test Browse by Author Names Browse by Titles of Works Browse by Subjects of Works Browse by Issue Dates of Works
       

Advanced Search
Home   
 
Browse   
Communities
& Collections
  
Issue Date   
Author   
Title   
Subject   
 
Sign on to:   
Receive email
updates
  
My Account
authorized users
  
Edit Profile   
 
Help   
About T-Space   

T-Space at The University of Toronto Libraries >
School of Graduate Studies - Theses >
Doctoral >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/29861

Title: Design and Evaluation of a Mobile Phone-based Remote Patient Monitoring System for Heart Failure Management: A Focus on Self-care
Authors: Seto, Emily
Advisor: Leonard, Kevin
Department: Health Policy, Management and Evaluation
Keywords: patient monitoring
self-care
mobile phone
heart failure
Issue Date: 31-Aug-2011
Abstract: Methods to improve self-care and clinical management of heart failure are required, especially in light of the anticipated increase in heart failure prevalence and associated high costs. Remote patient monitoring (RPM) has been shown to improve heart failure outcomes, but the feasibility and efficacy of mobile phone-based RPM systems are still unknown. The main objectives of this research were to investigate the optimal design of a mobile phone-based RPM system, and to determine the effects of the system on self-care, clinical management, and health outcomes. A mobile phone-based RPM system was first developed using a user-centric design process. It was then evaluated with a six-month randomized controlled trial consisting of 100 patients attending a heart function clinic. The quality of life improved only for the intervention group, but both intervention and control groups improved with respect to self-care, heart function, and heart failure prognosis. The clinic was determined to be a confounder. Patients who were enrolled into the clinic for less than six months showed significantly greater improvements (six months is required for patients to stabilize from medication optimization). Therefore, a subgroup analysis using data from the 63 patients who were enrolled into the clinic for over six months at time of recruitment was performed. The results from the subgroup analysis indicated that the RPM system improved self-care, heart function, and heart failure prognosis at statistically significant and clinically meaningful levels. These improvements were found to be a result of enhanced self-care knowledge and practices, as well as enhanced clinical management enabled by the system. No differences in mortality or hospital admissions were found between groups, but the trial was underpowered to detect changes in these outcome measures. In summary, mobile phone-based RPM was found to be a feasible and effective tool to help improve heart failure management and outcomes.
URI: http://hdl.handle.net/1807/29861
Appears in Collections:Doctoral

Files in This Item:

File Description SizeFormat
Seto_Emily_201106_PhD_thesis.pdf12.59 MBAdobe PDF
View/Open

This item is licensed under a Creative Commons License
Creative Commons

Items in T-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

uoft