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Zand A, Nguyen A, Reynolds C, Khandadash A, Esrailian E, Hommes D. Patient Experience and Satisfaction with an e-Health Care Management Application for Inflammatory Bowel Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211747. [PMID: 34831502 PMCID: PMC8619840 DOI: 10.3390/ijerph182211747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
Background: Rising healthcare expenditures have been partially attributed to suboptimal management of inflammatory bowel diseases (IBD). Electronic health interventions may help improve care management for IBD patients, but there is a need to better understand patient perspectives on these emerging technologies. Aims: The primary aim was to evaluate patient satisfaction and experience with the UCLA eIBD mobile application, an integrative care management platform with disease activity monitoring tools and educational modules. The secondary objective was to capture patient feedback on how to improve the mobile application. Methods: We surveyed IBD patients treated at the UCLA Center for Inflammatory Bowel Diseases. The patient experience survey assessed the patients’ overall satisfaction with the application, perception of health outcomes after participation in the program, and feedback on educational modules as well as areas for application improvement. Results: 50 patients were included. The responses indicated that the patients were greatly satisfied with the ease of patient–provider communication within the application and appointment scheduling features (68%). A majority of respondents (54%) also reported that program participation resulted in improved perception of disease control and quality of life. Lastly, a majority of participants (79%) would recommend this application to others. Conclusions: Mobile tools such as UCLA eIBD have promising implications for integration into patients’ daily lives. This patient satisfaction study suggests the feasibility of using this mobile application by patients and providers. We further showed that UCLA eIBD and its holistic approach led to improved patient experience and satisfaction, which can provide useful recommendations for future electronic health solutions.
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Affiliation(s)
- Aria Zand
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
- Department of Digestive Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence:
| | - Audrey Nguyen
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Courtney Reynolds
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Ariela Khandadash
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Eric Esrailian
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Daniel Hommes
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
- Department of Digestive Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Fonner VA, Kennedy S, Desai R, Eichberg C, Martin L, Meissner EG. Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study. JMIR Form Res 2021; 5:e22513. [PMID: 34042596 PMCID: PMC8193483 DOI: 10.2196/22513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/29/2020] [Accepted: 04/13/2021] [Indexed: 12/18/2022] Open
Abstract
Background Patient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized. Objective The purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina. Methods We conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses. Results Most patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload. Conclusions Patients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients.
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Affiliation(s)
- Virginia A Fonner
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.,Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, United States
| | - Samuel Kennedy
- Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, United States
| | - Rohan Desai
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Christie Eichberg
- Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, United States
| | - Lisa Martin
- Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, United States
| | - Eric G Meissner
- Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, United States
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Hewitt C, Lloyd KC, Tariq S, Durrant A, Claisse C, Kasadha B, Gibbs J. Patient-generated data in the management of HIV: a scoping review. BMJ Open 2021; 11:e046393. [PMID: 34011598 PMCID: PMC8137219 DOI: 10.1136/bmjopen-2020-046393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Patient-generated data (PGData) are an emergent research area and may improve HIV care. The objectives of this scoping review were to synthesise, evaluate and make recommendations based on the available literature regarding PGData use in HIV care. DESIGN Scoping review. DATA SOURCES Embase, Medline, CINAHL Plus, Web of Science, Scopus, PsycINFO and Emcare databases. ELIGIBILITY CRITERIA Studies involving PGData use within HIV care for people living with HIV and/or healthcare professionals (HCPs) published before February 2021. DATA EXTRACTION AND SYNTHESIS Data were extracted using a table and the Mixed Methods Appraisal Tool was used to assess empirical rigour. We used thematic analysis to evaluate content. RESULTS 11 articles met the eligibility criteria. Studies were observational, predominantly concerned hypothetical or novel digital platforms, mainly conducted in high-income settings, and had small sample sizes (range=10-160). There were multiple definitions of PGData. In the majority of studies (n=9), participants were people living with HIV, with a few studies including HCPs, informatics specialists or mixed participant groups. Participants living with HIV were aged 23-78 years, mostly men, of diverse ethnicities, and had low educational, health literacy and income levels.We identified four key themes: (1) Perceptions of PGData and associated digital platforms; (2) Opportunities; (3) Anticipated barriers and (4) Potential impact on patient-HCP relationships. CONCLUSIONS Use of PGData within HIV care warrants further study, especially with regard to digital inequalities, data privacy and security. There is a need for longitudinal data on use within HIV in a variety of settings with a broad range of users, including impact on clinical outcomes. This will allow greater understanding of the role of PGData use in improving the health and well-being of people living with HIV, which is increasingly pertinent as digital healthcare becomes more widespread as a result of COVID-19.
