A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE)

Abstract

A worldwide demographic shift is in progress and the aged population proportion is projected to more than double across the next four decades. Our current healthcare models may not be adequate to handle this shift in demography, which may have serious consequences for the ageing population who are more prone to chronic diseases. One proposed remediation is to provide in-home assisted healthcare with technology-intervened approaches. Telemedicine, telehealth, e-health are paradigms found in scientific literature that provide clinical treatment through a technology intervention. In evidence-based medical science, these technology interventions are evaluated through clinical trials, which are targeted to measure improvements in medical conditions and the treatment's cost effectiveness. However, effectiveness of a technology also depends on the interaction pattern between the technology and its' users, especially the patients. This paper presents (1) a meta-synthesis of clinical trials for technology-intervened treatments of type 2 diabetes and (2) the Clinical User-Experience Evaluation (CUE). CUE is a recommendation for future telemedicine clinical trials that focuses on the patient as the user from Human-Computer Interaction (HCI) perspective and was developed as part of this research. The clinical trials reviewed were interpreted from a technology perspective and the non-medical or non-biological improvements of the users (patients) rather than the medical outcome. Results show that technology-intervened treatments provide positive behavior changes among patients and are potentially highly beneficial for chronic illness management such as type 2 diabetes. The results from the CUE method show how it complements clinical trials to capture patients' interaction with a technology.

Complementing a Clinical Trial With Human-Computer Interaction: Patients’ User Experience With Telehealth (Preprint)

“…Due to time and resource restrictions, we decided a contextual inquiry and observations, followed by a semistructured interview was appropriate. The research method and protocol was named clinical user-experience evaluation (CUE) [5] (Figure 2). CUE consisted of three stages.…”

“…Therefore, to understand how a technology may influence in behavioral changes among T2D patients, interaction of patients with a technology should be investigated. Jalil et al ( [5]) proposed HCI inspired methodology the CUE targeted towards understanding patients and their use of telehealth. The two key findings from past telehealth, ehealth clinical trials from HCI perspective include [5]:…”

“…Jalil et al ( [5]) proposed HCI inspired methodology the CUE targeted towards understanding patients and their use of telehealth. The two key findings from past telehealth, ehealth clinical trials from HCI perspective include [5]:…”

“…We found different levels of interest in the patients based on the observations and their explanations stages 1 and 2 of the CUE. We provide a persona categorization to understand the nine patients in the CUE, which include: enthusiastic, tolerant, indifferent and resistant patients [5]. These categories need to be validated with a higher population of patients.…”

“…An investigation through meta-synthesis conducted in 2014 of past clinical trials of telehealth T2D concluded that there is a need for a new practices that could capture the experience of users (patients) in a clinical trial [5]. The discipline of HumanComputer Interaction (HCI) is an interdisciplinary area of computer science/information technology, behavioral sciences, psychology, human factors and several other disciplines.…”