scholarly journals User-Centered Design of a Mobile Health Intervention to Enhance Exacerbation-Related Self-Management in Patients With Chronic Obstructive Pulmonary Disease (Copilot): Mixed Methods Study

10.2196/15449 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15449 ◽  
Author(s):  
Yvonne J G Korpershoek ◽  
Sander Hermsen ◽  
Lisette Schoonhoven ◽  
Marieke J Schuurmans ◽  
Jaap C A Trappenburg
Keyword(s):  
Development Process ◽  
Usability Testing ◽  
Self Management ◽  
Chronic Obstructive ◽  
User Centered Design ◽  
Working Mechanism ◽  
Obstructive Pulmonary Disease ◽  
Analysis And Design ◽  
Mhealth Intervention ◽  
Iterative Software

Background Adequate self-management skills are of great importance for patients with chronic obstructive pulmonary disease (COPD) to reduce the impact of COPD exacerbations. Using mobile health (mHealth) to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. However, there is limited knowledge on how to design mHealth interventions that are effective, meet the needs of end users, and are perceived as useful. By following an iterative user-centered design (UCD) process, an evidence-driven and usable mHealth intervention was developed to enhance exacerbation-related self-management in patients with COPD. Objective This study aimed to describe in detail the full UCD and development process of an evidence-driven and usable mHealth intervention to enhance exacerbation-related self-management in patients with COPD. Methods The UCD process consisted of four iterative phases: (1) background analysis and design conceptualization, (2) alpha usability testing, (3) iterative software development, and (4) field usability testing. Patients with COPD, health care providers, COPD experts, designers, software developers, and a behavioral scientist were involved throughout the design and development process. The intervention was developed using the behavior change wheel (BCW), a theoretically based approach for designing behavior change interventions, and logic modeling was used to map out the potential working mechanism of the intervention. Furthermore, the principles of design thinking were used for the creative design of the intervention. Qualitative and quantitative research methods were used throughout the design and development process. Results The background analysis and design conceptualization phase resulted in final guiding principles for the intervention, a logic model to underpin the working mechanism of the intervention, and design requirements. Usability requirements were obtained from the usability testing phases. The iterative software development resulted in an evidence-driven and usable mHealth intervention—Copilot, a mobile app consisting of a symptom-monitoring module, and a personalized COPD action plan. Conclusions By following a UCD process, an mHealth intervention was developed that meets the needs and preferences of patients with COPD, is likely to be used by patients with COPD, and has a high potential to be effective in reducing exacerbation impact. This extensive report of the intervention development process contributes to more transparency in the development of complex interventions in health care and can be used by researchers and designers as guidance for the development of future mHealth interventions.

scholarly journals User-Centered Design of a Mobile Health Intervention to Enhance Exacerbation-Related Self-Management in Patients With Chronic Obstructive Pulmonary Disease (Copilot): Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Yvonne J G Korpershoek ◽  
Sander Hermsen ◽  
Lisette Schoonhoven ◽  
Marieke J Schuurmans ◽  
Jaap C A Trappenburg
Keyword(s):  
Development Process ◽  
Usability Testing ◽  
Self Management ◽  
Chronic Obstructive ◽  
User Centered Design ◽  
Working Mechanism ◽  
Obstructive Pulmonary Disease ◽  
Analysis And Design ◽  
Mhealth Intervention ◽  
Iterative Software

BACKGROUND Adequate self-management skills are of great importance for patients with chronic obstructive pulmonary disease (COPD) to reduce the impact of COPD exacerbations. Using mobile health (mHealth) to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. However, there is limited knowledge on how to design mHealth interventions that are effective, meet the needs of end users, and are perceived as useful. By following an iterative user-centered design (UCD) process, an evidence-driven and usable mHealth intervention was developed to enhance exacerbation-related self-management in patients with COPD. OBJECTIVE This study aimed to describe in detail the full UCD and development process of an evidence-driven and usable mHealth intervention to enhance exacerbation-related self-management in patients with COPD. METHODS The UCD process consisted of four iterative phases: (1) background analysis and design conceptualization, (2) alpha usability testing, (3) iterative software development, and (4) field usability testing. Patients with COPD, health care providers, COPD experts, designers, software developers, and a behavioral scientist were involved throughout the design and development process. The intervention was developed using the behavior change wheel (BCW), a theoretically based approach for designing behavior change interventions, and logic modeling was used to map out the potential working mechanism of the intervention. Furthermore, the principles of design thinking were used for the creative design of the intervention. Qualitative and quantitative research methods were used throughout the design and development process. RESULTS The background analysis and design conceptualization phase resulted in final guiding principles for the intervention, a logic model to underpin the working mechanism of the intervention, and design requirements. Usability requirements were obtained from the usability testing phases. The iterative software development resulted in an evidence-driven and usable mHealth intervention—Copilot, a mobile app consisting of a symptom-monitoring module, and a personalized COPD action plan. CONCLUSIONS By following a UCD process, an mHealth intervention was developed that meets the needs and preferences of patients with COPD, is likely to be used by patients with COPD, and has a high potential to be effective in reducing exacerbation impact. This extensive report of the intervention development process contributes to more transparency in the development of complex interventions in health care and can be used by researchers and designers as guidance for the development of future mHealth interventions.

