title: Factors associated with telemonitoring use among patients with chronic heart failure.
abstract: Background In adults with chronic heart failure (HF; defined as people with previously diagnosed left ventricular dysfunction) telemonitoring randomized controlled trials (RCTs) failed to consistently demonstrate improved clinical outcomes. We aimed to examine if patient and HF characteristics are associated with device preferences and use. Methods Using a cross-sectional, multicenter, international design, ambulatory and hospitalized adults with HF in Ohio, California, and Denmark viewed a six-minute video of telemonitoring configurations (tablet, smart phone, and key fob) and completed questionnaires. Comparative analyses were performed and when significant, pairwise comparisons were performed using Bonferroni-adjusted significance levels. Results Of 206 participants, 48.2% preferred smart phones for telemonitoring, especially when traveling (54.8%), with new/worsening symptoms (50%), for everyday use (50%), and connecting with doctors (48.5%). Participants preferred two-way communication and a screen with words over voice or number pads. Of device purposes, allowing for nurse communication ranked highest, followed by maintaining overall health. Very few patient and HF factors were associated with device preferences. Patients with higher health literacy ( p = 0.007), previous/current device use history ( p = 0.008), higher education level ( p = 0.035), and married/cohabitating status ( p = 0.023) had higher perceptions of ease of using devices. Those who were asymptomatic or had mild HF had higher self-confidence for health devices ( p = 0.024) and non-white patients perceived devices as more useful ( p = 0.033). Conclusion Telemonitoring use may be enhanced by simple plug-and-play type devices, two-way communication, and features that meet patients' personal learning and use needs.
authors: 1 Office of Nursing Research and Innovation-Nursing Institute and Kaufman Center for Heart Failure-Heart and Vascular Institute, Cleveland Clinic Health System, USA.
authors: Nancy M
authors: NM
authors: Albert
authors: 2 Laboratory of Telehealth and Telerehabilitation, SMI, Department of Health Science and Technology, Aalborg University, Denmark.
authors: Birthe
authors: B
authors: Dinesen
authors: 3 Department of Psychology, Aarhus University, Denmark.
authors: Helle
authors: H
authors: Spindler
authors: 4 Department of Cardiology, University of California, Davis and University of California, Davis Medical Center, USA.
authors: Jeffrey
authors: J
authors: Southard
authors: 5 Quantitative Health Sciences, Cleveland Clinic Health System, USA.
authors: James F
authors: JF
authors: Bena
authors: 6 Betty Irene Moore School of Nursing, University of California, Davis, USA.
authors: Sheryl
authors: S
authors: Catz
authors: 6 Betty Irene Moore School of Nursing, University of California, Davis, USA.
authors: Tae Youn
authors: TY
authors: Kim
authors: 7 Department of Cardiology, Vendsyssel Hospital, Denmark.
authors: Gitte
authors: G
authors: Nielsen
authors: 4 Department of Cardiology, University of California, Davis and University of California, Davis Medical Center, USA.
authors: Katherine
authors: K
authors: Tong
authors: 8 Strategic Technologies and Alliances, University of California, Davis and University of California Davis Medical Center, and The Center for Information Technology Research in the Interest of Society, University of California, Berkeley, USA.
authors: Thomas S
authors: TS
authors: Nesbitt
mesh_terms: D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods* / Q000706:statistics & numerical data; D057240:Patient Preference; D000068997:Smartphone; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data
keywords: Remote monitoring; heart failure; mobile health; smart phones; telehealth apps