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Automated E-Counseling for Chronic Heart Failure: CHF-CePPORT Trial.
Robert P Nolan1,2, Heather J Ross3,2, Michael E Farkouh3,2
1Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Center (R.P.N.), University Health Network, Toronto, ON, Canada.
Circulation. Heart Failure
|January 19, 2021
Summary
This study found that while e-counseling did not improve quality of life for chronic heart failure (CHF) patients, it increased engagement and improved self-care behaviors. Further research is needed to optimize telehealth interventions for CHF management.
Area of Science:
- Cardiology
- Digital Health
- Health Services Research
Background:
- Telehealth programs are recommended for improving health-related quality of life in chronic heart failure (CHF) patients.
- Automated e-counseling programs offer a scalable approach to support CHF self-care.
- Evaluating the efficacy and usability of such digital interventions is crucial.
Purpose of the Study:
- To assess the efficacy of an internet-based e-counseling program compared to usual care in improving health-related quality of life for CHF patients.
- To evaluate secondary outcomes including program engagement and self-care behaviors.
- To explore the association between patient engagement with the e-counseling program and health-related quality of life.
Main Methods:
- A Canadian multi-site, double-blind, randomized trial involving 231 patients with chronic heart failure.
- Comparison between usual care plus e-counseling versus usual care plus e-based conventional education (e-UC).
- Primary outcome: 12-month change in Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS); Secondary outcomes: program engagement, self-care behaviors, diet, and physical activity.
Main Results:
- The primary endpoint (KCCQ-OS improvement) was not significantly different between e-counseling and e-UC groups (29.6% vs 34.0%, P=0.51).
- E-counseling significantly increased program engagement (logon weeks, hours, and frequency) compared to e-UC (P<0.05).
- E-counseling demonstrated a positive association between program engagement and quality of life, and improved CHF self-care behaviors and diet.
Conclusions:
- The automated e-counseling program did not meet its primary endpoint for improving health-related quality of life in CHF patients.
- However, e-counseling significantly enhanced patient engagement and positively impacted CHF self-care behaviors and dietary habits.
- The findings suggest potential for e-counseling in specific aspects of chronic heart failure management, particularly regarding engagement and behavioral support.
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