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Breckner A, Litke N, Göbl L, Wiezorreck L, Miksch A, Szecsenyi J, Wensing M, Weis A. Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study. JMIR Form Res 2022; 6:e34786. [PMID: 36006666 PMCID: PMC9459841 DOI: 10.2196/34786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/07/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background Mobile health (mHealth) interventions for self-management are a promising way to meet the needs of patients with chronic diseases in primary care practices. Therefore, an mHealth intervention, TelePraCMan, was developed and evaluated for patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, high blood pressure, or heart failure in a German primary care setting. TelePraCMan entails a symptom diary, an appointment manager, a manager to document goals, and a warning system. The app should foster the self-management of participating patients. Objective We aimed to examine the effects of TelePraCMan on patient activation and quality of life and explored the underlying contextual factors, impacts, and degree of implementation. Methods In a prospective observational study design, we collected data by using interviews and written questionnaires from participating patients (intervention and control groups) and primary care workers (physicians and practice assistants). The primary outcomes of interest were patient-reported quality of life (12-Item Short Form Survey) and patient activation (patient activation measure). The quantitative analysis focused on differences between patients in the intervention and control groups, as well as before (T0) and after (T1) the intervention. Interviews were analyzed by using qualitative content analysis via MAXQDA (VERBI GmbH). Results At baseline, 25 patients and 24 primary care workers completed the questionnaire, and 18 patients and 21 primary care workers completed the follow-up survey. The patients were predominantly male and, on average, aged 64 (SD 11) years (T0). The primary care workers were mostly female (62%) and, on average, aged 47 (SD 10) years (T0). No differences were observed in the outcomes before and after the intervention or between the intervention and control groups. In the additional interviews, 4 patients and 11 primary care workers were included. The interviewees perceived that the intervention was useful for some patients. However, contextual factors and problems with implementation activities negatively affected the use of the app with patients. The main reasons for the low participation were the COVID-19 pandemic and the target group, which seemed to have less interest in mHealth; the interviewees attributed this to the older age of patients. However, the respondents felt that the app would be better accepted in 5 or 10 years. Conclusions Although the TelePraCMan app was rated as very good and important by the participants, few patients used it. The digital intervention was hardly implemented and had limited impact in the current setting of German primary care. Trial Registration German Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85
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Affiliation(s)
- Amanda Breckner
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Nicola Litke
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Linda Göbl
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Lars Wiezorreck
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Antje Miksch
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Aline Weis
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
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Lim HM, Abdullah A, Ng CJ, Teo CH, Valliyappan IG, Abdul Hadi H, Ng WL, Noor Azhar AM, Chiew TK, Liew CS, Chan CS. Utility and usability of an automated COVID-19 symptom monitoring system (CoSMoS) in primary care during COVID-19 pandemic: A qualitative feasibility study. Int J Med Inform 2021; 155:104567. [PMID: 34536808 PMCID: PMC8420087 DOI: 10.1016/j.ijmedinf.2021.104567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/27/2021] [Accepted: 08/26/2021] [Indexed: 11/26/2022]
Abstract
Background COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users’ perspective. Objectives This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users. Methods This was a qualitative study using in-depth interviews. Patients with suspected COVID-19 infection who used CoSMoS Telegram bot to monitor their COVID-19 symptoms and doctors who conducted the telemonitoring via CoSMoS dashboard were recruited. Universal sampling was used in this study. We stopped the recruitment when data saturation was reached. Patients and doctors shared their experiences using CoSMoS, its utility and usability for COVID-19 symptoms monitoring. Data were coded and analysed using thematic analysis. Results A total of 11 patients and 4 doctors were recruited into this study. For utility, CoSMoS was useful in providing close monitoring and continuity of care, supporting patients’ decision making, ensuring adherence to reporting, and reducing healthcare workers’ burden during the pandemic. In terms of usability, patients expressed that CoSMoS was convenient and easy to use. The use of the existing social media application for symptom monitoring was acceptable for the patients. The content in the Telegram bot was easy to understand, although revision was needed to keep the content updated. Doctors preferred to integrate CoSMoS into the electronic medical record. Conclusion CoSMoS is feasible and useful to patients and doctors in providing remote monitoring and teleconsultation during the COVID-19 pandemic. The utility and usability evaluation enables the refinement of CoSMoS to be a patient-centred monitoring system.
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Affiliation(s)
- Hooi Min Lim
- Department of Primary Care Medicine, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia; University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Adina Abdullah
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Chirk Jenn Ng
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chin Hai Teo
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Indra Gayatri Valliyappan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Haireen Abdul Hadi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wei Leik Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Abdul Muhaimin Noor Azhar
- Department of Emergency Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Thiam Kian Chiew
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Software Engineering, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Seng Chan
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Artificial Intelligence, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Freiesleben SD, Megges H, Herrmann C, Wessel L, Peters O. Overcoming barriers to the adoption of locating technologies in dementia care: a multi-stakeholder focus group study. BMC Geriatr 2021; 21:378. [PMID: 34154542 PMCID: PMC8218472 DOI: 10.1186/s12877-021-02323-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Locating technologies are a subtype of assistive technology that aim to support persons with dementia by helping manage spatial orientation impairments and provide aid to care partners by intervening when necessary. Although a variety of locating devices are commercially available, their adoption has remained low in the past years. Several studies have explored barriers to the adoption of assistive technologies from the perspective of professional stakeholders, but in-depth explorations for locating technologies are sparse. Additionally, the inputs of business professionals are lacking. The aim of this study was to expand knowledge on barriers to the adoption of locating technologies from a multi-stakeholder professional perspective, and to explore strategies to optimize adoption. Methods In total, 22 professionals working in business (n = 7), healthcare (n = 6) and research (n = 9) fields related to gerontology and gerontechnology participated in our focus group study. Perceptions on the value of using locating technologies for dementia care, barriers to their adoption, as well as salient services and information dissemination strategies were explored. After verbatim transcription, transcripts were analysed following an inductive data-driven content analysis approach in MAXQDA. Results Six key adoption barriers centering on: (1) awareness-, (2) technological-, (3) product characteristic- and (4) capital investment-based limitations, (5) unclear benefits, as well as (6) ethical concerns emerged. The interplay between barriers was high. Five core themes on services and information dissemination strategies centering on: (1) digital autonomy support, (2) emergency support, (3) information dissemination actors, (4) product acquisition, and (5) product advertising were extracted. Conclusions Our study with interdisciplinary stakeholders expands knowledge on barriers to the adoption of locating technologies for dementia care, and reinforces recommendations that an interdisciplinary strategy is needed to optimize adoption. Also, our findings show that focusing on services to increase digital autonomy and on information dissemination strategies has been largely overlooked and may be particularly effective. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02323-6.
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Affiliation(s)
- Silka Dawn Freiesleben
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany. .,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.
| | - Herlind Megges
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.,Present address: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), Berlin, Germany
| | - Christina Herrmann
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Lauri Wessel
- European New School of Digital Studies, European University Viadrina, Große Scharrnstraße 59, 15230, Frankfurt (Oder), Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
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