PMID- 29983549
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1177-889X (Print)
IS  - 1177-889X (Electronic)
IS  - 1177-889X (Linking)
VI  - 12
DP  - 2018
TI  - The dynamics of self-care in the course of heart failure management: data from 
      the IN TOUCH study.
PG  - 1113-1122
LID - 10.2147/PPA.S162219 [doi]
AB  - INTRODUCTION: Self-care is an important patient-reported outcome (PRO) for heart 
      failure (HF) patients, which might be affected by disease management and/or 
      telemonitoring (TM). The number of studies reporting the influence of TM on 
      self-care is limited. AIMS: This study aimed: to assess whether TM, in addition 
      to information-and-communication-technology (ICT)-guided disease management 
      system (ICT-guided DMS), affects self-care behavior; to evaluate the dynamics of 
      self-care during the study; to investigate factors contributing to self-care 
      changes; and to identify a patient profile that predisposes the patient to 
      improvement in self-care. METHODS: In the INnovative ICT-guided-DMS combined with 
      Telemonitoring in OUtpatient clinics for Chronic HF patients (IN TOUCH) study, 
      177 patients were randomized to either ICT-guided DMS or TM+ICT-guided DMS, with 
      a follow-up of 9 months. The current analysis included 118 participants (mean 
      age: 69+/-11.5 years; 70% male) who filled the following PRO instruments: the 
      nine-item European Heart Failure Self-care Behaviour scale (EHFScBs), Hospital 
      Anxiety and Depression scale (HADs), and Minnesota Living with HF Questionnaire 
      (MLHFQ). RESULTS: The baseline level of self-care was better in the 
      TM+ICT-guided-DMS group (n=58) compared to ICT-guided-DMS group (n=60, p=0.023). 
      Self-care behavior improved in the ICT-guided-DMS group (p<0.01) but not in the 
      TM+ICT-guided-DMS group. Factors associated with self-care worsening were as 
      follows: higher physical subscale of MLHFQ (per 10 points, p<0.05), lower left 
      ventricular ejection fraction (LVEF) (per 5%, p<0.05), lower New York Heart 
      Association (NYHA) class (class III vs class II, p<0.05). The subgroups of 
      patients who had an initial EHFScBs total score >28, or from 17 to 28 with 
      concomitant HADs depression subscale (HADs_D) score </=8, demonstrated the greatest 
      potential to improve self-care during the study. CONCLUSION: TM did not have an 
      advantage on self-care improvement. Poor physical aspect of quality of life, 
      lower LVEF, and lower NYHA class were associated with self-care worsening. The 
      greatest self-care improvement may be achieved in those patients who have low or 
      medium initial self-care level in the absence of depression.
FAU - Lycholip, Edita
AU  - Lycholip E
AD  - Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, 
      Lithuania, edita.lycholip@santa.lt.
AD  - Center of Cardiology and Angiology, Vilnius University Hospital Santaros Clinics, 
      Vilnius, Lithuania, edita.lycholip@santa.lt.
FAU - Thon Aamodt, Ina
AU  - Thon Aamodt I
AD  - Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic 
      Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University 
      Hospital, Oslo, Norway.
AD  - Department of Nursing Science, Institute of Health and Society, Faculty of 
      Medicine, University of Oslo, Oslo, Norway.
FAU - Lie, Irene
AU  - Lie I
AD  - Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic 
      Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University 
      Hospital, Oslo, Norway.
FAU - Simbelyte, Toma
AU  - Simbelyte T
AD  - Clinic of Internal Medicine, Centre of Family and Internal Medicine, Vilnius 
      University Santaros Clinics, Vilnius University, Vilnius, Lithuania.
FAU - Puronaite, Roma
AU  - Puronaite R
AD  - Center of Cardiology and Angiology, Vilnius University Hospital Santaros Clinics, 
      Vilnius, Lithuania, edita.lycholip@santa.lt.
AD  - Centre of Informatics and Development, Vilnius University Hospital Santaros 
      Clinics, Vilnius, Lithuania.
AD  - Institute of Mathematics and Informatics, Vilnius University, Vilnius, Lithuania.
FAU - Hillege, Hans
AU  - Hillege H
AD  - Department of Cardiology, University Medical Center Groningen, University of 
      Groningen, Groningen, the Netherlands.
FAU - de Vries, Arjen
AU  - de Vries A
AD  - Department of Cardiology, University Medical Center Groningen, University of 
      Groningen, Groningen, the Netherlands.
FAU - Kraai, Imke
AU  - Kraai I
AD  - PRA Health Sciences - Early Development Services, Groningen, the Netherlands.
FAU - Stromberg, Anna
AU  - Stromberg A
AD  - Department of Medical and Health Sciences, Linkoping University, Linkoping, 
      Sweden.
FAU - Jaarsma, Tiny
AU  - Jaarsma T
AD  - Department of Social and Welfare Studies, Linkoping University, Norrkoping, 
      Sweden.
FAU - Celutkiene, Jelena
AU  - Celutkiene J
AD  - Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, 
      Lithuania, edita.lycholip@santa.lt.
AD  - Center of Cardiology and Angiology, Vilnius University Hospital Santaros Clinics, 
      Vilnius, Lithuania, edita.lycholip@santa.lt.
LA  - eng
PT  - Journal Article
DEP - 20180626
PL  - New Zealand
TA  - Patient Prefer Adherence
JT  - Patient preference and adherence
JID - 101475748
PMC - PMC6027682
OTO - NOTNLM
OT  - disease management
OT  - heart failure
OT  - patient-reported outcomes
OT  - self-care
OT  - telemonitoring
COIS- Disclosure JC received honorary fees from Novartis, Orivas, Grindex, and Amgen. 
      The authors report no other conflicts of interest in this work.
EDAT- 2018/07/10 06:00
MHDA- 2018/07/10 06:01
PMCR- 2018/06/26
CRDT- 2018/07/10 06:00
PHST- 2018/07/10 06:00 [entrez]
PHST- 2018/07/10 06:00 [pubmed]
PHST- 2018/07/10 06:01 [medline]
PHST- 2018/06/26 00:00 [pmc-release]
AID - ppa-12-1113 [pii]
AID - 10.2147/PPA.S162219 [doi]
PST - epublish
SO  - Patient Prefer Adherence. 2018 Jun 26;12:1113-1122. doi: 10.2147/PPA.S162219. 
      eCollection 2018.