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Appl Clin Inform 2024; 15(04): 709-716
DOI: 10.1055/a-2273-5278
Research Article

Patients with Heart Failure: Internet Use and Mobile Health Perceptions

Albert Sohn
1   Department of Medical Education and Clinical Sciences, Washington State University, Spokane, Washington, United States
2   Department of Health Systems and Population Health, University of Washington, Seattle, Washington, United States
3   Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
,
Anne M. Turner
2   Department of Health Systems and Population Health, University of Washington, Seattle, Washington, United States
4   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
,
William Speier
3   Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
,
Gregg C. Fonarow
5   Division of Cardiology, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
,
Michael K. Ong
6   Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
7   Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California, United States
8   VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
,
Corey W. Arnold
3   Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
9   Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, United States
10   Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, United States
11   Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, United States
› Institutsangaben Funding This study was supported by the National Heart, Lung, and Blood Institute under grants R56HL135425 and R01HL141773.
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Abstract

Background Heart failure is a complex clinical syndrome noted on approximately one in eight death certificates in the United States. Vital to reducing complications of heart failure and preventing hospital readmissions is adherence to heart failure self-care routines. Mobile health offers promising opportunities for enhancing self-care behaviors by facilitating tracking and timely reminders.

Objectives We sought to investigate three characteristics of heart failure patients with respect to their heart failure self-care behaviors: (1) internet use to search for heart failure information; (2) familiarity with mobile health apps and devices; and (3) perceptions of using activity trackers or smartwatches to aid in their heart failure self-care.

Methods Forty-nine heart failure patients were asked about their internet and mobile health usage. The structured interview included questions adapted from the Health Information National Trends Survey.

Results Over 50% of the patients had utilized the internet to search for heart failure information in the past 12 months, experience using health-related apps, and thoughts that an activity tracker or smartwatch could help them manage heart failure. Qualitative analysis of the interviews revealed six themes: trust in their physicians, alternatives to mobile health apps, lack of need for mobile health devices, financial barriers to activity tracker and smartwatch ownership, benefits of tracking and reminders, and uncertainty of their potential due to lack of knowledge.

Conclusion Trust in their physicians was a major factor for heart failure patients who reported not searching for health information on the internet. While those who used mobile health technologies found them useful, patients who did not use them were generally unaware of or unknowledgeable about them. Considering patients' preferences for recommendations from their physicians and tendency to search for heart failure information including treatment and management options, patient–provider discussions about mobile health may improve patient knowledge and impact their usage.

Keywords

heart failure - mHealth - internet - patient–provider communication - self-care

Protection of Human and Animal Subjects

Data collection and analysis presented in this work were carried out under research protocol #17-001312 approved by the University of California, Los Angeles, Institutional Review Board. We obtained signed informed consent from all participants in the study.


