Usability and feasibility of a personalised, web-based education and self-management approach for patients with chronic heart failure across four European sites (STABILISE-HF)

Niveditha Daneeza Dinesh Kanna (Aachen)1, H. Amin (Maastricht)2, J. Brandts (Aachen)1, M. Jacobsen (Aachen)1, J. J. Boyne (Maastricht)3, M. Murphy (Dublin)4, A. McNulty (Belfast)5, L. Dixon (Belfast)6, L. Hill (Belfast)5, M. Barrett (Dublin)7, D. Müller-Wieland (Aachen)1, N. Marx (Aachen)1, K. Schütt (Aachen)1, H.-P. Brunner La-Rocca (Maastricht)8, M. Verket (Aachen)1

1Uniklinik RWTH Aachen Med. Klinik I - Kardiologie, Angiologie und Internistische Intensivmedizin Aachen, Deutschland; 2Maastricht University Medical Center Cardiology Department Maastricht, Deutschland; 3Maastricht University Department of Health Services Research Maastricht, Niederlande; 4St Vincent’s University Hospital Department of Cardiology Dublin, Irland; 5Queen’s University Belfast School of Nursing and Midwifery Belfast, Großbritannien; 6Queens University Belfast School of Nursing and Midwifery Belfast, Großbritannien; 7University College Dublin Catherine McAuley Education & Research Centre Dublin, Irland; 8Maastricht University Medical Center Maastricht, Niederlande


Aim: The aim of this study was to evaluate the usability of an eHealth app, SanaCoach Heart Failure, in patients with chronic heart failure.

Methods: For the PASSION-HF Study, patients with chronic heart failure (HF) were recruited across four centres in Aachen (DE), Belfast (GB-NIR), Dublin (IE), and Maastricht (NE) from 2019-2023. The participants received an initial training in the usage of the eHealth app, (SanaCoach Heart Failure) and were asked to use it for 26 weeks. After the initiation session, participants received prompts to complete regular monitoring sessions, including submitting details on their symptoms and vital signs. These included blood pressure, heart rate, weight and HF symptoms (dyspnoea, oedema, palpitations and angina pectoris). Follow-up visits were performed at 12 and 26 weeks. The primary endpoint was the System Usability Scale (SUS) score. The system usability scale is a validated questionnaire containing ten different questions that address the usability and learnability of a system.

Results: In total, 542 participants were enrolled. 432 were male (76.9%) and 110 were female (23.1%). The mean age was 64.1 ± 13.1 years. Additionally, 62% had Heart failure with reduced ejection fraction (HFrEF), 19% with mildly reduced (HFmrEF) and 19% with preserved ejection fraction (HFpEF). In total, 420 (77.5%) participants completed at least one monitoring session. The mean compliance rate of monitoring sessions for all users was 72.8% ± 30.7%. The median score of the System Usability Scale (SUS) was ‘good’ (82,5%, IQR 65-92,5%) according to the rating scale. There were no significant differences between male and female in the use of monitoring sessions (73% vs. 74%). Patients older than 65 years filled out the monitoring sessions significantly more often than those who were younger than 65 years old (77% vs 69%, p=0.001). In respect to possible differences of usage between the days of the week, there was a lower number of completed monitoring sessions over the weekend (Fig 1).

Fig 1: Number of completed monitoring sessions for all users

Conclusion: In line with a good SUS score, the majority of the participants utilised the app. The app was often used by participants older than 65 years old which may contribute to the improvement of remote monitoring and therapy adherence in elderly individuals. Decreased use of the app during Saturdays and Sundays might result in less effective monitoring of the patients over the weekend. These findings will be taken into consideration when further developing eHealth solutions to maximise utilisation by users.

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