Table 1.

Mobile health apps or systems that tested usability and/or potential efficacy on patients with heart failure.

Author	Study type	Intervention components	Outcomes measured	Results
Athilingam [32]	Pilot study (n=18) compared mobile app (HeartMapp) with HF education-only app, follow-up in 30 days	Symptom assessment, weight, blood pressure, medication management, alert and cues for action, mood and cognition assessment, deep breathing exercise for improved psychological health, track physical activity, support and communication with self-identified circle, track performance statistics	SCHFIa, KCCQb, MMAQc, AHFKTd, PHQ-9e, SEf, SUSg	Trends of improved self-management, knowledge, and QoLh. Usability established. Partial eta squared indicated small-to-moderate effect sizes (self-care 0.249, HFi knowledge 0.337, QoL 0.156). Completion rate was 80%.
Austin [41]	Pre-post evaluation (n=60)	Daily interactive voice messages on educational tips	Readmission	Reduced readmission rate by 50% in 30 days; 25% dropout rate.
Dang [42]	RCTj (n=61), intervention group (n=42), usual care (n=19)	Mobile system to alert for symptom assessment, weight, and blood pressure; mobile phone–assisted case management program in VAk evaluated self-care efficacy, knowledge, behavior, and QoL; follow-up 3 months	EHFScBSl, DHFKSm, HDSn, HFSEo, MLHFQp, SEMCDq, SF-36r	Usability established on minority population, program satisfaction scores (mean 6.84 [SD 0.46]), self-efficacy and QoL improved; 15% never used the app after enrollment.
Hagglund [44]	RCT (n=72), intervention (n=32), control group (n=40)	Weight and symptom assessment and HF education with a new system called home intervention system (HISs, OPTILOGG)	EHFScBS, DHFKS, KCCQ, SF-36	Improved self-management, QoL, and physical function (all P<.05). Median adherence was 88%.
Hale [34]	Pilot RCT (n=25), intervention group (n=11), control (n=14)	MedCentry for medication management with alerts and dispensing medication on time. Measured medication adherence objectively on the device and subjectively using questionnaire	MLHFQ, MMAQ, PHQ-8t, readmission, usability of device	High medication adherence rate (95%), decreased hospitalization among intervention group 9% versus 50%, QoL improved (P=.02).
Pai [45]	Pre-post evaluation (n=130)	Weight, blood pressure, symptom assessment, alerts, medication management, track physical activity, used video education and clinician connect for care access	Readmission	53% reduction in readmission rate after rolling out the app.
Nundy [35]	Pilot, quasi-experimental (n=15)	Only text messages on HF education	SCHFI	Reported improved self-management (P=.002).
Piette [46]	Comparative effectiveness (n=165) study	Interactive voice response system with care partners in VA. Tracked weight, symptom assessment, medication management, alerts, and support system with care partners	NSSQu, CES-Dv	Improved medication adherence (P=.032).
Scherr [47]	RCT (n=108, equal 54 in groups)	MOBITEL platform used weight, blood pressure, and mobile phone for notification and access to data	Readmission, usability survey	Intention-to-treat 33% (1 death, 17 hospitalizations) in control group compared with 17% (0 deaths, 11 hospitalizations) in the intervention group; relative risk reduction 50% (95% CI 3%-74%, P=.06).
Seto [48]	RCT (n=100) mobile phone app and usual care with 6-month follow-up	Daily weight, symptom assessment, blood pressure, and EKGw reading	SCHFI, MLHFQ, EKG, readmission	Improved self-care score (P=.03) and QoL (P=.05) among intervention group.
Suh [37]	Pilot study (n=26) pre-post evaluation	Weight, blood pressure, symptom assessment, reminder, and activity tracking	HFSASx, readmission, observation of usability	Reported improved outcome on weight assessment. Patients reduced 5.6% of weight and blood pressure (P=.002).

^aSCHFI: Self-Care of Heart Failure Index.

^bKCCQ: Kansas City Cardiomyopathy Questionnaire.

^cMMAQ: Morisky Medication Adherence Questionnaire.

^dAHFKT: Atlanta Heart Failure Knowledge Test.

^ePHQ-9: Patient Health Questionnaire–9 item.

^fSE: Self-Efficacy Scale.

^gSUS: System Usability Scale.

^hQoL: quality of life.

ⁱHF: heart failure.

^jRCT: randomized controlled trial.

^kVA: Veterans Administration.

^lEHFScBS: European Heart Failure Self-Care Behavior Scale.

^mDHFKS: Dutch Heart Failure Knowledge Scale.

ⁿHDS: Health Distress Scale.

^oHFSE: Heart Failure Self-Efficacy scale.

^pMLHFQ: Minnesota Living With Heart Failure Questionnaire.

^qSEMCD: Self-Efficacy for Managing Chronic Disease.

^rSF-36: Short Form–36 item.

^sHIS: home intervention system.

^tPHQ-8: Patient Health Questionnaire–8 item.

^uNSSQ: Norbeck Social Support Questionnaire.

^vCES-D: Center for Epidemiologic Studies–Depression scale.

^wEKG: electrocardiogram.

^xHFSAS: Heart Failure Somatic Awareness Scale.