title: Patient-centred home-based management of heart failure. Findings from a randomised clinical trial evaluating a tablet computer for self-care, quality of life and effects on knowledge.
abstract: OBJECTIVE
  To evaluate whether a new home intervention system (HIS, OPTILOGG(®)) consisting of a specialised software, a tablet computer (tablet) wirelessly connected to a weight scale may improve self-care behaviour, health-related quality of life (HRQoL), knowledge about heart failure (HF) and reduce hospital days due to HF.
  
  
  METHODS
  82 patients (32% females) with mean age: 75 ± 8 years hospitalised with HF were randomised at discharge to an intervention group (IG) equipped with the HIS or to a control group (CG) receiving standard HF information only. The tablet contained information about HF and lifestyle advice according to current guidelines. It also showed present dose of diuretic, changes in patient-measured weight and HRQoL over time.
  
  
  RESULTS
  After 3 months the IG displayed a dramatic improvement in self-care with p < 0.05 (median IG: 17 [IQR: 13, 22] and CG: 21 [IQR: 17, 25]). The disease-specific HRQoL was measured by Kansas City Cardiomyopathy Questionnaire. The IG had significantly higher score (median IG: 65.1 [IQR: 38.5, 83.3] vs. CG: 52.1 [IQR: 41.1, 64.1] p < 0.05) and an improved physical limitation (median IG: 54.2 [IQR: 37.7, 83.3] vs. CG: 45.8 [IQR: 25.0, 54.2] p < 0.05) There was no difference in knowledge. IG showed fewer HF-related days in the hospital, with 1.3 HF-related hospital days/patient versus 3.5 in CG (risk ratio: 0.38; 95% confidence interval: 0.31-0.46; p < 0.05).
  
  
  CONCLUSIONS
  HF patients with a HIS tablet computer and scale improved in self-care and HRQoL. Days in hospital due to HF were reduced. A medical device that is easy to use can be a valuable tool for improving self-care and outcome in patients with HF.
authors.affiliation: Department of Cardiology, Karolinska Institutet, Karolinska University Hospital Huddinge , Stockholm , Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Hägglund
authors.forename: Patrik
authors.initials: P
authors.lastname: Lyngå
authors.forename: Filippa
authors.initials: F
authors.lastname: Frie
authors.forename: Bengt
authors.initials: B
authors.lastname: Ullman
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
authors.forename: Michael
authors.initials: M
authors.lastname: Melin
authors.forename: Inger
authors.initials: I
authors.lastname: Hagerman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D034201:Computers, Handheld; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010349:Patient Compliance; D010353:Patient Education as Topic; D010359:Patient Readmission; D018802:Patient-Centered Care; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D013548:Sweden; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome
keywords: adherence; heart failure; home monitoring; knowledge; quality of life; self-care