scholarly journals Personalized and Self-Management: Systematic Search and Evaluation Quality Factors and User Preference of Drug Reference Apps in Taiwan

2021 ◽  
Vol 11 (8) ◽  
pp. 790
Author(s):  
Yu-Chun Chen ◽  
Wei-Wei Liao ◽  
Mei-Chin Su ◽  
Yen-Hsi Lin

Background: Drug reference apps promote self-management and improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. This study aimed to describe a systematic and stepwise process to identify drug reference apps in Taiwan, assess the quality of these apps, and analyze the influential factors for user ratings. Methods: A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. Results: A total of 23 drug reference apps in Taiwan were identified and analyzed. Generally, these drug reference apps were evaluated as acceptable quality with an average MARS score of 3.23. Higher user engagement, more functionality, better aesthetics, and more information associated with higher user ratings. Navigation is the most influential factor on higher user ratings (AME: 13.15%) followed by performance (AME: 11.03%), visual appeal (AME: 10.87%), credibility (AME: 10.67%), and quantity of information (AME: 10.42%). Conclusions: User experience and information clearly affect user ratings of drug reference apps. Five key factors should be considered when designing drug reference apps.

2021 ◽  
Author(s):  
Yu-Chun Chen ◽  
Wei-Wei Liao ◽  
Mei-Chin Su ◽  
Yen-Hsi Lin

BACKGROUND Drug reference apps play various distinct and vital roles through the medication use process. A drug reference app that carried out comprehensive localized drug information would greatly improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. OBJECTIVE This current study aimed to describe a systematic and stepwise process to identify drug reference apps with localized drug information in Taiwan. Moreover, we assessed the quality of these apps by using a reliable quality assessment tool and further analyzing the influential factors for user ratings. METHODS A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Apps were divided into two groups: higher user ratings and lower user ratings. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted, and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. A p-value< 0.05 was considered statistically significant. RESULTS A total of 23 drug reference apps in Taiwan had been identified and analyzed. Ten apps had higher user star ratings (>=4 stars), and 13 apps had lower user star ratings ( < 4 stars). These drug reference apps had acceptable quality with an average MARS score of 3.23. Apps with higher user star ratings had higher MARS scores than the lowers (engagement (2.70 v.s. 2.50, P= .005), functionality (3.85 v.s. 3.49, P= .003), aesthetics (3.39 v.s. 2.98, P < .001), and information (3.55 v.s. 3.25, P= .005)). The regression model showed five influential factors for higher user ratings (navigation, AME, 13.15%; performance, AME, 11.03%; visual appeal, AME, 10.87%; credibility, AME, 10.67%; quantity of information, AME, 10.42%). CONCLUSIONS The proposed KESS algorithm could be a valuable and unbiased framework for systematic search for app. While the higher engagement, more functionality, better aesthetics, and more information associated with higher user ratings, there are five most influential factors, navigation, performance, visual appeal, credibility, and quantity of information among the four elements.


2020 ◽  
Author(s):  
Tehmina Gladman ◽  
Grace Tylee ◽  
Steve Gallagher ◽  
Jonathan Mair ◽  
Rebecca Grainger

BACKGROUND Mobile apps are widely used in health professions, which increases the need for simple methods to determine the quality of apps. In particular, teachers need the ability to curate high-quality mobile apps for student learning. OBJECTIVE This study aims to systematically search for and evaluate the quality of clinical skills mobile apps as learning tools. The quality of apps meeting the specified criteria was evaluated using two measures—the widely used Mobile App Rating Scale (MARS), which measures general app quality, and the Mobile App Rubric for Learning (MARuL), a recently developed instrument that measures the value of apps for student learning—to assess whether MARuL is more effective than MARS in identifying high-quality apps for learning. METHODS Two mobile app stores were systematically searched using clinical skills terms commonly found in medical education and apps meeting the criteria identified using an approach based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9 apps were identified during the screening process. The apps were rated independently by 2 reviewers using MARS and MARuL. RESULTS The intraclass correlation coefficients (ICCs) for the 2 raters using MARS and MARuL were the same (MARS ICC [two-way]=0.68; <i>P</i>&lt;.001 and MARuL ICC [two-way]=0.68; <i>P</i>&lt;.001). Of the 9 apps, Geeky Medics-OSCE revision (MARS Android=3.74; MARS iOS=3.68; MARuL Android=75; and MARuL iOS=73) and OSCE PASS: Medical Revision (MARS Android=3.79; MARS iOS=3.71; MARuL Android=69; and MARuL iOS=73) scored highly on both measures of app quality and for both Android and iOS. Both measures also showed agreement for the lowest rated app, Patient Education Institute (MARS Android=2.21; MARS iOS=2.11; MARuL Android=18; and MARuL iOS=21.5), which had the lowest scores in all categories except information (MARS) and professional (MARuL) in both operating systems. MARS and MARuL were both able to differentiate between the highest and lowest quality apps; however, MARuL was better able to differentiate apps based on teaching and learning quality. CONCLUSIONS This systematic search and rating of clinical skills apps for learning found that the quality of apps was highly variable. However, 2 apps—Geeky Medics-OSCE revision and OSCE PASS: Medical Revision—rated highly for both versions and with both quality measures. MARS and MARuL showed similar abilities to differentiate the quality of the 9 apps. However, MARuL’s incorporation of teaching and learning elements as part of a multidimensional measure of quality may make it more appropriate for use with apps focused on teaching and learning, whereas MARS’s more general rating of quality may be more appropriate for health apps targeting a general health audience. Ratings of the 9 apps by both measures also highlighted the variable quality of clinical skills mobile apps for learning. CLINICALTRIAL


