scholarly journals Mobile Health in Chronic Disease Management and Patient Empowerment: Exploratory Qualitative Investigation Into Patient-Physician Consultations (Preprint)

2021 ◽  
Author(s):  
Kathrine Stampe ◽  
Sharon Kishik ◽  
Sune Dueholm Müller
Keyword(s):  
Chronic Diseases ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Patient Empowerment ◽  
Unintended Consequences ◽  
Self Management ◽  
Noncompliant Patient ◽  
Lifestyle Choices ◽  
Relevant Topic ◽  
Cost Efficient

BACKGROUND Chronic diseases often present severe consequences for those affected. The management and treatment of chronic diseases largely depend on patients’ lifestyle choices and how they cope with the disease in their everyday lives. Accordingly, the ability of patients to self-manage diseases is a highly relevant topic. In relation to self-management, studies refer to patient empowerment as strengthening patients’ voices and enabling them to assert control over their health and treatment. Mobile health (mHealth) provides cost-efficient means to support self-management and foster empowerment. OBJECTIVE There is a scarcity of research investigating how mHealth affects patient empowerment during patient-physician consultations. The objective of this study is to address this knowledge gap by investigating how mHealth affects consultations and patient empowerment. METHODS We relied on data from an ethnographic field study of 6 children and adolescents diagnosed with juvenile idiopathic arthritis. We analyzed 6 patient-physician consultations and drew on Michel Foucault’s concepts of power and power technology. RESULTS Our results suggest that the use of mHealth constitutes practices that structure the consultations around deviations and noncompliant patient behavior. Our analysis shows how mHealth is used to discipline patients and <i>correct</i> their behavior. We argue that the use of mHealth during consultations may unintentionally lead to relevant aspects of patients’ lives related to the disease being ignored; thus, inadvertently, patients’ voices may be silenced. CONCLUSIONS Our results show that concrete uses of mHealth may conflict with extant literature on empowerment, which emphasizes the importance of strengthening the patients’ voices and enabling patients to take more control of their health and treatment. We contribute to the state-of-the-art knowledge by showing that the use of mHealth may have unintended consequences that do not lead to empowerment. Our analysis underscores the need for further research to investigate how mHealth impacts patient empowerment during consultations.

scholarly journals App Features for Type 1 Diabetes Support and Patient Empowerment: Systematic Literature Review and Benchmark Comparison (Preprint)

2018 ◽  
Author(s):  
Antonio Martinez-Millana ◽  
Elena Jarones ◽  
Carlos Fernandez-Llatas ◽  
Gunnar Hartvigsen ◽  
Vicente Traver
Keyword(s):  
Type 1 Diabetes ◽  
Disease Management ◽  
Mobile Health ◽  
Diabetes Management ◽  
Patient Empowerment ◽  
Self Management ◽  
Inclusion Criteria ◽  
Data Record ◽  
Level 1

BACKGROUND Research in type 1 diabetes management has increased exponentially since the irruption of mobile health apps for its remote and self-management. Despite this fact, the features affect in the disease management and patient empowerment are adopted by app makers and provided to the general population remain unexplored. OBJECTIVE To study the gap between literature and available apps for type 1 diabetes self-management and patient empowerment and to discover the features that an ideal app should provide to people with diabetes. METHODS The methodology comprises systematic reviews in the scientific literature and app marketplaces. We included articles describing interventions that demonstrated an effect on diabetes management with particular clinical endpoints through the use of mobile technologies. The features of these apps were gathered in a taxonomy of what an ideal app should look like to then assess which of these features are available in the market. RESULTS The literature search resulted in 231 matches. Of these, 55 met the inclusion criteria. A taxonomy featuring 3 levels of characteristics was designed based on 5 papers which were selected for the synthesis. Level 1 includes 10 general features (Personalization, Family support, Agenda, Data record, Insulin bolus calculator, Data management, Interaction, Tips and support, Reminders, and Rewards) Level 2 and Level 3 included features providing a descriptive detail of Level 1 features. Eighty apps matching the inclusion criteria were analyzed. None of the assessed apps fulfilled the features of the taxonomy of an ideal app. Personalization (70/80, 87.5%) and Data record (64/80, 80.0%) were the 2 top prevalent features, whereas Agenda (5/80, 6.3%) and Rewards (3/80, 3.8%) where the less predominant. The operating system was not associated with the number of features (P=.42, F=.81) nor the type of feature (P=.20, χ2=11.7). Apps were classified according to the number of level 1 features and sorted into quartiles. First quartile apps had a regular distribution of the ten features in the taxonomy whereas the other 3 quartiles had an irregular distribution. CONCLUSIONS There are significant gaps between research and the market in mobile health for type 1 diabetes management. While the literature focuses on aspects related to gamification, rewarding, and social communities, the available apps are focused on disease management aspects such as data record and appointments. Personalized and tailored empowerment features should be included in commercial apps for large-scale assessment of potential in the self-management of the disease.

