A Nurse-Led Model of Care with Telemonitoring to Manage Patients with Heart Failure in Primary Health Care: A Mixed-Method Feasibility Study

Jessica Longhini,1 Federica Canzan,1 Paola Zambiasi,2 Stefano Toccoli,2 Lorenzo Gios,3 Maurizio Del Greco,2 Simona Sforzin,2 Monica Moz,3 Michela Fracchetti,2 Luisa Saiani,1 Renata Brolis,2 Annamaria Guarnier,2 Mariangela Soverini,2 Massimiliano Maines,2 Elisa Ambrosi1 1Department of Diagnostics and Public Health, University of Verona, Verona, Italy; 2Azienda Provinciale per i Servizi Sanitari, Trento, Italy; 3TrentinoSalute4.0, Competence Center for Digital Health, Trento, ItalyCorrespondence: Jessica Longhini, University of Verona, Strada le Grazie 8, Verona, Italy, Tel +393405322936, Email jessica.longhini@univr.itPurpose: To determine whether a nurse-led care model with telemonitoring in primary care for patients with stable heart failure and their caregivers is feasible and acceptable.Patients and Methods: A mixed-methods feasibility study was conducted. Patients with stable heart failure and their caregivers were consecutively enrolled from March 2021 to April 2022. Participants were managed by nurses in a community health center through education and monitoring with a mobile app. The outcomes were feasibility outcomes, self-care outcomes, and qualitative acceptability and satisfaction. Quantitative and qualitative outcomes were linked to understanding how the model of care might benefit patients.Results: Twenty-six patients and nine of their caregivers were enrolled. Ten participants used the mobile app. Nineteen patients and eight caregivers were interviewed. Participants who improved their self-care appreciated the help in finding coping strategies, being close to the clinic, and feeling cared for. Participants with fewer improvements in self-care perceived the model of care as useless and were far from the centre. Participants decided to use the app mainly for usefulness prevision, and most of them were satisfied.Conclusion: The model of care was not successful in recruiting patients, and adjustments are needed to improve the recruitment strategy and to engage people who perceive the model of care as not useful or unable to use the app.Keywords: nursing, primary care, heart failure, cardiology, general practice