10.2196/14836 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e14836 ◽  
Author(s):  
Enying Gong ◽  
Zongmuyu Zhang ◽  
Xurui Jin ◽  
Yishan Liu ◽  
Lumin Zhong ◽  
...  

Background The emergence and advancement of mobile technologies offer a promising opportunity for people with diabetes to improve their self-management. Despite the proliferation of mobile apps, few studies have evaluated the apps that are available to the millions of people with diabetes in China. Objective This study aimed to conduct a systematic search of Chinese mobile apps for diabetes self-management and to evaluate their quality, functionality, and features by using validated rating scales. Methods A systematic search was conducted to identify Chinese apps for diabetes self-management in the four most popular Chinese language mobile app stores. Apps were included if they were designed for diabetes self-management and contained at least one of the following components: blood glucose management, dietary and physical activity management, medication taking, and prevention of diabetes-related comorbidities. Apps were excluded if they were unrelated to health, not in Chinese, or the targeted users are health care professionals. Apps meeting the identified inclusion criteria were downloaded and evaluated by a team of 5 raters. The quality, functionalities, and features of these apps were assessed by using the Mobile App Rating Scale (MARS), the IMS Institute for Healthcare Informatics Functionality score, and a checklist of self-management activities developed based on the Chinese diabetes self-management guideline, respectively. Results Among 2072 apps searched, 199 were eligible based on the inclusion criteria, and 67 apps were successfully downloaded for rating. These 67 apps had an average MARS score of 3.42 out of 5, and 76% (51/67) of the apps achieved an acceptable quality (MARS score >3.0). The scores for the four subdomains of MARS were 3.97 for functionality, 3.45 for aesthetics, 3.21 for information, and 3.07 for engagement. On average, reviewed apps applied five out of the 19 examined behavior change techniques, whereas the average score on the subjective quality for the potential impact on behavior change is 3 out of 5. In addition, the average score on IMS functionality was 6 out of 11. Functionalities in collecting, recording, and displaying data were mostly presented in the reviewed apps. Most of the apps were multifeatured with monitoring blood glucose and tracking lifestyle behaviors as common features, but some key self-management activities recommended by clinical guidelines, such as stress and emotional management, were rarely presented in these apps. Conclusions The general quality of the reviewed apps for diabetes self-management is suboptimal, although the potential for improvement is significant. More attention needs to be paid to the engagement and information quality of these apps through co-design with researchers, public health practitioners, and consumers. There is also a need to promote the awareness of the public on the benefit and potential risks of utilizing health apps for self-management.


2018 ◽  
Author(s):  
Hussein Jamaladin ◽  
Tom H van de Belt ◽  
Lianda CH Luijpers ◽  
Falco R de Graaff ◽  
Sebastian JH Bredie ◽  
...  