scholarly journals Potential reach of mobile health for educating, empowering and engaging chronically diseased patients: evidence from a survey in Egypt

2019 ◽  
Author(s):  
Rehab A. Rayan
Keyword(s):  
Diabetes Mellitus ◽  
Health Literacy ◽  
Patient Education ◽  
Chronic Diseases ◽  
Mobile Devices ◽  
Mobile Health ◽  
Patient Engagement ◽  
Self Management ◽  
Healthcare Technology ◽  
Multiple Interventions

Patient education includes multiple interventions for teaching patients about their health to improve their outcomes. The term has evolved to the more active terms (patient engagement and empowerment). Patients, who are diagnosed with chronic diseases that cost patients lifelong treatmentand dangerous complications (e.g. Diabetes mellitus) need to be responsible for their health by self-management. With more computers and mobile devices owners globally, telehealth offers promising healthcare technology interventions to improve the patient’s health literacy.

scholarly journals The Use of Health IT for Chronic Disease Management: A comprehensive review of diabetes applications used for self-management of the disease (Preprint)

2019 ◽  
Author(s):  
Lorrin Robinson ◽  
Jamesa Hogges ◽  
Ingrid Brown ◽  
Kennedy Craig ◽  
Akasha Lawrence ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
The Self ◽  
Self Management ◽  
Consumer Reviews ◽  
Health Apps ◽  
Apple Ios ◽  
Mobile Health Apps

BACKGROUND Mobile health (mHealth) smartphone applications (apps) have shown promise in the self-management of chronic disease. Management of key disease variances can be performed through these applications to increase patient engagement in disease self-management. In today’s oversaturated health app market, what selection criteria do consumers employ to choose mobile health apps for disease self-management? App quality is critical in monitoring disease controls but is often linked to consumer popularity rather clinical recommendations of effectiveness in disease management. This paper provides a comprehensive review of features found in mobile health apps frequently used in the self-management of diabetes. OBJECTIVE The objective of this study was to review features of frequently used and high consumer-rated mobile health apps used in the self-management of diabetes within the Apple iOS store. These applications were cross-referenced against high consumer-rated health apps found in other online diabetes sources. This study aimed to highlight key features of consumer-favored mobile health apps used in the self-management of diabetes. METHODS A primary Apple iOS store search was conducted using the term “diabetes apps” on an Apple iPad. The top five most frequently used mobile health apps were identified and rated by the number of consumer reviews, application ratings, and the presence of key diabetes management features: dietary blood glucose, A1C, insulin, physical activity and prescription medication. A subsequent Google search was conducted using the search term “best Apple diabetes apps”. The top three search results – Healthline, Everyday Health, and Diabetes Apps, American Diabetes Association – were explored. The top five frequently used apps among those sources were examined against the same Apple iOS criteria. RESULTS Twelve mobile health apps were reviewed in total due to repetition in popularity across the four evaluated sources. Only one health app – Glucose Buddy Diabetes Tracker – appeared most frequently used within the Apple iOS store and across the other three sources. The OneTouch Reveal app ranked first on the list in the iOS store with 39,000 consumer reviews and a rating of 4.7 out of 5.0 stars while only appearing once among the other sources. Blood glucose tracking was evident across all apps, but other disease management features varied in type with at least three of the five key features being present across the 12 reviewed apps. Subscription costs and integration needs were present which could play a major role in consumer app selection. While mobile app preference was assessed and defined by the number of consumer reviews and star ratings, there were no scientific standards used in the selection and ranking of the health apps within this study. CONCLUSIONS Mobile health applications (apps) have shown promise in chronic disease management, but a surge in development of these non-regulated health solutions points to a need for standards in quality. A governing body of health information technology, clinical, policymaking, and other industry stakeholders, including patients, could be beneficial in defining health application standards for effective chronic disease management. Variabilities in features, cost, and other management inconsistencies could be diminished by regulatory uniformity and increase both patient engagement activities and disease outcomes.

