Use of a Self-Care and Educational Mobile App to Improve Outcomes of Patients with Acute Decompensated Heart Failure during the COVID-19 Pandemic

Abstract Introduction Expansion in digital health using mobile phone health applications has increased recently. We developed a mobile phone application (Aintree Heart Failure Passport-AHFP APP) for heart failure (HF) patient education, self-care and improved medication adherence. Methods This was a prospective observational study of patients with acute decompensated HF managed with day-case intravenous diuretics in a HF specialist nurse delivered Ambulatory Acute Heart Failure Unit (AAHFU) in a British university hospital during the ongoing COVID-19 pandemic (March 2020 to July 2021). We assessed self-care behaviour (European Heart Failure Self-care Behaviour scale – EHFSBs-9) and medication adherence (Medication Adherence Report Scale -MARS-5) at 2 weeks post-presentation in patients who utilised the AHFP APP and compared 30-day HF re-admissions with annual hospital HF data. Results 148 out of 221 consecutive ADHF patients treated in the AAHFU downloaded the AHFP Mobile APP. 45% were women and mean age of the cohort 62 ± 6.1 years. 55% patients had HF with reduced ejection fraction (HFrEF), 34% had HF with preserved EF (HFpEF) and 11% had HF with mildly reduced EF. Mean EHFSBs-9 was 19.1±6.7; mean MARS-5 score 23.3±1.HF 30 day re-hospitalisation incidence significantly lower (11%) in the APP cohort compared to the incidence of 19% amongst all patients with ADHF during the study period (p=0.02). Conclusions Our pilot feasibility study suggests that use of a HF educational self-care mobile phone APP in ADHF patients during the COVID pandemic, leads to high quality self-care behaviour, high medication adherence and also lower levels of 30-day HF re-hospitalisation. These results will need to be validated in a randomised controlled trial. 3 Key Points The use of digital healthcare technologies such as mobile APPs, is rapidly increasing This study analyses the role of our heart failure educational and self-care mobile APP, used by patients with acute decompensated heart failure during the COVID-19 pandemic Our results show that use of the mobile APP can lead to high levels of self-care, medication adherence and also reduced 30 day readmissions