App Versus Logbook for Weight Monitoring and Help-Seeking Behavior in Heart Failure: A Single-Group Quasi-Experimental Study: A Single-Group Quasi-Experimental Study

BACKGROUND: Weight monitoring as part of heart failure (HF) self-care enables timely intervention to prevent hospitalizations. Apps with prompts may improve adherence to monitoring and earlier help-seeking behavior compared with paper logbooks. OBJECTIVE: This study aimed to evaluate the effectiveness of the Fluid Heart Tracker App compared with a paper logbook for weight monitoring in patients with HF, focusing on monitoring adherence, help-seeking behavior, and hospitalization. METHODS: A quasi-experimental, multicenter study was conducted in 2 consecutive 12-month phases, guided by the Situation-Specific Theory of HF Self-Care. A logbook was used initially (phase 1), followed by the Fluid Heart Tracker App (phase 2). Of 184 participants, 136 completed both phases. Analyses compared adherence, help-seeking behavior, and hospitalization outcomes between both phases. RESULTS: App adherence was higher (median: 346.5 days, interquartile range [IQR] = 299-360) than logbook use (median: 315 days, IQR = 36-365; P < .001). Help-seeking behavior increased from 43.4% in phase 1 to 73.5% in phase 2 ( P = .031), while the longest delay reduced from 14 to 2 days ( P < .001). Males were more likely to initiate app use ( P = .046); age was not a barrier ( P = .668). Hospitalization rates according to app use frequency did not differ ( P = .384). Declines were observed in the number of participants hospitalized ( P = .0066) and the number of episodes ( P = .0035). CONCLUSIONS: These results support integrating simple, alert-enabled apps such as the Fluid Heart Tracker into HF programs to strengthen self-care and reduce preventable admissions.