SCHeLTI Platform: an Intervention Support System Tailored for a Randomized Controlled Trial (Preprint)

BACKGROUND With the rapid development of eHealth technologies, the convenient exchange of health-related electronic data can promote interactive exchange of information between healthcare providers (HCPs) and patients, making the communication between doctors and patients more coordinated and transparent. The Sino-Canada Healthy Life Trajectories Initiative (SCHeLTI) study is an ongoing randomized controlled trial to evaluate the effectiveness of a multifaceted, community-family-mother-child intervention on childhood overweight and obesity (OWO). A management system to support the SCHeLTI interventions needs to be developed. OBJECTIVE Considering the need for a supporting system to facilitate the implementation of interventions and the exchange of information between HCPs and participants, the SCHeLTI platform was designed and developed with the aim to facilitate the context-specific interventions in the SCHeLTI study. METHODS We tailored the SCHeLTI platform to the specifics of the SCHeLTI study. Multiple professional background experts were involved in the process of building the application, including the participation of personnel with medical professional background, clinical trials coordination and computer science. In the pilot phase, we collected feedback from HCPs and participants in the use process to further optimize the product. RESULTS The SCHeLTI platform includes the interworking and interconnection between the participants' mobile phone and the HCP's computers. A mobile application and a Web based management system were designed. The participant's terminal (the SCHeLTI APP) was successfully implemented and fully integrated into the intervention programme. The computer terminal managed by the research team create an innovative support environment that guides the participants toward healthy lifestyle changes. CONCLUSIONS A technically advanced and web-based management terminal and mobile phone app corresponding to the SCHeLTI needs were developed and used in the SCHeLTI study. CLINICALTRIAL trial registration No. ChiCTR1800017773

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Patients and Professionals as Partners in Hypertension Care: Qualitative Substudy of a Randomized Controlled Trial Using an Interactive Web-Based System Via Mobile Phone (Preprint)

10.2196/preprints.26143 ◽

2020 ◽

Author(s):

Ulrika Andersson ◽

Ulrika Bengtsson ◽

Agneta Ranerup ◽

Patrik Midlöv ◽

Karin Kjellgren

Keyword(s):

Health Care ◽

Randomized Controlled Trial ◽

Mobile Phone ◽

Controlled Trial ◽

Lifestyle Changes ◽

Hypertension Management ◽

Web Based ◽

Randomized Controlled ◽

Use Of Technology ◽

Web Based System

BACKGROUND The use of technology has the potential to support the patient´s active participation regarding treatment of hypertension. This might lead to changes in the roles of the patient and health care professional and affect the partnership between them. OBJECTIVE The aim of this qualitative study was to explore the partnership between patients and health care professionals and the roles of patients and professionals in hypertension management when using an interactive web-based system for self-management of hypertension via the patient’s own mobile phone. METHODS Focus group interviews were conducted with 22 patients and 15 professionals participating in a randomized controlled trial in Sweden aimed at lowering blood pressure (BP) using an interactive web-based system via mobile phones. The interviews were audiorecorded and transcribed and analyzed using thematic analysis. RESULTS Three themes were identified: the technology, the patient, and the professional. The technology enabled documentation of BP treatment, mainly for sharing knowledge between the patient and the professional. The patients gained increased knowledge of BP values and their relation to daily activities and treatment. They were able to narrate about their BP treatment and take a greater responsibility, inspired by new insights and motivation for lifestyle changes. Based on the patient’s understanding of hypertension, professionals could use the system as an educational tool and some found new ways of communicating BP treatment with patients. Some reservations were raised about using the system, that it might be too time-consuming to function in clinical practice and that too much measuring could result in stress for the patient and an increased workload for the professionals. In addition, not all professionals and patients had adopted the instructions regarding the use of the system, resulting in less realization of its potential. CONCLUSIONS The use of the system led to the patients taking on a more active role in their BP treatment, becoming more of an expert of their BP. When using the system as intended, the professionals experienced it as a useful resource for communication regarding BP and lifestyle. Patients and professionals described a consultation on more equal grounds. The use of technology in hypertension management can promote a constructive and person-centered partnership between patient and professional. However, implementation of a new way of working should bring benefits and not be considered a burden for the professionals. To establish a successful partnership, both the patient and the professional need to be motivated toward a new way of working. CLINICALTRIAL ClinicalTrials.gov NCT03554382; https://clinicaltrials.gov/ct2/show/NCT03554382

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Patients and Professionals as Partners in Hypertension Care: Qualitative Substudy of a Randomized Controlled Trial Using an Interactive Web-Based System Via Mobile Phone

Journal of Medical Internet Research ◽

10.2196/26143 ◽

2021 ◽

Vol 23 (6) ◽

pp. e26143

Author(s):

Ulrika Andersson ◽

Ulrika Bengtsson ◽

Agneta Ranerup ◽

Patrik Midlöv ◽

Karin Kjellgren

Keyword(s):

Health Care ◽

Randomized Controlled Trial ◽

Mobile Phone ◽

Controlled Trial ◽

Lifestyle Changes ◽

Hypertension Management ◽

Web Based ◽

Randomized Controlled ◽

Use Of Technology ◽

Web Based System

Background The use of technology has the potential to support the patient´s active participation regarding treatment of hypertension. This might lead to changes in the roles of the patient and health care professional and affect the partnership between them. Objective The aim of this qualitative study was to explore the partnership between patients and health care professionals and the roles of patients and professionals in hypertension management when using an interactive web-based system for self-management of hypertension via the patient’s own mobile phone. Methods Focus group interviews were conducted with 22 patients and 15 professionals participating in a randomized controlled trial in Sweden aimed at lowering blood pressure (BP) using an interactive web-based system via mobile phones. The interviews were audiorecorded and transcribed and analyzed using thematic analysis. Results Three themes were identified: the technology, the patient, and the professional. The technology enabled documentation of BP treatment, mainly for sharing knowledge between the patient and the professional. The patients gained increased knowledge of BP values and their relation to daily activities and treatment. They were able to narrate about their BP treatment and take a greater responsibility, inspired by new insights and motivation for lifestyle changes. Based on the patient’s understanding of hypertension, professionals could use the system as an educational tool and some found new ways of communicating BP treatment with patients. Some reservations were raised about using the system, that it might be too time-consuming to function in clinical practice and that too much measuring could result in stress for the patient and an increased workload for the professionals. In addition, not all professionals and patients had adopted the instructions regarding the use of the system, resulting in less realization of its potential. Conclusions The use of the system led to the patients taking on a more active role in their BP treatment, becoming more of an expert of their BP. When using the system as intended, the professionals experienced it as a useful resource for communication regarding BP and lifestyle. Patients and professionals described a consultation on more equal grounds. The use of technology in hypertension management can promote a constructive and person-centered partnership between patient and professional. However, implementation of a new way of working should bring benefits and not be considered a burden for the professionals. To establish a successful partnership, both the patient and the professional need to be motivated toward a new way of working. Trial Registration ClinicalTrials.gov NCT03554382; https://clinicaltrials.gov/ct2/show/NCT03554382

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