scholarly journals Patients’ Experiences of Using Smartphone Apps to Support Self-Management and Improve Medication Adherence in Hypertension: Qualitative Study

10.2196/17470 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e17470
Author(s):  
Ciara M McBride ◽  
Eimear C Morrissey ◽  
Gerard J Molloy
Keyword(s):  
Medication Adherence ◽  
Personal Responsibility ◽  
Self Management ◽  
Antihypertensive Drug Therapy ◽  
Semistructured Interview ◽  
Management Support ◽  
Smartphone Apps ◽  
Improve Medication Adherence ◽  
Self Monitoring ◽  
Feasible Method

Background Worldwide, hypertension control rates remain suboptimal despite clinically effective antihypertensive drug therapy. Patient failure to take medication as prescribed (ie, nonadherence) is the most important factor contributing to poor control. Smartphone apps can facilitate the delivery of evidence-based behavior change techniques to improve adherence and may provide a scalable, usable, and feasible method to deliver self-management support. Objective The aim of this study is to explore patients’ experiences of the usability and feasibility of smartphone apps to support self-management and improve medication adherence in hypertension. Methods A qualitative descriptive study was conducted. A total of 11 people living with hypertension from the West of Ireland were sampled purposively and interviewed about their experience of using a self-management app for a 4-week period, which included two key functionalities: self-monitoring of blood pressure (BP) and medication reminders. Thematic analysis was carried out on the semistructured interview data. Results Participants’ age ranged from 43 to 74 years (mean 62 years, SD 9.13). Three themes were identified: digital empowerment of self-management, human versus digital systems, and digital sustainability. Although patients’ experience of using the technology to self-monitor BP was one of empowerment, characterized by an enhanced insight and understanding into their condition, control, and personal responsibility, the reminder function was only feasible for patients who reported unintentional nonadherence to treatment. Patients experienced the app as a sustainable tool to support self-management and found it easy to use, including those with limited technological competence. Conclusions The study’s findings provide new insights into the experience of using apps to support medication adherence in hypertension. Overall, the data support apps as a usable and feasible method to aid self-management of hypertension and highlight the need for personalized functionality, particularly with regard to medication adherence reminder strategies. The study’s findings challenge the perspective that the use of these technologies to support self-management can inevitably add to the burden of treatment experienced by patients.

scholarly journals Patients’ Experiences of Using Smartphone Apps to Support Self-Management and Improve Medication Adherence in Hypertension: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Ciara M McBride ◽  
Eimear C Morrissey ◽  
Gerard J Molloy
Keyword(s):  
Medication Adherence ◽  
Personal Responsibility ◽  
Self Management ◽  
Antihypertensive Drug Therapy ◽  
Semistructured Interview ◽  
Management Support ◽  
Smartphone Apps ◽  
Improve Medication Adherence ◽  
Self Monitoring ◽  
Feasible Method

BACKGROUND Worldwide, hypertension control rates remain suboptimal despite clinically effective antihypertensive drug therapy. Patient failure to take medication as prescribed (ie, nonadherence) is the most important factor contributing to poor control. Smartphone apps can facilitate the delivery of evidence-based behavior change techniques to improve adherence and may provide a scalable, usable, and feasible method to deliver self-management support. OBJECTIVE The aim of this study is to explore patients’ experiences of the usability and feasibility of smartphone apps to support self-management and improve medication adherence in hypertension. METHODS A qualitative descriptive study was conducted. A total of 11 people living with hypertension from the West of Ireland were sampled purposively and interviewed about their experience of using a self-management app for a 4-week period, which included two key functionalities: self-monitoring of blood pressure (BP) and medication reminders. Thematic analysis was carried out on the semistructured interview data. RESULTS Participants’ age ranged from 43 to 74 years (mean 62 years, SD 9.13). Three themes were identified: digital empowerment of self-management, human versus digital systems, and digital sustainability. Although patients’ experience of using the technology to self-monitor BP was one of empowerment, characterized by an enhanced insight and understanding into their condition, control, and personal responsibility, the reminder function was only feasible for patients who reported unintentional nonadherence to treatment. Patients experienced the app as a sustainable tool to support self-management and found it easy to use, including those with limited technological competence. CONCLUSIONS The study’s findings provide new insights into the experience of using apps to support medication adherence in hypertension. Overall, the data support apps as a usable and feasible method to aid self-management of hypertension and highlight the need for personalized functionality, particularly with regard to medication adherence reminder strategies. The study’s findings challenge the perspective that the use of these technologies to support self-management can inevitably add to the burden of treatment experienced by patients.

