ong term effects of smart care program based on clinical prognosis map for the prevention of heart failure in myocardial infarction patients with left ventricular dysfunction

Background: To prevent progression to heart failure, which is expected to occur due to aging and an increase in myocardial infarction, self-management of lifestyle habits and risk factors is necessary in middle-aged men after myocardial infarction who are at risk. Objectives: This study aimed to develop a smartphone app that self-monitors lifestyle habits and risk factors weekly and provides individualized algorithm-based feedback, and to verify its effectiveness for 12 months. This study developed a smartphone app that included a checklist for weekly self-monitoring of lifestyle habits and risk factors and individualized algorithm-based feedback, and provided assistant consultation from a nurse regarding the application and application results of the app. An attempt was made to verify the effect over the years. Design: This study applied a prospective, single-blinded, two-arm, randomized controlled trial with a repeated measure design. Participants and Setting: We recruited middle-aged male post myocardial infarction patients with a moderately reduced left ventricular ejection fraction = 50% from the cardiology outpatient or ward of two university hospitals in Seoul, Korea from August 2021 to July 2023. Methods: The smartphone app included a weekly lifestyle habits self-monitoring checklist, providing algorithm-based feedback messages by an animated nurse, and learning information. Additionally, the app generated visualized data from the accumulated checklist results, and a nurse provided face-to-face feedback during patients’ regular outpatient visits. Data were collected using a structured self-report questionnaire, and repeated measures ANOVA was applied using the SPSS/WIN 240.0 program to test hypotheses about the effectiveness of the intervention after three, six, and 12 months. Results: Health behaviors increased in the intervention group (n = 35) compared to the control group (n = 33) at three, six, and 12 months, and the main effect, time, and interaction effects between groups were significant (F = 10.24, p < .001). Depression (F = 3.55, p = .020) and negative illness perception (F = 6.23, p < .001) decreased significantly over time in both groups, but there was no difference between the groups. There was a significant time and group interaction effect on illness perception (F = 3.15, p = .026). In resilience, there was a significant main effect of the difference between groups (F = 5.54, p = .022), but the interaction effect with time was not significant. Conclusions: Weekly self-monitoring of lifestyle habits using a smartphone app had a positive effect on improving health behavior over 12 month period in middle-aged male post-myocardial infarction patients at risk for heart failure. Follow-up studies are needed to determine whether the use of this smartphone app maintains longer-term behavioral changes and improves heart failure-related physiological indicators.