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The utility of predicting hospitalizations among patients with heart failure using mHealth: observational study

Cartledge, Susie, Maddison, Ralph, Vogrin, Sara, Falls, Roman, Tumur, Odgerel, Hopper, Ingrid and Neil, Christopher 2020, The utility of predicting hospitalizations among patients with heart failure using mHealth: observational study, JMIR mHealth and uHealth, vol. 8, no. 12, pp. 1-10, doi: 10.2196/18496.

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Title The utility of predicting hospitalizations among patients with heart failure using mHealth: observational study
Author(s) Cartledge, SusieORCID iD for Cartledge, Susie orcid.org/0000-0002-6837-2244
Maddison, RalphORCID iD for Maddison, Ralph orcid.org/0000-0001-8564-5518
Vogrin, Sara
Falls, Roman
Tumur, Odgerel
Hopper, Ingrid
Neil, Christopher
Journal name JMIR mHealth and uHealth
Volume number 8
Issue number 12
Article ID e18496
Start page 1
End page 10
Total pages 10
Publisher JMIR Publications Inc.
Place of publication Toronto, Ont.
Publication date 2020-12
ISSN 2291-5222
2291-5222
Keyword(s) cardiac failure
heart failure
readmission
hospitalization
risk prediction
mHealth
Summary Background Heart failure decompensation is a major driver of hospitalizations and represents a significant burden to the health care system. Identifying those at greatest risk of admission can allow for targeted interventions to reduce this risk. Objective This paper aims to compare the predictive value of objective and subjective heart failure respiratory symptoms on imminent heart failure decompensation and subsequent hospitalization within a 30-day period. Methods A prospective observational pilot study was conducted. People living at home with heart failure were recruited from a single-center heart failure outpatient clinic. Objective (blood pressure, heart rate, weight, B-type natriuretic peptide) and subjective (4 heart failure respiratory symptoms scored for severity on a 5-point Likert scale) data were collected twice weekly for a 30-day period. Results A total of 29 participants (median age 79 years; 18/29, 62% men) completed the study. During the study period, 10 of the 29 participants (34%) were hospitalized as a result of heart failure. For objective data, only heart rate exhibited a between-group difference. However, it was nonsignificant for variability (P=.71). Subjective symptom scores provided better prediction. Specifically, the highest precision of heart failure hospitalization was observed when patients with heart failure experienced severe dyspnea, orthopnea, and bendopnea on any given day (area under the curve of 0.77; sensitivity of 83%; specificity of 73%). Conclusions The use of subjective respiratory symptom reporting on a 5-point Likert scale may facilitate a simple and low-cost method of predicting heart failure decompensation and imminent hospitalization. Serial collection of symptom data could be augmented using ecological momentary assessment of self-reported symptoms within a mobile health monitoring strategy for patients at high risk for heart failure decompensation.
Language eng
DOI 10.2196/18496
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30145416

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.