Supplementary Material



Publikationsverlauf

Eingereicht: 01. November 2023

Angenommen: 20. Februar 2024

Accepted Manuscript online:
21. Februar 2024

Artikel online veröffentlicht:
28. August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Coronel R, de Groot JR, van Lieshout JJ. Defining heart failure. Cardiovasc Res 2001; 50 (03) 419-422
    CrossrefPubMedGoogle Scholar
  • 2 Jessup M, Abraham WT, Casey DE. et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009; 119 (14) 1977-2016
    CrossrefPubMedGoogle Scholar
  • 3 Tsao CW, Aday AW, Almarzooq ZI. et al. Heart disease and stroke statistics-2022 update: a report from the American Heart Association. Circulation 2022; 145 (08) e153-e639 [published correction appears in Circulation 2022;146(10):e141]
    CrossrefPubMedGoogle Scholar
  • 4 Urbich M, Globe G, Pantiri K. et al. A systematic review of medical costs associated with heart failure in the USA (2014-2020). PharmacoEconomics 2020; 38 (11) 1219-1236
    CrossrefPubMedGoogle Scholar
  • 5 Osenenko KM, Kuti E, Deighton AM, Pimple P, Szabo SM. Burden of hospitalization for heart failure in the United States: a systematic literature review. J Manag Care Spec Pharm 2022; 28 (02) 157-167
    PubMedGoogle Scholar
  • 6 Dunlay SM, Shah ND, Shi Q. et al. Lifetime costs of medical care after heart failure diagnosis. Circ Cardiovasc Qual Outcomes 2011; 4 (01) 68-75
    CrossrefPubMedGoogle Scholar
  • 7 Liang L, Moore B, Soni A. National inpatient hospital costs: the most expensive conditions by payer, 2017. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD):: Agency for Healthcare Research and Quality (US);; July 14, 2020
    Google Scholar
  • 8 Del Gobbo LC, Kalantarian S, Imamura F. et al. Contribution of major lifestyle risk factors for incident heart failure in older adults: the cardiovascular health study. JACC Heart Fail 2015; 3 (07) 520-528
    CrossrefPubMedGoogle Scholar
  • 9 Heidenreich PA, Bozkurt B, Aguilar D. et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice guidelines. Circulation 2022; 145 (18) e895-e1032 [published correction appears in Circulation 2022;145(18):e1033] [published correction appears in Circulation 2022;146(13):e185] [published correction appears in Circulation 2023;147(14):e674]
    CrossrefPubMedGoogle Scholar
  • 10 Dunlay SM, Redfield MM, Weston SA. et al. Hospitalizations after heart failure diagnosis a community perspective. J Am Coll Cardiol 2009; 54 (18) 1695-1702
    CrossrefPubMedGoogle Scholar
  • 11 Keenan PS, Normand SL, Lin Z. et al. An administrative claims measure suitable for profiling hospital performance on the basis of 30-day all-cause readmission rates among patients with heart failure. Circ Cardiovasc Qual Outcomes 2008; 1 (01) 29-37
    CrossrefPubMedGoogle Scholar
  • 12 Krumholz HM, Merrill AR, Schone EM. et al. Patterns of hospital performance in acute myocardial infarction and heart failure 30-day mortality and readmission. Circ Cardiovasc Qual Outcomes 2009; 2 (05) 407-413
    CrossrefPubMedGoogle Scholar
  • 13 Krumholz HM, Parent EM, Tu N. et al. Readmission after hospitalization for congestive heart failure among Medicare beneficiaries. Arch Intern Med 1997; 157 (01) 99-104
    CrossrefPubMedGoogle Scholar
  • 14 Mesbahi H, Kermansaravi F, Kiyani F. The effect of teach-back training on self-care and readmission of patients with heart failure. Med Surg Nurs J. 2020; 9 (03) e111465
    CrossrefPubMedGoogle Scholar
  • 15 Rizzuto N, Charles G, Knobf MT. Decreasing 30-day readmission rates in patients with heart failure. Crit Care Nurse 2022; 42 (04) 13-19 [published correction appears in Crit Care Nurse 2022;42(5):7]
    CrossrefPubMedGoogle Scholar
  • 16 Finney Rutten LJ, Blake KD, Greenberg-Worisek AJ, Allen SV, Moser RP, Hesse BW. Online health information seeking among US adults: measuring progress toward a healthy people 2020 objective. Public Health Rep 2019; 134 (06) 617-625
    CrossrefPubMedGoogle Scholar
  • 17 Flynn KE, Smith MA, Freese J. When do older adults turn to the internet for health information? Findings from the Wisconsin Longitudinal Study. J Gen Intern Med 2006; 21 (12) 1295-1301
    CrossrefPubMedGoogle Scholar
  • 18 Suenaga H, Vicente MR. Online and offline health information seeking and the demand for physician services. Eur J Health Econ 2022; 23 (03) 337-356
    CrossrefPubMedGoogle Scholar
  • 19 Wong C, Harrison C, Britt H, Henderson J. Patient use of the internet for health information. Aust Fam Physician 2014; 43 (12) 875-877
    PubMedGoogle Scholar
  • 20 Chu JT, Wang MP, Shen C, Viswanath K, Lam TH, Chan SSC. How, when and why people seek health information online: qualitative study in Hong Kong. Interact J Med Res 2017; 6 (02) e24
    CrossrefPubMedGoogle Scholar
  • 21 Bujnowska-Fedak MM, Węgierek P. The impact of online health information on patient health behaviours and making decisions concerning health. Int J Environ Res Public Health 2020; 17 (03) 880
    CrossrefPubMedGoogle Scholar
  • 22 Swire-Thompson B, Lazer D. Public health and online misinformation: challenges and recommendations. Annu Rev Public Health 2020; 41: 433-451
    CrossrefPubMedGoogle Scholar
  • 23 Wang Y, McKee M, Torbica A, Stuckler D. Systematic literature review on the spread of health-related misinformation on social media. Soc Sci Med 2019; 240: 112552
    CrossrefPubMedGoogle Scholar
