text4hf: a randomized controlled trial of a tailored text messaging intervention to improve self-care in older adult patients with heart failure

Conditions: Heart Failure

Summary: the goal of this study is to determine whether an individually tailored text messaging intervention can improve self-care in older adult patients with heart failure. the main question it aims to answer are: * is a tailored text messaging intervention feasible and acceptable among older adult patients with heart failure? * does tailored text messaging improve self-care in adult patients with heart failure? participants will be randomly assigned to one of two groups for 12 weeks: 1) intervention (text messaging); or 2) control group. both groups will receive usual care, which includes regular follow-up visits at the heart failure clinic (standard care), plus a "discharge packet for patients diagnosed with heart failure", developed by the american heart association. both groups will be asked via text messages and/or telephone calls to complete questionnaires at baseline/start, 4 weeks and 12 weeks, about self-care, quality of life, health beliefs, medications, diet, etc. participants assigned to the intervention group will also receive approximately 5 text messages/week targeting medication adherence, heart-healthy diet, and daily hf symptoms monitoring for 12 weeks.

heart failure (hf) is a serious chronic condition and the most common hospital discharge diagnosis among older adults in the united states. almost 7 million americans are diagnosed with hf and new cases are rapidly rising at a rate of nearly 1 million per year. this feasibility pilot randomized controlled trial will be conducted using individually tailored text message (tm) intervention, delivered to improve hf self-care adherence. this randomized controlled trial in older adult patients (≥50 years of age) with hf to determine the feasibility (recruitment capability, acceptability), and preliminary efficacy of the text4hf intervention compared with usual care over 12 weeks. thirty (n=30) adult patients from the university of illinois hospital \& health sciences system (uih) will be randomly assigned to the intervention or usual care group. patients in the tm intervention (text4hf) will receive messages that target the most common self-care factors known to precipitate hf hospitalizations (medication adherence, heart-healthy diet, and daily hf symptoms monitoring).

Eligibility criteria:
inclusion criteria: * ≥50 years of age * hf stage c, nyha class i-iv and on a loop diuretic * own a mobile phone with text message plan * ability to speak and read english * suboptimal hf self-care. (schfi score of 3 or less in at least 2 items of any subscale: self-care maintenance, symptom perception, or self-management) exclusion criteria: * heart transplant, savr/tavr or ventricular assist device, or cardiac resynchronization therapy (crt) - implantation, and/or heart transplantation (htx) within the next 3 months * coronary revascularization, and/or crt-implantation within the last 30 days (emr review) * psychosis * hospice or end-of-life care * advanced renal disease (i.e. stage iv, egfr \<25 or hemodialysis) * cognitive impairment * unable to self-manage (take medication, bathe, use the toilet, etc.) * currently living in a nursing home

Keywords: heart failure mhealth text messaging mobile phone