JMIR Publications

ABSTRACT

Background:

Heart failure (HF) is a highly prevalent and chronic life-limiting condition that has the highest 30-day readmission rate of any condition, placing a significant burden on patients, families, and the healthcare system. Rapidly evolving mobile health (mHealth) technologies such as smartphones, mobile health apps, wearable activity tracking devices, and other smart and connected health technologies, offer great opportunities for supporting many aspects of HF self-care. However, little is known about smartphone ownership and use of such mHealth technologies for self-management of HF among patients.

Objective:

The purpose of this study was to assess smartphone ownership as well as patient attitudes toward using mHealth technologies for HF self-care in a predominantly minority population in an urban clinical setting.

Methods:

We conducted a cross-sectional survey of adult outpatients (≥18 years of age) at an academic outpatient HF clinic in the Midwest. The survey consisted of 34 questions assessing patient demographics, ownership of smartphones and other mHealth devices, frequently used smartphone features, use of mHealth apps, and interest in using mHealth technologies for self-monitoring and management of vital signs and HF symptoms.

Results:

A total of 144 patients were approached and of those 100 (female 63%) participated in the study. Participants had mean age of 61.3 years (Standard deviation: ±12.25) and were predominantly Black/African American (61%) and Hispanic/Latino (18%). Virtually all study participants (93%) owned a cell phone. The share of patients that owned a smartphone was 68% (68/100). Racial/ethnic minorities that identify as Black/African American or Hispanic/Latino reported higher smartphone ownership rates compared to White patients with HF (73.8% of Black/AA& 61.1% Hisp/Latino vs. 52.9% White). The vast majority of participants under age 65 owned a smartphone 91% (29-49 yrs) and 83% (50-64 yrs). Only 41% of individuals over age 65 owned smartphones. Age, education, and employment status were significant predictors of smartphone ownership. Of those participants who owned a smartphone, 88% had an internet data plan, and 74% had a short message service plan that allowed them to send and receive unlimited text messages. The most common smartphone features used by study participants were text messaging (75%), internet browsing (63.2%), and mobile apps (60.3%). Use of mHealth apps and wearable activity trackers (e.g., Fitbits) for self-monitoring of HF-related parameters was low (22.1% and 15% respectively). The most popular HF-related self-care measures participants would like to monitor with the use of mHealth technologies were physical activity (67.6%), blood pressure (64.7%) and medication use (58.8%).

Conclusions:

The majority of patients with HF have smartphones and are interested in using commercial mobile health apps and connected health devices to self-monitor their condition. Thus, there is a great opportunity to capitalize on the high smartphone ownership among minority patients to increase reach and enhance HF self-management through mHealth interventions.