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A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes.

Publication ,  Journal Article
Felker, GM; Sharma, A; Mentz, RJ; She, L; Green, CL; Granger, BB; Heitner, JF; Cooper, L; Teuteberg, J; Grodin, JL; Rosenfield, K; Hudson, L ...
Published in: J Card Fail
November 2022

BACKGROUND: Mobile health (mHealth) platforms can affect health behaviors but have not been rigorously tested in randomized trials. OBJECTIVES: We sought to evaluate the effectiveness of a pragmatic mHealth intervention in patients with heart failure (HF) and diabetes (DM). METHODS: We conducted a multicenter randomized trial in 187 patients with both HF and DM to assess an mHealth intervention to improve physical activity and medication adherence compared to usual care. The primary endpoint was change in mean daily step count from baseline through 3 months. Other outcomes included medication adherence, health-related quality of life and metabolomic profiling. RESULTS: The mHealth group had an increase in daily step count of 151 steps/day at 3 months, whereas the usual-care group had a decline of 162 steps/day (least squares mean between-group difference = 313 steps/day; 95% CI: 8 619; P = 0.044). Medication adherence, measured using the Voils Adherence Questionnaire, did not change from baseline to 3 months (LS-mean change -0.08 in mHealth vs -0.15 in usual care; P = 0.47). The mHealth group had an improvement in Kansas City Cardiomyopathy Questionnaire Overall Summary Score compared to the usual-care group (LS-mean difference = 5.5 points, 95% CI: 1.4, 9.6; P = 0.009). Thirteen metabolites, primarily medium- and long-chain acylcarnitines, changed differently between treatment groups from baseline to 3 months (P < 0.05). CONCLUSIONS: In patients with HF and DM, a 3-month mHealth intervention significantly improved daily physical activity, health-related quality of life and metabolomic markers of cardiovascular health but not medication adherence. CONDENSED ABSTRACT: Heart failure (HF) and diabetes (DM) have overlapping biological and behavioral risk factors. We conducted a multicenter randomized, clinical trial in 187 patients with both HF (regardless of ejection fraction) and DM to assess whether an mHealth intervention could improve physical activity and medication adherence. The mHealth group had an increase in mean daily step count and quality of life but not in medication adherence. Medium- and long-chain acylcarnitines changed differently in treatment groups from baseline to 3 months (P < 0.05). These data have important implications for designing effective lifestyle interventions in HF and DM.

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

November 2022

Volume

28

Issue

11

Start / End Page

1575 / 1583

Location

United States

Related Subject Headings

  • Telemedicine
  • Quality of Life
  • Medication Adherence
  • Humans
  • Heart Failure
  • Diabetes Mellitus
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1110 Nursing
 

Citation

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Felker, G. M., Sharma, A., Mentz, R. J., She, L., Green, C. L., Granger, B. B., … Shah, S. H. (2022). A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes. J Card Fail, 28(11), 1575–1583. https://doi.org/10.1016/j.cardfail.2022.07.048
Felker, G Michael, Abhinav Sharma, Robert J. Mentz, Lilin She, Cynthia L. Green, Bradi B. Granger, John F. Heitner, et al. “A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes.J Card Fail 28, no. 11 (November 2022): 1575–83. https://doi.org/10.1016/j.cardfail.2022.07.048.
Felker GM, Sharma A, Mentz RJ, She L, Green CL, Granger BB, et al. A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes. J Card Fail. 2022 Nov;28(11):1575–83.
Felker, G. Michael, et al. “A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes.J Card Fail, vol. 28, no. 11, Nov. 2022, pp. 1575–83. Pubmed, doi:10.1016/j.cardfail.2022.07.048.
Felker GM, Sharma A, Mentz RJ, She L, Green CL, Granger BB, Heitner JF, Cooper L, Teuteberg J, Grodin JL, Rosenfield K, Hudson L, Kwee LC, Ilkayeva O, Shah SH. A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes. J Card Fail. 2022 Nov;28(11):1575–1583.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

November 2022

Volume

28

Issue

11

Start / End Page

1575 / 1583

Location

United States

Related Subject Headings

  • Telemedicine
  • Quality of Life
  • Medication Adherence
  • Humans
  • Heart Failure
  • Diabetes Mellitus
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1110 Nursing