904e55c4cf3731e3d36727073c4c587b 302827.pdf 9fc9564b4a352c7717e65d9da658c84e0b9916b8 302827.pdf 93907862f9c62d601b2935caa80ad4d98762227ab8a064fc410aa47310c010aa 302827.pdf Title: Does an eHealth Intervention Reduce Complications and Healthcare Resources? A mHeart Single-Center Randomized-Controlled Trial Subject: (1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients’ adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients’ adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p = 0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections (17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004) or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; p = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care. Keywords: heart transplant; eHealth; complications; resource use Author: Mar Gomis-Pastor, Sonia Mirabet Perez, Anna De Dios Lopez, Vicenç Brossa Loidi, Laura Lopez Lopez, Rebeca Pelegrin Cruz and Mª Antonia Mangues Bafalluy Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Feb 10 08:18:19 2023 CET ModDate: Fri Feb 10 08:21:39 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 974625 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JFFBIV+VnURWPalladioL Type 1 Custom yes yes no 10 0 MSDRGT+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 AZURTL+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 TKLJOY+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 NJAOJC+CMSY10 Type 1 Builtin yes yes no 28 0 VGVAWT+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 50 0 AFLMDA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 84 0 AFLMDC+PalatinoLinotype TrueType WinAnsi yes yes no 87 0 AFLMDE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 90 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 105 0 AFLMDA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 119 0 AFLMDC+PalatinoLinotype TrueType WinAnsi yes yes no 122 0 AFLMDE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 125 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-11-19 02:45:26 CET RepresentationInformation: 302827.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-11-18 10:01:44 CET Size: 974625 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 286 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Trial Design and Ethical Aspects Destination: subsection.2.1 Item: Title: Participants Destination: subsection.2.2 Item: Title: In-Clinic Visits and Interventions Destination: subsection.2.3 Item: Title: Outcomes Destination: subsection.2.4 Children: Item: Title: Health Outcomes Destination: subsubsection.2.4.1 Item: Title: Use of Resources Destination: subsubsection.2.4.2 Item: Title: Analysis Destination: subsection.2.5 Children: Item: Title: Descriptive Analysis Destination: subsubsection.2.5.1 Item: Title: Analysis by Objectives Destination: subsubsection.2.5.2 Item: Title: Results Destination: section.3 Children: Item: Title: Patient Description Destination: subsection.3.1 Item: Title: Mortality and Complications during Follow-Up in the Overall Population Destination: subsection.3.2 Item: Title: Differences in Health Outcomes between Patients on Intervention and the Control Group Destination: subsection.3.3 Item: Title: Healthcare Resource Use during Follow-Up in the Overall Population Destination: subsection.3.4 Item: Title: Differences in Healthcare Resource Use between Patients in the Intervention and Control Groups Destination: subsection.3.5 Item: Title: Differences in Complications and Healthcare Resource Use between Adherent and Non-Adherent Immunosuppressive Treatment Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Does an eHealth Intervention Reduce Complications and Healthcare Resources? A mHeart Single-Center Randomized-Controlled Trial Author: Mar Gomis-Pastor, Sonia Mirabet Perez, Anna De Dios Lopez, Vicenç Brossa Loidi, Laura Lopez Lopez, Rebeca Pelegrin Cruz and Mª Antonia Mangues Bafalluy Subject: (1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients’ adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients’ adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p = 0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections (17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004) or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; p = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care. 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