PMID- 25499976
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20141216
LR  - 20200930
IS  - 1929-0748 (Print)
IS  - 1929-0748 (Electronic)
IS  - 1929-0748 (Linking)
VI  - 3
IP  - 4
DP  - 2014 Dec 11
TI  - Design and Usage of the HeartCycle Education and Coaching Program for Patients 
      With Heart Failure.
PG  - e72
LID - 10.2196/resprot.3411 [doi]
LID - e72
AB  - BACKGROUND: Heart failure (HF) is common, and it is associated with high rates of 
      hospital readmission and mortality. It is generally assumed that appropriate 
      self-care can improve outcomes in patients with HF, but patient adherence to many 
      self-care behaviors is poor. OBJECTIVE: The objective of our study was to develop 
      and test an intervention to increase self-care in patients with HF using a novel, 
      online, automated education and coaching program. METHODS: The online automated 
      program was developed using a well-established, face-to-face, home-based cardiac 
      rehabilitation approach. Education is tailored to the behaviors and knowledge of 
      the individual patient, and the system supports patients in adopting self-care 
      behaviors. Patients are guided through a goal-setting process that they conduct 
      at their own pace through the support of the system, and they record their 
      progress in an electronic diary such that the system can provide appropriate 
      feedback. Only in challenging situations do HF nurses intervene to offer help. 
      The program was evaluated in the HeartCycle study, a multicenter, observational 
      trial with randomized components in which researchers investigated the ability of 
      a third-generation telehealth system to enhance the management of patients with 
      HF who had a recent (<60 days) admission to the hospital for symptoms or signs of 
      HF (either new onset or recurrent) or were outpatients with persistent New York 
      Heart Association (NYHA) functional class III/IV symptoms despite treatment with 
      diuretic agents. The patients were enrolled from January 2012 through February 
      2013 at 3 hospital sites within the United Kingdom, Germany, and Spain. RESULTS: 
      Of 123 patients enrolled (mean age 66 years (SD 12), 66% NYHA III, 79% men), 50 
      patients (41%) reported that they were not physically active, 56 patients (46%) 
      did not follow a low-salt diet, 6 patients (5%) did not restrict their fluid 
      intake, and 6 patients (5%) did not take their medication as prescribed. About 
      80% of the patients who started the coaching program for physical activity and 
      low-salt diet became adherent by achieving their personal goals for 2 consecutive 
      weeks. After becoming adherent, 61% continued physical activity coaching, but 
      only 36% continued low-salt diet coaching. CONCLUSIONS: The HeartCycle education 
      and coaching program helped most nonadherent patients with HF to adopt 
      recommended self-care behaviors. Automated coaching worked well for most patients 
      who started the coaching program, and many patients who achieved their goals 
      continued to use the program. For many patients who did not engage in the 
      automated coaching program, their choice was appropriate rather than a failure of 
      the program.
FAU - Stut, Wim
AU  - Stut W
AUID- ORCID: 0000-0002-0468-2315
AD  - Philips Research, Eindhoven, Netherlands. wim.stut@philips.com.
FAU - Deighan, Carolyn
AU  - Deighan C
AUID- ORCID: 0000-0002-3492-4389
FAU - Armitage, Wendy
AU  - Armitage W
AUID- ORCID: 0000-0002-3974-9225
FAU - Clark, Michelle
AU  - Clark M
AUID- ORCID: 0000-0002-5645-9385
FAU - Cleland, John G
AU  - Cleland JG
AUID- ORCID: 0000-0002-1471-7016
FAU - Jaarsma, Tiny
AU  - Jaarsma T
AUID- ORCID: 0000-0002-4197-4026
LA  - eng
PT  - Journal Article
DEP - 20141211
PL  - Canada
TA  - JMIR Res Protoc
JT  - JMIR research protocols
JID - 101599504
PMC - PMC4275507
OTO - NOTNLM
OT  - e-counseling
OT  - heart failure
OT  - lifestyle
OT  - patient adherence
OT  - self-care
OT  - telehealth
COIS- Conflicts of Interest: WS is employed by Philips. JGC has received research 
      funding and honoraria for advice from Philips.
EDAT- 2014/12/17 06:00
MHDA- 2014/12/17 06:01
PMCR- 2014/12/11
CRDT- 2014/12/16 06:00
PHST- 2014/03/20 00:00 [received]
PHST- 2014/10/19 00:00 [accepted]
PHST- 2014/09/24 00:00 [revised]
PHST- 2014/12/16 06:00 [entrez]
PHST- 2014/12/17 06:00 [pubmed]
PHST- 2014/12/17 06:01 [medline]
PHST- 2014/12/11 00:00 [pmc-release]
AID - v3i4e72 [pii]
AID - 10.2196/resprot.3411 [doi]
PST - epublish
SO  - JMIR Res Protoc. 2014 Dec 11;3(4):e72. doi: 10.2196/resprot.3411.