A Self-Care Mobile Application for Patients with Acute Decompensated Heart Failure During the COVID-19 Pandemic
4 affiliations
- 1Department of Cardiology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Lower Lane, Liverpool L9 7AL, UK
- 2Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
- 3Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- 4Department of Cardiology, Lipidology and Internal Medicine, Medical University of Bialystok, 15-540 Bialystok, Poland
Abstract
Background: Mobile health applications may support self-care following acute decompensated heart failure (ADHF), particularly when conventional healthcare contact is limited. We evaluated the integration of the Aintree Heart Failure Passport (AHFP) application into a specialist ambulatory ADHF pathway and described self-care behaviour, medication adherence and 30-day heart failure rehospitalisation among app users. Methods: This prospective, single-centre observational study included consecutive patients treated with day-case intravenous diuretics in a consultant-led ambulatory heart failure unit at a UK university hospital between March 2020 and July 2021. Patients with access to a smartphone were offered the AHFP application. Self-care behaviour and medication adherence were assessed two weeks after presentation using the nine-item European Heart Failure Self-care Behaviour Scale (EHFScB-9) and five-item Medication Adherence Report Scale (MARS-5), respectively. Thirty-day HF hospitalisation among application users was compared with a separate cohort of hospitalised HF patients recorded in the National Heart Failure Audit (73/382, 19.1%). This inpatient cohort was used as a contextual benchmark rather than a matched control group. Results: Of 221 consecutive patients treated for ADHF, 148 (67%) downloaded and registered with the AHFP application. Their mean age was 62 ± 6.1 years, and 45% were women. At two weeks, the mean EHFScB-9 score was 19.1 ± 6.7, and the mean MARS-5 score was 23.3 ± 1.0. Within 30 days, 16 patients (10.8%; 95% CI 6.8–16.8%) were hospitalised with HF, accounting for 73 inpatient bed-days. The corresponding 30-day readmission rate in the separate inpatient audit cohort was 19.1% (73/382). Conclusions: The AHFP application was downloaded and registered by 67% of patients treated within an ambulatory ADHF pathway. Self-care behaviour and medication adherence were assessed at two weeks. The observed 30-day HF hospitalisation rate was lower than that of a separate inpatient audit cohort, although differences in patient selection and care setting preclude attribution to the application. These findings support the feasibility of integrating a self-care application into specialist ambulatory HF care and warrant further evaluation in controlled studies.
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BibTeX
@article{essa2026selfcare,
title = {{A Self-Care Mobile Application for Patients with Acute Decompensated Heart Failure During the COVID-19 Pandemic}},
author = {Hani Essa and Gregory Yoke Hong Lip and Rajiv Sankaranarayanan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208183},
url = {https://www.mdpi.com/2077-0383/15/20/8183},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A Self-Care Mobile Application for Patients with Acute Decompensated Heart Failure During the COVID-19 Pandemic
AU - Hani Essa
AU - Gregory Yoke Hong Lip
AU - Rajiv Sankaranarayanan
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208183
UR - https://www.mdpi.com/2077-0383/15/20/8183
AB - Background: Mobile health applications may support self-care following acute decompensated heart failure (ADHF), particularly when conventional healthcare contact is limited. We evaluated the integration of the Aintree Heart Failure Passport (AHFP) application into a specialist ambulatory ADHF pathway and described self-care behaviour, medication adherence and 30-day heart failure rehospitalisation among app users. Methods: This prospective, single-centre observational study included consecutive patients treated with day-case intravenous diuretics in a consultant-led ambulatory heart failure unit at a UK university hospital between March 2020 and July 2021. Patients with access to a smartphone were offered the AHFP application. Self-care behaviour and medication adherence were assessed two weeks after presentation using the nine-item European Heart Failure Self-care Behaviour Scale (EHFScB-9) and five-item Medication Adherence Report Scale (MARS-5), respectively. Thirty-day HF hospitalisation among application users was compared with a separate cohort of hospitalised HF patients recorded in the National Heart Failure Audit (73/382, 19.1%). This inpatient cohort was used as a contextual benchmark rather than a matched control group. Results: Of 221 consecutive patients treated for ADHF, 148 (67%) downloaded and registered with the AHFP application. Their mean age was 62 ± 6.1 years, and 45% were women. At two weeks, the mean EHFScB-9 score was 19.1 ± 6.7, and the mean MARS-5 score was 23.3 ± 1.0. Within 30 days, 16 patients (10.8%; 95% CI 6.8–16.8%) were hospitalised with HF, accounting for 73 inpatient bed-days. The corresponding 30-day readmission rate in the separate inpatient audit cohort was 19.1% (73/382). Conclusions: The AHFP application was downloaded and registered by 67% of patients treated within an ambulatory ADHF pathway. Self-care behaviour and medication adherence were assessed at two weeks. The observed 30-day HF hospitalisation rate was lower than that of a separate inpatient audit cohort, although differences in patient selection and care setting preclude attribution to the application. These findings support the feasibility of integrating a self-care application into specialist ambulatory HF care and warrant further evaluation in controlled studies.
SN - 2077-0383
ER -