Heart failure patients' perceptions and use of technology to manage disease symptoms.

BACKGROUND Technology use for symptom management is beneficial for both patients and physicians. Widespread acceptance of technology use in healthcare fuels continued development of technology with ever-increasing sophistication. Although acceptance of technology use in healthcare by medical professionals is evident, less is known about the perceptions, preferences, and use of technology by heart failure (HF) patients. This study explores patients' perceptions and current use of technology for managing HF symptoms (MHFS). MATERIALS AND METHODS A qualitative analysis of in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Fifteen participants (mean age, 64.43 years) with HF were recruited from hospitals, cardiology clinics, and community groups. RESULTS All study participants reported use of a home monitoring device, such as an ambulatory blood pressure device or bathroom scale. The majority of participants reported not accessing online resources for additional MHFS information. However, several participants stated their belief that technology would be useful for MHFS. Participants reported increased access to care, earlier indication of a worsening condition, increased knowledge, and greater convenience as potential benefits of technology use while managing HF symptoms. For most participants financial cost, access issues, satisfaction with current self-care routine, mistrust of technology, and reliance on routine management by their current healthcare provider precluded their use of technology for MHFS. CONCLUSIONS Knowledge about HF patients' perceptions of technology use for self-care and better understanding of issues associated with technology access can aid in the development of effective health behavior interventions for individuals who are MHFS and may result in increased compliance, better outcomes, and lower healthcare costs.

[1]  D. Mozaffarian,et al.  Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[2]  O. Dalgard,et al.  The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study , 2012, BMC Geriatrics.

[3]  Hege Andreassen,et al.  eHealth Trends across Europe 2005-2007 , 2007 .

[4]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[5]  Patricia C Clark,et al.  Family Influences on Heart Failure Self-care and Outcomes , 2008, The Journal of cardiovascular nursing.

[6]  Vimla L. Patel,et al.  Usability in the real world: assessing medical information technologies in patients' homes , 2003, J. Biomed. Informatics.

[7]  J. Cleland,et al.  Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis , 2007, BMJ : British Medical Journal.

[8]  L. A. Bonet,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2010, European journal of heart failure.

[9]  Simon Stewart,et al.  Structured telephone support or telemonitoring programmes for patients with chronic heart failure , 2010, The Cochrane database of systematic reviews.

[10]  Meika Loe,et al.  A sociological approach to ageing, technology and health. , 2010, Sociology of health & illness.

[11]  A. Strömberg,et al.  Development and testing of the European Heart Failure Self‐Care Behaviour Scale , 2003, European journal of heart failure.

[12]  C. Chronaki,et al.  European citizens' use of E-health services: A study of seven countries , 2007, BMC public health.

[13]  Juerg Schwitter,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2010, European journal of heart failure.

[14]  J. Ornato,et al.  ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult—Summary Article , 2005 .

[15]  Charles C. Hinnant,et al.  Exploring digital divides: An examination of eHealth technology use in health information seeking, communication and personal health information management in the USA , 2011, Health Informatics J..

[16]  R F DeBusk,et al.  A comprehensive management system for heart failure improves clinical outcomes and reduces medical resource utilization. , 1997, The American journal of cardiology.

[17]  Michael Oeff,et al.  Home telemonitoring in patients with chronic heart failure: a chance to improve patient care? , 2010, Deutsches Arzteblatt international.

[18]  Martin Knapp,et al.  Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study , 2012, BMC Health Services Research.

[19]  Randall E. Williams,et al.  Telemanagement of heart failure: a diuretic treatment algorithm for advanced practice nurses. , 2002, Heart & lung : the journal of critical care.

[20]  T. Bodenheimer,et al.  Patient self-management of chronic disease in primary care. , 2002, JAMA.

[21]  E. Keogh,et al.  Technologically-assisted behaviour change: a systematic review of studies of novel technologies for the management of chronic illness , 2009, Journal of telemedicine and telecare.

[22]  G. Fonarow,et al.  Heart failure disease management programs: not a class effect. , 2004, Circulation.

[23]  Ben-Tzion Karsh,et al.  Review Paper: A Systematic Review of Patient Acceptance of Consumer Health Information Technology , 2009, J. Am. Medical Informatics Assoc..

[24]  M. Bujnowska-Fedak,et al.  The impact of telehome care on health status and quality of life among patients with diabetes in a primary care setting in Poland. , 2011, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[25]  Elsa Marziali,et al.  E-health program for patients with chronic disease. , 2009, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[26]  Claudia Sprenger,et al.  Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany , 2010, International journal of telemedicine and applications.

[27]  H. Krumholz,et al.  Telemonitoring in patients with heart failure. , 2010, The New England journal of medicine.

[28]  C. Bulpitt,et al.  Knowledge and communication difficulties for patients with chronic heart failure: qualitative study , 2000, BMJ : British Medical Journal.

[29]  S. Cotten,et al.  Characteristics of online and offline health information seekers and factors that discriminate between them. , 2004, Social science & medicine.

[30]  J. B. Brooke,et al.  SUS: A 'Quick and Dirty' Usability Scale , 1996 .

[31]  Silke Schmidt,et al.  Acceptance of telemonitoring to enhance medication compliance in patients with chronic heart failure. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[32]  A. Strömberg The crucial role of patient education in heart failure , 2005, European journal of heart failure.

[33]  Rajeev Chaudhry,et al.  A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits. , 2012, Archives of internal medicine.

[34]  S. Meystre The current state of telemonitoring: a comment on the literature. , 2005, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[35]  Angela Fagerlin,et al.  Use of the Internet and Ratings of Information Sources for Medical Decisions: Results from the DECISIONS Survey , 2010, Medical decision making : an international journal of the Society for Medical Decision Making.

[36]  R. Gabbay,et al.  What Do People with Diabetes Talk about on a Diabetes Social Networking Web Site? , 2012, Journal of diabetes science and technology.

[37]  K. McDonald Disease Management Programs for Heart Failure , 2010, Current treatment options in cardiovascular medicine.

[38]  Nigel H. Lovell,et al.  Patients' perceptions of a home telecare system , 2008, Int. J. Medical Informatics.

[39]  W. Shrank,et al.  Online Social Networking by Patients with Diabetes: A Qualitative Evaluation of Communication with Facebook , 2011, Journal of General Internal Medicine.

[40]  W. Suter,et al.  Theory-based telehealth and patient empowerment. , 2011, Population health management.

[41]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[42]  C. Hawn Take two aspirin and tweet me in the morning: how Twitter, Facebook, and other social media are reshaping health care. , 2009, Health affairs.

[43]  D. J. Veldhuisen,et al.  Non‐compliance in patients with heart failure; how can we manage it? , 2005, European journal of heart failure.

[44]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. , 2009, Circulation.

[45]  Shuai Xu,et al.  A Novel Handheld Device for Use in Remote Patient Monitoring of Heart Failure Patients—Design and Preliminary Validation on Healthy Subjects , 2012, Journal of Medical Systems.

[46]  Volkmar Falk,et al.  2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. , 2016, Revista espanola de cardiologia.

[47]  J. Coyne,et al.  Social Support and Self-Care of Patients with Heart Failure , 2008, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[48]  Marjorie Skubic,et al.  Home-Based Assistive Technologies for Elderly: Attitudes and Perceptions , 2005, AMIA.

[49]  Susan S. Woods,et al.  Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. , 2008, Evidence report/technology assessment.

[50]  B. Wakefield,et al.  Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[51]  N. Shah,et al.  Telehealth monitoring with nurse clinician oversight-reply. , 2012, Archives of internal medicine.