scholarly journals Facilitators and Barriers to Chronic Disease Self-Management and Mobile Health Interventions for People Living With Diabetes and Hypertension in Cambodia: Qualitative Study

10.2196/13536 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e13536
Author(s):  
Lesley Steinman ◽  
Hen Heang ◽  
Maurits van Pelt ◽  
Nicole Ide ◽  
Haixia Cui ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Focus Groups ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Self Management ◽  
Facilitators And Barriers

Background In many low- and middle-income countries (LMICs), heart disease and stroke are the leading causes of death as cardiovascular risk factors such as diabetes and hypertension rapidly increase. The Cambodian nongovernmental organization, MoPoTsyo, trains local residents with diabetes to be peer educators (PEs) to deliver chronic disease self-management training and medications to 14,000 people with hypertension and/or diabetes in Cambodia. We collaborated with MoPoTsyo to develop a mobile-based messaging intervention (mobile health; mHealth) to link MoPoTsyo’s database, PEs, pharmacies, clinics, and people living with diabetes and/or hypertension to improve adherence to evidence-based treatment guidelines. Objective This study aimed to understand the facilitators and barriers to chronic disease management and the acceptability, appropriateness, and feasibility of mHealth to support chronic disease management and strengthen community-clinical linkages to existing services. Methods We conducted an exploratory qualitative study using semistructured interviews and focus groups with PEs and people living with diabetes and/or hypertension. Interviews were recorded and conducted in Khmer script, transcribed and translated into the English language, and uploaded into Atlas.ti for analysis. We used a thematic analysis to identify key facilitators and barriers to disease management and opportunities for mHealth content and format. The information-motivation-behavioral model was used to guide data collection, analysis, and message development. Results We conducted six focus groups (N=59) and 11 interviews in one urban municipality and five rural operating districts from three provinces in October 2016. PE network participants desired mHealth to address barriers to chronic disease management through reminders about medications, laboratory tests and doctor’s consultations, education on how to incorporate self-management into their daily lives, and support for obstacles to disease management. Participants preferred mobile-based voice messages to arrive at dinnertime for improved phone access and family support. They desired voice messages over texts to communicate trust and increase accessibility for persons with limited literacy, vision, and smartphone access. PEs shared similar views and perceived mHealth as acceptable and feasible for supporting their work. We developed 34 educational, supportive, and reminder mHealth messages based on these findings. Conclusions These mHealth messages are currently being tested in a cluster randomized controlled trial (#1R21TW010160) to improve diabetes and hypertension control in Cambodia. This study has implications for practice and policies in Cambodia and other LMICs and low-resource US settings that are working to engage PEs and build community-clinical linkages to facilitate chronic disease management.

Effectiveness of Mobile Health Interventions on Management of Patients with Hypertension: Systematic Review of Systematic Reviews (Preprint)

2021 ◽  
Author(s):  
Sisi Wu ◽  
Chunhua Long ◽  
Shasha Li ◽  
Xuemei Tu
Keyword(s):  
Systematic Reviews ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Meta Analysis ◽  
Self Management ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Hypertension Management ◽  
Management Behaviors

