| Objective: To explore the feasibility of intelligent mobile APP in remote management for chronic heart failure(CHF).Methods: We selected the outpatients of Northern Jiangsu People's Hospital from December 2016 to March 2017 who were made the clinical diagnosis by cardiologist were divided into two groups(experimental group and control group)to complete the6-month study.Patients in both groups were given standardized treatment.All the patients were followed up in outpatient department on the 3rd and 6th months after enrollment.Patients in the experimental group were installed with mobile APP at the beginning,and used APP for remote follow-up on the 1st,2nd,4th and 5th months after enrollment.During the follow-up,patients in the experimental group could communicate with doctors via APP at any time,and doctors gave suggestions through APP,collecting feelings of using mobile APP.At the end of the study,we selected the completion of follow-up visits in both groups and the time about APP use in the experimental group,and compared the medication compliance(Morisky scale),self-management ability(ehfscbs-9 scale)and cardiac function(6-minute walk distance,left ventricular ejection fraction,n-terminal brain natripeptide precursor)were compared between the two groups.Results:After 6 months of follow-up,a total of 125 people completed the study,61 in the experimental group and 64 in the control group,2 were lost in the experimental group and 6 in control group.The expected outpatient follow-up of the control and experimental group were 78.1% and 82.8%.The proportion of patients who failed to complete the expected outpatient service due to inconvenience were 50.0% and 38.1%respectively.It is expected that 83.2% of mobile APP follow-up will be completed,operation failure accounted for 9.8% of the failed follow-up.A total of 182 follow-upvisits were made by the unexpected mobile APP,among which 102 were voluntary consultation about the change of the disease,and 43(42.2%)were caused by emotional anxiety after remote evaluation,which were successfully solved after psychological counseling finally.The unexpected outpatient visits of the control group was 98 times,among which 41.8% visited the hospital due to emotional anxiety and did not adjust the treatment plan;and the experimental group were and 48 times,among which 22.9% visited the hospital due to emotional anxiety and did not adjust the treatment plan.More than 90% of APP users said that the mobile APP is convenient to operate,and they can get timely feedback from doctors and are satisfied with the feedback content.There were differences in family participation,distance between the patient's address and the hospital,and the expected APP follow-up times(P<0.05).There was no difference in the expected APP use times among people of ages,education levels and economic level(P>0.05).Before the study,there was no significant difference in Morisky scale score(4.5±2.1vs4.6±2.0,P>0.05)and ehfscbs-9scale score(22.2±2.6vs22.9±2.0,P>0.05)between two groups.After the study,the Morisky scale score of the experimental group was significantly higher than control group(6.1±1.5vs4.7±1.9,P<0.05),while the ehfscbs-9 scale score was significantly lower(18.8±1.8vs23.1±2.2,P<0.05).Before the study,6-minute walking distance(330.0±73.7vs313.4±72.3,P> 0.05),left ventricular ejection fraction(47.7±9.7vs46.9±11.3,P > 0.05)and n-terminal brain natriuretic peptide precursor(2114.2±2783.9vs2491.8±1737.5,P > 0.05)between the experimental group and the control group;After the study,the 6-minute walking distance(355.8.0±66.1vs315.8±55.7,P < 0.05)and left ventricular ejection fraction(52.3±10.0vs47.9±12.8,P < 0.05)of the patients in the experimental group were significantly higher than those in the control group,and the n-terminal brain natriuretic peptide precursor(1126.9±998.8vs2557.4±2163.6,P<0.05)were significantly lower than those in the control group.Conclusions : This study shows that remote management of patients with chronic heart failure through mobile APP is feasible.APP can be successfully installed in mostpatients,and with the participation of family members,it can also realize effective remote management of elderly patients.Remote management through APP can achieve health education and psychological counseling,and improve the medication compliance self-management ability and cardiac function of patients with heart failure.It can help to reduce unnecessary outpatient visits,improve the utilization rate of medical resources and relieve medical pressure.Long-term clinical benefits need to be further demonstrated by larger clinical studies. |
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