نبذة مختصرة : Reviewer: Ross, Stephen ; [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2005/1/e8/ ] Background: Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. Objective: This pilot study evaluated the feasibility and patients’ acceptability of using the Internet to communicate with patients with symptomatic heart failure. Methods: Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. Results: Between May 3, 1999 and November 1, 2002, 62 patients (mean age 48.7 years) were enrolled. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3386 entries out of all 5098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient’s entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3386 comments ...
Relation: Rich M W, Beckham V, Wittenberg C, Leven C L, Freedland K E, Carney R M. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med Nov 2, 1995. Vol. 333(18) p. 1190-5. URL: http://content.nejm.org/cgi/pmidlookup?view=short&pmid=7565975; Rich M W, Vinson J M, Sperry J C, Shah A S, Spinner L R, Chung M K, Davila-roman V. Prevention of readmission in elderly patients with congestive heart failure: results of a prospective, randomized pilot study. J Gen Intern Med Nov 1993. Vol. 8(11) p. 585-90.; Mcalister F A, Lawson F M, Teo K K, Armstrong P W. A systematic review of randomized trials of disease management programs in heart failure. Am J Med Apr 1, 2001. Vol. 110(5) p. 378-84.; Liu P, Arnold J M, Belenkie I, Demers C, Dorian P, Gianetti N, Haddad H, Howlett J, Ignazewski A, Jong P, Mckelvie R, Moe G, Parker J D, Rao V, Rouleau J L, Teo K, Tsuyuki R, White M, Huckel V, Issac D, Johnstone D, Leblanc M-H, Lee H, Newton G, Niznick J, Ross H, Roth S, Roy D, Smith S, Sussex B, Yusuf S. Canadian Cardiovascular Society. The 2002/3 Canadian Cardiovascular Society consensus guideline update for the diagnosis and management of heart failure. Can J Cardiol Mar 31, 2003. Vol. 19(4) p. 347-356.; Tate Deborah F, Jackvony Elizabeth H, Wing Rena R. Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA Apr 9, 2003. Vol. 289(14) p. 1833-6.; Tate D F, Wing R R, Winett R A. Using Internet technology to deliver a behavioral weight loss program. JAMA Mar 7, 2001. Vol. 285(9) p. 1172-7.; Dew Mary Amanda, Goycoolea Jean M, Harris Ronna C, Lee Ann, Zomak Rachelle, Dunbar-jacob Jacqueline, Rotondi Armando, Griffith Bartley P, Kormos Robert L. An internet-based intervention to improve psychosocial outcomes in heart transplant recipients and family caregivers: development and evaluation. J Heart Lung Transplant Jun 2004. Vol. 23(6) p. 745-58.; Ross Stephen E, Moore Laurie A, Earnest Mark A, Wittevrongel Loretta, Lin Chen-Tan. Providing a web-based online medical record with electronic communication capabilities to patients with congestive heart failure: randomized trial. J Med Internet Res May 14, 2004. Vol. 6(2) p. e12. URL: http://www.jmir.org/10.2196/jmir.6.2.e12; Earnest Mark A, Ross Stephen E, Wittevrongel Loretta, Moore Laurie A, Lin Chen-Tan. Use of a patient-accessible electronic medical record in a practice for congestive heart failure: patient and physician experiences. J Am Med Inform Assoc 2004. Vol. 11(5) p. 410-7.; Mazzi Christian P, Kidd Michael. A framework for the evaluation of Internet-based diabetes management. J Med Internet Res Jan 10, 2002. Vol. 4(1) p. e1. URL: http://www.jmir.org/10.2196/jmir.4.1.e1; Delgado Diego H, Costigan Jeannine, Wu Robert, Ross Heather J. An interactive Internet site for the management of patients with congestive heart failure. Can J Cardiol Nov 2003. Vol. 19(12) p. 1381-5.; Committee on Maintaining Privacy and Security in Health Care applicati, Computer Science and Telecommincations Board Commission on Physical sc. For the Record: Protecting Electronic Health Information National Academies Press; Washington DC. Jul 1, 1997.; Riegel Barbara, Carlson Beverly, Kopp Zoe, Lepetri Barbara, Glaser Dale, Unger Alan. Effect of a standardized nurse case-management telephone intervention on resource use in patients with chronic heart failure. Arch Intern Med Mar 25, 2002. Vol. 162(6) p. 705-12.; Stewart S, Pearson S, Horowitz J D. Effects of a home-based intervention among patients with congestive heart failure discharged from acute hospital care. Arch Intern Med May 25, 1998. Vol. 158(10) p. 1067-72.; Rector TS, Kubo SH, Cohn JN. Patients' self-assessment of their congestive heart failure. II. Content, reliability, and validity of a new measure - the Minnesota Living with Heart Failure questionnaire. Heart Failure 1987. Vol. 3 p. 198-209.; Liederman Eric M, Morefield Catrina S. Web messaging: a new tool for patient-physician communication. J Am Med Inform Assoc 2003. Vol. 10(3) p. 260-70.; DeLone WD, McLean ER. The DeLone and McLean model of information systems success: a ten-year update. Journal of Management Information Systems 2003. Vol. 19(4) p. 9-30.; Robert C Wu, Diego Delgado, Jeannine Costigan, Jane MacIver, Heather Ross. Pilot Study of an Internet Patient-Physician Communication Tool for Heart Failure Disease Management. J Med Internet Res 2005;7(1):e8; http://hdl.handle.net/1807/4742
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