Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring
BackgroundPrevious trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs. ObjectivesThe objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and cl...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2012-02-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | http://www.jmir.org/2012/1/e25/ |
| _version_ | 1818560112342597632 |
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| author | Seto, Emily Leonard, Kevin J Cafazzo, Joseph A Barnsley, Jan Masino, Caterina Ross, Heather J |
| author_facet | Seto, Emily Leonard, Kevin J Cafazzo, Joseph A Barnsley, Jan Masino, Caterina Ross, Heather J |
| author_sort | Seto, Emily |
| collection | DOAJ |
| description | BackgroundPrevious trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs.
ObjectivesThe objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical management, and (2) to determine the features that enable successful heart failure telemonitoring.
MethodsSemi-structured interviews were conducted with 22 heart failure patients attending a heart function clinic who had used a mobile phone-based telemonitoring system for 6 months. The telemonitoring system required the patients to take daily weight and blood pressure readings, weekly single-lead ECGs, and to answer daily symptom questions on a mobile phone. Instructions were sent to the patient’s mobile phone based on their physiological values. Alerts were also sent to a cardiologist’s mobile phone, as required. All clinicians involved in the study were also interviewed post-trial (N = 5). The interviews were recorded, transcribed, and then analyzed using a conventional content analysis approach.
ResultsThe telemonitoring system improved patient self-care by instructing the patients in real-time how to appropriately modify their lifestyle behaviors. Patients felt more aware of their heart failure condition, less anxiety, and more empowered. Many were willing to partially fund the use of the system. The clinicians were able to manage their patients’ heart failure conditions more effectively, because they had physiological data reported to them frequently to help in their decision-making (eg, for medication titration) and were alerted at the earliest sign of decompensation. Essential characteristics of the telemonitoring system that contributed to improved heart failure management included immediate self-care and clinical feedback (ie, teachable moments), how the system was easy and quick to use, and how the patients and clinicians perceived tangible benefits from telemonitoring. Some clinical concerns included ongoing costs of the telemonitoring system and increased clinical workload. A few patients did not want to be watched long-term while some were concerned they might become dependent on the system.
ConclusionsThe success of a telemonitoring system is highly dependent on its features and design. The essential system characteristics identified in this study should be considered when developing telemonitoring solutions.
Key Words |
| first_indexed | 2024-12-14T00:34:13Z |
| format | Article |
| id | doaj.art-24638047b6664963bb7cd29c8258d100 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-12-14T00:34:13Z |
| publishDate | 2012-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-24638047b6664963bb7cd29c8258d1002022-12-21T23:24:43ZengJMIR PublicationsJournal of Medical Internet Research1438-88712012-02-01141e2510.2196/jmir.1912Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based TelemonitoringSeto, EmilyLeonard, Kevin JCafazzo, Joseph ABarnsley, JanMasino, CaterinaRoss, Heather JBackgroundPrevious trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs. ObjectivesThe objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical management, and (2) to determine the features that enable successful heart failure telemonitoring. MethodsSemi-structured interviews were conducted with 22 heart failure patients attending a heart function clinic who had used a mobile phone-based telemonitoring system for 6 months. The telemonitoring system required the patients to take daily weight and blood pressure readings, weekly single-lead ECGs, and to answer daily symptom questions on a mobile phone. Instructions were sent to the patient’s mobile phone based on their physiological values. Alerts were also sent to a cardiologist’s mobile phone, as required. All clinicians involved in the study were also interviewed post-trial (N = 5). The interviews were recorded, transcribed, and then analyzed using a conventional content analysis approach. ResultsThe telemonitoring system improved patient self-care by instructing the patients in real-time how to appropriately modify their lifestyle behaviors. Patients felt more aware of their heart failure condition, less anxiety, and more empowered. Many were willing to partially fund the use of the system. The clinicians were able to manage their patients’ heart failure conditions more effectively, because they had physiological data reported to them frequently to help in their decision-making (eg, for medication titration) and were alerted at the earliest sign of decompensation. Essential characteristics of the telemonitoring system that contributed to improved heart failure management included immediate self-care and clinical feedback (ie, teachable moments), how the system was easy and quick to use, and how the patients and clinicians perceived tangible benefits from telemonitoring. Some clinical concerns included ongoing costs of the telemonitoring system and increased clinical workload. A few patients did not want to be watched long-term while some were concerned they might become dependent on the system. ConclusionsThe success of a telemonitoring system is highly dependent on its features and design. The essential system characteristics identified in this study should be considered when developing telemonitoring solutions. Key Wordshttp://www.jmir.org/2012/1/e25/ |
| spellingShingle | Seto, Emily Leonard, Kevin J Cafazzo, Joseph A Barnsley, Jan Masino, Caterina Ross, Heather J Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring Journal of Medical Internet Research |
| title | Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring |
| title_full | Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring |
| title_fullStr | Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring |
| title_full_unstemmed | Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring |
| title_short | Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring |
| title_sort | perceptions and experiences of heart failure patients and clinicians on the use of mobile phone based telemonitoring |
| url | http://www.jmir.org/2012/1/e25/ |
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