Adults with congenital heart disease: ready for mobile health?

R W Treskes, M Koole, D Kauw, M M Winter, M Monteiro, D Dohmen, A Abu-Hanna, M P Schijven, B J Mulder, B J Bouma, M J Schuuring, R W Treskes, M Koole, D Kauw, M M Winter, M Monteiro, D Dohmen, A Abu-Hanna, M P Schijven, B J Mulder, B J Bouma, M J Schuuring

Abstract

Purpose: Mobile health (mHealth) could improve the outcome of grown-up patients with congenital heart disease (GUCH) and reduce their emergency care utilisation. Inappropriate use of mHealth, however, can lead to data overload for professionals and unnecessary data collection for patients, increasing the burden for both. We aimed to determine the clinical characteristics of patients with high emergency care utilisation and to test whether these patients were willing to start using mHealth.

Methods: Clinical characteristics and emergency care utilisation of consecutive GUCH patients who visited one of the two participating cardiologists at the outpatient clinic of the Academic Medical Centre in Amsterdam were studied retrospectively. All patients were approached to fill in an mHealth questionnaire. A frequency of three or more emergency visits in 5 years was defined as high emergency care utilisation.

Results: In total, 202 consecutive GUCH patients who visited one of the two participating cardiologists were studied. Median age was 41 years, 47% were male, and 51% were symptomatic. In the previous 5 years, 134 emergency visits were identified. Of all patients, 8% had high emergency care utilisation. High emergency care utilisation was associated with patients being symptomatic, using antiarrhythmic drugs or diuretics. In total, 75% of all patients with high emergency care utilisation were willing to start using mHealth.

Conclusion: GUCH patients who are symptomatic, those on antiarrhythmic drug therapy and those on diuretics are suitable candidates for enrolment in future mHealth initiatives because of both high care utilisation and high motivation to start using mHealth.

Keywords: Congenital heart disease; Delivery of healthcare; GUCH; Mobile health; Resource utilisation; eHealth.

Conflict of interest statement

Conflict of interest

R.W. Treskes, M. Koole, D. Kauw, M.M. Winter, M. Monteiro, D. Dohmen, A. Abu-Hanna, M.P. Schijven, B.J. Mulder, B.J. Bouma and M.J. Schuuring declare that they have no competing interests.

Ethical approval

For the collection of medical data from all the participating GUCH patients, permission was granted by the Ethics Committee (reference number W16_057). For the questionnaire survey no approval from the Institutions’ Ethics Committee was required under Dutch law, since it was not burdensome for the patients.

Figures

Fig. 1
Fig. 1
Frequency of emergency care visits, reasons and subsequent diagnoses
Fig. 2
Fig. 2
Flow chart of patient selection. GUCH grown-up patients with congenital heart disease

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