This paper is in the following e-collection/theme issue:

TTRN CPH 2022: "Digital Health beyond COVID-19: Lessons Learned" (37)

Published on in Vol 9 (2023)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/41064, first published .
Clinical Outcomes After Viewing Video Education on Danger Signs and Symptoms of Worsening Heart Failure and Self-care Actions

Clinical Outcomes After Viewing Video Education on Danger Signs and Symptoms of Worsening Heart Failure and Self-care Actions

Clinical Outcomes After Viewing Video Education on Danger Signs and Symptoms of Worsening Heart Failure and Self-care Actions

Authors of this article:

Nancy Albert1 Author Orcid Image ;   Carol Babcock2 ;   Anna Maria Gray-Leyko3 ;   James Bena1 ;   Shannon Morrison1 ;   Dorothy Sayler2 ;   Michelle Levay1
Article Authors Cited by Tweetations Metrics

    Abstract

    1Cleveland Clinic, Cleveland, OH, United States

    2Atrium Health, Macon, GA, United States

    3Wellspan Health, York Hospital, York, PA, United States

    *these authors contributed equally

    Corresponding Author:

    Nancy Albert, PhD

    Cleveland Clinic

    9500 Euclid Avenue

    Mail code J3-4

    Cleveland, OH, 44195

    United States

    Phone: 1 2164447028

    Fax:1 2164451776

    Email: albertn@ccf.org


    Background: Patients with heart failure (HF) must understand subtle escalation in fatigue, dyspnea, and edema before they are triggered to control worsening status.

    Objective: The aim of this paper is to examine if video education of HF danger signs or symptoms recognition and control, developed using symbolic modeling (social cognitive theory), leads to between-group differences in functional status, symptoms, and self-efficacy for managing symptoms at 30-days, all-cause, and HF-related hospitalization, emergency department visits, and death at 30, 90, and 180 days.

    Methods: Using a 2-group, randomized controlled, multicenter, single-blind design, patients received video education (VE) plus usual care (UC) or UC alone before hospital discharge. VE patients also had access to content post discharge. Thirty-day functional status, fatigue, dyspnea, and self-efficacy for managing symptoms were assessed using valid, reliable tools. In the analysis, multivariable models were created to compare changes in patient-reported outcomes from baseline to 30-days post discharge and morbidity or mortality outcomes up to 180 days.

    Results: Of 369 VE and 377 UC patients enrolled from 7 sites, mean age was 68.0 (SD 12.4) years, and 206 (55.9%) were male. At 30 days, there were no between-group differences in the change in functional status, fatigue, dyspnea, and self-efficacy from baseline. In multivariable analyses, between-group outcomes did not differ at 30 or 90 days. At 180 days, HF-related events and HF-related hospitalization were higher in the video group—odds ratios (95% CI): 1.42 (1.04, 1.94), P=.03; and 1.44 (1.05, 1.97), P=.03, respectively. In time-to-event adjusted analyses, video patients had earlier HF-related hospitalization, compared to UC patients—hazard ratio (95% CI) 1.32 (1.02, 1.72), P=.04.

    Conclusions: Video education on recognition and control of danger signs or symptoms paradoxically increased HF-related events and hospitalization and decreased time to first HF-related hospitalization. Increased recognition of subtle HF signs or symptoms via video education is valuable but must be connected to patient or family self-care actions that reduce HF signs or symptoms.

    Trial Registration: ClinicalTrials.gov NCT03657459; https://clinicaltrials.gov/ct2/show/NCT03657459

    Conflicts of Interest: None declared.

    iproc 2023;9:e41064

    doi:10.2196/41064

    Keywords

    heart failure; video education; danger signs 

    Edited by B Dinesen; This is a non–peer-reviewed article. submitted 13.07.22; accepted 01.02.23; published 15.02.23

    Copyright

    ©Nancy Albert, Carol Babcock, Anna Maria Gray-Leyko, James Bena, Shannon Morrison, Dorothy Sayler, Michelle Levay. Originally published in Iproceedings (https://www.iproc.org), 15.02.2023.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.