  • 24 Zan S, Agboola S, Moore SA, Parks KA, Kvedar JC, Jethwani K. Patient engagement with a mobile web-based telemonitoring system for heart failure self-management: a pilot study. JMIR Mhealth Uhealth 2015; 3 (02) e33
    CrossrefPubMedGoogle Scholar
  • 25 Negarandeh R, Zolfaghari M, Bashi N, Kiarsi M. Evaluating the effect of monitoring through telephone (tele-monitoring) on self-care behaviors and readmission of patients with heart failure after discharge. Appl Clin Inform 2019; 10 (02) 261-268
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 26 Reamer C, Chi WN, Gordon R. et al. Continuous remote patient monitoring in patients with heart failure (cascade study): protocol for a mixed methods feasibility study. JMIR Res Protoc 2022; 11 (08) e36741
    CrossrefPubMedGoogle Scholar
  • 27 Lefler LL, Rhoads SJ, Harris M. et al. Evaluating the use of mobile health technology in older adults with heart failure: mixed-methods study. JMIR Aging 2018; 1 (02) e12178
    CrossrefPubMedGoogle Scholar
  • 28 Schmaderer M, Miller JN, Mollard E. Experiences of using a self-management mobile app among individuals with heart failure: qualitative study. JMIR Nurs 2021; 4 (03) e28139
    CrossrefPubMedGoogle Scholar
  • 29 Foster M, Xiong W, Quintiliani L, Hartmann CW, Gaehde S. Preferences of older adult veterans with heart failure for engaging with mobile health technology to support self-care: qualitative interview study among patients with heart failure and content analysis. JMIR Form Res 2022; 6 (12) e41317
    CrossrefPubMedGoogle Scholar
  • 30 Sohn A, Speier W, Lan E. et al. Assessment of heart failure patients' interest in mobile health apps for self-care: survey study. JMIR Cardio 2019; 3 (02) e14332
    CrossrefPubMedGoogle Scholar
  • 31 Sohn A, Speier W, Lan E. et al. Integrating remote monitoring into heart failure patients' care regimen: a pilot study. PLoS One 2020; 15 (11) e0242210
    CrossrefPubMedGoogle Scholar
  • 32 Criteria Committee of New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Blood Vessels. 9th ed. Dolgin M, ed. Boston: Little, Brown & Co; 1994
    Google Scholar
  • 33 Nelson DE, Kreps GL, Hesse BW. et al. The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun 2004; 9 (05) 443-460 , discussion 81–84
    CrossrefPubMedGoogle Scholar
  • 34 Dervin B. An overview of sense-making research: concepts, methods and results to date. Paper presented at the Annual Meeting of the International Communication Association,. Dallas, TX, May 1983
    PubMedGoogle Scholar
  • 35 Bates MJ. The design of browsing and berrypicking techniques for the online search interface. Online Review. 1989; 13 (05) 407-424
    CrossrefPubMedGoogle Scholar
  • 36 Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. Manage Inf Syst Q 1989; 13: 319-340
    CrossrefPubMedGoogle Scholar
  • 37 Chaudhuri S, Le T, White C, Thompson H, Demiris G. Examining health information-seeking behaviors of older adults. Comput Inform Nurs 2013; 31 (11) 547-553
    CrossrefPubMedGoogle Scholar
  • 38 Hall AK, Bernhardt JM, Dodd V. Older adults' use of online and offline sources of health information and constructs of reliance and self-efficacy for medical decision making. J Health Commun 2015; 20 (07) 751-758
    CrossrefPubMedGoogle Scholar
  • 39 Ivynian SE, Newton PJ, DiGiacomo M. Patient preferences for heart failure education and perceptions of patient-provider communication. Scand J Caring Sci 2020; 34 (04) 1094-1101
    CrossrefPubMedGoogle Scholar
  • 40 LaValley SA, Kiviniemi MT, Gage-Bouchard EA. Where people look for online health information. Health Info Libr J 2017; 34 (02) 146-155
    CrossrefPubMedGoogle Scholar
  • 41 Cajita MI, Hodgson NA, Lam KW, Yoo S, Han HR. Facilitators of and barriers to mHealth adoption in older adults with heart failure. Comput Inform Nurs 2018; 36 (08) 376-382
    PubMedGoogle Scholar
  • 42 Gordon NP, Crouch E. Digital information technology use and patient preferences for internet-based health education modalities: cross-sectional survey study of middle-aged and older adults with chronic health conditions. JMIR Aging 2019; 2 (01) e12243
    CrossrefPubMedGoogle Scholar
  • 43 Yao R, Zhang W, Evans R, Cao G, Rui T, Shen L. Inequities in health care services caused by the adoption of digital health technologies: scoping review. J Med Internet Res 2022; 24 (03) e34144
    CrossrefPubMedGoogle Scholar
  • 44 Allida S, Du H, Xu X. et al. mHealth education interventions in heart failure. Cochrane Database Syst Rev 2020; 7 (07) CD011845
    PubMedGoogle Scholar
  • 45 Andersen TO, Langstrup H, Lomborg S. Experiences with wearable activity data during self-care by chronic heart patients: qualitative study. J Med Internet Res 2020; 22 (07) e15873
    CrossrefPubMedGoogle Scholar
  • 46 Mercer K, Giangregorio L, Schneider E, Chilana P, Li M, Grindrod K. Acceptance of commercially available wearable activity trackers among adults aged over 50 and with chronic illness: a mixed-methods evaluation. JMIR Mhealth Uhealth 2016; 4 (01) e7
    CrossrefPubMedGoogle Scholar
  • 47 Alharbi M, Straiton N, Gallagher R. Harnessing the potential of wearable activity trackers for heart failure self-care. Curr Heart Fail Rep 2017; 14 (01) 23-29
    CrossrefPubMedGoogle Scholar
  • 48 Gregory ME, Cao W, Rahurkar S. et al. Exploring the incorporation of a novel cardiotoxicity mobile health app into care of patients with cancer: qualitative study of patient and provider perspectives. JMIR Cancer 2023; 9: e46481
    CrossrefPubMedGoogle Scholar