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Wang Q, Lee RLT, Hunter S, Zhu A, Chan SWC. Patient Engagement in a Mobile App-Based Rehabilitation Program for Total Hip or Knee Arthroplasty: Secondary Data Analysis of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e57635. [PMID: 39353187 DOI: 10.2196/57635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/05/2024] [Accepted: 08/07/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Health care professionals use mobile apps to support patients' rehabilitation after total hip or knee arthroplasty. Understanding patient engagement in such mobile health interventions can help tailor these interventions to better support patients. OBJECTIVE This study aimed to investigate patient engagement in a mobile app-based arthroplasty rehabilitation program and to investigate the association between patient engagement and their characteristics. METHODS Data were extracted from a pool of 42 participants in the experimental arm of a randomized controlled trial that used a mobile app (WeChat [Tencent Holdings Limited])-based program to support patients' rehabilitation after total hip or knee arthroplasty. The primary outcomes were the number of days the participants accessed the program and completed recommended rehabilitation tasks. Secondary outcomes included data on the participants' posts on a discussion forum, messages sent by the participants, access to the program components, and reading and sharing the program content. Generalized linear models were used to analyze the association between patient engagement and personal characteristics. RESULTS The participants reported in a rehabilitation diary accessing the program on a mean of 5.2 (SD 2) days per week and completing recommended rehabilitation tasks on a mean of 6.5 (SD 0.8) days per week. The majority (31/42, 74%) posted on the discussion forum, with a mean of 18.1 (SD 21.2) posts. Most participants (37/42, 88%) sent messages to health care professionals, with a mean of 14 (SD 15.9) messages. The program components were visited for a total of 525 times. The program content was read 898 times and shared 82 times in total. Generalized linear models showed that both primary outcomes, the number of days the participants accessed the program (B=6.46, 95% CI 1.98-15.35; χ21=11.1, P=.001) and the number of days they completed rehabilitation tasks (B=2.65, 95% CI 0.45-5.48; χ21=5.7, P=.02), were positively associated with having a high school education or above. In addition, the number of posts on the discussion forum was positively associated with living with family, having a high school education or above, undergoing total knee arthroplasty, having comorbidities, and the score of self-efficacy but was negatively associated with age. The number of messages sent by the participants was positively associated with having a high school education or above, having comorbidities, and the score of self-efficacy. CONCLUSIONS Patient engagement in mobile arthroplasty rehabilitation is associated with their education level, cohabitation status, age, type of surgery, presence of comorbidities, and sense of self-efficacy. Program developers can consider these characteristics and use strategies, such as family involvement, in the design of mobile arthroplasty rehabilitation programs to enhance patient engagement in such interventions. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621000867897; https://tinyurl.com/mtdw25fp.
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MESH Headings
- Humans
- Male
- Female
- Arthroplasty, Replacement, Knee/rehabilitation
- Arthroplasty, Replacement, Knee/psychology
- Mobile Applications/standards
- Mobile Applications/statistics & numerical data
- Patient Participation/psychology
- Patient Participation/statistics & numerical data
- Patient Participation/methods
- Middle Aged
- Arthroplasty, Replacement, Hip/rehabilitation
- Arthroplasty, Replacement, Hip/psychology
- Arthroplasty, Replacement, Hip/methods
- Aged
- Secondary Data Analysis
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Affiliation(s)
- Qingling Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Regina Lai-Tong Lee
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Sharyn Hunter
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Aiyong Zhu
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Schrauben SJ, Park D, Amaral S, Purcell A, Zhang S, Kearney M, Bilger A, Feldman HI, Dember LM. Supporting Self-Management of Healthy Behaviors in Chronic Kidney Disease and Hypertension: The Supporting Self-Management of Healthy Behaviors Pilot Randomized Trial. Clin J Am Soc Nephrol 2024; 19:01277230-990000000-00419. [PMID: 38954482 PMCID: PMC11390029 DOI: 10.2215/cjn.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 06/27/2024] [Indexed: 07/04/2024]
Abstract
Key Points
Support programs for self-management are underutilized among people with CKD.Implementing a smartphone support tool for self-monitoring physical activity and BP was feasible among people with CKD and hypertension.Despite low digital health literacy, Supporting Self-Management of Healthy Behaviors was observed to be readily usable because of high levels of adherence and usability scores.
Background
Support programs for self-management are underutilized among people with CKD. We examined the feasibility of a smartphone-based intervention to support physical activity and BP monitoring, Supporting Self-Management of Healthy Behaviors (SMART-HABITS), for individuals with CKD and hypertension.
Methods
SMART-HABITS was piloted in a 12-week randomized cross-over trial among people with CKD and hypertension. Participants were asked to monitor BP ≥3-times/wk and step counts ≥5-times/wk. Participants were randomized to BP communication approach–self-report through text message for 6 weeks versus automatic reporting with a smartphone application (app) paired to a Bluetooth enabled BP machine for the alternate 6 weeks. The approach to monitoring and reporting steps was the same during both phases. Primary outcomes were adoption (retention and use of SMART-HABITS dashboard), adherence (% of transmitted BP and step counts), and acceptability as assessed with surveys and interviews. Secondary outcomes were reach, maintenance, CKD knowledge, digital health literacy, self-management, self-efficacy, quality of life, step counts, and BP values. Interviews were conducted at study end.
Results
Of the 47 randomized participants, 44 (94%) completed the text phase and 43 (92%) completed the app phase. The median age was 63 years, 49% were female, and 45% were Black. Retention was 91%. BP adherence was 87% in the text phase and 74% in the app phase, and step count adherence was 97%. Acceptability scores were high, and interviews largely conveyed acceptance. CKD knowledge increased but remaining survey scores did not change. Mean step counts increased from the prestudy period similarly in both phases. BP did not change over time.
Conclusions
Implementing a smartphone support tool for self-management was feasible among people with CKD and hypertension. The approach can supplement clinic-based care and potentially lead to less cardiovascular disease and CKD progression.
Clinical Trial registry name and registration number:
NCT04858295.
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Affiliation(s)
- Sarah J Schrauben
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Diane Park
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sandra Amaral
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Siqi Zhang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew Kearney
- Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrea Bilger
- Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Harold I Feldman
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura M Dember
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Tosin MHS, Mecone CAC, Oliveira EFM, Tsui DS, Tan SB, Irene S, Oliveira BC, de Oliveira BGRB. Nursing and Parkinson's Disease: A Scoping Review of Worldwide Studies. Clin Nurs Res 2021; 31:230-238. [PMID: 34486425 DOI: 10.1177/10547738211044047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This scoping review aims to evaluate the characteristics of worldwide studies evolving the scope of nursing practice in Parkinson's disease (PD). We conducted a three-step search strategy using 11 databases and reference lists. Of the 4,174 screened studies we included 324 (8%). Most were published during 1978 to 2020, with significant increasing in publications from 2002 onwards and a forecast to double in the next 10 years (total expected = 614, ±62.2, R2 = .998). We identified studies involving nine contexts of nursing practice in PD, in four continents and 31 countries, most of them of observational design (47.2%), funded (52.2%), authored by nurses (70.1%), and related to Nursing care/Guidelines (32.1%), Educational/Research content (16.4%), Symptom management/Medication adherence (14.5%), and Family caregiving (11.1%). The worldwide studies evolving the scope of nursing practice in PD is growing in several health context. These results can guide future research and evidence-based practice involving the role of nurses in PD.
