关重要，并作为未来研究的基础，该研究将在更大的随机临床试验中使用强大的推动通知系统来测试移动应用程序，这种技术方法对改善自我管理和降低疾病的发病率具有积极意义。它还将促进引入一种新颖的工具，而技术则有可能为自我管理共同和使人衰弱的慢性健康状况带来新的范式。