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Effectiveness of the European Society of Cardiology/Heart Failure Association website heartfailurematters.org and an e-health adjusted care pathway in patients with stable heart failure: results of the e-Vita HF randomized controlled trial
Univ Utrecht, Netherlands.
Univ Utrecht, Netherlands.
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-4197-4026
Univ Utrecht, Netherlands.
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2019 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 21, no 2, p. 238-246Article in journal (Refereed) Published
Abstract [en]

Background Efficient incorporation of e-health in patients with heart failure (HF) may enhance health care efficiency and patient empowerment. We aimed to assess the effect on self-care of (i) the European Society of Cardiology/Heart Failure Association website on top of usual care, and (ii) an e-health adjusted care pathway leaving out in person routine HF nurse consultations in stable HF patients. Methods and results In a three-group parallel-randomized trial in stable HF patients from nine Dutch outpatient clinics, we compared two interventions ( website and an e-health adjusted care pathway) to usual care. The primary outcome was self-care measured with the European Heart Failure Self-care Behaviour Scale. Secondary outcomes were health status, mortality, and hospitalizations. In total, 450 patients were included. The mean age was 66.8 +/- 11.0 years, 74.2% were male, and 78.8% classified themselves as New York Heart Association I or II at baseline. After 3 months of follow-up, the mean score on the self-care scale was significantly higher in the groups using the website and the adjusted care pathway compared to usual care (73.5 vs. 70.8, 95% confidence interval 0.6-6.2; and 78.2 vs. 70.8, 95% confidence interval 3.8- 9.4, respectively). The effect attenuated, until no differences after 1 year between the groups. Quality of life showed a similar pattern. Other secondary outcomes did not clearly differ between the groups. Conclusions Both the website and an e-health adjusted care pathway improved self-care in HF patients on the short term, but not on the long term. Continuous updating of e-health facilities could be helpful to sustain effects.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 21, no 2, p. 238-246
Keywords [en]
Telemedicine; Heart failure; Self-care; Mortality; Hospitalization
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-154843DOI: 10.1002/ejhf.1354ISI: 000458652400014PubMedID: 30485612OAI: oai:DiVA.org:liu-154843DiVA, id: diva2:1293687
Note

Funding Agencies|Foundation Care Within Reach (In Dutch: Stichting Zorg Binnen Bereik)

Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-06-27

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