PENERAPAN TEKNIK SELF MANAGEMENT TERHADAP KEPATUHAN BEROBAT PENDERITA HIV DI YOGYAKARTA

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuliati Hasanah
Keyword(s):  
Medication Adherence ◽  
Behavioral Approach ◽  
Self Management ◽  
Single Subject ◽  
Single Subject Design ◽  
Self Monitoring ◽  
Self Evaluation ◽  
Subject Design ◽  
Management Techniques ◽  
The Subject

Abstract Self management is a strategy in which the cognitive behavioral approach in the application, subject to the expected full attendance during the intervention process. NAP is an HIV patient and had undergone antiretroviral therapy. Saturation, fatigue experienced by NAP during the ARV therapy, so found some times subject medical leave provisions. Healthy behavior in a sick person (in this case a person suffering from HIV) one of which is adherent to treatment that must be endured. This research aims to gain result the applying of self management techniques against medication adherence of NAP patient with HIV in the Balai Rehabilitasi Sosial Pamardi PutraYogyakarta. This study focuses on the application of self-management techniques that include self-monitoring, self reinforcement and self evaluation of medication adherence that includes aspects of belief, accept and act on the subject. Researchers used quantitative approach by using the method of single subject design N = 1 model A-B-A now where the measurements and observations made in each phase. The subject in this study as many as one person with initials NAP. The purpose of this study is to look at the effect of applying the self management technique against NAP’s medication adherence. The results of this study indicate that the application of self-management techniques have a positive effect in improving NAP’s medication adherence with skor of 2SD smaller than skor of the mean phase difference A2 and A1. Stages through the application of this technique is extracting and determining value, set goals, formulate an action plan, the implementation of self-monitoring, self reinforcement and self evaluation. Based on the analysis of the results of the study concluded that the motivation, participation and discipline will determine the effectiveness of the intervention. Support of family members is also important to support the commitment of the subjects in this therapy.Keywords: behavior modification, HIV, medication adherence, self-management AbstrakManusia dapat memutuskan dan menentukan dirinya sendiri. Berdasarkan asumsi tersebut teknik self management merupakan salah satu teknik modifikasi perilaku yang memfokuskan pada regulasi diri. Self management merupakan salah satu strategi dalam pendekatan perilaku kognitif dimana dalam penerapannya, subjek diharapkan kehadiran penuh selama proses intervensi. NAP adalah seorang penderita HIV dan telah menjalani terapi ARV. Kejenuhan, kelelahan dialami NAP selama mengikuti terapi ARV, sehingga ditemukan beberapa kali subjek meninggalkan ketentuan-ketentuan medis. Perilaku sehat pada orang sakit (dalam kasus ini seseorang yang menderita HIV) salah satunya adalah patuh terhadap pengobatan yang harus dijalani. Penelitian ini bertujuan untuk memperoleh hasil dari penerapan teknik self management terhadap kepatuhan berobat subjek NAP sebagai penderita HIV di Balai Rehabilitasi Sosial Pamardi Putra Yogyakarta. Penelitian ini menitikberatkan pada penerapan teknik self management yang mencakup self monitoring, self reinforcement dan self evaluation terhadap kepatuhan berobat yang mencakup aspek mempercayai (belief), menerima (accept) dan tindakan (act) pada subjek. Peneliti menggunakan pendekatan kuantitatif dengan menggunakan metode single subject design N=1 dengan model A-B-A dinama pengukuran dan pengamatan dilakukan di setiap fase. Subjek dalam penelitian ini sebanyak satu orang dengan inisial NAP. Tujuan penelitian ini adalah untuk melihat pengaruh penerapan teknik self management terhadap kepatuhan berobat subjek NAP. Hasil penelitian ini menunjukkan bahwa penerapan teknik self management mempunyai pengaruh positif dalam meningkatkan kepatuhan berobat subjek NAP dengan nilai 2SD lebih kecil dari selisih mean fase A2 dan A1. Tahapan yang dilalui dalam penerapan teknik ini adalah penggalian dan penentuan value, menetapkan goals, merumuskan rencana tindakan, pelaksanaan self monitoring, self reinforcement dan self evaluation. Berdasarkan analisa hasil penelitian disimpulkan bahwa motivasi, peran serta dan kedisiplinan akan menentukan efektifitas intervensi. Dukungan anggota keluarga juga penting untuk mendukung komitmen subjek dalam terapi ini.Kata kunci:  HIV, kepatuhan berobat, modifikasi perilaku, self management

scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2021 ◽  
Author(s):  
Justine Chan ◽  
Margaret De Melo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

Organizational Factors Associated With Self-management Behaviors in Diabetes Primary Care Clinics

2009 ◽  
Vol 35 (5) ◽  
pp. 843-850 ◽  
Author(s):  
Amer A. Kaissi ◽  
Michael Parchman
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Medication Adherence ◽  
Support System ◽  
Clinical Information ◽  
Organizational Characteristics ◽  
Self Management ◽  
Management Support ◽  
Primary Care Clinics ◽  
Management Behaviors

Purpose The purpose of this article is to examine the relationship between organizational characteristics as measured by the Chronic Care Model (CCM) and patient self-management behaviors among patients with type 2 diabetes. Methods The study design was cross-sectional. The study setting included 20 primary care clinics from South Texas. The sample included approximately 30 consecutive patients that were enrolled from each clinic for a sample of 617 patients. For the data collection procedures, the CCM survey was completed by caregivers in the clinic. Self-management behaviors were obtained from patient exit surveys. For measures, the CCM consisted of 6 structural dimensions: (1) organization support, (2) community linkages, (3) self-management support, (4) decision support system, (5) delivery system design, and (6) clinical information systems. Patient self-management behavior included whether the patient reported always doing all 4 of the following behaviors as they were instructed: (1) checking blood sugars, (2) following diabetes diet, (3) exercising, and (4) taking medications. For data analyses, to account for clustering of patients within clinics, hierarchical logistic regression models were used. Results Self-management support was positively associated with medication adherence, while decision support system was positively associated with exercise and all 4 self-management behaviors. Surprisingly, community linkages were negatively associated with medication adherence, while clinical information system was negatively associated with diet and all 4 behaviors. A total score, including all dimensions, was positively associated with only exercise. Conclusions Health care providers and diabetes educators in primary care clinics should consider how organizational characteristics of the clinic might influence self-management behaviors of patients. The focus should be on better access to evidence-based information at the point of care and self-management needs and activities.

scholarly journals Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Hemakumar Devan ◽  
Devin Farmery ◽  
Lucy Peebles ◽  
Rebecca Grainger
Keyword(s):  
Pain Management ◽  
Rating Scale ◽  
Mobile Apps ◽  
Management Strategies ◽  
Persistent Pain ◽  
Self Management ◽  
Management Support ◽  
Smartphone Apps ◽  
Management Skills ◽  
Pain Diary

