title: Effects of multidisciplinary Internet-based program on management of heart failure.
abstract: OBJECTIVES: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF). METHODS: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant's record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics. RESULTS: The treatment group had a high (85%) adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001), amount of exercise (p = 0.001), and quality of life (p = 0.001), and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001), blood pressure (systolic, p = 0.002; diastolic, p < 0.001), frequency of emergency room visit, and length of hospital stay (both p = 0.001). CONCLUSIONS: An effective program to change one's behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient's daily record, which can be accomplished through Internet use.
authors.affiliation: Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA.
authors.forename: Machiko R
authors.initials: MR
authors.lastname: Tomita
authors.forename: Bin-Min
authors.initials: BM
authors.lastname: Tsai
authors.forename: Nadine M
authors.initials: NM
authors.lastname: Fisher
authors.forename: Neeraj A
authors.initials: NA
authors.lastname: Kumar
authors.forename: Greg
authors.initials: G
authors.lastname: Wilding
authors.forename: Kathy
authors.initials: K
authors.lastname: Stanton
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Naughton