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Affiliation(s)
- Michelle Hyczy S Tosin
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Rush University Medical Center, Chicago, IL, USA
| | | | | | | | | | - Sin Irene
- Singapore General Hospital, Singapore
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Habib B, Buckeridge D, Bustillo M, Marquez SN, Thakur M, Tran T, Weir DL, Tamblyn R. Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge. JAMIA Open 2021; 4:ooab050. [PMID: 34345805 PMCID: PMC8325487 DOI: 10.1093/jamiaopen/ooab050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/10/2021] [Accepted: 06/17/2021] [Indexed: 11/14/2022] Open
Abstract
Objective The objectives of this pilot study were (1) to assess the feasibility of a larger evaluation of Smart About Meds (SAM), a patient-centered medication management mobile application, and (2) to evaluate SAM’s potential to improve outcomes of interest, including adherence to medication changes made at hospital discharge and the occurrence of adverse events. Materials and Methods We conducted a pilot randomized controlled trial among patients discharged from internal medicine units of an academic health center between June 2019 and March 2020. Block randomization was used to randomize patients to intervention (received access to SAM at discharge) or control (received usual care). Patients were followed for 30 days post-discharge, during which app use was recorded. Pharmacy claims data were used to measure adherence to medication changes made at discharge, and physician billing data were used to identify emergency department visits and hospital readmissions during follow-up. Results Forty-nine patients were eligible for inclusion in the study at hospital discharge (23 intervention, 26 control). In the 30 days of post-discharge, 15 (65.2%) intervention patients used the SAM app. During this period, intervention patients adhered to a larger proportion of medication changes (83.7%) than control patients (77.8%), including newly prescribed medications (72.7% vs 61.7%) and dose changes (90.9% vs 81.8%). A smaller proportion of intervention patients (8.7%) were readmitted to hospital during follow-up than control patients (15.4%). Conclusion The high uptake of SAM among intervention patients supports the feasibility of a larger trial. Results also suggest that SAM has the potential to enhance adherence to medication changes and reduce the risk of downstream adverse events. This hypothesis needs to be tested in a larger trial. Trial registration Clinicaltrials.gov, registration number NCT04676165.
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Affiliation(s)
- Bettina Habib
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada
| | - David Buckeridge
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Melissa Bustillo
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada
| | | | - Manish Thakur
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada
| | - Thai Tran
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada
| | - Daniala L Weir
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Department of Medicine, McGill University Health Center, Montreal, Canada
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5
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Fischer F, Kleen S. Possibilities, Problems, and Perspectives of Data Collection by Mobile Apps in Longitudinal Epidemiological Studies: Scoping Review. J Med Internet Res 2021; 23:e17691. [PMID: 33480850 PMCID: PMC7864774 DOI: 10.2196/17691] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background The broad availability of smartphones and the number of health apps in app stores have risen in recent years. Health apps have benefits for individuals (eg, the ability to monitor one’s health) as well as for researchers (eg, the ability to collect data in population-based, clinical, and observational studies). Although the number of health apps on the global app market is huge and the associated potential seems to be great, app-based questionnaires for collecting patient-related data have not played an important role in epidemiological studies so far. Objective This study aims to provide an overview of studies that have collected patient data using an app-based approach, with a particular focus on longitudinal studies. This literature review describes the current extent to which smartphones have been used for collecting (patient) data for research purposes, and the potential benefits and challenges associated with this approach. Methods We conducted a scoping review of studies that used data collection via apps. PubMed was used to identify studies describing the use of smartphone app questionnaires for collecting data over time. Overall, 17 articles were included in the summary. Results Based on the results of this scoping review, there are only a few studies that integrate smartphone apps into data-collection approaches. Studies dealing with the collection of health-related data via smartphone apps have mainly been developed with regard to psychosomatic, neurodegenerative, respiratory, and cardiovascular diseases, as well as malign neoplasm. Among the identified studies, the duration of data collection ranged from 4 weeks to 12 months, and the participants’ mean ages ranged from 7 to 69 years.
Potential can be seen for real-time information transfer, fast data synchronization (which saves time and increases effectivity), and the possibility of tracking responses longitudinally. Furthermore, smartphone-based data-collection techniques might prevent biases, such as reminder bias or mistakes occurring during manual data transfers. In chronic diseases, real-time communication with physicians and early detection of symptoms enables rapid modifications in disease management. Conclusions The results indicate that using mobile technologies can help to overcome challenges linked with data collection in epidemiological research. However, further feasibility studies need to be conducted in the near future to test the applicability and acceptance of these mobile apps for epidemiological research in various subpopulations.
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Affiliation(s)
- Florian Fischer
- Institut of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Sina Kleen
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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Gao S, Kaudimba KK, Cai J, Tong Y, Tian Q, Liu P, Liu T, Chen P, Wang R. A Mobile Phone App-Based Tai Chi Training in Parkinson's Disease: Protocol for a Randomized Controlled Study. Front Neurol 2021; 11:615861. [PMID: 33519695 PMCID: PMC7838616 DOI: 10.3389/fneur.2020.615861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 11/27/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction: With an increasing number of China's aging population, Parkinson's disease (PD) increases year by year. Persons with PD exhibit abnormal balance functions, leading to motor skills difficulties, such as unstable walking or even falling. Therefore, activities of daily living and quality of life are affected. This study aims to explore the effectiveness of Tai Chi training based on the mobile phone app in improving the balance ability of persons with PD. Methods and Analysis: A randomized, single-blind, parallel controlled trial will be conducted in this study. One hundred forty-four persons with PD who meet the inclusion criteria will be randomly divided into a 1:1:1 ratio: (1) control group, (2) basic experimental group (basic app with no Tai Chi training features), and (3) balanced-enhanced experimental group (basic app with Tai Chi training features). Individuals with PD will be evaluated on balance and motor function outcomes. The primary outcome measure is the limits of stability (including the maximum excursion and direction control); the secondary outcome measures include the Unified Parkinson's Disease Rating Scale III (UPDRS-III), Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up & Go (TUG), 6-Minute Walk Test (6MWT), and 39-item Parkinson's Disease Questionnaire (PDQ-39). Each group of patients will go through an assessment at baseline, 17 and 33 weeks. Discussion: This study will evaluate the effectiveness of the mobile phone app Tai Chi training on the balance function of persons with PD. We assume that a challenging Tai Chi project based on a mobile phone app will improve balance in the short and long term. As walking stability progresses, it is expected that daily activities and quality of life improve. These findings will be used to improve the effectiveness of future home management measures for persons with PD. Ethics and Dissemination: This study has been approved by the ethical review committee of the Shanghai University of Sport (approval number: 102772019RT056). Informed consent will be obtained from all participants or their guardians. The authors intend to submit the study findings to peer-reviewed journals or academic conferences to be published. Clinical Trial Registration: Chinese Clinical Trial Registry (ChiCTR2000029135).
