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Patient Adherence to a Mobile Phone-Based Heart Failure Telemonitoring Program: A Longitudinal Mixed-Methods Study.
Patrick Ware1,2, Mala Dorai2, Heather J Ross3,4,5
1Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, Toronto, ON, Canada.
JMIR Mhealth and Uhealth
|February 27, 2019
Summary
Patient adherence to telemonitoring for heart failure declines over time, particularly in younger individuals. Older patients show higher and more consistent adherence, suggesting targeted interventions can improve self-care outcomes.
Area of Science:
- Digital Health
- Cardiology
- Health Services Research
Background:
- Telemonitoring (TM) offers potential to enhance heart failure (HF) management through improved patient self-care and clinical decision-making.
- Consistent patient adherence to home readings is crucial for realizing the benefits of TM in HF care.
Purpose of the Study:
- To quantify patient adherence rates in a mobile phone-based TM program for heart failure.
- To identify factors influencing longitudinal adherence, including enrollment duration, patient characteristics, and perceptions of the TM program.
Main Methods:
- A mixed-methods approach guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2).
- Calculation of overall and monthly adherence rates for weight, blood pressure, heart rate, and symptom readings.
- Regression analyses to assess the impact of time, age, sex, and disease severity, supplemented by questionnaires and interviews.
Main Results:
- Overall average adherence was 73.6%, with a significant monthly decline of 1.4%.
- Older patients demonstrated higher adherence rates over time, while sex and disease severity were not significant predictors.
- Patient perceptions of performance expectancy, effort expectancy, facilitating conditions, social influence, and habit significantly explained adherence.
Conclusions:
- Adherence to telemonitoring for heart failure decreases over time, a trend more pronounced in younger patient groups.
- Interventions should consider age-specific strategies to maximize adherence, thereby improving the evaluation of TM effectiveness and resource allocation.
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