Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 22, 2023
Date Accepted: Mar 12, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Self-monitoring using a Mobile Application to improve symptoms and Reduce rehospitalization and morTality in Heart Failure (SMART-HF trial)
ABSTRACT
Background:
Current heart failure (HF) guidelines recommend a multidisciplinary approach, discharge education and self-management for HF. However, the recommendations are challenging to implement in real-world clinical settings.
Objective:
We developed a mobile health platform for self-care and feedback and aimed to evaluate whether this smartphone application (app)-based intervention with Bluetooth-connected monitoring devices and a feedback system can help improve HF symptoms and clinical outcomes.
Methods:
Seven tertiary hospitals in South Korea participated in this prospective, randomized, multicenter study (SMART-HF study). We enrolled patients aged ≥20 years hospitalized for acute HF who could use a smartphone. In the intervention group (n=39), the apps were automatically paired with Bluetooth-connected monitoring devices. The patients could enter their information daily, including vital signs, HF symptoms, diet, medications, and exercise regimen, into the app and receive feedback or alerts on their input. In the control group (n=38), patients could only enter their blood pressure, heart rate, and weight using conventional, non-Bluetooth devices and could not receive any feedback or alerts from the app.
Results:
At 4 weeks, the change in dyspnea symptom score from baseline was significantly greater in the intervention group than in the control group (-1.3±2.1 vs. -0.3±2.3, P=0.048). There was a significant reduction in body water composition from baseline to the final measurement in the intervention group (baseline level 7.4±2.5 vs. final level 6.6±2.5, P=0.003). App adherence by either log-in or percentage of days when symptoms entered was higher in the intervention group than in the control group. Composite endpoints, including death, rehospitalization, and urgent HF visits, were not significantly different between the two groups
Conclusions:
Our mobile health platform demonstrated feasibility and efficacy in improving the symptoms of patients with HF. Clinical Trial: The study design has been registered in ClinicalTrials.gov NCT05668000)
Citation
