BACKGROUND
In previous work, a prototype mobile health (mHealth) App was co-designed with patients, family physicians, and researchers to enhance self-management and optimize conservative management for patients with mild to moderate knee osteoarthritis (OA).
OBJECTIVE
To evaluate the overall usability, quality, and effectiveness of an mHealth App prototype for aiding knee OA self-management from the perspectives of OA patients and health care providers (HCPs).
METHODS
Using methods triangulation of qualitative and quantitative data, we conducted a pilot evaluation of an mHealth App prototype co-developed with patients and HCPs. We recruited adult patients aged >20 years with early knee OA (n=18) who experienced knee pain on most days of the month at any time in the past and HCPs (n=7) to participate. In the qualitative assessment, patient and HCPs perspectives were elicited on the likeability and usefulness of App features and functionalities, and the perceived impact of the App on patient-HCP communication. The quantitative assessment involved evaluating the App using usability, quality, and effectiveness metrics. The patient baseline assessments included a semi-structured interview and survey to gather demographics, and to assess quality of life (EQ5D-5L) and patient activation (PAM). Following the 6-week usability trial period, a follow-up survey assessed patients’ perceptions of App usability and quality, and longitudinal changes in quality of life and patient activation. Semi-structured interviews and surveys were also conducted with HCPs (n=7) at baseline to evaluate usability and quality of the App prototype.
RESULTS
Interviews with patients and HCPs revealed overall positive impressions of the App prototype features and functionalities relating to likeability and usefulness. Between the baseline and follow-up patient assessments, mean EQ5D-5L scores improved from 0.77 to 0.67 (p=0.04) and PAM scores increased from 80.4 to 87.9 (p=0.01). Following the 6-week evaluation, patients reported a mean system usability scale (SUS) score of 57.8 indicating marginal acceptability according to SUS cut-offs. The mean number of goals set over the usability period 2.47 (SD 3.08) and mean number of activities completed for knee OA self-management over the study period were 22.2 (SD 17.8). Spearman’s rank correlation (rs) calculations revealed follow-up PAM scores were weakly correlated (rs = -0.32) with the number of goals achieved and the number (rs=0.19) of activities performed over the 6-week usability period. HCPs reported a mean SUS score of 39.1, indicating unacceptable usability.
CONCLUSIONS
This evidence-based and patient-centered App prototype represents a potential use of mHealth for improving outcomes and enhancing conservative care by promoting patient activation and shared decision-making around OA management. However, the future iterations of the App prototype are required to address shortcomings in usability and quality.
Translation, cross-cultural adaptation and validation of the English Lequesne Algofunctional index in to Bengali