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Affiliation(s)
- Song Gao
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Keneilwe Kenny Kaudimba
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jiaxin Cai
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yao Tong
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Institute of Sport Science, Shenyang Sport University, Shenyang, China
| | - Qianqian Tian
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Peize Liu
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Tiemin Liu
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China.,State Key Laboratory of Genetic Engineering, Department of Endocrinology and Metabolism, School of Life Sciences, Institute of Metabolism and Integrative Biology, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Peijie Chen
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Ru Wang
- Shanghai Key Laboratory for Human Athletic Ability Development and Support, School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Zhu H, Chen X, Yang J, Wu Q, Zhu J, Chan SWC. Mobile Breast Cancer e-Support Program for Chinese Women With Breast Cancer Undergoing Chemotherapy (Part 3): Secondary Data Analysis. JMIR Mhealth Uhealth 2020; 8:e18896. [PMID: 32936087 PMCID: PMC7527913 DOI: 10.2196/18896] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/17/2020] [Accepted: 08/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background Many app-based interventions targeting women with breast cancer have been developed and tested for effectiveness. However, information regarding the evaluation of the usage of these interventions is scarce. A better understanding of usage data is important to determine how women use apps and how these interventions affect health outcomes. Objective This study aimed to examine the usage duration and login frequency of an app-based intervention, the Breast Cancer e-Support (BCS) program, and to investigate the association between usage data and participants’ demographic and medical characteristics. Methods This study is a secondary data analysis of a randomized controlled trial assessing the effectiveness of the BCS program. The BCS program contains four modules: Learning Forum, Discussion Forum, Ask-the-Expert Forum, and Your Story Forum. A total of 57 women in the intervention group accessed the BCS program during their 12-week chemotherapy. The app’s background system tracked the usage duration and login frequency for each forum and the entire BCS program. Results The total usage duration per participant ranged from 0 to 9371 minutes, and the login frequency per participant ranged from 0 to 774 times. The Discussion Forum and the Learning Forum were the most frequently used modules. The general linear model showed that age, education, family monthly income, and employment were associated with BCS usage duration and/or login frequency. Age (F1,45=10.09, P=.003, B=115.34, 95% CI 42.22-188.47) and education level (F1,45=7.22, P=.01, B=1949.63, 95% CI 487.76-3411.50) were positively associated with the usage duration of the entire BCS program. Family monthly income was positively associated with the usage duration of the Learning Forum (F1,45=11.85, P=.001, B=1488.55, 95% CI 617.58-2359.51) and the login frequency of the entire BCS program (F1,45=4.47, P=.04, B=113.68, 95% CI 5.33-222.03). Employment was negatively associated with the usage duration of the Ask-the-expert Forum (F1,45=4.50, P=.04, B=–971.87, 95% CI –1894.66 to –49.07) and the Your Story Forum (F1,45=5.36, P=.03, B=–640.71, 95% CI –1198.30 to –83.11) and positively associated with the login frequency of the entire BCS program (F1,45=10.86, P=.002, B=192.88, 95% CI 75.01-310.74). No statistical differences were found between BCS usage data and cancer stage, BMI, comorbidity, types of surgery, or cycles of chemotherapy. Conclusions Overall, this study found considerable variability in the usage of app-based interventions. When health care professionals incorporate app-based interventions into their routine care for women with breast cancer, the learning and discussion functions of apps should be strengthened to promote engagement. Additionally, characteristics of women with breast cancer, such as age, level of education, income, and employment status, should be taken in consideration to develop tailored apps that address their particular needs and therefore improve their engagement with the app. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000639426; http://www.ANZCTR.org.au/ACTRN12616000639426.aspx
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Affiliation(s)
- Haihua Zhu
- Nursing Department, First Affiliated Hospital, Xiamen University, Xiamen, China
| | - Xiuwan Chen
- Nursing Department, First Affiliated Hospital, Xiamen University, Xiamen, China
| | - Jinqiu Yang
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
| | - Qiaoling Wu
- Hospital Infection Management Office, China-Japan Friendship Hospital, Beijing, China
| | - Jiemin Zhu
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
| | - Sally Wai-Chi Chan
- Global Engagement and Partnership Division, UON Singapore campus, University of Newcastle, Newcastle, Australia
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Nadal C, Sas C, Doherty G. Technology Acceptance in Mobile Health: Scoping Review of Definitions, Models, and Measurement. J Med Internet Res 2020; 22:e17256. [PMID: 32628122 PMCID: PMC7381045 DOI: 10.2196/17256] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Designing technologies that users will be interested in, start using, and keep using has long been a challenge. In the health domain, the question of technology acceptance is even more important, as the possible intrusiveness of technologies could lead to patients refusing to even try them. Developers and researchers must address this question not only in the design and evaluation of new health care technologies but also across the different stages of the user's journey. Although a range of definitions for these stages exists, many researchers conflate related terms, and the field would benefit from a coherent set of definitions and associated measurement approaches. OBJECTIVE This review aims to explore how technology acceptance is interpreted and measured in mobile health (mHealth) literature. We seek to compare the treatment of acceptance in mHealth research with existing definitions and models, identify potential gaps, and contribute to the clarification of the process of technology acceptance. METHODS We searched the PubMed database for publications indexed under the Medical Subject Headings terms "Patient Acceptance of Health Care" and "Mobile Applications." We included publications that (1) contained at least one of the terms "acceptability," "acceptance," "adoption," "accept," or "adopt"; and (2) defined the term. The final corpus included 68 relevant studies. RESULTS Several interpretations are associated with technology acceptance, few consistent with existing definitions. Although the literature has influenced the interpretation of the concept, usage is not homogeneous, and models are not adapted to populations with particular needs. The prevalence of measurement by custom surveys suggests a lack of standardized measurement tools. CONCLUSIONS Definitions from the literature were published separately, which may contribute to inconsistent usage. A definition framework would bring coherence to the reporting of results, facilitating the replication and comparison of studies. We propose the Technology Acceptance Lifecycle, consolidating existing definitions, articulating the different stages of technology acceptance, and providing an explicit terminology. Our findings illustrate the need for a common definition and measurement framework and the importance of viewing technology acceptance as a staged process, with adapted measurement methods for each stage.
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Affiliation(s)
- Camille Nadal
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Corina Sas
- School of Computing and Communications, Lancaster University, Lancaster, United Kingdom
| | - Gavin Doherty
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
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Koivisto J, Malik A. Gamification for Older Adults: A Systematic Literature Review. THE GERONTOLOGIST 2020; 61:e360-e372. [PMID: 32530026 PMCID: PMC8437506 DOI: 10.1093/geront/gnaa047] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has predominantly focused on examining the effects of gamification among young adults, while other demographic groups such as older adults have received less attention. In this review, we synthesize existing scholarly work on the impact of gamification for older adults. RESEARCH DESIGN AND METHODS A systematic search was conducted using 4 academic databases from inception through January 2019. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Twelve empirical peer-reviewed studies written in English, focusing on older adults aged ≥55, including a gameful intervention, and assessing subjective or objective outcomes were identified. Eleven of the 12 studies were conducted in the health domain. Randomized controlled study settings were reported in 8 studies. Positively oriented results were reported in 10 of 12 studies on visual attention rehabilitation, diabetes control, increasing positive emotions for patients with subthreshold depression, cognitive training and memory tests, engagement in training program, perceptions of self-efficacy, motivation and positive emotions of social gameplay conditions, increased physical activity and balancing ability, and increased learning performance and autonomy experiences. The results are, however, mostly weak indications of positive effects. DISCUSSION AND IMPLICATIONS Overall, the studies on gameful interventions for older adults suggest that senior users may benefit from gamification and game-based interventions, especially in the health domain. However, due to methodological shortcomings and limited amount of research available, further work in the area is called for.
