A randomized trial of mobile health support for heart failure patients and their informal caregivers: impacts on caregiver-reported outcomes.
A randomized trial of mobile health support for heart failure patients and their informal caregivers: impacts on caregiver-reported outcomes.
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DOI：
10.1097/mlr.0000000000000378
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发表时间：
2015-08
期刊：
影响因子：
3
通讯作者：
Aikens JE
中科院分区：
文献类型：
--
作者：
Piette JD;Striplin D;Marinec N;Chen J;Aikens JE
Mobile health services may improve chronic illness care, but interventions rarely support informal caregivers’ efforts. To determine whether automated feedback to caregivers of chronic heart failure (HF) patients impacts caregiving burden and assistance with self-management. Randomized comparative effectiveness trial. 369 HF patients were recruited from a VA healthcare system. All patients participated with a “CarePartner” or informal caregiver outside their household. Patients randomized to “standard mHealth” received weekly automated self-care support calls for 12 months with notifications about problems sent to clinicians. “mHealth+CP” patients received identical services, plus email summaries and suggestions for self-care assistance automatically sent to their CarePartners. At baseline, six- and twelve months, CarePartners completed assessments of caregiving strain, depressive symptoms, and participation in self-care support. mHealth+CP CarePartners reported less caregiving strain than controls at both 6- and 12-months (both p≤.03). That effect as well as improvements in depressive symptoms were seen primarily among CarePartners reporting greater burden at baseline (p ≤.03 for interactions between arm and baseline strain/depression at both endpoints). While most mHealth+CP CarePartners increased the amount of time spent in self-care support, those with the highest time commitment at baseline reported decreases at both follow-ups (all p<.05). mHealth+CP CarePartners reported more frequently attending patients’ medical visits at six months (p=.049) and greater involvement in medication adherence at both endpoints (both p≤.032). When CarePartners experienced significant caregiving strain and depression, systematic feedback about their patient-partner decreased those symptoms. Feedback also increased most CarePartners’ engagement in self-care.
