Approximately 6.5 million adults in the United States have heart failure (HF), with an estimated cost of >$30 billion annually and a projected prevalence increase of 46% by 2030. Heart failure is characterized by a poor quality of life, from worsening symptoms until death, but HF is amenable to symptom management. Patient self-care behaviors are well known to improve HF outcomes; however, self-care is underused, and pharmacological interventions are seen as more important by patients, clinicians, and health care systems. Recent meta-analyses show that mobile health (mHealth) monitoring (remote patient monitoring) is generally effective in reducing HF hospitalization and short-term mortality. Furthermore, mHealth monitoring has shown some efficacy in improving quality of life, medication adherence, cardiac lifestyle behaviors, disease management, and patient satisfaction. In past research, the investigators assessed hospitalizations and mortality as primary outcomes, but gaps in knowledge remain, especially the impact on important patient-centered outcomes, such as self-care, symptom management, functional capacity, psychological distress, and caregiver burden. This clinical trial, titled Innovative Care Model for Older Adults With Chronic Heart Failure (iCOACH), aimed to accomplish the following aims.
