Randomised pilot study comparing a coach to SMARTPhone reminders to aid the management of heart failure (HF) patients: humans or machines.
Rahel EynanRobert PetrellaCheryl ForchukMerrick ZwarensteinJames E CalvinPublished in: BMJ open quality (2024)
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.
Keyphrases
- heart failure
- end stage renal disease
- randomized controlled trial
- clinical trial
- newly diagnosed
- chronic kidney disease
- primary care
- study protocol
- prognostic factors
- peritoneal dialysis
- open label
- atrial fibrillation
- blood pressure
- left ventricular
- health insurance
- physical activity
- patient reported outcomes
- patient reported