myHip&Knee: Improving Patient Engagement and Self-Management through Mobile Technology

Introduction: Rapidly growing use of mobile technology provides a platform for self-management of care support for those with chronic conditions. Few studies have explored the characteristics or access patterns of kidney transplant recipients who use mHealth applications (apps) for self-management of care. Research Questions: The primary aim of this study was to describe demographics, use, barriers, and perceptions of mobile apps for self-management of care among adult kidney transplants recipients. The secondary aim was to compare blood urea nitrogen, glomerular filtration rate, and number of hospitalizations among mHealth app users, other app users, and non-app users. Methods: A cross-sectional design was used to administer the Mobile Application Use among Kidney Transplant Recipients Questionnaire. Descriptive statistics, χ2 statistics, and analysis of variance were used for the primary aim and linear regression was used for the secondary aim. Results: The sample included mostly African American males (n = 123, 75.5%) with a mean age of 50 (13.2) years. Knowledge was the greatest barrier reported by the non-app users (mHealth app users 9%, other app users 12%, non-app users, 49%, P < .001). Significantly fewer hospitalizations were found in the mHealth app users compared to other app users (regression coefficient b = −1.2, standard error [SE] = 0.5) and non-app users ( b = −0.9, SE = 0.6), adjusting for patient demographic and clinical characteristics. Discussion: Findings suggest a relationship may exist between mHealth app use and a decrease in the number of hospitalizations following kidney transplantation.

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Preferences for mHealth Technology and Text Messaging Communication in Patients With Type 2 Diabetes: Qualitative Interview Study (Preprint)

10.2196/preprints.25958 ◽

2020 ◽

Author(s):

Julie C Lauffenburger ◽

Renee A Barlev ◽

Ellen S Sears ◽

Punam A Keller ◽

Marie E McDonnell ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Mobile Technology ◽

Diabetes Care ◽

Technology Use ◽

Text Messages ◽

Self Management ◽

Care Providers ◽

Mhealth Technology

BACKGROUND Individuals with diabetes need regular support to help them manage their diabetes on their own, ideally delivered via mechanisms that they already use, such as their mobile phones. One reason for the modest effectiveness of prior technology-based interventions may be that the patient perspective has been insufficiently incorporated. OBJECTIVE This study aims to understand patients’ preferences for mobile health (mHealth) technology and how that technology can be integrated into patients’ routines, especially with regard to medication use. METHODS We conducted semistructured qualitative individual interviews with patients with type 2 diabetes from an urban health care system to elicit and explore their perspectives on diabetes medication–taking behaviors, daily patterns of using mobile technology, use of mHealth technology for diabetes care, acceptability of text messages to support medication adherence, and preferred framing of information within text messages to support diabetes care. The interviews were digitally recorded and transcribed. The data were analyzed using codes developed by the study team to generate themes, with representative quotations selected as illustrations. RESULTS We conducted interviews with 20 participants, of whom 12 (60%) were female and 9 (45%) were White; in addition, the participants’ mean glycated hemoglobin A1c control was 7.8 (SD 1.1). Overall, 5 key themes were identified: patients try to incorporate cues into their routines to help them with consistent medication taking; many patients leverage some form of technology as a cue to support adherence to medication taking and diabetes self-management behaviors; patients value simplicity and integration of technology solutions used for diabetes care, managing medications, and communicating with health care providers; some patients express reluctance to rely on mobile technology for these diabetes care behaviors; and patients believe they prefer positively framed communication, but communication preferences are highly individualized. CONCLUSIONS The participants expressed some hesitation about using mobile technology in supporting diabetes self-management but have largely incorporated it or are open to incorporating it as a cue to make medication taking more automatic and less burdensome. When using technology to support diabetes self-management, participants exhibited individualized preferences, but overall, they preferred simple and positively framed communication. mHealth interventions may be improved by focusing on integrating them easily into daily routines and increasing the customization of content.

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Improved Patient Engagement in Self-management of Health, a Key to Sustainable Preventative Healthcare Systems

Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering - Wireless Mobile Communication and Healthcare ◽

10.1007/978-3-319-98551-0_15 ◽

2018 ◽

pp. 129-137

Author(s):

Adriana Alexandru ◽

Marilena Ianculescu ◽

Dora Coardos

Keyword(s):

Patient Engagement ◽

Healthcare Systems ◽

Self Management ◽

Preventative Healthcare

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Exploring the moderating role of perceived flexibility advantages in mobile learning continuance intention (MLCI)

The International Review of Research in Open and Distributed Learning ◽

10.19173/irrodl.v15i3.1722 ◽

2014 ◽

Vol 15 (3) ◽

Cited By ~ 8

Author(s):

Rui-Ting Huang ◽

Chia-Hua Hsiao ◽

Tzy-Wen Tang ◽

Tsung-Cheng Lien

Keyword(s):

Mobile Learning ◽

Mobile Technology ◽

Subjective Norm ◽

The Body ◽

Perceived Usefulness ◽

Self Management ◽

Continuance Intention ◽

The Relationship ◽

Moderating Role

The primary purpose of this study was to explore the key factors that could affect mobile learning continuance intention (MLCI), and examine the moderating effect of perceived flexibility advantages (PFA) on the relationship between key mobile learning elements and continuance intention. Five hundred undergraduate students who had previously adopted mobile devices to learn English took part in this study. Partial least squares (PLS) analysis was utilized to test the hypotheses in this study. It has been found that the perceived usefulness of mobile technology, subjective norm, and self-management of learning could be closely linked to mobile learning continuance intention. With particular respect to the moderating role of perceived flexibility advantages, it has been demonstrated that PFA could moderate the relationship between perceived usefulness of mobile technology and mobile learning continuance intention, as well as the association between subjective norm and mobile learning continuance intention, whereas PFA did not moderate the link between self-management of learning and mobile learning continuance intention.This report has further added to the body of knowledge in the field of mobile learning through empirical examination.