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Affiliation(s)
- Clara Hewitt
- Institute for Global Health, University College London, London, UK
| | - Karen C Lloyd
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
| | - Abigail Durrant
- Open Lab, School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline Claisse
- Open Lab, School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
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Mehraeen E, Safdari R, SeyedAlinaghi S, Mohammadzadeh N. Exploring and Prioritization of Mobile-Based Self-Management Strategies for HIV Care. Infect Disord Drug Targets 2020; 19:288-296. [PMID: 30345930 DOI: 10.2174/1871526518666181022113900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/20/2018] [Accepted: 10/12/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Appropriate mobile-based self-management strategies can be as new approaches to decelerate the HIV infection progression and improve the quality of life. This study aims at (i) identifying in the literature mobile-based self-management strategies for HIV care and (ii) prioritizing those from the point of view of infectious diseases specialists. This study provides some clues to design useful mobile-based self-management tools for HIV patients, from the point of view of practitioners. METHODS This mixed methods study was done in two main phases. In the first phase, a review was conducted in: PubMed, Web of Science, Science Direct, Scopus, and Ovid. In this manner, related studies published between 2010 and 2017 and in the English language were reviewed. In the second phase, identified mobile-based self-management strategies were scored and prioritized by 23 participants. Frequency distribution and mean reports were calculated using SPSS statistical software. RESULTS By detailed reviewing of 24 related articles, the HIV mobile-based self-management strategies were identified in 47 categories and subcategories. According to the findings, "enhance the quality of life" was the main self-management strategy addressed by reviewed studies. However, "antiretroviral therapy and medication adherence" was reported at a higher rate to be a more helpful strategy than "enhance the quality of life". CONCLUSION In this study, helpful HIV mobile-based self-management strategies were identified that can be used to guide self-management interventions which have the potential to improve the healthcare services for people living with HIV.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Reza Safdari
- Department of Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
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Wu D, Huang W, Zhao P, Li C, Cao B, Wang Y, Stoneking S, Tang W, Luo Z, Wei C, Tucker J. A Crowdsourced Physician Finder Prototype Platform for Men Who Have Sex with Men in China: Qualitative Study of Acceptability and Feasibility. JMIR Public Health Surveill 2019; 5:e13027. [PMID: 31596245 PMCID: PMC6913768 DOI: 10.2196/13027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/22/2019] [Accepted: 08/19/2019] [Indexed: 12/31/2022] Open
Abstract
Background Men who have sex with men (MSM), including both gay and bisexual men, have a high prevalence of HIV and sexually transmitted infections (STIs) in China. However, healthcare seeking behaviors and engagement in clinical services among MSM are often suboptimal. Global evidence shows that embedding online HIV or sexual health services into gay social networking applications holds promise for facilitating higher rates of healthcare utilization among MSM. We developed a prototype of a gay-friendly health services platform, designed for integration within a popular gay social networking app (Blued) in China. Objective The purpose of this study was to evaluate the acceptability of the platform and ask for user feedback through focus group interviews with young MSM in Guangzhou and Shenzhen, cities in Southern China. Methods The prototype was developed through an open, national crowdsourcing contest. Open crowdsourcing contests solicit community input on a topic in order to identify potential improvements and implement creative solutions. The prototype included a local, gay-friendly, STI physician finder tool and online psychological consulting services. Semistructured focus group discussions were conducted with MSM to ask for their feedback on the platform, and a short survey was administered following discussions. Thematic analysis was used to analyze the data in NVivo, and we developed a codebook based on the first interview. Double coding was conducted, and discrepancies were discussed with a third individual until consensus was reached. We then carried out descriptive analysis of the survey data. Results A total of 34 participants attended four focus group discussions. The mean age was 27.3 years old (SD 4.6). A total of 32 (94%) participants obtained at least university education, and 29 (85%) men had seen a doctor at least once before. Our survey results showed that 24 (71%) participants had interest in using the online health services platform and 25 (74%) thought that the system was easy to use. Qualitative data also revealed that there was a high demand for gay-friendly healthcare services which could help with care seeking. Men felt that the platform could bridge gaps in the existing HIV or STI service delivery system, specifically by identifying local gay-friendly physicians and counselors, providing access to online physician consultation and psychological counseling services, creating space for peer support, and distributing pre-exposure prophylaxis and sexual health education. Conclusions Crowdsourcing can help develop a community-centered online platform linking MSM to local gay-friendly HIV or STI services. Further research on developing social media–based platforms for MSM and evaluating the effectiveness of such platforms may be useful for improving sexual health outcomes.