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Affiliation(s)
- Jonna Koivisto
- Communication Sciences, Faculty of Information Technology and Communication Sciences, Tampere University, Finland
| | - Aqdas Malik
- Department of Computer Science, Aalto University, Finland
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10
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Rodriguez Hermosa JL, Fuster Gomila A, Puente Maestu L, Amado Diago CA, Callejas González FJ, Malo De Molina Ruiz R, Fuentes Ferrer ME, Álvarez Sala-Walther JL, Calle Rubio M. Compliance and Utility of a Smartphone App for the Detection of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease: Cohort Study. JMIR Mhealth Uhealth 2020; 8:e15699. [PMID: 32191213 PMCID: PMC7118552 DOI: 10.2196/15699] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/14/2019] [Accepted: 12/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background In recent years, mobile health (mHealth)–related apps have been developed to help manage chronic diseases. Apps may allow patients with a chronic disease characterized by exacerbations, such as chronic obstructive pulmonary disease (COPD), to track and even suspect disease exacerbations, thereby facilitating self-management and prompt intervention. Nevertheless, there is insufficient evidence regarding patient compliance in the daily use of mHealth apps for chronic disease monitoring. Objective This study aimed to provide further evidence in support of prospectively recording daily symptoms as a useful strategy to detect COPD exacerbations through the smartphone app, Prevexair. It also aimed to analyze daily compliance and the frequency and characteristics of acute exacerbations of COPD recorded using Prevexair. Methods This is a multicenter cohort study with prospective case recruitment including 116 patients with COPD who had a documented history of frequent exacerbations and were monitored over the course of 6 months. At recruitment, the Prevexair app was installed on their smartphones, and patients were instructed on how to use the app. The information recorded in the app included symptom changes, use of medication, and use of health care resources. The patients received messages on healthy lifestyle behaviors and a record of their cumulative symptoms in the app. There was no regular contact with the research team and no mentoring process. An exacerbation was considered reported if medical attention was sought and considered unreported if it was not reported to a health care professional. Results Overall, compliance with daily records in the app was 66.6% (120/180), with a duration compliance of 78.8%, which was similar across disease severity, age, and comorbidity variables. However, patients who were active smokers, with greater dyspnea and a diagnosis of depression and obesity had lower compliance (P<.05). During the study, the patients experienced a total of 262 exacerbations according to daily records in the app, 99 (37.8%) of which were reported exacerbations and 163 (62.2%) were unreported exacerbations. None of the subject-related variables were found to be significantly associated with reporting. The duration of the event and number of symptoms present during the first day were strongly associated with reporting. Despite substantial variations in the COPD Assessment Test (CAT), there was improvement only among patients with no exacerbation and those with reported exacerbations. Nevertheless, CAT scores deteriorated among patients with unreported exacerbations. Conclusions The daily use of the Prevexair app is feasible and acceptable for patients with COPD who are motivated in their self-care because of frequent exacerbations of their disease. Monitoring through the Prevexair app showed great potential for the implementation of self-care plans and offered a better diagnosis of their chronic condition.
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Affiliation(s)
- Juan Luis Rodriguez Hermosa
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Medical Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Luis Puente Maestu
- Pulmonology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Carlos Antonio Amado Diago
- Pulmonology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Medical Department, School of Medicine, Universidad de Cantabria, Santander, Spain
| | | | | | - Manuel E Fuentes Ferrer
- Departament of Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Jose Luis Álvarez Sala-Walther
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Medical Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Myriam Calle Rubio
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Medical Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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11
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Garfield S, Furniss D, Husson F, Etkind M, Williams M, Norton J, Ogunleye D, Jubraj B, Lakhdari H, Franklin BD. How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience. BMJ Qual Saf 2020; 29:764-773. [PMID: 31949006 PMCID: PMC7467504 DOI: 10.1136/bmjqs-2019-010194] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/16/2019] [Accepted: 12/22/2019] [Indexed: 02/03/2023]
Abstract
Background Patients often carry medication lists to mitigate information loss across healthcare settings. We aimed to identify mechanisms by which these lists could be used to support safety, key supporting features, and barriers and facilitators to their use. Methods We used a mixed-methods design comprising two focus groups with patients and carers, 16 semistructured interviews with healthcare professionals, 60 semistructured interviews with people carrying medication lists, a quantitative features analysis of tools available for patients to record their medicines and usability testing of four tools. Findings were triangulated using thematic analysis. Distributed cognition for teamwork models were used as sensitising concepts. Results We identified a wide range of mechanisms through which carrying medication lists can improve medication safety. These included improving the accuracy of medicines reconciliation, allowing identification of potential drug interactions, facilitating communication about medicines, acting as an aide-mémoire to patients during appointments, allowing patients to check their medicines for errors and reminding patients to take and reorder their medicines. Different tools for recording medicines met different needs. Of 103 tools examined, none met the core needs of all users. A key barrier to use was lack of awareness by patients and carers that healthcare information systems can be fragmented, a key facilitator was encouragement from healthcare professionals. Conclusion Our findings suggest that patients and healthcare professionals perceive patient-held medication lists to have a wide variety of benefits. Interventions are needed to raise awareness of the potential role of these lists in enhancing patient safety. Such interventions should empower patients and carers to identify a method that suits them best from a range of options and avoid a ‘one size fits all’ approach.
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Affiliation(s)
- Sara Garfield
- Pharmacy department, Imperial College Healthcare NHS Trust, London, UK .,Patient Safety Translational Research Centre, Imperial College London, London, UK.,Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | | | - Fran Husson
- Pharmacy department, Imperial College Healthcare NHS Trust, London, UK
| | - Mike Etkind
- Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Marney Williams
- Pharmacy department, Imperial College Healthcare NHS Trust, London, UK
| | - John Norton
- Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Della Ogunleye
- Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Barry Jubraj
- NIHR CLAHRC, London, UK.,Medicines Use & Safety Division, Specialist Pharmacy Service, London, UK
| | - Hanaa Lakhdari
- Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Bryony Dean Franklin
- Pharmacy department, Imperial College Healthcare NHS Trust, London, UK.,Patient Safety Translational Research Centre, Imperial College London, London, UK.,Department of Practice and Policy, UCL School of Pharmacy, London, UK
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12
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Rudolf I, Pieper K, Nolte H, Junge S, Dopfer C, Sauer-Heilborn A, Ringshausen FC, Tümmler B, von Jan U, Albrecht UV, Fuge J, Hansen G, Dittrich AM. Assessment of a Mobile App by Adolescents and Young Adults With Cystic Fibrosis: Pilot Evaluation. JMIR Mhealth Uhealth 2019; 7:e12442. [PMID: 31750841 PMCID: PMC6895868 DOI: 10.2196/12442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/25/2019] [Accepted: 07/21/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cystic fibrosis (CF) continues to be the most common life-limiting chronic pulmonary disease in adolescents and young adults. Treatment of CF demands a high treatment time investment to slow the progression of lung function decline, the most important contributor to morbidity and mortality. Adherence is challenging in CF due to the high treatment burden and the lack of immediate health consequences in case of nonadherence. Lung function decline is particularly pronounced in the transition phase between 12 and 24 years of age. The improvement of self-management and self-responsibility and independence from parents and desire for normalcy are conflicting aspects for many adolescents with CF, which influence adherence to the time-consuming pulmonary therapy. Mobile health (mHealth) care apps could help to support self-management and independence and thereby reconcile seemingly conflicting goals to improve adherence, quality of life, and ultimately CF life expectancy. OBJECTIVE This study aimed to (1) assess user behavior and satisfaction among adolescents and young adults with CF over an observation period of three months using an mHealth app; (2) identify areas of improvement for this mHealth app; and (3) compare overall and disease-specific satisfaction, lung function, and anthropometry before and after using the mHealth app. METHODS A total of 27 adolescents and young adults with CF (age range 12-24 years, mean age 16 years, SD 3 years; 14 females, 11 males) used a free mHealth app for three months of whom 25 provided questionnaire data for analysis at the end of the study. Data collection was carried out using questionnaires on usage characteristics and life satisfaction, and standardized assessment of lung function and anthropometry. RESULTS The use of the reminder function for medication declined from 70% (15/21) of the participants at week 4 to 65% (13/20) at week 8 of the observation period. At the end of the study, only 17% (4/23) of the participants wanted to continue using the app. Nevertheless, 56% (14/25) of participants saw the mobile app as a support for everyday life. Potential improvements targeting hedonistic qualities were identified to improve mHealth app adherence. Comparisons of satisfaction with different life aspects hinted at improvements or stabilization for the subitem respiration and the subitem lack of handicap by CF, suggesting that app use might stabilize certain CF-specific aspects of the weighted satisfaction with life. Lung function and anthropometry were not affected consistently. CONCLUSIONS Most of the patients did not want to continue using the app after the study period. Only a few CF-specific aspects of weighted life satisfaction were possibly stabilized by the mHealth app; clinical parameters were not affected. Adaptation of the functions to adolescent-specific needs could improve the long-term use and thus positively affect the disease course.
