A text messaging intervention to improve heart failure self-management after hospital discharge in a largely African-American population: before-after study.
A text messaging intervention to improve heart failure self-management after hospital discharge in a largely African-American population: before-after study.
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DOI：
10.2196/jmir.2317
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发表时间：
2013-03-11
影响因子：
7.4
通讯作者：
Meltzer DO
中科院分区：
文献类型：
--
作者：
Nundy S;Razi RR;Dick JJ;Smith B;Mayo A;O'Connor A;Meltzer DO
人们越来越关注寻找新的方法来减少急性失代偿性心力衰竭（ADHF）再入院时的健康差异。短信是改善低收入人群慢性病自我管理的一个很有前途的平台，但在ADHF中基本上尚未探索。这项研究的目的是评估的可行性和可接受性的短信为基础的（SMS：短信服务）的干预，主要是非洲裔美国人的ADHF人口，并探讨其对自我管理的影响。ADHF住院患者在出院后30天内参加了一个基于自动短信的心力衰竭项目。消息提供自我护理提醒和患者饮食教育，症状识别和医疗保健导航。在入组时收集人口统计学和手机使用数据，并在完成时进行退出调查。在干预前和干预后进行心力衰竭自我护理指数（SCHFI），并使用样本t检验（复合）和Wilcoxon秩和检验（个体）进行比较。通过图表抽象收集临床数据。在招募的51例患者中，27例同意参与，15例入组（14例非裔美国人，1例白色）。入组障碍包括没有个人手机（n=12），未通过简易智力考试（n=3），需要代理人（n=2），重听（n=1）和拒绝（n=3）。另外3名参与者因健康原因退出研究，另外3名参与者因技术问题退出研究。共有6例患者（5例非洲裔美国人，1例白色）完成了干预后调查。平均年龄为50岁（范围23-69），一半以上有医疗补助或没有保险（60%，9/15）。收缩功能障碍患者的平均射血分数为22%，至少三分之二的患者在过去一年中有过住院史。参与者强烈同意该计划易于使用（83%），减少了漏服药片（66%），并减少了盐的摄入量（66%）。维持（平均综合评分49至78，P=.003）和管理（57至86，P=.002）在4周时有所改善，而信心没有变化（57至75，P=.11）。在显示统计学显著改善的6个SCHFI项目中，有5个是短信干预的具体目标。在一个城市，主要是非洲裔美国人社区，超过一半的ADHF患者有资格并有兴趣在出院后参加短信计划。使用移动的电话是一个重大障碍，应在今后的干预措施中加以解决。在完成研究的参与者中，我们观察到高满意度和心力衰竭自我管理改善的初步证据。
There is increasing interest in finding novel approaches to reduce health disparities in readmissions for acute decompensated heart failure (ADHF). Text messaging is a promising platform for improving chronic disease self-management in low-income populations, yet is largely unexplored in ADHF. The purpose of this pre-post study was to assess the feasibility and acceptability of a text message–based (SMS: short message service) intervention in a largely African American population with ADHF and explore its effects on self-management. Hospitalized patients with ADHF were enrolled in an automated text message–based heart failure program for 30 days following discharge. Messages provided self-care reminders and patient education on diet, symptom recognition, and health care navigation. Demographic and cell phone usage data were collected on enrollment, and an exit survey was administered on completion. The Self-Care of Heart Failure Index (SCHFI) was administered preintervention and postintervention and compared using sample t tests (composite) and Wilcoxon rank sum tests (individual). Clinical data were collected through chart abstraction. Of 51 patients approached for recruitment, 27 agreed to participate and 15 were enrolled (14 African-American, 1 White). Barriers to enrollment included not owning a personal cell phone (n=12), failing the Mini-Mental exam (n=3), needing a proxy (n=2), hard of hearing (n=1), and refusal (n=3). Another 3 participants left the study for health reasons and 3 others had technology issues. A total of 6 patients (5 African-American, 1 White) completed the postintervention surveys. The mean age was 50 years (range 23-69) and over half had Medicaid or were uninsured (60%, 9/15). The mean ejection fraction for those with systolic dysfunction was 22%, and at least two-thirds had a prior hospitalization in the past year. Participants strongly agreed that the program was easy to use (83%), reduced pills missed (66%), and decreased salt intake (66%). Maintenance (mean composite score 49 to 78, P=.003) and management (57 to 86, P=.002) improved at 4 weeks, whereas confidence did not change (57 to 75, P=.11). Of the 6 SCHFI items that showed a statistically significant improvement, 5 were specifically targeted by the texting intervention. Over half of ADHF patients in an urban, largely African American community were eligible and interested in participating in a text messaging program following discharge. Access to mobile phones was a significant barrier that should be addressed in future interventions. Among the participants who completed the study, we observed a high rate of satisfaction and preliminary evidence of improvements in heart failure self-management.
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影响因子：
7.4
作者：
Scherr D;Kastner P;Kollmann A;Hallas A;Auer J;Krappinger H;Schuchlenz H;Stark G;Grander W;Jakl G;Schreier G;Fruhwald FM;MOBITEL Investigators
通讯作者：
MOBITEL Investigators
DOI：
10.1089/tmj.2008.0099
发表时间：
2009-04-01
期刊：
TELEMEDICINE JOURNAL AND E-HEALTH
影响因子：
--
作者：
Krishna, Santosh;Boren, Suzanne Austin;Balas, E. Andrew
通讯作者：
Balas, E. Andrew
影响因子：
2
作者：
Riegel, Barbara;Lee, Christopher S.;Carlson, Beverly
通讯作者：
Carlson, Beverly
DOI：
10.1111/j.1532-5415.1990.tb03450.x
发表时间：
1990-12-01
影响因子：
6.3
作者：
VINSON, JM;RICH, MW;MCNAMARA, T
通讯作者：
MCNAMARA, T
DOI：
10.1056/nejmoa1010029
发表时间：
2010-12-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chaudhry SI;Mattera JA;Curtis JP;Spertus JA;Herrin J;Lin Z;Phillips CO;Hodshon BV;Cooper LS;Krumholz HM
通讯作者：
Krumholz HM