BACKGROUND Using a mobile app for self-management could make it easier for patients to get insight into their blood pressure patterns. However, little is known about the availability, quality, and features of mobile apps targeting blood pressure. OBJECTIVE The goal of the research was to determine the availability, functionality, and quality of mobile apps that could be used for blood pressure monitoring purposes. METHODS A systematic app search was performed based on the standards for systematic reviews. We searched the Dutch official app stores for Android and iOS platforms using predefined keywords and included all English and Dutch mobile apps targeting blood pressure. Two independent assessors determined eligibility and quality of the apps using the 5-point Mobile App Rating Scale (MARS). Quality scores of the apps with and without 17 a priori selected characteristics were compared using independent sample t tests. RESULTS A total of 184 apps (104 Android, 80 iOS) met the inclusion criteria. The mean overall MARS score was 2.63 (95% CI 2.55-2.71) for Android and 2.64 (95% CI 2.56-2.71) for iOS. The apps Bloeddruk (4.1) and AMICOMED BP (3.6) had the highest quality scores on the Android and iOS platforms, respectively. Of the app characteristics recorded, only pricing, in-app advertisements, and local data storage were not associated with the quality scores. In only 3.8% (7/184) of the apps, involvement of medical experts in its development was mentioned, whereas none of the apps was formally evaluated with results published in a peer-reviewed journal. CONCLUSIONS This study provides an overview of the best apps currently available in the app stores and important key features for self-management that can be used by health care providers and patients with hypertension to identify a suitable app targeting blood pressure monitoring. However, the majority of the apps targeting blood pressure monitoring were of poor quality. Therefore, it is important to involve medical experts in the developmental stage of health-related mobile apps to improve the quality of these apps.


10.2196/25377 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e25377
Author(s):  
Tehmina Gladman ◽  
Grace Tylee ◽  
Steve Gallagher ◽  
Jonathan Mair ◽  
Rebecca Grainger

Background Mobile apps are widely used in health professions, which increases the need for simple methods to determine the quality of apps. In particular, teachers need the ability to curate high-quality mobile apps for student learning. Objective This study aims to systematically search for and evaluate the quality of clinical skills mobile apps as learning tools. The quality of apps meeting the specified criteria was evaluated using two measures—the widely used Mobile App Rating Scale (MARS), which measures general app quality, and the Mobile App Rubric for Learning (MARuL), a recently developed instrument that measures the value of apps for student learning—to assess whether MARuL is more effective than MARS in identifying high-quality apps for learning. Methods Two mobile app stores were systematically searched using clinical skills terms commonly found in medical education and apps meeting the criteria identified using an approach based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9 apps were identified during the screening process. The apps were rated independently by 2 reviewers using MARS and MARuL. Results The intraclass correlation coefficients (ICCs) for the 2 raters using MARS and MARuL were the same (MARS ICC [two-way]=0.68; P<.001 and MARuL ICC [two-way]=0.68; P<.001). Of the 9 apps, Geeky Medics-OSCE revision (MARS Android=3.74; MARS iOS=3.68; MARuL Android=75; and MARuL iOS=73) and OSCE PASS: Medical Revision (MARS Android=3.79; MARS iOS=3.71; MARuL Android=69; and MARuL iOS=73) scored highly on both measures of app quality and for both Android and iOS. Both measures also showed agreement for the lowest rated app, Patient Education Institute (MARS Android=2.21; MARS iOS=2.11; MARuL Android=18; and MARuL iOS=21.5), which had the lowest scores in all categories except information (MARS) and professional (MARuL) in both operating systems. MARS and MARuL were both able to differentiate between the highest and lowest quality apps; however, MARuL was better able to differentiate apps based on teaching and learning quality. Conclusions This systematic search and rating of clinical skills apps for learning found that the quality of apps was highly variable. However, 2 apps—Geeky Medics-OSCE revision and OSCE PASS: Medical Revision—rated highly for both versions and with both quality measures. MARS and MARuL showed similar abilities to differentiate the quality of the 9 apps. However, MARuL’s incorporation of teaching and learning elements as part of a multidimensional measure of quality may make it more appropriate for use with apps focused on teaching and learning, whereas MARS’s more general rating of quality may be more appropriate for health apps targeting a general health audience. Ratings of the 9 apps by both measures also highlighted the variable quality of clinical skills mobile apps for learning.


2021 ◽  
Author(s):  
Alessio Bricca ◽  
Alessandro Pellegrini ◽  
Graziella Zangger ◽  
Jonas Ahler J ◽  
Madalina Jäger ◽  
...  

