Digital Health: Implications for Heart Failure Management

Singhal, Arvind; Cowie, Martin R.

doi:10.15420/cfr.2020.28

Cited by 31 publications

(25 citation statements)

References 52 publications

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“…eHealth can be defined as “health services and information delivered or enhanced through the Internet and related technologies” [ 15 ]. In a broader sense, it can encompass a range of services or systems that facilitate health care practice through the use of information and communication technologies, including electronic health records, e-prescriptions, digital interventions, telemedicine, and mobile health [ 16 ]. Furthermore, eHealth is increasingly being applied to the prevention and treatment of several mental illnesses, including but not limited to smoking cessation, anxiety, depression, and suicidal ideation [ 17 - 20 ].…”

Section: Introductionmentioning

confidence: 99%

eHealth-Based Psychosocial Interventions for Adults With Insomnia: Systematic Review and Meta-analysis of Randomized Controlled Trials

Deng¹,

Kleij²,

Shen³

et al. 2023

J Med Internet Res

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Background Worldwide, insomnia remains a highly prevalent public health problem. eHealth presents a novel opportunity to deliver effective, accessible, and affordable insomnia treatments on a population-wide scale. However, there is no quantitative integration of evidence regarding the effectiveness of eHealth-based psychosocial interventions on insomnia. Objective We aimed to evaluate the effectiveness of eHealth-based psychosocial interventions for insomnia and investigate the influence of specific study characteristics and intervention features on these effects. Methods We searched PubMed, Embase, Web of Science, PsycINFO, and the Cochrane Central Register of Controlled Trials from database inception to February 16, 2021, for publications investigating eHealth-based psychosocial interventions targeting insomnia and updated the search of PubMed to December 6, 2021. We also screened gray literature for unpublished data. Eligible studies were randomized controlled trials of eHealth-based psychosocial interventions targeting adults with insomnia. Random-effects meta-analysis models were used to assess primary and secondary outcomes. Primary outcomes were insomnia severity and sleep quality. Meta-analyses were performed by pooling the effects of eHealth-based psychosocial interventions on insomnia compared with inactive and in-person conditions. We performed subgroup analyses and metaregressions to explore specific factors that affected the effectiveness. Secondary outcomes included sleep diary parameters and mental health–related outcomes. Results Of the 19,980 identified records, 37 randomized controlled trials (13,227 participants) were included. eHealth-based psychosocial interventions significantly reduced insomnia severity (Hedges g=−1.01, 95% CI −1.12 to −0.89; P<.001) and improved sleep quality (Hedges g=−0.58, 95% CI −0.75 to −0.41; P<.001) compared with inactive control conditions, with no evidence of publication bias. We found no significant difference compared with in-person treatment in alleviating insomnia severity (Hedges g=0.41, 95% CI −0.02 to 0.85; P=.06) and a significant advantage for in-person treatment in enhancing sleep quality (Hedges g=0.56, 95% CI 0.24-0.88; P<.001). eHealth-based psychosocial interventions had significantly larger effects (P=.01) on alleviating insomnia severity in clinical samples than in subclinical samples. eHealth-based psychosocial interventions that incorporated guidance from trained therapists had a significantly greater effect on insomnia severity (P=.05) and sleep quality (P=.02) than those with guidance from animated therapists or no guidance. Higher baseline insomnia severity and longer intervention duration were associated with a larger reduction in insomnia severity (P=.004). eHealth-based psychosocial interventions significantly improved each secondary outcome. Conclusions eHealth interventions for insomnia are effective in improving sleep and mental health and can be considered a promising treatment for insomnia. Our findings support the wider dissemination of eHealth interventions and their further promotion in a stepped-care model. Offering blended care could improve treatment effectiveness. Future research needs to elucidate which specific intervention components are most important to achieve intervention effectiveness. Blended eHealth interventions may be tailored to benefit people with low socioeconomic status, limited access to health care, or lack of eHealth literacy.

