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

Abstract

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 ‘ heartfailurematters.org ’ 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 ( heartfailurematters.org 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 heartfailurematters.org 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. Clinical Trial registration: ClinicalTrials.gov ID NCT01755988.

Figures of the Heart Failure Association (HFA): Prof. Dr. Tiny Jaarsma, HFA Board Member (2018–2020), Coordinator Patient Care: Management and Delivery Committee and Co‐Chair HFA Task Force on Palliative Care

“…A second important development is the use of social media and new ways of communication with our peers and patients. I have great expectations of heartfailurematters.org, our patient website that now is translated into many languages, making it accessible for heart failure patients and their carers in across the world . A third important development is that HFA broadens the view to include patients and caregivers in activities.…”

February 2019 at a glance: pathophysiology, exercise capacity, diuretics and valve disease

“…Wagenaar et al . studied the effects on self‐care of two web‐based systems, the http://heartfailurematters.org website and the e‐health adjusted care pathway, compared to usual care, using a prospective, randomized, controlled design.…”

“…Wagenaar et al 16 studied the effects on self-care of two web-based systems, the heartfailurematters.org website and the e-health adjusted care pathway, compared to usual care, using a prospective, randomized, controlled design. After 3 months of follow-up, the mean score on the self-care scale was significantly higher in the website-based groups.…”

E‐health in self‐care of heart failure patients: promises become reality

“…In this issue of the Journal, a study evaluated both the e‐Vita platform and the HFM website in comparison to usual care alone in stable HF patients. The primary outcome was self‐care [assessed by the European Heart Failure Self‐care Behaviour (EHFScB) scale] and the secondary outcomes were health status, hospitalizations and all‐cause mortality . An improvement in self‐care at 3 months when received the HFM website compared to usual care alone (mean score on EHFScB scale 73.5 vs. 70.8; difference 2.7, 95% confidence interval 0.6–6.2) was observed.…”