Feasibility and Acceptability of Utilizing a Smartphone Based Application to Monitor Outpatient Discharge Instruction Compliance in Cardiac Disease Patients around Discharge from Hospitalization

Abstract

The purpose of this study was to determine the feasibility and acceptability of utilizing a smartphone based application to monitor compliance in patients with cardiac disease around discharge. For 60 days after discharge, patients' medication compliance, physical activity, follow-up care, symptoms, and reading of education material were monitored daily with the application. 16 patients were enrolled in the study (12 males, 4 females, age 55 ± 18 years) during their hospital stay. Five participants were rehospitalized during the study and did not use the application once discharged. Seven participants completed 1–30 days and four patients completed >31 days. For those 11 patients, medication reminders were utilized 37% (1–30-day group) and 53% (>31-day group) of the time, education material was read 44% (1–30) and 53% (>31) of the time, and physical activity was reported 25% (1–30) and 42% (>31) of the time. Findings demonstrated that patients with stable health utilized the application, even if only minimally. Patients with decreased breath sounds by physical exam and who reported their health as fair to poor on the day of discharge were less likely to utilize the application. Acceptability of the application to report health status varied among the stable patients.

Cloudy with a Chance of Pain: Engagement and Subsequent Attrition of Daily Data Entry in a Smartphone Pilot Study Tracking Weather, Disease Severity, and Physical Activity in Patients With Rheumatoid Arthritis

“…In a 90-day study of sleep disturbance in 30 patients with breast cancer, the overall compliance rate for daily data entry following a push notification was 45% [20]. A 2-month study using smartphones to examine compliance in patients with cardiac disease following hospital discharge recruited 11 patients, only 4 of whom completed data entry beyond 31 days [21]. Thus, our results show better ongoing engagement than other studies in the limited literature on smartphone collection of longitudinal self-reported data.…”

Mobile Phone-Based Joint Angle Measurement for Functional Assessment and Rehabilitation of Proprioception

“…Using the Smartphone for home rehabilitation exercises just started since these tools are now available to the largest number in developed countries. It was firstly studied for cardiac disease [ 57 , 58 ], pulmonary rehabilitation [ 59 ], or prevention of ankles sprains [ 60 , 61 ].…”

Mobile health and cardiac rehabilitation in older adults

“…34 A study of 62 male patients in Poland undergoing CR after acute MI also showed that a home-based program, with remote ECG monitoring and a mobile device with preprogrammed exercise instructions, showed similar benefit in physical capacity compared to traditional CR. 59 Several small studies have also supported the feasibility of various mHealth applications in the setting of CR, with success in monitoring medication adherence, 13,21 estimating levels of physical activity, 60 and providing real-time data to clinicians for feedback. 33 Notably, older adults in these studies did not report difficulty using the mHealth technology.…”

“…26 As the population ages and CVD becomes more common, these types of mHealth applications could be of particular utility in older adults. A list of selected studies 11,[13][14][15][16][17][18]20,21,23,24,[26][27][28][29][30][31][32][33][34][35][36][37][38][39] regarding mHealth in this domain that may be relevant to older adults is provided in Table 1. The remainder of this narrative review will focus on mHealth cardiac rehabilitation (mHealth-CR) in older patients, which represents a particularly attractive target for intervention.…”