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Affiliation(s)
- Isa Rudolf
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
| | - Katharina Pieper
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Helga Nolte
- Haus Schutzengel, Mukoviszidose eV, Hannover, Germany
| | - Sibylle Junge
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Christian Dopfer
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
| | | | - Felix C Ringshausen
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical University, Hannover, Germany
| | - Burkhard Tümmler
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
| | - Ute von Jan
- Peter L Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
| | - Urs-Vito Albrecht
- Peter L Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
| | - Gesine Hansen
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
| | - Anna-Maria Dittrich
- Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover, German Centre for Lung Research, Hannover Medical University, Hannover, Germany
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13
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Li B, Wu Y, Hao Z, Yan X, Chen B. The effects of trust on life satisfaction in the context of WeChat use. TELEMATICS AND INFORMATICS 2019. [DOI: 10.1016/j.tele.2019.101241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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14
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Doyle N, Murphy M, Brennan L, Waugh A, McCann M, Mellotte G. The “
Mikidney
” smartphone app pilot study: Empowering patients with Chronic Kidney Disease. J Ren Care 2019; 45:133-140. [DOI: 10.1111/jorc.12281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Nuala Doyle
- Renal UnitSt. James's Hospital Dublin Ireland
| | | | - Laura Brennan
- Department of Clinical NutritionSt. James's Hospital Dublin Ireland
| | - Alice Waugh
- Department of PhysiotherapySt. James's Hospital Dublin Ireland
| | - Margaret McCann
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and MidwiferyTrinity College Dublin Dublin Ireland
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15
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Hsieh WT, Su YC, Han HL, Huang MY. A Novel mHealth Approach for a Patient-Centered Medication and Health Management System in Taiwan: Pilot Study. JMIR Mhealth Uhealth 2018; 6:e154. [PMID: 29970356 PMCID: PMC6053609 DOI: 10.2196/mhealth.9987] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/12/2018] [Accepted: 06/18/2018] [Indexed: 12/05/2022] Open
Abstract
Background Mobile health (mHealth) apps have recently demonstrated the potential to engage and empower people to improve their own health. Although the availability of health-related apps is increasing, their adoption rate in Taiwan is exceptionally low mainly due to the preponderance of Western culture-based app designs that are challenging for non-English-speaking individuals. To our knowledge, no mHealth app is available in Taiwan that is culturally tailored for Chinese-speaking users and that applies a patient-centered approach to self-manage medication and health. Objective The purpose of this study was to design and deploy a culturally tailored mHealth system that could be easily integrated into current clinical practice and to evaluate how this mHealth system could support the continuity of patient care in Taiwan. Methods An mHealth information system and a mobile app were designed. To promote the best patient experience, a Quick Response (QR) code system was developed to enable efficient registration of personal medication information through the mobile app. The app also supported notifications for drug utilization, refills, and symptom checks. Patients were encouraged to record medication use, symptoms, and self-assessments in the app during their treatment period. Evaluation of the novel mHealth system was conducted from August 1, 2016 to December 31, 2016 at MacKay Memorial Hospital, Taipei, Taiwan. Population data and app usage statistics were analyzed. Results During the 5-month implementation period, a total of 25,909 users downloaded the app with an overall 7-day retention rate of 15.4% (SD 3.9). Young male adults (range 25-44 years) were the predominant user population. Patients’ feedback on app usability and design, QR code system as drug input method, medication reminders, and linking family or friends into care networks was generally positive. Physicians showed great interest in utilizing patient-generated data in their care process, and the positive medication adherence rate was the most highly valued component of this system. Conclusions This pilot study demonstrated the value of a novel mHealth approach for individualized medication and health management in Taiwan. The mHealth system shows the potential to optimize personalized care into existing clinical services and may help hospitals and health authorities perform continuous quality improvement and policy development.
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Affiliation(s)
- Wen-Ting Hsieh
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yung-Cheng Su
- Department of Emergency, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hsin-Lien Han
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Yuan Huang
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Emergency, MacKay Memorial Hospital, Taipei, Taiwan
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16
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Garfield S, Furniss D, Husson F, Turley M, Dean Franklin B. Use of patient-held information about medication (PHIMed) to support medicines optimisation: protocol for a mixed-methods descriptive study. BMJ Open 2018; 8:e021764. [PMID: 29950473 PMCID: PMC6042590 DOI: 10.1136/bmjopen-2018-021764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Risks of poor information transfer across health settings are well documented, particularly for medication. There is also increasing awareness of the importance of greater patient activation. Patients may use various types of patient-held information about medication (PHIMed) to facilitate medication transfer, which may be paper or electronic. However, it is not known how PHIMed should best be used, whether it improves patient outcomes, nor is its key 'active ingredients' known. Discussion with patients and carers has highlighted this as a priority for research. We aim to identify how PHIMed is used in practice, barriers and facilitators to its use and key features of PHIMed that support medicines optimisation in practice. METHODS AND ANALYSIS This study will take place in Greater London, England. We will include patients with long-term conditions, carers and healthcare professionals. The study has four work packages (WPs). WP1 involves qualitative interviews with healthcare professionals (n=16) and focus groups with patients and carers (n=20), including users and non-users of PHIMed, to study perceptions around its role, key features, barriers and facilitators, and any unintended consequences. WP2 will involve documentary analysis of how PHIMed is used, what is documented and read, and by whom, in a stratified sample of 60 PHIMed users. In WP3, we will carry out a descriptive analysis of PHIMed tools used/available, both electronic and paper, and categorise their design and key features based on those identified in WP1/2. Finally, in WP4, findings from WPs 1-3 will be integrated and analysed using distributed cognition as a theoretical framework to explore how information is recorded, transformed and propagated among different people and artefacts. ETHICS AND DISSEMINATION The study has National Health Service ethics approval. It will provide initial recommendations around the present use of PHIMed to optimise patient care for patients, carers and healthcare professionals.
