A Randomized Trial of Mobile Health Support for Heart Failure Patients and Their Informal Caregivers

Impacts on Caregiver-reported Outcomes

Bibliographic Data

ID9102810
AuthorsJohn D Piette (0000-0002-7241-2798, Michigan Department of Health and Human Services, corresponding author), Dana Striplin (0000-0003-0149-8528, Michigan Department of Health and Human Services, corresponding author), Nicolle Marinec (0000-0003-3085-6419, Michigan Department of Health and Human Services, corresponding author), Jenny Chen (0000-0002-2992-4771), Jenny Chen‐Charles (0000-0002-5040-0905, Michigan Department of Health and Human Services, corresponding author), James E Aikens (0000-0002-3795-9018, University of Michigan)
Year2015
Volume53
Issue8
Pages692-699
Publication date2015-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000378
PMID26125415
PMCIDPMC4503477
OpenAlexW2399279637
LanguageEN
Citations received5
References cited29

BACKGROUND: Mobile health services may improve chronic illness care, but interventions rarely support informal caregivers' efforts. OBJECTIVES: To determine whether automated feedback to caregivers of chronic heart failure patients impacts caregiving burden and assistance with self-management. RESEARCH DESIGN: Randomized comparative effectiveness trial. SUBJECTS: A total of 369 heart failure patients were recruited from a Veterans Health Administration health care system. All patients participated with a "CarePartner" or informal caregiver outside their household. INTERVENTION: Patients randomized to "standard mHealth" received weekly automated self-care support calls for 12 months with notifications about problems sent to clinicians. "mobile health+CarePartner" (mHealth+CP) patients received identical services, plus email summaries and suggestions for self-care assistance automatically sent to their CarePartners. MEASURES: At baseline, 6, and 12 months, CarePartners completed assessments of caregiving strain, depressive symptoms, and participation in self-care support. RESULTS: mHealth+CP CarePartners reported less caregiving strain than controls at both 6 and 12 months (both P≤0.03). That effect as well as improvements in depressive symptoms were seen primarily among CarePartners reporting greater burden at baseline (P≤0.03 for interactions between arm and baseline strain/depression at both endpoints). Although most mHealth+CP CarePartners increased the amount of time spent in self-care support, those with the highest time commitment at baseline reported decreases at both follow-ups (all P<0.05). mHealth+CP CarePartners reported more frequently attending patients' medical visits at 6 months (P=0.049) and greater involvement in medication adherence at both endpoints (both P≤0.032). CONCLUSIONS: When CarePartners experienced significant caregiving strain and depression, systematic feedback about their patient-partner decreased those symptoms. Feedback also increased most CarePartners' engagement in self-care

Anxiety · Clinical trial · Depression (economics) · Depressive symptoms · Health care · Heart failure · mHealth · Physical therapy · Psychiatry · Psychological intervention · Randomized controlled trial · Chronic Disease Management Strategies · Heart Failure Treatment and Management · Internal Medicine · Medicine · Mobile Health and mHealth Applications · Gerontology

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