Key result
A multidisciplinary Internet-based self-management program significantly improved quality of life, heart failure symptoms, and knowledge, while reducing emergency room visits and hospital stays compared to usual care.
Why the study?
Does a multidisciplinary Internet-based self-management program improve outcomes and reduce healthcare utilization in patients with heart failure?
RCT (n=40)
Open-label
Randomized
Yes
Does a multidisciplinary Internet-based self-management program improve outcomes and reduce healthcare utilization in patients with heart failure?
Absolute Event Rate: 14.2% vs 6.8%
p-value: p=0.001
A multidisciplinary Internet-based self-management program significantly improves quality of life, symptoms, and healthcare utilization in patients with heart failure.
Supports integration of internet-based multidisciplinary programs into heart failure care; extends RCT evidence for digital self-management reducing utilization.
OBJECTIVES: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF). METHODS: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant's record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics. RESULTS: The treatment group had a high (85%) adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001), amount of exercise (p = 0.001), and quality of life (p = 0.001), and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001), blood pressure (systolic, p = 0.002; diastolic, p < 0.001), frequency of emergency room visit, and length of hospital stay (both p = 0.001). CONCLUSIONS: An effective program to change one's behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient's daily record, which can be accomplished through Internet use.
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Machiko Tomita (2008) conducted an RCT in Heart failure (n=40). Multidisciplinary Internet-based self-management program vs. Usual care was evaluated on Change in Quality of Life (QOL) score at 12 months (p=0.001). A multidisciplinary Internet-based self-management program significantly improved quality of life, heart failure symptoms, and knowledge, while reducing emergency room visits and hospital stays compared to usual care.
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