Tele-empowerment for older adult heart failure: An RCT confirming dual 8-week sustained gains in functional status, promoting lifestyle, and caregiver burden reduction

Heart failure (HF) prevalence and barriers to traditional rehabilitation, functional limitations, and health care access in aging populations necessitate innovative solutions. This study assessed the effectiveness of tele-empowerment in enhancing functional status, promoting lifestyle modifications, and reducing caregiver burden among older adult patients with HF. This randomized clinical trial was conducted at Rouhani Hospital, Iran (2025). A total of 72 heart failure patients aged 65 years or older (NYHA Class II-III) were block-randomized (1:1; block size of 4) to receive either tele-empowerment or standard care. The 8-week program consisted of 24 sessions, delivered through a smartphone messaging app. The results showed statistically significant improvements in the intervention group across all primary outcomes. The virtual empowerment group Compared to baseline demonstrated Increased functional status (mean difference = 22.1, 95% CI: 14.1; 29.9, p < .001), Enhanced lifestyle modifications (MD = 38.9, 95% CI: 30.3; 47.5, p < .001), Reduced caregiver burden (MD = -19.6, 95% CI: −25.9; −12.9, p < .001) at 1-month follow-ups. In contrast, control group participants showed no clinically meaningful changes in functional status, lifestyle modification, or caregiver burden. Repeated-measures ANOVA revealed significant improvements in the intervention group vs. control at 2-month follow-up. This RCT confirms that tele-empowerment significantly improves functional status, lifestyle modifications, and caregiver burden in older adult heart failure patients, with benefits sustained at 2-month follow-up. Its cost-effectiveness and capacity to overcome access barriers demonstrate clinical utility for integration into standard HF management protocols.Trial registration Iranian Registry of Clinical Trials IRCT20240912063016N1. Registered on January 31, 2025, before to the enrollment of the first participant. https://irct.behdasht.gov.ir/trial/79139.