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The ManageHF Just-in-Time Adaptive Mobile Application Interventions to Promote Self-Management and Improve Outcomes
Michael P Dorsch1,2, Mohamed S Ali3, Amy Krambrink4
1College of Pharmacy, University of Michigan-Ann Arbor, 248 Church Street, Ann Arbor, US.
JMIR Mhealth and Uhealth
|December 22, 2025
Summary
This study explored mobile health interventions for heart failure (HF) self-management. While promising for improving quality of life, the trial
Area of Science:
- Cardiology
- Digital Health
- Clinical Trials
Background:
- Heart failure (HF) poses a significant healthcare burden, with frequent hospitalizations among older adults.
- Gaps in HF self-management, such as symptom recognition and dietary adherence, contribute to poor outcomes.
- Existing mobile health (mHealth) strategies for HF self-management show variable results, necessitating novel approaches.
Purpose of the Study:
- To assess the efficacy of two just-in-time adaptive interventions (JITAIs) via mobile app for HF self-management.
- Interventions focused on symptom recognition and sodium restriction to reduce readmissions and improve health-related quality of life (HRQOL) over 12 weeks.
Main Methods:
- A 2x2 factorial, double-blind, randomized controlled trial (RCT) involving patients hospitalized for acute HF.
- Participants were randomized to receive both JITAIs, one JITAI, or an active control.
- Primary outcome: composite of all-cause death, HF readmission, and changes in HRQOL (MLHFQ).
Main Results:
- The trial was prematurely discontinued due to COVID-19 pandemic-related recruitment challenges.
- Sixty-two participants were enrolled; 43 completed the study.
- Due to early termination and small sample size, statistical significance was limited.
Conclusions:
- Mobile health technology shows potential for supporting heart failure management and enhancing HRQOL.
- Further research with improved recruitment and retention is needed to confirm intervention efficacy.
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