BACKGROUND Mobile applications (Apps) offer an opportunity to improve the lifestyle of patients with chronic conditions or multimorbidity. However, for Apps to be recommended in clinical practice, their quality and potential for behaviour change are important. OBJECTIVE To investigate the quality and potential for behaviour change of health Apps for patients with a chronic condition or multimorbidity (defined as two or more chronic conditions). METHODS We followed the Cochrane Handbook guidelines to conduct and report this study. A systematic search of Apps available in English or Danish on App Store and Google Play for patients with one or more of the following common and disabling conditions: osteoarthritis, heart condition (heart failure and ischaemic heart disease), hypertension, type 2 diabetes mellitus, depression and chronic obstructive pulmonary disease was conducted. The search strategy combined keywords related to these conditions. One author screened the title and content of the identified apps. Subsequently, three authors independently downloaded the Apps in a smartphone and assessed the quality of the Apps and their potential for behaviour change using the Mobile App Rating Scale (MARS-21 items, score ranging 0-5, higher is better) and the App Behavior Change Scale (ABACUS-21 items, score ranging 0-21, higher is better), respectively. We included the five highest-rated and the five most downloaded apps but only assessed the quality and potential for behaviour change of the free content. RESULTS We screened 453 Apps and ultimately included 60. Most of the Apps were available in both the App Store and Google Play (58%). The overall average quality of the Apps was 3.48 (SD 0.28) on the MARS scale, and the overall potential for behaviour change was 8.07 (SD 2.30) on the ABACUS scale. Apps for depression and patients with multimorbidity tended to have higher overall MARS and ABACUS scores, respectively. The most common self-monitoring features presented in the Apps in support of behaviour change were physiological (e.g., blood pressure monitoring) in 64% of the Apps, weight/diet, or physical activity in 41% and 36%, respectively, and stress management in 37%. Only 14% of the Apps were completely free, while 86% had in-app-purchase for some content. CONCLUSIONS Apps for patients with a chronic condition or multimorbidity appear to be of acceptable quality but have a low-to-moderate potential for behaviour change. Our results provide a useful overview for patients and clinicians who would like to use Apps for managing chronic conditions and suggest the need to improve the Apps in terms of quality and potential for behaviour change. CLINICALTRIAL https://osf.io/nvhuy/


10.2196/10718 ◽  
2018 ◽  
Vol 6 (10) ◽  
pp. e10718 ◽  
Author(s):  
Alejandro Salazar ◽  
Helena de Sola ◽  
Inmaculada Failde ◽  
Jose Antonio Moral-Munoz

2019 ◽  
Author(s):  
Marco Bardus ◽  
Nathalie Awada ◽  
Lilian A Ghandour ◽  
Elie-Jacques Fares ◽  
Tarek Gherbal ◽  
...  

BACKGROUND With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. OBJECTIVE This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. METHODS We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. RESULTS MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (<i>P</i>&lt;.001). The lowest correlation was observed in the area of usability (<i>r</i>=0.685), followed by aesthetics (<i>r</i>=0.827), information quality (<i>r</i>=0.854), engagement (<i>r</i>=0.894), and total app quality (<i>r</i>=0.897). Subjective quality was also highly correlated (<i>r</i>=0.820). CONCLUSIONS MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.


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.


2021 ◽  
Author(s):  
Antonia Lambrecht ◽  
Nicolas Vuillerme ◽  
Christina Raab ◽  
David Simon ◽  
Eva-Maria Messner ◽  
...  

BACKGROUND Mobile applications promise to improve current health care. A growing number app quality studies exist to help patients and physicians choose appropriate, helpful and useful applications. However, current mobile app quality ratings are mostly physician-based. They exclude patients although as end-users, patients are able to provide the most relevant feedback. In a recent physician-based review of rheumatic apps, Rheuma Auszeit received the best overall rating (4.2/5), however this app has never been systematically evaluated by the intended end-users, rheumatic patients. OBJECTIVE The aim of this study was (1) to assess the quality of Rheuma Auszeit by rheumatic patients and (2) to evaluate the association between uMARS (User Version of the Mobile App Rating Scale) scores and patients’ characteristics. METHODS Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to evaluate the app Rheuma Auszeit using the uMARS and to complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. uMARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. The association between uMARS scores and patients’ characteristics was further explored. RESULTS Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P<.004). Older male rheumatic patients reported a higher subjective quality score (P<.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho=0.18; P<.042). Preferred time of app usage significantly correlated with engagement (Rho=0.20; P<.024), functionality (Rho=0.19; P<.029), total uMARS score (Rho=0.21; P<.017) and subjective quality score (Rho=0.21; P<.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%). CONCLUSIONS Rheuma Auszeit was well accepted by patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. The study highlights the potential and feasibility of therapeutic complementary digital solutions in rheumatology.


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