An Analysis of Apps with a Medication List Functionality for Older People with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint)

2021 ◽  
Author(s):  
Yohanca Maria Diaz-Skeete ◽  
David McQuaid ◽  
Adewale Samuel Akinosun ◽  
Idongesit Ekerete ◽  
Natacha Carragher ◽  
...  

BACKGROUND Managing the care of older patients with heart failure (HF) largely centres on medication management. Due to their frequent medication or dosing changes, an app supporting them to keep an up-to-date list of medication could be advantageous. During COVID-19 times, HF outpatients’ consultations are taking place virtually or by phone. An app with the capability to share the medication list with healthcare professionals before consultation could support the clinic efficiency, for example, reducing consultation time. However, the influence of apps on maintaining an up to date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE The objectives of this review are twofold: to review apps with a medication list functionality and to evaluate the quality of the apps included in the review using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS A systematic search of apps was conducted in June 2019 using the Google Play StoreTM and iTunes App StoreTM. The MARS was used independently by four researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS Google play and iOS app stores searches identified 483 potential apps (292 from Android stores and 191 from Apple stores). Six apps met the inclusion criteria. Medisafe app had the highest overall MARS score (4/5) and the medication list & medical records app had the lowest overall score (2.5/5). Five out of the six apps achieved an acceptable quality MARS score (>3.0). Two apps scored the maximum number of features (n=11) according to the IMS Institute for Healthcare Informatics functionality score and two scored the lowest (n=5). The apps had on average 8 functions based on the IMS functionality criteria (range 5 to 11). CONCLUSIONS The quality of current apps with a medication list functionality varies regarding their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality. However, the subjective quality or satisfaction with the apps was poor. Only three apps are based on scientific evidence and have been previously tested. Two apps featured all the IMS Institute for Healthcare Informatics functionalities and half do not provide clear instructions on how to enter medication data, do not display vital parameters data in an easy to understand format and do not guide users on how or when to take their medication. CLINICALTRIAL N/A

2021 ◽  
Author(s):  
Maximilian Gerner ◽  
Nicolas Vuillerme ◽  
Timothée Aubourg ◽  
Eva-Maria Messner ◽  
Yannik Terhorst ◽  
...  

BACKGROUND Patients suffering from inflammatory bowel diseases (IBD) frequently need long-term medical treatment. Mobile apps promise to complement and improve IBD management, however, so far there is no scientific analysis of their quality. OBJECTIVE To evaluate the quality of German IBD mobile apps targeting inflammatory bowel disease patients and physicians treating IBD patients using the Mobile Application Rating Scale (MARS). METHODS The German Apple App Store and Google Play store were systematically searched to identify German IBD mobile apps for patients and physician use. MARS was used to independently assess app quality by 6 physicians, 3 using Android and 3 using iOS smartphones. Apps were randomly assigned so that the 4 apps with the most downloads were rated by all raters and the remaining apps were rated by 1 Android and 1 iOS user. RESULTS In total, we identified 1764 apps in the Apple App Store and Google Play Store. After removing apps that were not related to IBD (1386) and not available in German (317), 61 apps remained. After removing duplicates (3), congress (7), journal (4), and clinical study apps (6), as well as excluding apps that were available in only one of the two app stores (20) and apps which can only be used with an additional device (7) , 14 apps fulfilled the inclusion criteria. The app “CED Dokumentation und Tipps” had the highest overall MARS score with 4.11/5. Median MARS scores of the 14 apps were ranging from 2.38 and 4.11. All of the analyzed apps addressed patients. Three apps are classified as medical products. There was no significant difference between iOS and Android raters. CONCLUSIONS The quality of German IBD apps is largely heterogeneous. Furthermore, despite promising international study results, little evidence exists proving a clinical benefit for German IBD apps. MARS seems to be a suitable method to identify relevant apps. Accordingly, clinical studies and also patient inclusion in the app development process are needed to effectively implement mobile apps in routine care.


2021 ◽  
Author(s):  
Christian Lull ◽  
Jan Alwin von Ahnen ◽  
Georg Groß ◽  
Victor Olsavszky ◽  
Johannes Knitza ◽  
...  

BACKGROUND Psoriasis is a chronic inflammatory skin disease. The visibility of the erythematous plaques on the skin as well as the pain and itch caused by the skin lesions frequently leads to psychological distress in patients. Smartphone apps are widespread, easily accessible and could effectively complement current management strategies of psoriasis patients. OBJECTIVE To systematically identify and objectively assess the quality of currently publicly available German apps for psoriasis patients and compile brief, ready-to-use app descriptions. METHODS We conducted a systematic search and assessment of German apps for psoriasis patients available in the Google Play and Apple App Store. The identified apps were randomly assigned to and independently rated using the Mobile Application Rating Scale (MARS) by three reviewers. Apps were ranked accordingly to their mean MARS rating and the highest ranked app was evaluated independently by two psoriasis patients using the User Version of the Mobile Application Rating Scale (uMARS). App information, including origin, main function and technical aspects and was congregated. RESULTS In total, we were able to identify 95 different apps for psoriasis, of which 15 were available in both app stores, 5 were not specifically intended for psoriasis patients and 1 was designed for clinical trials only. Consequently, the remaining nine apps were included in the final evaluation. Mean MARS score varied between 3.51 and 4.18. The app with the highest mean MARS score was “Psoriasis Helferin” (4.18/5) . When rated by patients, the app was rated lower in all MARS subcategories, resulting in a mean uMARS score of 3.48. CONCLUSIONS App quality was heterogenous and only a minority of identified apps was available in both app stores. The discrepant patient results highlight the importance of involving patients when developing and evaluating health apps. CLINICALTRIAL Deutsches Register klinische Studien (DRKS): DRKS00020963