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Affiliation(s)
- Sara Garfield
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- UCL School of Pharmacy, London, UK
| | | | - Fran Husson
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - Margaret Turley
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - Bryony Dean Franklin
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- UCL School of Pharmacy, London, UK
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17
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Dugas M, Crowley K, Gao GG, Xu T, Agarwal R, Kruglanski AW, Steinle N. Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans. PLoS One 2018. [PMID: 29513683 PMCID: PMC5841664 DOI: 10.1371/journal.pone.0192807] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
mHealth tools to help people manage chronic illnesses have surged in popularity, but evidence of their effectiveness remains mixed. The aim of this study was to address a gap in the mHealth and health psychology literatures by investigating how individual differences in psychological traits are associated with mHealth effectiveness. Drawing from regulatory mode theory, we tested the role of locomotion and assessment in explaining why mHealth tools are effective for some but not everyone. A 13-week pilot study investigated the effectiveness of an mHealth app in improving health behaviors among older veterans (n = 27) with poorly controlled Type 2 diabetes. We developed a gamified mHealth tool (DiaSocial) aimed at encouraging tracking of glucose control, exercise, nutrition, and medication adherence. Important individual differences in longitudinal trends of adherence, operationalized as points earned for healthy behavior, over the course of the 13-week study period were found. Specifically, low locomotion was associated with unchanging levels of adherence during the course of the study. In contrast, high locomotion was associated with generally stronger adherence although it exhibited a quadratic longitudinal trend. In addition, high assessment was associated with a marginal, positive trend in adherence over time while low assessment was associated with a marginal, negative trend. Next, we examined the relationship between greater adherence and improved clinical outcomes, finding that greater adherence was associated with greater reductions in glycated hemoglobin (HbA1c) levels. Findings from the pilot study suggest that mHealth technologies can help older adults improve their diabetes management, but a “one size fits all” approach may yield suboptimal outcomes.
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Affiliation(s)
- Michelle Dugas
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
- Center for Health Information & Decision Systems, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
- * E-mail:
| | - Kenyon Crowley
- Center for Health Information & Decision Systems, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
- College of Information Studies, University of Maryland, College Park, Maryland, United States of America
| | - Guodong Gordon Gao
- Center for Health Information & Decision Systems, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
- Decision, Operations, & Information Technologies, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
| | - Timothy Xu
- Department of Biology, Emory University, Atlanta, Georgia, United States of America
| | - Ritu Agarwal
- Center for Health Information & Decision Systems, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
- Decision, Operations, & Information Technologies, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America
| | - Arie W. Kruglanski
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
| | - Nanette Steinle
- Maryland Veterans Administration Health Care Center, Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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18
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Jonassaint CR, Kang C, Abrams DM, Li JJ, Mao J, Jia Y, Long Q, Sanger M, Jonassaint JC, De Castro L, Shah N. Understanding patterns and correlates of daily pain using the Sickle cell disease Mobile Application to Record Symptoms via Technology (SMART). Br J Haematol 2017; 183:306-308. [PMID: 29076140 DOI: 10.1111/bjh.14956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Charles R Jonassaint
- School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Chaeryon Kang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel M Abrams
- Department of Engineering Sciences and Applied Mathematics, Northwestern University, Chicago, IL, USA
| | - Jingyi J Li
- Department of Statistics, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jason Mao
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yimeng Jia
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - Qi Long
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Maureen Sanger
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Jude C Jonassaint
- School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Laura De Castro
- School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Nirmish Shah
- Division of Hematology, Duke University, Durham, NC, USA
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19
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Hartz J, Yingling L, Powell-Wiley TM. Use of Mobile Health Technology in the Prevention and Management of Diabetes Mellitus. Curr Cardiol Rep 2017; 18:130. [PMID: 27826901 DOI: 10.1007/s11886-016-0796-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality globally, with diabetes being an independent risk factor. Adequate diabetes management has proven to be resource-intensive, requiring frequent lab work, primary care and specialist visits, and time-consuming record-keeping by the patient and care team. New mobile health (mHealth) technologies have enhanced how diabetes is managed and care is delivered. While more recent work has investigated mHealth devices as complementary tools in behavioral interventions for diabetes prevention and management, little is still known about the effectiveness of mHealth technology as stand-alone intervention tools for reducing diabetes risk. In addition, more work is needed to identify the role of mHealth technology in treating vulnerable populations to ameliorate cardiovascular health disparities. With advances in mobile health technology development for diabetes prevention and management, these modalities will likely play an increasingly prominent role in reducing cardiometabolic risk for the US population.
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Affiliation(s)
- Jacob Hartz
- Department of Cardiology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - Leah Yingling
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10, 5-3330, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Tiffany M Powell-Wiley
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10, 5-3330, 10 Center Drive, Bethesda, MD, 20892, USA.
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20
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Yan M, Or C. A 12-week pilot study of acceptance of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension. Health Informatics J 2017; 25:828-843. [PMID: 28820007 DOI: 10.1177/1460458217724580] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study tested a structural model examining the effects of perceived usefulness, perceived ease of use, attitude, subjective norm, perceived behavioral control, health consciousness, and application-specific self-efficacy on the acceptance (i.e. behavioral intention and actual usage) of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension. The model was tested using partial least squares structural equation modeling, with 119 observations that were obtained by pooling data across three time points over a 12-week period. The results indicate that all of the seven constructs examined had a significant total effect on behavioral intention and explained 74 percent of the variance. Also, application-specific self-efficacy and behavioral intention had a significant total effect on actual usage and explained 17 percent of the variance. This study demonstrates that technology acceptance is determined by patient characteristics, technology attributes, and social influences. Applying the findings may increase the likelihood of acceptance.
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Affiliation(s)
- Mian Yan
- The University of Hong Kong, Hong Kong
| | - Calvin Or
- The University of Hong Kong, Hong Kong
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21
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El-Saifi N, Moyle W, Jones C, Tuffaha H. Medication Adherence in Older Patients With Dementia: A Systematic Literature Review. J Pharm Pract 2017; 31:322-334. [DOI: 10.1177/0897190017710524] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Older patients with dementia are often unable to take their medications as prescribed due to cognitive and physical impairment. Objectives: To review the evidence on medication adherence in older patients with dementia in terms of the level of adherence, outcomes, contributing factors, and available interventions. Methods: A systematic literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searched databases included CINAHL, Cochrane Library, DARE, MEDLINE, and PubMed. Results: Eighteen studies reported levels of medication adherence or discontinuation and related factors. Medication adherence ranged from 17% to 42%, and medication discontinuation before the end of treatment ranged from 37% to 80%. Nonadherence was associated with an increased risk of hospitalization or death, while increasing age, choice of medication, use of concomitant medications, and medicines’ costs were reported to decrease medication adherence. Telehealth home monitoring and treatment modification were the only interventions reported in the literature to improve medication adherence in this population. Conclusion: Older patients with dementia have a low level of medication adherence. Future research should focus on the development and implementation of interventions to help older patients with dementia and their caregivers make better use of medications.