BACKGROUND Mobile health (mHealth) has provided a powerful platform for chronic disease management recent years. Although some previous systematic reviews evaluated the effectiveness of mHealth on hypertension management, there were inconsistent findings. OBJECTIVE To systematically evaluate the effectiveness of mHealth interventions on the management of patients with hypertension and to provide recommendations for the clinic and future researches. METHODS Databases including Embase, Cochrane Library, CINAHL, CNKI, SinoMed, WanFang and VIP Database were searched to collect systematic reviews and meta-analysis on mHealth interventions for hypertension management. Two researchers independently screened the articles and extracted data, and the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) was used to evaluate the methodological quality of the included reviews. RESULTS A total of 11 systematic reviews were included. Three reviews were rated as high quality, four moderate quality, three low quality, one critically low quality. Mobile phone was the most common intervention type, followed by the internet. Seven reviews performed meta-analysis and showed that mHealth was associated with significant reduction in SBP from 2.28mmHg(95%CI 0.66-3.90; I2=100%) to 14.77 mmHg(95%CI 11.76-17.77; I2=90%) and DBP from 1.50mmHg(95%CI 0.80-2.20; I2=62%) to 8.17 mmHg(95%CI 5.67-10.67; I2=86%). Self-management behaviors included medication adherence, diet, smoking, alcohol drinking, exercise and BP monitoring, there were inconsistent results on the effectiveness of mHealth interventions. CONCLUSIONS The mHealth interventions can improve BP control in patients with hypertension, but its impact on self-management behaviors is not confirmed.

scholarly journals Facilitators and Barriers to Chronic Disease Self-Management and Mobile Health Interventions for People Living With Diabetes and Hypertension in Cambodia: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Lesley Steinman ◽  
Hen Heang ◽  
Maurits van Pelt ◽  
Nicole Ide ◽  
Haixia Cui ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Focus Groups ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Self Management ◽  
Facilitators And Barriers

BACKGROUND In many low- and middle-income countries (LMICs), heart disease and stroke are the leading causes of death as cardiovascular risk factors such as diabetes and hypertension rapidly increase. The Cambodian nongovernmental organization, MoPoTsyo, trains local residents with diabetes to be peer educators (PEs) to deliver chronic disease self-management training and medications to 14,000 people with hypertension and/or diabetes in Cambodia. We collaborated with MoPoTsyo to develop a mobile-based messaging intervention (mobile health; mHealth) to link MoPoTsyo’s database, PEs, pharmacies, clinics, and people living with diabetes and/or hypertension to improve adherence to evidence-based treatment guidelines. OBJECTIVE This study aimed to understand the facilitators and barriers to chronic disease management and the acceptability, appropriateness, and feasibility of mHealth to support chronic disease management and strengthen community-clinical linkages to existing services. METHODS We conducted an exploratory qualitative study using semistructured interviews and focus groups with PEs and people living with diabetes and/or hypertension. Interviews were recorded and conducted in Khmer script, transcribed and translated into the English language, and uploaded into Atlas.ti for analysis. We used a thematic analysis to identify key facilitators and barriers to disease management and opportunities for mHealth content and format. The information-motivation-behavioral model was used to guide data collection, analysis, and message development. RESULTS We conducted six focus groups (N=59) and 11 interviews in one urban municipality and five rural operating districts from three provinces in October 2016. PE network participants desired mHealth to address barriers to chronic disease management through reminders about medications, laboratory tests and doctor’s consultations, education on how to incorporate self-management into their daily lives, and support for obstacles to disease management. Participants preferred mobile-based voice messages to arrive at dinnertime for improved phone access and family support. They desired voice messages over texts to communicate trust and increase accessibility for persons with limited literacy, vision, and smartphone access. PEs shared similar views and perceived mHealth as acceptable and feasible for supporting their work. We developed 34 educational, supportive, and reminder mHealth messages based on these findings. CONCLUSIONS These mHealth messages are currently being tested in a cluster randomized controlled trial (#1R21TW010160) to improve diabetes and hypertension control in Cambodia. This study has implications for practice and policies in Cambodia and other LMICs and low-resource US settings that are working to engage PEs and build community-clinical linkages to facilitate chronic disease management.

User-Centered Design Enhances Usability of an mHealth System for Users with Dexterity Impairments (Preprint)

2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  
Keyword(s):  
User Interface ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Independent Living ◽  
Health Interventions ◽  
Self Management ◽  
User Centered Design ◽  
Entire Study ◽  
Efficiency And Effectiveness ◽  
User Centered

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

scholarly journals Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes

2021 ◽  
pp. 193229682199317
Author(s):  
Karolina Leziak ◽  
Eleanor Birch ◽  
Jenise Jackson ◽  
Angelina Strohbach ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mobile Health ◽  
Low Income ◽  
Self Regulation ◽  
Health Inequities ◽  
Comparison Method ◽  
Rapid Expansion ◽  
Self Management ◽  
Postpartum Women ◽  
Design Elements

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.

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