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Patient engagement and self-management in pulmonary arterial hypertension

European Respiratory Review ◽

10.1183/16000617.0078-2016 ◽

2016 ◽

Vol 25 (142) ◽

pp. 399-407 ◽

Cited By ~ 19

Author(s):

Jytte Graarup ◽

Pisana Ferrari ◽

Luke S. Howard

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Patient Engagement ◽

Healthcare Providers ◽

Holistic Approach ◽

Self Management ◽

Care And Support ◽

High Quality Information ◽

Pulmonary Arterial ◽

The Impact

Improved care in pulmonary arterial hypertension has led to increased longevity for patients, with a paralleled evolution in the nature of their needs. There is more focus on the impact of the disease on their day-to-day activities and quality of life, and a holistic approach is coming to the front of pulmonary arterial hypertension management, which places the patient at the centre of their own healthcare. Patients are thus becoming more proactive, involved and engaged in their self-care, and this engagement is an important factor if patient outcomes are to improve. In addition, involvement of the patient may improve their ability to cope with pulmonary arterial hypertension, as well as help them to become effective in the self-management of their disease. Successful patient engagement can be achieved through effective education and the delivery and communication of timely, high-quality information. A multidisciplinary approach involving healthcare professionals, carers, patient associations and expert patient programmes can also encourage patients to engage. Strategies that promote patient engagement can help to achieve the best possible care and support for the patient and also benefit healthcare providers.

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Experiences of Adults With Type 1 Diabetes Using Glucose Sensor–Based Mobile Technology for Glycemic Variability: Qualitative Study (Preprint)

10.2196/preprints.14032 ◽

2019 ◽

Author(s):

Marilyn D Ritholz ◽

Owen Henn ◽

Astrid Atakov Castillo ◽

Howard Wolpert ◽

Stephanie Edwards ◽

...

Keyword(s):

Type 1 Diabetes ◽

Qualitative Study ◽

Mobile Technology ◽

Glucose Sensor ◽

Self Care ◽

Glycemic Variability ◽

Mobile App ◽

Self Management ◽

Freestyle Libre

BACKGROUND Adults with type 1 diabetes (PWDs) face challenging self-management regimens including monitoring their glucose values multiple times a day to assist with achieving glycemic targets and reduce the risk of long-term diabetes complications. Recent advances in diabetes technology have reportedly improved glycemia, but little is known about how PWDs utilize mobile technology to make positive changes in their diabetes self-management. OBJECTIVE The aim of this qualitative study was to explore PWDs’ experiences using Sugar Sleuth, a glucose sensor–based mobile app and Web-based reporting system, integrated with the FreeStyle Libre glucose monitor that provides feedback about glycemic variability. METHODS We used a qualitative descriptive research design and conducted semistructured interviews with 10 PWDs (baseline mean glycated hemoglobin, HbA1c) 8.0%, (SD 0.45); 6 males and 4 females, aged 52 years (SD 15), type 1 diabetes (T1D) duration 31 years (SD 13), 40% (4/10, insulin pump) following a 14-week intervention during which they received clinical support and used Sugar Sleuth to evaluate and understand their glucose data. Audio-recorded interviews were transcribed, coded, and analyzed using thematic analysis and NVivo 11 (QSR International Pty Ltd). RESULTS A total of 4 main themes emerged from the data. Participants perceived Sugar Sleuth as an Empowering Tool that served to inform lifestyle choices and diabetes self-management tasks, promoted preemptive self-care actions, and improved discussions with clinicians. They also described Sugar Sleuth as providing a Source of Psychosocial Support and offering relief from worry, reducing glycemic uncertainty, and supporting positive feelings about everyday life with diabetes. Participants varied in their Approaches to Glycemic Data: 40% (4/10) described using Sugar Sleuth to review data, understand glycemic cause and effect, and plan for future self-care. On the contrary, 60% (6/10) were reluctant to review past data; they described receiving benefits from the immediate numbers and trend arrows, but the app still prompted them to enter in the suspected causes of glucose excursions within hours of their occurrence. Finally, only 2 participants voiced Concerns About Use of Sugar Sleuth; they perceived the app as sometimes too demanding of information or as not attuned to the socioeconomic backgrounds of PWDs from diverse populations. CONCLUSIONS Results suggest that Sugar Sleuth can be an effective educational tool to enhance both patient-clinician collaboration and diabetes self-management. Findings also highlight the importance of exploring psychosocial and socioeconomic factors that may advance the understanding of PWDs’ individual differences when using glycemic technology and may promote the development of customized mobile tools to improve diabetes self-management.

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