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Affiliation(s)
- Najwan El-Saifi
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
| | - Cindy Jones
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
| | - Haitham Tuffaha
- School of Medicine, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
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22
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Chen Y, Yang L, Hu H, Chen J, Shen B. How to Become a Smart Patient in the Era of Precision Medicine? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1028:1-16. [PMID: 29058213 DOI: 10.1007/978-981-10-6041-0_1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objective of this paper is to define the definition of smart patients, summarize the existing foundation, and explore the approaches and system participation model of how to become a smart patient. Here a thorough review of the literature was conducted to make theory derivation processes of the smart patient; "data, information, knowledge, and wisdom (DIKW) framework" was performed to construct the model of how smart patients participate in the medical process. The smart patient can take an active role and fully participate in their own health management; DIKW system model provides a theoretical framework and practical model of smart patients; patient education is the key to the realization of smart patients. The conclusion is that the smart patient is attainable and he or she is not merely a patient but more importantly a captain and global manager of one's own health management, a partner of medical practitioner, and also a supervisor of medical behavior. Smart patients can actively participate in their healthcare and assume higher levels of responsibility for their own health and wellness which can facilitate the development of precision medicine and its widespread practice.
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Affiliation(s)
- Yalan Chen
- Center for Systems Biology, Soochow University, Suzhou, 215006, China.,Department of Medical Informatics, School of Medicine, Nantong University, Nantong, 226001, China
| | - Lan Yang
- Center for Systems Biology, Soochow University, Suzhou, 215006, China
| | - Hai Hu
- Center for Systems Biology, Soochow University, Suzhou, 215006, China
| | - Jiajia Chen
- School of Chemistry, Biology and Material Engineering, Suzhou University of Science and Technology, No1. Kerui road, Suzhou, Jiangsu, 215011, China
| | - Bairong Shen
- Center for Systems Biology, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu, 215006, China.
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23
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Kessel KA, Vogel MME, Schmidt-Graf F, Combs SE. Mobile Apps in Oncology: A Survey on Health Care Professionals' Attitude Toward Telemedicine, mHealth, and Oncological Apps. J Med Internet Res 2016; 18:e312. [PMID: 27884810 PMCID: PMC5146327 DOI: 10.2196/jmir.6399] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/19/2016] [Accepted: 11/08/2016] [Indexed: 12/11/2022] Open
Abstract
Background Mobile apps are an evolving trend in the medical field. To date, few apps in an oncological context exist. Objective The aim was to analyze the attitude of health care professionals (HCPs) toward telemedicine, mHealth, and mobile apps in the field of oncology. Methods We developed and conducted an online survey with 24 questions evaluating HCPs’ general attitude toward telemedicine and patients using medical mobile apps. Specific questions on the possible functionality for patients and the resulting advantages and disadvantages for both the patients’ and HCPs’ daily clinical routine were evaluated. Results A total of 108 HCPs completed the survey. In all, 88.9% (96/108) considered telemedicine useful and 84.3% (91/108) supported the idea of an oncological app complementing classical treatment. Automatic reminders, timetables, and assessment of side effects and quality of life during therapy were rated as the most important functions. In contrast, uncertainty regarding medical responsibility and data privacy were reasons mostly named by critics. Most (64.8%, 70/108) were in favor of an alert function due to data input needing further clarification, and 94% (66/70) were willing to contact the patient after a critical alert. In all, 93.5% (101/108) supported the idea of using the collected data for scientific research. Moreover, 75.0% (81/108) believed establishing a mobile app could be beneficial for the providing hospital. Conclusions A majority of HCPs are in favor of telemedicine and the use of oncological apps by patients. Assessing side effects can lead to quicker response and thus lower inconvenience for patients. Clinical data, such as life quality and treatment satisfaction, could be used to evaluate and improve the therapy workflow. Eventually, a mobile app would enhance the patients’ relationship to their treating department because they are in permanent contact.
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Affiliation(s)
- Kerstin A Kessel
- Klinikum rechts der Isar, Department of Radiation Oncology, Technical University of Munich (TUM), Munich, Germany.,Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Marco M E Vogel
- Klinikum rechts der Isar, Department of Radiation Oncology, Technical University of Munich (TUM), Munich, Germany.,Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Friederike Schmidt-Graf
- Klinikum rechts der Isar, Department of Neurology, Technical University of Munich (TUM), Munich, Germany
| | - Stephanie E Combs
- Klinikum rechts der Isar, Department of Radiation Oncology, Technical University of Munich (TUM), Munich, Germany.,Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München (HMGU), Neuherberg, Germany
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24
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Mertens A, Brandl C, Miron-Shatz T, Schlick C, Neumann T, Kribben A, Meister S, Diamantidis CJ, Albrecht UV, Horn P, Becker S. A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation: A crossover design study comparing documentation via iPad with paper-based control. Medicine (Baltimore) 2016; 95:e4446. [PMID: 27603339 PMCID: PMC5023861 DOI: 10.1097/md.0000000000004446] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 06/30/2016] [Accepted: 07/09/2016] [Indexed: 11/25/2022] Open
Abstract
Medication adherence is crucial for success in the management of patients with chronic conditions. This study analyzes whether a mobile application on a tablet aimed at supporting drug intake and vital sign parameter documentation affects adherence in elderly patients.Patients with coronary heart disease and no prior knowledge of tablet computers were recruited. They received a personal introduction to the mobile application Medication Plan, installed on an Apple iPad. The study was conducted using a crossover design with 3 sequences: initial phase, interventional phase (28 days of using the app system), and comparative phase (28 days of using a paper diary). Users experienced the interventional and comparative phases alternately.A total of 24 patients (12 males; mean age 73.8 years) were enrolled in the study. The mean for subjectively assessed adherence (A14-scale; 5-point Likert scale, from "never" to "very often" which results in a score from 0 to 56) before the study was 50.0 (SD = 3.44). After both interventions there was a significant increase, which was more pronounced after the interventional phase (54.0; SD = 2.01) than after the comparative phase (52.6; SD = 2.49) (for all pairs after both interventions, P <0.001). Neither medical conditions nor the number of drug intake (amount and frequency of drug taking) per day affected subjective adherence. Logging data showed a significantly stronger adherence for the medication app than the paper system for both blood pressure recordings (P <0.001) and medication intake (P = 0.033). The majority of participants (n = 22) stated that they would like to use the medication app in their daily lives and would not need further assistance with the app.A mobile app for medication adherence increased objectively and subjectively measured adherence in elderly users undergoing rehabilitation. The findings have promising clinical implications: digital tools can assist chronic disease patients achieve adherence to medication and to blood pressure measurement. Although this requires initial offline training, it can reduce complications and clinical overload because of nonadherence.