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Section: Introductionmentioning

confidence: 99%

eHealth-Based Psychosocial Interventions for Adults With Insomnia: Systematic Review and Meta-analysis of Randomized Controlled Trials

Deng¹,

Kleij²,

Shen³

et al. 2023

J Med Internet Res

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“…Patients with HF are vulnerable because they require regular and ongoing disease monitoring and management to reduce the risk of deterioration, and many fragile patients with HF have limited access to the health care system. The COVID-19 pandemic has forced health care systems to re-evaluate reimbursement for eHealth solutions to promote more widespread adoption of HF care [ 15 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Husebø¹,

Storm²,

Urstad³

et al. 2022

J Med Internet Res

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Background Heart failure (HF) is a clinical syndrome with high incidence rates, a substantial symptom and treatment burden, and a significant risk of readmission within 30 days after hospitalization. The COVID-19 pandemic has revealed the significance of using eHealth interventions to follow up on the care needs of patients with HF to support self-care, increase quality of life (QoL), and reduce readmission rates during the transition between hospital and home. Objective The aims of this review are to summarize research on the content and delivery modes of HF posthospitalization eHealth interventions, explore patient adherence to the interventions, and examine the effects on the patient outcomes of self-care, QoL, and readmissions. Methods A restricted systematic review study design was used. Literature searches and reviews followed the (PRISMA-S) Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension checklist, and the CINAHL, MEDLINE, Embase, and Cochrane Library databases were searched for studies published between 2015 and 2020. The review process involved 3 groups of researchers working in pairs. The Mixed Methods Appraisal Tool was used to assess the included studies’ methodological quality. A thematic analysis method was used to analyze data extracted from the studies. Results A total of 18 studies were examined in this review. The studies were published between 2015 and 2019, with 56% (10/18) of them published in the United States. Of the 18 studies, 16 (89%) were randomized controlled trials, and 14 (78%) recruited patients upon hospital discharge to eHealth interventions lasting from 14 days to 12 months. The studies involved structured telephone calls, interactive voice response, and telemonitoring and included elements of patient education, counseling, social and emotional support, and self-monitoring of symptoms and vital signs. Of the 18 studies, 11 (61%) provided information on patient adherence, and the adherence levels were 72%-99%. When used for posthospitalization follow-up of patients with HF, eHealth interventions can positively affect QoL, whereas its impact is less evident for self-care and readmissions. Conclusions This review suggests that patients with HF should receive prompt follow-up after hospitalization and eHealth interventions have the potential to improve these patients’ QoL. Patient adherence in eHealth follow-up trials shows promise for successful future interventions and adherence research. Further studies are warranted to examine the effects of eHealth interventions on self-care and readmissions among patients with HF.

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“…It can also improve self‐management and empowerment for people and lead to greater efficiencies in the health care system (Silva‐Cardoso et al, 2021 ). Teleconsultation, telemonitoring and the use of wearable devices and apps for heart failure health and lifestyle support are increasing rapidly, but caution is warranted regarding such technology, especially concerning issues such as data validity and privacy, and support for patients and clinicians using these technologies is an important consideration (Singhal & Cowie, 2021 ).…”

Section: Telehealthmentioning

confidence: 99%

The changing role of patients, and nursing and medical professionals as a result of digitalization of health and heart failure care

Boyne

Ski

Fitzsimons

et al. 2022

J Nursing Management

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Digital Health: Implications for Heart Failure Management

Cited by 31 publications

References 52 publications

eHealth-Based Psychosocial Interventions for Adults With Insomnia: Systematic Review and Meta-analysis of Randomized Controlled Trials

eHealth-Based Psychosocial Interventions for Adults With Insomnia: Systematic Review and Meta-analysis of Randomized Controlled Trials

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

The changing role of patients, and nursing and medical professionals as a result of digitalization of health and heart failure care

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