Influencing factors for heart failure patients in accepting digital technology for self-care
Authors: Mcnulty A E , Hill L , Mccune C , Dixon L , Thompson D R , Watson C J , Tonry C , Fitzsimons D 
Published: July 2024

Abstract

Background
Heart failure (HF) is a complex, progressive debilitating condition. Despite advances in pharmaceuticals, implantable devices and surgical therapies, long-term outcomes and quality of life for many with HF remain poor. The Covid-19 pandemic prompted healthcare professionals to employ new ways of working, including greater use of digital technologies. While patients were receptive to this change, it required them to be more responsible and aware of their symptoms. However, perceptions of the longer-term use of digital technology, as it becomes more embedded in modern HF services, are uncertain.

Purpose
To identify factors that influence patients’ perceptions of using an E-Health device in HF management.

Methods
Clinicians and researchers from across four countries (UK, Netherlands, Ireland, and Germany) developed a 43 item questionnaire. Ethical approval was obtained, and 165 questionnaires were distributed to HF patients in a single UK site between February 2021 and May 2022. Patients who met the inclusion criteria, informed written or audio recorded consent was obtained, taking into consideration patient preference and the impact of ongoing Covid-19 restrictions. Patients recorded their responses in the questionnaire in written form or electronically via the Qualtrics platform. Demographic data, such as age, marital status, educational background was collected. Patients were asked which factors would influence their decision to use technology to help manage their HF treatment. Using SPSS Version 27 an independent researcher performed frequency and chi-squared analyses, with post-hoc corrections.

Results
Results from responders are presented as percentages. There was a response rate of 61% with 101 questionnaires completed. Most respondents were male (n= 67, 66%), 26 patients (26%) over the age of 70 years. The majority of patients (n=74, 74%) had children, with most (n=63, 63%) having two or more. In total, 60 (60%) patients reported their highest level of education as secondary school, only 25 (25%) completed tertiary level education. Upon questioning regarding the use of technology to manage HF symptoms, 45 (47%) patients considered an E-health device could be beneficial, and 40 (42%) were unsure (See Figure 1) Over half who responded (n=54, 60%,) would seek the advice of their HF nurse if experiencing a cardiac problem. When asked who would convince them to use an E-health device, 88% (n=77) named their HF nurse, followed by research findings (67%).

Conclusion
Many patients with HF have a positive perception towards digital technology and can envisage its role in their future management. HF nurses are in an ideal position to encourage patients to embrace technology and develop personalised ways of integrating it into their care. Future use of technology and artificial intelligence is changing the face of healthcare; however, it is imperative it is safe and trustworthy, and enhances HF patients personalised care.Figure 1