BACKGROUND Smartphone apps are a potential mechanism for development of self-management skills in people with persistent pain. However, the inclusion of best-practice content items in available pain management apps fostering core self-management skills for self-management support is not known. OBJECTIVE The aim of the study was to evaluate the contents of smartphone apps providing information on pain management strategies for people with persistent pain facilitating self-management support and to appraise the app quality. METHODS A systematic search was performed in the New Zealand App Store and Google Play Store. Apps were included if they were designed for people with persistent pain, provided information on pain self-management strategies, and were available in English. App contents were evaluated using an a priori 14-item self-management support (SMS-14) checklist. App quality was assessed using the 23-item Mobile Apps Rating Scale. RESULTS Of the 939 apps screened, 19 apps met the inclusion criteria. Meditation and guided relaxation were the most frequently included self-management strategies. Overall, the included apps met a median of 4 (range 1-8) of the SMS-14 checklist. A total of 3 apps (Curable, PainScale-Pain Diary and Coach, and SuperBetter) met the largest number of items (8 out of 14) to foster self-management of pain. Self-monitoring of symptoms (n=11) and self-tailoring of strategies (n=9) were frequently featured functions, whereas a few apps had features facilitating social support and enabling communicating with clinicians. No apps provided information tailored to the cultural needs of the user. The app quality mean scores using Mobile Apps Rating Scale ranged from 2.7 to 4.5 (out of 5.0). Although use of 2 apps (Headspace and SuperBetter) has been shown to improve health outcomes, none of the included apps have been evaluated in people with persistent pain. CONCLUSIONS Of the 3 apps (Curable, PainScale-Pain Diary and Coach, and SuperBetter) that met the largest number of items to support skills in self-management of pain, 2 apps (PainScale-Pain Diary and Coach and SuperBetter) were free, suggesting the potential for using apps as a scalable, wide-reaching intervention to complement face-to-face care. However, none provided culturally tailored information. Although 2 apps (Headspace and SuperBetter) were validated to show improved health outcomes, none were tested in people with persistent pain. Both users and clinicians should be aware of such limitations and make informed choices in using or recommending apps as a self-management tool. For better integration of apps in clinical practice, concerted efforts are required among app developers, clinicians, and people with persistent pain in developing apps and evaluating for clinical efficacy.

Perspectives of Fear as a Barrier to Self-Management in Non-Hispanic Black Men With Type 2 Diabetes

2018 ◽  
Vol 45 (6) ◽  
pp. 987-996 ◽  
Author(s):  
Ledric D. Sherman ◽  
Joni S. Williams
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Perceived Control ◽  
Diabetes Management ◽  
Phenomenological Approach ◽  
Self Management ◽  
Semistructured Interview ◽  
Self Monitoring

Background. Self-managing type 2 diabetes (T2D) is critical but often challenging for non-Hispanic Black (NHB) men. Fears may contribute to poor self-management; however, the evidence is sparse. The purpose of this study is to examine the relationship between fear and diabetes self-management in NHB men from the southern United States. Methods. Nineteen NHB men with T2D were recruited from barbershops and churches. Interviews were conducted using a semistructured interview guide. Transcripts were analyzed using a phenomenological approach and focused on identifying common themes describing the perceptions of fear as a barrier to self-managing T2D in the study participants. Results. More than 68% of the sample was >55 years of age, where 42% reported an annual income of ≥$100,000, 74% were married, and 26% had a college degree. Fifty-three percent expressed fear with diabetes management, while 47% reported no fears with diabetes management. Direct fears associated with self-management included the use of needles and syringes for self-monitoring and medication adherence, respectively. Indirect fears were associated with the development of adverse complications resulting in poor mental and physical quality of life. No fears were reported secondary to diabetes knowledge, perceived control, and social support. Conclusions. In this sample of NHB men, fear was perceived by many as a direct barrier to self-management and an indirect barrier to optimal quality of life. These findings suggest the need to address the fears of NHB men when guiding treatment and developing research interventions to improve self-management skills.

scholarly journals Smartphone Apps to Improve Medication Adherence

2016 ◽  
Vol 25 ◽  
pp. S331-S332 ◽  
Author(s):  
K. Santo ◽  
J. Chalmers ◽  
C. Chow ◽  
J. Redfern
Keyword(s):  
Medication Adherence ◽  
Smartphone Apps ◽  
Improve Medication Adherence
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