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Affiliation(s)
- Alexander Mertens
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Christopher Brandl
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Talya Miron-Shatz
- Center for Medicine in the Public Interest, New York City, NY
- Marketing Department, Business School, Ono Academic College, Kiryat Ono, Israel
| | - Christopher Schlick
- Institute of Industrial Engineering and Ergonomics of RWTH Aachen University, Aachen, Germany
| | - Till Neumann
- Department of Cardiology, University Duisburg-Essen, Essen, Germany
| | - Andreas Kribben
- Institute for Drug Safety, University Hospital Essen, Essen, Germany
- Department of Nephrology, University Duisburg-Essen, Essen
| | - Sven Meister
- Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
| | | | - Urs-Vito Albrecht
- Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig—Institute of Technology and Hannover Medical School, Hannover, Germany
| | - Peter Horn
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Stefan Becker
- Institute for Drug Safety, University Hospital Essen, Essen, Germany
- Department of Nephrology, University Duisburg-Essen, Essen
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25
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Mobile Technology Improves Therapy-Adherence Rates in Elderly Patients Undergoing Rehabilitation—A Crossover Design Study. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/978-3-319-41652-6_28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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26
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Heldenbrand S, Martin BC, Gubbins PO, Hadden K, Renna C, Shilling R, Dayer L. Assessment of medication adherence app features, functionality, and health literacy level and the creation of a searchable Web-based adherence app resource for health care professionals and patients. J Am Pharm Assoc (2003) 2016; 56:293-302. [PMID: 27067551 DOI: 10.1016/j.japh.2015.12.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess the features and level of health literacy (HL) of available medication adherence apps and to create a searchable website to assist health care providers (HCP) and patients identify quality adherence apps. PRACTICE DESCRIPTION Medication nonadherence continues to be a significant problem and leads to poor health outcomes and avoidable health care expense. The average adherence rate for chronic medications, regardless of disease state, is approximately 50% leaving significant room for improvement. PRACTICE INNOVATION Smartphone adherence apps are a novel resource to address medication nonadherence. With widespread smartphone use and the growing number of adherence apps, both HCP and patients should be able to identify quality adherence apps to maximize potential benefits. INTERVENTIONS Assess the features, functionality and level of HL of available adherence apps and create a searchable website to help both HCP and patients identify quality adherence apps. EVALUATION Online marketplaces (iTunes, Google Play, Blackberry) were searched in June of 2014 to identify available adherence apps. Online descriptions were recorded and scored based on 28 author-identified features across 4 domains. The 100 highest-scoring apps were user-tested with a standardized regimen to evaluate their functionality and level of HL. RESULTS 461 adherence apps were identified. 367 unique apps were evaluated after removing "Lite/Trial" versions. The median initial score based on descriptions was 15 (max of 68; range: 3 to 47). Only 77 apps of the top 100 highest-scoring apps completed user-testing and HL evaluations. The median overall user-testing score was 30 (max of 73; range: 16 to 55). CONCLUSION App design, functionality, and level of HL varies widely among adherence apps. While no app is perfect, several apps scored highly across all domains. The website www.medappfinder.com is a searchable tool that helps HCP and patients identify quality apps in a crowded marketplace.
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Davies MJ, Kotadia A, Mughal H, Hannan A, Alqarni H. The attitudes of pharmacists, students and the general public on mHealth applications for medication adherence. Pharm Pract (Granada) 2015; 13:644. [PMID: 26759619 PMCID: PMC4696122 DOI: 10.18549/pharmpract.2015.04.644] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/02/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND During recent years mobile technology has developed tremendously and has infiltrated the healthcare field. Mobile healthcare (mHealth) applications, or apps, may be used to support patient adherence to medication thus promoting optimal treatment outcomes and reducing medication wastage. OBJECTIVE This study shall consider the opinions of United Kingdom (UK) based pharmacists, pharmacy undergraduates and members of the general public towards the use of mHealth apps to promote adherence to prescribed medication regimens. METHODS On Liverpool John Moores University (LJMU) ethical approval, the 25 item questionnaire was distributed to UK registered pharmacists within inner city Liverpool and Manchester (n=500), pharmacy undergraduates studying at LJMU (n=420) and members of the general public within Liverpool City Centre (n=400). The questions were formatted as multiple choice, Likert scales or the open answer type. The data were analysed using simple frequencies, cross tabulations and non-parametric techniques in the SPSS v22 program. RESULTS The number of completed questionnaires from the pharmacist, student and general public cohorts were 245, 333 and 400; respectively. The data indicated that the general public rely heavily upon daily routine to take medication as prescribed (54.1%) with mHealth app use being extremely low (1.5%); a similar trend was noted for the pharmacist / student cohorts. The age of the individual is an important consideration, with the younger generation likely to engage with mHealth apps and the older generation less so. Here, education and training are important. Pharmacists (82.3%) would be happy to deliver training packages to the public who would in turn happily receive such training (84%). Key barriers precluding mHealth app use include data reliability, security and technical difficulties. CONCLUSION Adherence apps hold great promise to support the patient and their healthcare needs. In order to increase acceptance and uptake simple, user-friendly designs must be considered and constructed. In addition, such technology requires effective promotion and end user training in order to reach its full potential. Furthermore, the regulation of mobile adherence apps will be essential in order to overcome underlying patient concerns.
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Affiliation(s)
- Michael J Davies
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Alysha Kotadia
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Hassan Mughal
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Ashraf Hannan
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Hamdan Alqarni
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
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28
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Diamantidis CJ, Ginsberg JS, Yoffe M, Lucas L, Prakash D, Aggarwal S, Fink W, Becker S, Fink JC. Remote Usability Testing and Satisfaction with a Mobile Health Medication Inquiry System in CKD. Clin J Am Soc Nephrol 2015. [PMID: 26220816 DOI: 10.2215/cjn.12591214] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Inappropriate medication use is common in the care of patients with CKD. The feasibility of a simple mobile health tool designed to advise patients on safe medication usage in CKD was examined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Participants with predialysis CKD (defined as eGFR<60 ml/min per 1.73 m(2)) in the Safe Kidney Care Cohort Study were recruited for home usability testing of a novel medication inquiry system between January and September of 2013. Testing was through two mobile platforms: (1) short messaging service text or (2) personal digital assistant (e.g., iPod Touch). Twenty participants (one half assigned to one device and one half assigned to the other device) were enrolled and received an in-center tutorial on device usage before the end of the study visit. Participants were subsequently mailed three sample pill bottles with the name of randomly selected medications and asked to input these medications into the medication inquiry system. The medication inquiry system response options were as follows: (1) safe in CKD, (2) not safe in CKD, (3) use with caution/speak with your health care provider, or (4) error message (for an incorrectly inputted medication). Participants were asked to record the response issued by the medication inquiry system for each medication sent for usability testing. A user satisfaction survey was administered after completion of the protocol. RESULTS All participants owned a mobile telephone, but few owned a smartphone. Of 60 total medication queries, there were only three recorded errors, two of which occurred in the short messaging service texting group. Overall satisfaction with the application was high, with slightly higher satisfaction noted in the personal digital assistant group compared with the short messaging service group. CONCLUSIONS The mobile health medication inquiry system application had general ease of use and high acceptance across two platforms among individuals representative of the CKD population. Tailored mobile health technology may improve medication safety in CKD.
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Affiliation(s)
- Clarissa J Diamantidis
- Department of Medicine, Duke University of School of Medicine, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Center, Durham, North Carolina;
| | | | | | | | - Divya Prakash
- Data Warehouse and Analytics, St. Joseph Health System, Anaheim, California
| | - Saurabh Aggarwal
- Principal and Co-Founder, Novel Health Strategies, LLC, Columbia, Maryland
| | - Wanda Fink
- Principal and Co-Founder, Novel Health Strategies, LLC, Columbia, Maryland
| | - Stefan Becker
- Institute for Drug Safety, Department of Nephrology, University Hospital Essen, Essen, Germany; and
| | - Jeffrey C Fink
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland; Department of Medicine, Veterans Affairs Maryland Health Care System, Baltimore, Maryland
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