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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 7 (2005) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/4742


Title: Pilot Study of an Internet Patient-Physician Communication Tool for Heart Failure Disease Management
Authors: Wu, Robert C
Delgado, Diego
Costigan, Jeannine
MacIver, Jane
Ross, Heather
Keywords: Original Paper
Internet
disease management
congestive heart failure
physician-patient relations
communication
Issue Date: 26-Mar-2005
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Robert C Wu, Diego Delgado, Jeannine Costigan, Jane MacIver, Heather Ross. Pilot Study of an Internet Patient-Physician Communication Tool for Heart Failure Disease Management. J Med Internet Res 2005;7(1):e8 <URL: http://www.jmir.org/2005/1/e8/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2005/1/e8/ ] Background: Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. Objective: This pilot study evaluated the feasibility and patients’ acceptability of using the Internet to communicate with patients with symptomatic heart failure. Methods: Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. Results: Between May 3, 1999 and November 1, 2002, 62 patients (mean age 48.7 years) were enrolled.. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3386 entries out of all 5098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient’s entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3386 comments to the Heart Function Clinic. Based on the content analysis of 100 patient entries, the following major categories of communication were identified: patient information; patient symptoms; patient questions regarding their condition; patient coordinating own care; social responses. The number of comments decreased over time for both patients and clinicians. Conclusion: While the majority of patients discontinued use, 45% of the patients used the system and continued to use it on average for 1.5 years. An Internet tool is a feasible method of communication in a substantial proportion of patients with heart failure. Further study is required to determine whether clinical outcomes, such as quality of life or frequency of hospitalization, are improved.
Description: Reviewer: Ross, Stephen
URI: http://hdl.handle.net/1807/4742
ISSN: 1438-8871
Other Identifiers: doi:10.2196/jmir.7.1.e8
Rights: Copyright (cc) Retained by author(s) under a Creative Commons License: http://creativecommons.org/licenses/by/2.0/
Appears in Collections:Volume 7 (2005)

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