A Technological Tool Aimed at Self-Care in Patients With Multimorbidity: Cross-Sectional Usability Study (Preprint)

Abstract

BACKGROUND Information and communication technologies (ICTs) have been positioned as useful tools to facilitate self-care. The interaction between patient and technology, called usability, is particularly important for achieving positive health outcomes. Specific characteristics of patients with chronic diseases, including multimorbidity, can affect their interaction with different technologies. Thus, studying the usability of ICTs in the field of multimorbidity has become a key element to ensure its relevant role in promoting self-care. OBJECTIVE To analyze the usability of a technological tool dedicated to health and self-care in patients with multimorbidity in primary care. METHODS Descriptive observational cross-sectional usability study framed in the clinical trial in Primary Care of Madrid of the TeNDER project. Were included patients over 60 years of age who had one or more chronic disease, at least one of which was mild-moderate cognitive impairment and/or Parkinson’s disease and/or cardiovascular disease. From the 250 patients included in the project, 38 agreed to participate. The usability variables that were studied were the effectiveness in usability, which was determined by the degree of completion and the total number of errors per task; the efficiency in usability, evaluated as the average time to perform each task and the satisfaction in usability, quantified by the System Usability Scale (SUS). Five tasks were evaluated based in real case scenarios. Usability variables were described according to sociodemographic and clinical characteristics of patients. A logistic regression model was constructed to estimate the factors associated with the type of support provided for tasks completion. RESULTS From the total amount of patients included in the project, 38 agreed to participate. The median age of the participants was 75 years (IQR 72.0-79.0), 20/30 were women (52.6%) and suffered a median of eight chronic diseases (IQR 7.0-11.0). Thirty patients completed the usability study, with a usability effectiveness result of 89.3% (134/150 tasks completed). 66.7% of patients (20/30) completed all tasks and 56.7% (17/30) required personalized help on at least one task. In the multivariate analysis, educational level acted as a facilitating factor for independent task completion (OR 1.79, CI95% 0.47-6.83). The median time to complete the total tasks was 296 seconds (IQR 210.0-397.0) and the median satisfaction was 55 (IQR 45.0-62.5) out of 100. CONCLUSIONS Although usability effectiveness was high, the poor efficiency and usability satisfaction results suggest that there are other factors that may interfere with the results. It has not been possible to show that multimorbidity is a key factor in the usability results of a technological tool.