Technology-enabled learning has gone a step further as a novel tablet is helping heart failure patients to manage their disease including drug dosages. Patients with heart failure are prescribed diuretics which act on the kidneys to produce more urine, thereby reducing fluid retention and congestion. Patients are advised to monitor their weight, as a rapid loss could be a sign that the diuretic dose is too high while a sudden gain could indicate fluid retention and require reducing the dose.
“Approximately 60% of patients with heart failure receive treatment and follow up in primary care,” said lead author Maria Liljeroos. “Providing education to increase self-care is often a challenge in primary care due to lack of experience about heart failure and time.”
To improve the delivery of evidence based care for heart failure patients in all parts of the healthcare system, in 2010 a county council in Sweden established heart failure clinics in primary care. It also decided to test whether an e-health tool, called OPTILOGG, could help patients self-manage their condition.
OPTILOGG is a pre-programmed tablet attached to a weighing scale that provides heart failure education, registers body weight and symptoms, and titrates diuretics. If the tool detects heart failure deterioration, the patient is instructed to increase the dose of diuretics. If weight gain is above a pre-determined range patients should contact the heart failure clinic. Patients can use OPTILOGG as required without pushing any buttons and it takes less than 30 seconds a day.
OPTILOGG was previously shown to improve self-care in patients followed up by specialised heart failure clinics after hospitalisation. The current study evaluated its effectiveness in primary care. The study had three aims: to assess patients’ adherence to using OPTILOGG, to explore nurses’ experiences of the implementation, and to evaluate the effects on self-care behaviours.