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Guio J, Melo A, Saldarriaga MM, Fuentes C, Tíjaro-Ovalle N, Borda A, Guzmán Y, Bolaños E, Quintero G, Duarte M, Agudelo C, Aparicio S, Cuellar G, Bernal P, Paéz M, Rueda E, Rodriguez A, Alvarado F, Pinzón O, Romero M. A Novel Digital Educational Strategy Improves Treatment Adherence and Quality of Life in Patients with Multiple Myeloma. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:50-57. [PMID: 37875743 DOI: 10.1007/s13187-023-02374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/26/2023]
Abstract
Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.
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Affiliation(s)
- Juan Guio
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Melo
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Hematology and Hemotherapy Division, Hospital Clinico San Carlos, Madrid, Spain
| | - Mateo Mejía Saldarriaga
- Hematology and Oncology Division, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Cynthia Fuentes
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Andrés Borda
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Yuli Guzmán
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Elías Bolaños
- Education and Knowledge Management, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Guillermo Quintero
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Mónica Duarte
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Claudia Agudelo
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Soraya Aparicio
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Psychiatry, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Gina Cuellar
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Patricia Bernal
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Nuclear Medicine, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Marco Paéz
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Erica Rueda
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Agustina Rodriguez
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Fernando Alvarado
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Oscar Pinzón
- Enterprise Analytics Division, Memorial Hermann Health System, Houston, TX, USA
| | - Martha Romero
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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Lucero RJ, Yoon S, Suero-Tejeda N, Arcia A, Iribarren S, Mittelman M, Luchsinger J, Bakken S. Application of persuasive systems design principles to design a self-management application user interface for Hispanic informal dementia caregivers: user preferences and perceptions. JAMIA Open 2022; 5:ooab114. [PMID: 35178504 PMCID: PMC8846363 DOI: 10.1093/jamiaopen/ooab114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 07/15/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE We designed an mHealth application (app) user interface (UI) prototype informed by participatory design sessions, persuasive systems design (PSD) principles, and Lorig and Holman's self-management behavior framework to support self-management activities of Hispanic informal dementia caregivers and assessed their perceptions and preferences regarding features and functions of the app. MATERIALS AND METHODS Our observational usability study design employed qualitative methods and forced choice preference assessments to identify: (1) the relationship between user preferences for UI features and functions and PSD principles and (2) user preferences for UI design features and functions and app functionality. We evaluated 16 pairs of mHealth app UI prototype designs. Eight paper-based paired designs were used to assess the relationship between PSD principles and caregiver preferences for UI features and functions to support self-management. An Apple iPad WIFI 32GB was used to display another 8 paired designs and assess caregiver preferences for UI functions to support the self-management process. RESULTS Caregivers preferred an app UI with features and functions that incorporated a greater number of PSD principles and included an infographic to facilitate self-management. Moreover, caregivers preferred a design that did not depend on manual data entry, opting instead for functions such as drop-down list, drag-and-drop, and voice query to prioritize, choose, decide, and search when performing self-management activities. CONCLUSION Our assessment approaches allowed us to discern which UI features, functions, and designs caregivers preferred. The targeted application of PSD principles in UI designs holds promise for supporting personalized problem identification, goal setting, decision-making, and action planning as strategies for improving caregiver self-management confidence.
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Affiliation(s)
- Robert J Lucero
- School of Nursing, University of California, Los
Angeles, Los Angeles, California, USA,Corresponding Author: Robert J. Lucero, PhD, MPH, RN,
FAAN, School of Nursing, University of California, Los Angeles, 700 Tiverton
Avenue, CA, USA;
| | - Sunmoo Yoon
- Vagelos College of Physicians and Surgeons, Columbia
University Irving Medical Center, New York City, New York,
USA
| | - Niurka Suero-Tejeda
- School of Nursing, Columbia University Irving
Medical Center, New York City, New York, USA
| | - Adriana Arcia
- School of Nursing, Columbia University Irving
Medical Center, New York City, New York, USA
| | - Sarah Iribarren
- School of Nursing, University of
Washington, Seattle, Washington, USA
| | - Mary Mittelman
- School of Medicine, New York
University, New York City, New York, USA
| | - Jose Luchsinger
- Vagelos College of Physicians and Surgeons, Columbia
University Irving Medical Center, New York City, New York,
USA
| | - Suzanne Bakken
- Vagelos College of Physicians and Surgeons, Columbia
University Irving Medical Center, New York City, New York,
USA,School of Nursing, Columbia University Irving
Medical Center, New York City, New York, USA
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