Chronic obstructive pulmonary disease, exacerbation and self-management: a literature review

2021 ◽  
Vol 26 (9) ◽  
pp. 452-457
Author(s):  
Paula Boyer
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Literature Review ◽  
Pulmonary Disease ◽  
Signs And Symptoms ◽  
Health Condition ◽  
Self Management ◽  
Chronic Obstructive ◽  
Ageing Population ◽  
Obstructive Pulmonary Disease ◽  
Management Plans

Chronic obstructive pulmonary disease (COPD) is being increasingly diagnosed in the UKs on the rise, and is expected to continue to rise due to an ageing population with multiple co-morbidities and exposure to risk factors, such as cigarette smoke, noxious gases and air pollutants. The prevalence of this disease is high is areas of socioeconomic deprivation and among high industrial areas. The use of self-management plans in COPD is recommended by the National Institute for Health and Care Excellence (NICE), to enable to patients with this disease to be competent and confident in taking part in managing their own health condition and recognising signs and symptoms of an exacerbation. The aim of this article is to discuss self-management of COPD and the clinical guidance surrounding exacerbation of disease. A follow-up literature review will focus on the effectiveness of self-management plans in COPD.

scholarly journals Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

10.2196/16343 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16343 ◽  
Author(s):  
Sara Lundell ◽  
Mari Modig ◽  
Åsa Holmner ◽  
Karin Wadell
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Self Management ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Successful Implementation ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Home Telemonitoring

Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

scholarly journals Comprehensive care programmes in chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials and real-world studies

2021 ◽  
Author(s):  
Daniel Yoo ◽  
Mengqi Gong ◽  
Lei Meng ◽  
Cheuk Wai Wong ◽  
Guangping Li ◽  
...  
Keyword(s):  
Home Care ◽  
Meta Analysis ◽  
Comprehensive Care ◽  
Self Management ◽  
Chronic Obstructive ◽  
Chronic Obstructive Pulmonary Disorder ◽  
Obstructive Pulmonary Disease ◽  
Structured Care ◽  
Pulmonary Disorder ◽  
Medication Reviews

Background: Different comprehensive care programmes (CCPs) have been developed for patients with chronic obstructive pulmonary disorder (COPD), but data regarding their effectiveness have been controversial. PubMed and Embase were searched to 1st June 2017 for articles that investigated the effects of the different types of CCPs on hospitalization or mortality rates in COPD. Results: A total of 67 studies including 3472633 patients (mean age: 76.1+/-12.7 years old; 41% male) were analyzed. CCPs reduced all-cause hospitalizations (hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.63-0.79; P<0.001; I2:96%) and mortality (HR: 0.69, 95% CI: 0.573-0.83; P<0.001; I2:75%). Subgroup analyses for different CCP types were performed. Hospitalizations were reduced by pharmacist-led medication reviews (HR: 0.54; 95% CI: 0.37-0.78; P=0.001; I2:49%), structured care programmes (HR: 0.76; 95% CI: 0.66-0.87; P<0.0001; I2:88%) and self-management programmes (HR: 0.79; 95% CI: 0.64-0.99; P<0.05; I2:78%), but not continuity of care programmes (HR: 0.70; 95% CI: 0.36-1.36; P=0.29; I2:100%), early support discharge or home care packages (HR: 0.97; 95% CI: 0.91-1.04; P=0.37; I2:0%) or telemonitoring (HR: 0.61; 95% CI: 0.32-1.18; P=0.14; I2:94%). Mortality was reduced by early support discharge or home care packages (HR: 0.49; 95% CI: 0.30-0.80; P<0.01; I2:72%), structured care programmes (HR: 0.69; 95% CI: 0.53-0.90; P<0.01; I2:61%) and telemonitoring (HR: 0.52; 95% CI: 0.31-0.89; P<0.05; I2:0%), but not self-management programmes (HR: 0.79; 95% CI: 0.64-0.99; P<0.05; I2:78%). Conclusions: Comprehensive care programmes reduce hospitalization and mortality in COPD patients.

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