Effects of tailored telemonitoring on heart failure patients' knowledge, self-care, self-efficacy and adherence: a randomized controlled trial

Eur J Cardiovasc Nurs. 2014 Jun;13(3):243-52. doi: 10.1177/1474515113487464. Epub 2013 Apr 29.


Background: The education of patients with heart failure (HF) is an essential part of disease management. The perspectives of an increasing number of patients and a shortage of professionals force healthcare to explore new strategies in supporting patients to be better informed and more active.

Methods: Three hundred and eighty-two patients with HF (age 71±SD 11.2 years) were randomly assigned to either a telemonitoring or a usual care group. Patients received four postal questionnaires to assess their levels of self-reported knowledge, self-care, self-efficacy and adherence. Generalized estimating equations analysis was performed to assess the effects of telemonitoring during the 1-year follow-up. Corrections for baseline were performed if needed.

Results: Baseline differences between groups were found for self-care (p=0.001) and self-efficacy (p=0.024). Knowledge of patients in the telemonitoring group significantly improved with 0.9 point on a 15-points scale (p<0.001). Their self-care abilities improved with 1.5 point on a 10-item scale whereas no changes were found in patients receiving usual care (p<0.001). Self-efficacy of patients in the intervention group improved significantly after 6 months yet was not significantly different after 3 months and 1 year. For patients in the intervention group adherence improved for daily weighing (p<0.001) during the whole follow-up and for fluid intake (p=0.019) after 3 months and after 12 months (p=0.086). Adherence for activity recommendations improved (p=0.023) after 3 months and importance of medication adherence increased after 6 (p=0.012) and 12 months (p=0.037). No effects were found regarding appointments, diet, smoking and use of alcohol.

Conclusions: Tailored telemonitoring was found to educate patients with HF and to improve their self-care abilities and sense of self-efficacy.

Keywords: Heart failure; adherence; knowledge; self-care; self-efficacy; telemonitoring.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Nursing / methods
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Heart Failure* / nursing
  • Heart Failure* / psychology
  • Heart Failure* / therapy
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Self Care / methods*
  • Self Efficacy*
  • Surveys and Questionnaires
  • Telemedicine / methods*