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Affiliation(s)
- Dan Wu
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Social Entrepreneurship to Spur Health Global, Guangzhou, China
| | - Wenting Huang
- School of Public Health, Emory University, Atlanta, GA, United States
| | - Peipei Zhao
- Social Entrepreneurship to Spur Health Global, Guangzhou, China.,Shenzhen Nanshan Canter for Chronic Disease Control, Shenzhen, China
| | - Chunyan Li
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yifan Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Shelby Stoneking
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Weiming Tang
- Social Entrepreneurship to Spur Health Global, Guangzhou, China.,Project-China, University North Carolina at Chapel Hill, Guangzhou, China.,Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zhenzhou Luo
- Shenzhen Nanshan Canter for Chronic Disease Control, Shenzhen, China
| | - Chongyi Wei
- Department of Social and Behavior Health Sciences, Rutgers School of Public Health, Piscataway, NJ, United States
| | - Joseph Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Social Entrepreneurship to Spur Health Global, Guangzhou, China.,Project-China, University North Carolina at Chapel Hill, Guangzhou, China
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Marent B, Henwood F, Darking M. Development of an mHealth platform for HIV Care: Gathering User Perspectives Through Co-Design Workshops and Interviews. JMIR Mhealth Uhealth 2018; 6:e184. [PMID: 30339132 PMCID: PMC6231792 DOI: 10.2196/mhealth.9856] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 08/24/2018] [Accepted: 09/10/2018] [Indexed: 11/14/2022] Open
Abstract
Background Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth apps are rarely adopted and often considered to be of low quality by users. Only a few studies (conducted in the United States) have involved people living with HIV (PLWH) in the design of mHealth. Objective The goal of this study was to facilitate a co-design process among PLWH and clinicians across 5 clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth. Methods Between January and June 2016, 14 co-design workshops and 22 semistructured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analyzed thematically and iteratively, drawing on grounded theory techniques. Results Findings were established into 3 thematic clusters: (1) approaching the mHealth platform, (2) imagining the mHealth platform, and (3) anticipating the mHealth platform’s implications. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing information technology systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested medical functionalities (accessing test results, managing medicines and appointments, and digital communication channels), social functionalities (peer support network, international travel, etc), and general features (security and privacy, credibility, language, etc). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care. Conclusions Our approach to co-design enabled us to facilitate early engagement in the mHealth platform, enabling patient and clinician feedback to become embedded in the development process at a preprototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine, and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.
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Affiliation(s)
- Benjamin Marent
- School of Applied Social Science, University of Brighton, Falmer, United Kingdom
| | - Flis Henwood
- School of Applied Social Science, University of Brighton, Falmer, United Kingdom
| | - Mary Darking
- School of Applied Social Science, University of Brighton, Falmer, United Kingdom
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- School of Applied Social Science, University of Brighton, Falmer, United Kingdom
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Muessig KE, LeGrand S, Horvath KJ, Bauermeister JA, Hightow-Weidman LB. Recent mobile health interventions to support medication adherence among HIV-positive MSM. Curr Opin HIV AIDS 2017; 12:432-441. [PMID: 28639990 PMCID: PMC5762120 DOI: 10.1097/coh.0000000000000401] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW We describe recent mobile health (mHealth) interventions supporting antiretroviral therapy (ART) medication adherence among HIV-positive MSM. RECENT FINDINGS Keyword searches (1 January 2016-13 May 2017) identified 721 citations. Seven publications reporting on six studies met inclusion criteria. Five studies focused on MSM. Interventions primarily employed text messaging (n = 4), whereas two focused on smartphone apps and one on social media. Three studies measured intervention impact on adherence and found increased ART use intentions (n = 1), self-reported adherence (n = 1), and viral suppression (n = 1, no control group). Other mHealth interventions for HIV-positive MSM focused on status disclosure and reducing sexual risk. SUMMARY mHealth interventions to support ART adherence among MSM show acceptability, feasibility, and preliminary efficacy. No recent mHealth interventions for MSM measured impact on viral suppression compared with a control condition despite earlier (pre-2015) evidence for efficacy. Studies are underway that include multiple features designed to improve adherence within complex smartphone or internet-based platforms. Areas for future growth include overcoming measurement and engagement challenges, developing tools for coordinating patient and provider adherence data, testing combination interventions, and adapting efficacious interventions for new languages and geographic settings.
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