Author(s):  
Yannik Terhorst ◽  
Paula Philippi ◽  
Lasse Sander ◽  
Dana Schultchen ◽  
Sarah Paganini ◽  
...  

BACKGROUND Mobile health apps (MHA) have the potential to improve health care. The commercial MHA market is rapidly growing, but the content and quality of available MHA are unknown. Consequently, instruments of high psychometric quality for the assessment of the quality and content of MHA are highly needed. The Mobile Application Rating Scale (MARS) is one of the most widely used tools to evaluate the quality of MHA in various health domains. Only few validation studies investigating its psychometric quality exist with selected samples of MHAs. No study has evaluated the construct validity of the MARS and concurrent validity to other instruments. OBJECTIVE This study evaluates the construct validity, concurrent validity, reliability, and objectivity, of the MARS. METHODS MARS scoring data was pooled from 15 international app quality reviews to evaluate the psychometric properties of the MARS. The MARS measures app quality across four dimensions: engagement, functionality, aesthetics and information quality. App quality is determined for each dimension and overall. Construct validity was evaluated by assessing related competing confirmatory models that were explored by confirmatory factor analysis (CFA). A combination of non-centrality (RMSEA), incremental (CFI, TLI) and residual (SRMR) fit indices was used to evaluate the goodness of fit. As a measure of concurrent validity, the correlations between the MARS and 1) another quality assessment tool called ENLIGHT, and 2) user star-rating extracted from app stores were investigated. Reliability was determined using Omega. Objectivity was assessed in terms of intra-class correlation. RESULTS In total, MARS ratings from 1,299 MHA covering 15 different health domains were pooled for the analysis. Confirmatory factor analysis confirmed a bifactor model with a general quality factor and an additional factor for each subdimension (RMSEA=0.074, TLI=0.922, CFI=0.940, SRMR=0.059). Reliability was good to excellent (Omega 0.79 to 0.93). Objectivity was high (ICC=0.82). The overall MARS rating was positively associated with ENLIGHT (r=0.91, P<0.01) and user-ratings (r=0.14, P<0.01). CONCLUSIONS he psychometric evaluation of the MARS demonstrated its suitability for the quality assessment of MHAs. As such, the MARS could be used to make the quality of MHA transparent to health care stakeholders and patients. Future studies could extend the present findings by investigating the re-test reliability and predictive validity of the MARS.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Tucker ◽  
Alan Cuevas Villagomez ◽  
Tamar Krishnamurti

Abstract Background The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health (mHealth) apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated the quality of existing mHealth tools targeted to this time period in terms of sufficiency of maternal health information, inclusivity of people of color, and app usability. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were evaluated for extent and quality of maternal health information and inclusivity of people of color using an a priori coding scheme. App usability was evaluated using the Mobile Application Rating Scale (MARS) score. Results Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The coverage of maternal health information and inclusivity of people of color in app imagery both correlated positively with the MARS usability score of the app. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between MARS usability score and number of app users, as estimated by number of ratings for the app available on the app store. In addition, apps with evidence-based maternal health information had greater MARS engagement, information, and aesthetics scores. However, presence of evidence-based information did not correlate with greater numbers of app users. Conclusions Current commercially available peripartum apps range widely in quality. Overall current app offerings generally do not provide adequate maternal health information and are not optimally accessible to the target users in terms of inclusivity of women of color or app usability. Apps delivering evidence-based information and more usable design are more likely to meet these standards but are not more likely to be downloaded by users.


2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.


2019 ◽  
Vol 82 (20) ◽  
Author(s):  
Flávia Ribeiro do Carmo ◽  
Harriet Bárbara Maruxo ◽  
Willian Alves dos Santos

