User design and testing of SmartHeart: A mobile app for heart failure self-care

Heart failure requires complex and daily self-care that many patients struggle with for a range of reasons including limited health literacy, cognitive impairment, comorbidities, and emotional distress. This study describes the user-centred design and development of a mobile app (SmartHeart) to support comprehensive self-monitoring and improve self-care engagement for people with heart failure.

Building on previous co-design research and expert panel feedback, we developed an initial Figma prototype following user-centred design principles. Two online sessions were conducted with adults living with heart failure (n=7), including a focus group session and a follow-up individual feedback session. The same participants took part in both sessions to provide feedback on the functionality, aesthetics, navigation, and content. Data were analysed deductively based on heuristic principles of user interface design, with findings informing the iterative development of the SmartHeart mobile app. The functional app was tested in-home by two participants over two weeks to evaluate real-world usability and gather contextual feedback to inform further refinement.

The SmartHeart prototype was developed through expert workshops and user feedback. Participants emphasised simplicity, leading to a streamlined design with clear navigation, adaptable graphics, and larger fonts. The app's health tracking features were iteratively improved. User-driven modifications included personalised threshold alerts, simplified symptom reporting, and integrated medication reminders. Participants reported high satisfaction with the prototype interface and health monitoring capabilities; however, formative testing identified reliability issues that are being addressed prior to pilot evaluation. Findings primarily inform design refinements before evaluating clinical effectiveness.

The SmartHeart app was refined through user-centred design process involving direct feedback from individuals with heart failure, resulting in a self-care tool with user-friendly features, to be further evaluated in future research. These user-driven enhancements support self-care engagement and highlight the app's potential for real-world use and broader clinical integration.