title: A web application for self-monitoring improves symptoms in chronic systolic heart failure.
abstract: OBJECTIVE
  The objective of this study was to determine if a Web application that promoted mindfulness of the progress of the chronic disease through self-monitoring improved quality of life in heart failure.
  
  
  METHODS
  This was a prospective single-center single-group study. Participants were instructed how to use the Web application and to perform self-monitoring daily for 12 weeks. A comprehensive physical exam, assessment of New York Heart Association (NYHA) class, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and an evaluation of self-management were performed in person at baseline and at 12 weeks.
  
  
  RESULTS
  Participants consisted of older (mean, 59 years), predominantly female (63%) adults with NYHA class II or III symptoms. NYHA classification (preintervention versus postintervention, 2.5±0.13 versus 2.0±0.13; p=0.0032) and MLHFQ score (55.7±4.6 versus 42.6±5.1, respectively; p=0.0078) improved over 12 weeks of self-monitoring. A trend toward improvement was also demonstrated in weight (preintervention versus postintervention, 209±9.6 pounds versus 207±9.4 pounds; by paired t test, p=0.389), number of times exercised per week (1.29±0.5 versus 2.5±0.6, respectively; p=0.3), and walk distance (572±147 yards versus 845±187 yards, respectively; p=0.119). Jugular venous distention (preintervention versus postintervention, 8.1±0.6 cm versus 6.7±0.3 cm; p=0.083) and peripheral edema (29.2% versus 16.7%, respectively; p=0.375) decreased after 12 weeks of self-monitoring via the Web application.
  
  
  CONCLUSIONS
  A Web application for self-monitoring heart failure over 12 weeks improved both NYHA classification and MLHFQ score. The trend in improved physical activity and physical exam support these outcomes. The number of patients reporting a sodium-restricted diet increased over the 12 weeks, which may have led to the positive findings.
authors: 1 Department of Pharmacy Services, College of Pharmacy, University of Michigan Hospitals and Health Centers , Ann Arbor, Michigan.
authors: Michael P
authors: MP
authors: Dorsch
authors: Karen B
authors: KB
authors: Farris
authors: Barry E
authors: BE
authors: Bleske
authors: Todd M
authors: TM
authors: Koelling
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D054143:Heart Failure, Systolic / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D018709:Statistics, Nonparametric; D013997:Time Factors
keywords: congestive heart failure; health informatics; self-monitoring