Development Of A Mobile Health Application Program To Support Health Management For Patients Underwent Percutaneous Coronary Intervention And Its Clinical Pilot Testing

Aim To construct a mobile application program for patient's health management after percutaneous coronary intervention,and to explore its effect in improving the self-management level of patients by a clinical pilot testing,and to provide a reference for the new health management model of patients after percutaneous coronary intervention.Method The mobile application(APP,application)named “Energetic Heart ” was developed by a multidisciplinary team of experts.We searched for coronary heart disease health management-related applications and related research literature,consulted the guidelines for rehabilitation and secondary prevention of coronary heart disease,integrated health education manuals,and collaborated with software development teams based on the Java web development language.The application was built With Spring,Spring MVC,Hibernate as the framework technology.The intervention stage selected 51 patients underwent percutaneous coronary intervention(PCI)from March 2017 to September 2017 in the Department of Cardiology,Anhui Provincial hospital,and were randomized to control and intervention groups according to the random number table method.Before the patient was discharged from the hospital,a unified design questionnaire was used to investigate the general demographic data and disease-related data of the patients.We used the health education handbook as discharge guidance for the control group,and the intervention group installed the App.After 3 and 6 months of discharge,the patients were needed to fill with the Coronary Heart Disease Self-Management Scale(CSMS)and the Seattle Angina Questionnaire(SAQ)for measuring the patient's health management and quality of life levels.The intervention group filled the scales built in the APP while the control group will receive scales through the We Chat.The paired sample t-test was used to compare the level of coronary heart disease health management between the two groups after 6 months of intervention.Two groups of independent sample t-tests were used to measure the quality of life between groups.The trend of changes in health management at different nodes was determined by repeated measures analysis of variance.We also chose 15 patients from the intervention group to explore their using behavior and feedback about the energetic application.Results 1.The main functions and contents of the Energetic Heart App include 5modules: Health Encyclopedia,Knowledge about CHD,Cardiac Rehabilitation,Support Aid,and My Services,further more,my services also include medication reminders,medical record picture management,and specialist outpatient information.These modules make the App a multi-functional set including health education,service reminders,dynamic records,video education,and follow-up management.2.There was no significant difference in general demographics,disease characteristics and self-management scores between the intervention group and the control group before intervention(P>0.05).The self-management level of patients after PCI was lower before the intervention,and the scores were 65.50±13.14 and71.96±14.65,respectively.3.The results of repeated measures analysis of variance showed that cardiac activity APP can improve the patient's health management.The self-management level of patients in the intervention group and control group changed with time in different periods,and the time effect,group effect and interaction effect were statistically significant(P<0.05),and the time effect effect varied with grouping(P< 0.05).4.The self-management levels of the two groups were higher than the baseline after 6 months of discharge,and the scores were 89.71±19.89 points and 105.59±9.43 points,respectively.There was a statistically significant difference between the two groups(P<0.05).The intervention group had statistically significant differences in the three dimensions of daily life management,disease medical management,and emotional management.The control group had statistically significant difference in the dimensions except of emotional management(P<0.05).In the comparison between the 3 months after discharge and the 6 months after discharge,the self-management level of the control group was statistically significant,with scores of 98.82±11.58 points and89.71±19.89 points respectively.The score after 6 months intervention was 105.59±9.43 points,compared with 3 months' 100.50±8.87 points,the difference was not statistically significant.5.After the intervention,the difference in quality of life between the two groups was statistically significant in the stable state of angina(P<0.05).There was no significant difference in the degree of physical limitation,angina attack,satisfaction of treatment,and degree of disease recognition(P >0.05).6.Only once error was reported within the test period.Nine patients used the APP very often(one or more than one time a day),three patients used the APP occasionally(one time every two or three days)and three patients used the APP rarely(one time every five or seven days).Five patients used the APP less than 10 minutes every time.Nine patients used the APP 10 to 30 minutes every time,one patient used the APP more than 30 minutes every time.The modules arrayed on frequency descending order in turn were health encyclopedia,cardiac rehabilitation,knowledge of our heart,symptom record,picture management,medication reminder,stent assistant.Participants had a good experience in using the software overall and pointed out the shortcoming and suggestions for improvement.Conclusions The Energetic Heart APP can improve the health management of patients with coronary heart disease using mobile technology.It can help patients continue to obtain scientific guidance on disease-related information and disease health management after discharge,dynamically understand their status,and provide the hospital with a new method for continuous care.