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Development and Feasibility of Self-Management Application in Left-Ventricular Assist Devices

Casida, Jesus M.*; Aikens, James E.; Craddock, Heidi; Aldrich, Matthew W.§; Pagani, Francis D.†¶

doi: 10.1097/MAT.0000000000000673
Adult Circulatory Support

Despite major advancements in mechanical circulatory support, the self-management (SM) for patients with a left-ventricular assist device (LVAD) remains complex and challenging for patients and their caregivers. We have developed a mobile phone application (VAD Care App) to organize and simplify the LVAD SM process. This article describes the development and feasibility study of the app as an SM tool for LVAD patients and caregivers requiring support from ventricular assist device (VAD) coordinators. The specific aim was to evaluate the app’s acceptability and usability and the users’ competency. App features included an automated alert, data collection/reporting, and dynamic real-time interaction systems embedded in the LVAD SM process. Beta-testing of the prototype was completed by five adults. For the feasibility study, we employed a mixed-method descriptive research design involving nine patients and nine caregivers from two VAD centers in the Midwest. We asked them to use the app daily for more than 30 days and complete an app Evaluation Questionnaire and an interview. The questionnaire uses a five-point rating scale (1 = strongly disagree to 5 = strongly agree) evaluating usability, acceptability, and competency domains. Data generated from the questionnaires and interviews were analyzed with descriptive statistics and content analytic procedures. A total of 16 users (eight patients [all male] and eight caregivers [seven female]) aged 22 to 68 years completed the 30 day study. Median acceptability, usability, and competency scores were 4.6, 4.5, and 4.7, respectively. Based on the data, it is feasible for patients and caregivers to use an app as an LVAD SM tool warranting further research.

From the *University of Michigan School of Nursing, Ann Arbor, Michigan; University of Michigan Medical School, Ann Arbor, Michigan; Barnes-Jeiwsh Hospital/Washington University, St. Louis, Missouri; §Aldrich & Co., LLC, Box Elder, South Dakota; and University of Michigan Health System, Ann Arbor, Michigan.

Submitted for consideration March 2017; accepted for publication in revised form June 2017.

This study is funded by the NIH P20NR015331 and the University of Michigan School of Nursing, Ann Arbor, MI.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Jesus M. Casida, University of Michigan School of Nursing, Ann Arbor, MI. Email:

Copyright © 2018 by the American Society for Artificial Internal Organs