Randomised pilot study comparing a coach to SMARTPhone reminders to aid the management of heart failure (HF) patients: humans or machines

BMJ Open Qual. 2024 Jul 1;13(3):e002753. doi: 10.1136/bmjoq-2024-002753.

Abstract

Ambulatory management of congestive heart failure (HF) continues to be a challenging clinical problem. Recent studies have focused on the role of HF clinics, nurse practitioners and disease management programmes to reduce HF readmissions. This pilot study is a pragmatic factorial study comparing a coach intervention, a SMARTPHONE REMINDER system intervention and BOTH interventions combined to Treatment as USUAL (TAU). We determined that both modalities were acceptable to patients prior to randomisation. Fifty-four patients were randomised to the four groups. The COACH group had no readmissions for HF 6 months after enrolment compared with 18% for the SMARTPHONE REMINDER Group, 8% for the BOTH intervention group and 13% for TAU. Medium-to-high medication adherence was maintained in all four groups although sodium consumption was lower at 3 months for the COACH and combined (BOTH) groups. This pilot study suggests a beneficial effect on rehospitalisation with the use of support measures including coaches and telephone reminders that needs confirmation in a larger trial.

Keywords: Checklists; Chronic disease management; Healthcare quality improvement; Mobile Applications; Outpatients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Female
  • Heart Failure* / therapy
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Pilot Projects
  • Reminder Systems* / instrumentation
  • Reminder Systems* / statistics & numerical data
  • Smartphone* / statistics & numerical data