Effects of tailored telemonitoring on heart failure patients' knowledge, self-care, self-efficacy and adherence: A randomized controlled trial

J.J. Boyne, H.J.M. Vrijhoef, M.D. Spreeuwenberg, G. de Weerd, J. Kragten, A.P.M. Gorgels

Research output: Contribution to journalArticleScientificpeer-review

47 Citations (Scopus)

Abstract

Background:
The education of patients with heart failure (HF) is an essential part of disease management. The perspectives of an increasing number of patients and a shortage of professionals force healthcare to explore new strategies in supporting patients to be better informed and more active.
Methods:
Three hundred and eighty-two patients with HF (age 71±SD 11.2 years) were randomly assigned to either a telemonitoring or a usual care group. Patients received four postal questionnaires to assess their levels of self-reported knowledge, self-care, self-efficacy and adherence. Generalized estimating equations analysis was performed to assess the effects of telemonitoring during the 1-year follow-up. Corrections for baseline were performed if needed.
Results:
Baseline differences between groups were found for self-care (p=0.001) and self-efficacy (p=0.024). Knowledge of patients in the telemonitoring group significantly improved with 0.9 point on a 15-points scale (p<0.001). Their self-care abilities improved with 1.5 point on a 10-item scale whereas no changes were found in patients receiving usual care (p<0.001). Self-efficacy of patients in the intervention group improved significantly after 6 months yet was not significantly different after 3 months and 1 year. For patients in the intervention group adherence improved for daily weighing (p<0.001) during the whole follow-up and for fluid intake (p=0.019) after 3 months and after 12 months (p=0.086). Adherence for activity recommendations improved (p=0.023) after 3 months and importance of medication adherence increased after 6 (p=0.012) and 12 months (p=0.037). No effects were found regarding appointments, diet, smoking and use of alcohol.
Conclusions:
Tailored telemonitoring was found to educate patients with HF and to improve their self-care abilities and sense of self-efficacy.Keywords: Heart failure, telemonitoring, knowledge, self-care, adherence, self-efficacy
Original languageEnglish
Pages (from-to)243-252
JournalEuropean Journal of Cardiovascular Nursing
Volume13
Issue number3
DOIs
Publication statusPublished - 2014

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