A randomized trial of mobile health support for heart failure patients and their informal caregivers: impacts on caregiver-reported outcomes

Med Care. 2015 Aug;53(8):692-9. doi: 10.1097/MLR.0000000000000378.


Background: Mobile health services may improve chronic illness care, but interventions rarely support informal caregivers' efforts.

Objectives: To determine whether automated feedback to caregivers of chronic heart failure patients impacts caregiving burden and assistance with self-management.

Research design: Randomized comparative effectiveness trial.

Subjects: A total of 369 heart failure patients were recruited from a Veterans Health Administration health care system. All patients participated with a "CarePartner" or informal caregiver outside their household.

Intervention: Patients randomized to "standard mHealth" received weekly automated self-care support calls for 12 months with notifications about problems sent to clinicians. "mobile health+CarePartner" (mHealth+CP) patients received identical services, plus email summaries and suggestions for self-care assistance automatically sent to their CarePartners.

Measures: At baseline, 6, and 12 months, CarePartners completed assessments of caregiving strain, depressive symptoms, and participation in self-care support.

Results: mHealth+CP CarePartners reported less caregiving strain than controls at both 6 and 12 months (both P≤0.03). That effect as well as improvements in depressive symptoms were seen primarily among CarePartners reporting greater burden at baseline (P≤0.03 for interactions between arm and baseline strain/depression at both endpoints). Although most mHealth+CP CarePartners increased the amount of time spent in self-care support, those with the highest time commitment at baseline reported decreases at both follow-ups (all P<0.05). mHealth+CP CarePartners reported more frequently attending patients' medical visits at 6 months (P=0.049) and greater involvement in medication adherence at both endpoints (both P≤0.032).

Conclusions: When CarePartners experienced significant caregiving strain and depression, systematic feedback about their patient-partner decreased those symptoms. Feedback also increased most CarePartners' engagement in self-care.

Trial registration: ClinicalTrials.gov NCT00555360.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Aged
  • Depression / etiology
  • Depression / prevention & control*
  • Female
  • Heart Failure / psychology
  • Heart Failure / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Patient Care / methods*
  • Quality of Life
  • Self Care / methods
  • Social Support*
  • Telemedicine*
  • Telephone*

Associated data

  • ClinicalTrials.gov/NCT00555360