Objetiva-se identificar evidências científicas sobre a qualidade de vida em pacientes diagnosticados com insuficiênciacardíaca. Revisão integrativa realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde(LILACS), Base de Dados de Enfermagem (BDENF) e Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)com a seguinte questão norteadora: Como a insuficiência cardíaca interfere na qualidade de vida dos pacientescardiológicos? Foi utilizada a estratégia PICO com recorte temporal de 2011 a 2016, nos idiomas português, inglês eespanhol. As informações foram tabuladas em programa Microsoft Excel® e processadas a partir de estratégia: médiaaritmética descritiva simples, frequência absoluta e relativa. Encontrou-se 712 artigos na sua totalidade, após aplicaçãodos critérios de inclusão e exclusão foram selecionados 17 artigos científicos avaliados a partir da categoria: os principaisfatores que comprometem a qualidade de vida dos pacientes com insuficiência cardíaca. Conclui-se que os pacientes cominsuficiência cardíaca apresentam intolerância à realização de atividades físicas e têm seu sono prejudicado por conta dadispneia e fadiga, sintomas que contribuem para o declínio da qualidade de vida.Palavras-chave: Insuficiência Cardíaca; Qualidade de Vida; Enfermagem. ABSTRACTThe aim is to identify scientific evidence on the quality of life in patients diagnosed with heart failure. Integrativereview carried out in the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dadosde Enfermagem (BDENF) e Sistema Online de Busca e Análise de Literatura Médica (MEDLINE) databases withthe question: How does heart failure interfere with the quality of life of cardiology patients? The PICO strategywith time cut from 2011 to 2016 was used in Portuguese, English and Spanish. The information was tabulated inMicrosoft Excel® program and processed from strategy: simple descriptive arithmetic mean, absolute and relativefrequency. It found 712 articles in their totality, after applying the inclusion and exclusion criteria, were selected17 scientific articles evaluated from the category: the main factors that compromise the quality of life of patientswith heart failure. It concludes that the patients with heart failure are intolerant to physical activities and sleepimpaired due to dyspnea and fatigue, such symptoms that contribute to the decline of quality of life.Keywords: Heart failure; Quality of life; Nursing.


2021 ◽  
Author(s):  
Nicole E Werner ◽  
Janetta C Brown ◽  
Priya Loganathar ◽  
Richard J Holden

BACKGROUND The over 11 million care partners in the US who provide care to people living with Alzheimer’s disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to all aspects of their caregiving role. The proliferation of mobile applications (apps) for care partners has potential to meet the care partners’ needs, but the quality of apps is unknown. OBJECTIVE The present study aimed to 1) evaluate the quality of publicly available apps for care partners of people living with ADRD and 2) identify design features of low- and high-quality apps to guide future research and app development. METHODS We searched the US Apple and Google Play app stores with the criteria that the app needed to be 1) available in US Google play or Apple app stores, 2) directly accessible to users “out of the box”, 3) primarily intended for use by an informal (family, friend) caregiver or caregivers of a person with dementia. The included apps were then evaluated using the Mobile App Rating Scale (MARS), which includes descriptive app classification and rating using 23 items across five dimensions: engagement, functionality, aesthetics, information, and subjective quality. Next, we computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on the score driving factors for each item and what the app could have done to improve the score for that item. RESULTS We evaluated 17 apps (41% iOS only, 12% Android only, 47% both iOS and Android). We found that on average, the apps are of minimally acceptable quality. Although we identified apps above and below minimally acceptable quality, many apps had broken features and were rated as below acceptable for engagement and information. CONCLUSIONS Minimally acceptable quality is likely insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for mobile apps for care partners. The design features of high-quality apps we identified in this research can provide the foundation for benchmarking those standards.


2020 ◽  
Vol 130 (1) ◽  
pp. 78-91
Author(s):  
Eleonora M. C. Trecca ◽  
Antonio Lonigro ◽  
Matteo Gelardi ◽  
Brandon Kim ◽  
Michele Cassano

Objectives: Although the last few years have seen an increased number of smartphone applications (apps) disseminated in the field of Otolaryngology (ORL), these apps vary widely in quality. The aim of this paper, therefore, is to systematically review ORL apps directed towards patients in mobile app stores and the current literature. Methods: The Google Play Store, Apple App Store and PubMed were searched for ORL apps for patients using various keywords pertaining to different ORL subspecialties. Apps not relevant to the scope of this research and/or duplicates, educational apps, apps promoting a business, apps requiring specific separate hardware, and apps in non-English were excluded. In PubMed, keywords pertaining to the subspecialties were combined with “mobile app” in a search query; literature reviews, editorials, case reports, conference papers, duplicate articles, and articles irrelevant to ORL apps were excluded. The quality of apps with the highest number of reviews was assessed using the “Mobile App Rating Scale” (MARS), while the quality of the articles was rated using “The Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) Statement. Results: After searching the app stores, 1074 apps were included and grouped according to their ORL subspecialties. The overall MARS score of the ten most popular apps in each category was 3.65 out of 5. A total of 636 articles were identified in the literature, and 193 were included. The mean adherence percentage of the articles to the STROBE checklist was of 84.37%. Conclusions: Although the apps currently available need further development, their application in ORL appears promising. Further dialogue between physicians and patients, as well as formal support from professional and scientific associations, should be encouraged.


10.2196/13170 ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. e13170
Author(s):  
Alexandra Hoffmann ◽  
Corinna A Faust-Christmann ◽  
Gregor Zolynski ◽  
Gabriele Bleser

Background The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. Objective To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. Methods A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. Results The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. Conclusions The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor.


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