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

Jalil, Sakib; Myers, Trina; Atkinson, Ian; Soden, Muriel

doi:10.2196/humanfactors.9481

Cited by 13 publications

(15 citation statements)

References 26 publications

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“…This intervention has the potential to allow the CNS team to provide more efficient and safe care to the patients, a finding corroborated by Jalil et al [ 37 ], but it comes at a cost. The telemonitoring system generated a large dataset for each patient, which had to be reviewed.…”

Section: Discussionmentioning

confidence: 87%

Patient Empowerment Using Electronic Telemonitoring With Telephone Support in the Transition to Insulin Therapy in Adults With Type 2 Diabetes: Observational, Pre-Post, Mixed Methods Study

McGloin¹,

O'Connell²,

Glacken³

et al. 2020

J Med Internet Res

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Background Initiation of insulin therapy for the management of type 2 diabetes can be an unwelcome and distressful development for patients. Current evidence suggests that telemonitoring can help improve glycemic control in type 2 diabetes and can support empowerment to self-manage diabetes. This telemonitoring intervention was underpinned by an empowerment approach. Objective This study aimed to evaluate the clinical effectiveness and feasibility and the patients’ and health care providers’ experiences of a 12-week telemonitoring intervention with telephone support for patients commencing insulin therapy. This paper focuses on the impact on patient empowerment. Methods An observational, pre-post, multimethod, and triangulation design was employed to study a 12-week automated electronic telemonitoring intervention with telephone support from a diabetes clinical nurse specialist (CNS). Forty patients were recruited from the clinic as they were about to commence insulin therapy. In the quantitative arm, biometric data (hemoglobin A1c [HbA1c] and weight) and psychosocial data (diabetes empowerment scale [DES] scores and diabetes distress scale [DDS] scores) were gathered by the research team at baseline (T1), the end of the intervention (T2), and 3 months postintervention (T3). Data on hospital admission and general practitioner (GP) visits were collected for the duration of the study. In the qualitative arm, separate focus group interviews were conducted with the CNS team supporting the intervention (n=2) and patients (n=16). Results Of 39 patients who completed the intervention, 23 (59%) were male. The mean age of the sample was 62.4 years (range 37-80 years). The mean HbA1c (mmol/mol) decreased significantly between T1 and T2 (mean difference [MD] −17.13; P<.001) and T1 and T3 (MD −18.16; P<.001), with no significant impact on weight. In the focus groups, patients reported an increased awareness to self-manage diabetes and feelings of safety and comfort. There were 13% (5/39) of patients who had hypoglycemia on two or more occasions. A significant increase in the mean DES score occurred between T1 and T2 (MD 0.62; P=.001) and T1 and T3 (MD 0.72; P<.001). The mean DDS score decreased between T1 and T2 (MD −0.64; P=.002) and T1 and T3 (MD −0.6; P=.002). The mean patient satisfaction with the intervention was above 4 out of possible 5 on all items on the Telemedicine Satisfaction and Usefulness Questionnaire. We observed a reduction in diabetes clinic attendances and GP visits. A significant increase in workload was reported by the CNS team. Conclusions This intervention had an empowering effect for patients in the self-management of type 2 diabetes and has the potential to meet the need for safer and more effective care in insulin initiation in the community setting. We observed a significant increase in workload for health care staff. Telemonitoring needs to be streamlined with health care delivery and accompanied by adequate support services.

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Section: Discussionmentioning

confidence: 87%

Patient Empowerment Using Electronic Telemonitoring With Telephone Support in the Transition to Insulin Therapy in Adults With Type 2 Diabetes: Observational, Pre-Post, Mixed Methods Study

McGloin¹,

O'Connell²,

Glacken³

et al. 2020

J Med Internet Res

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“…The role of telemetry-enabled home monitoring was motivating, an incentive to improve self-care and evidence which facilitated meaningful conversation and dialogue with professionals. Jalil, Myers, Atkinson, Soden 2019 Australia (AU) [ 46 ] Complementing a clinical trial with human-computer interaction: Patients’ user experiences with telehealth To investigate how to discover patients’ user experiences in telehealth, eHealth, and mHealth in a clinical trial Semi structured interviews and survey within a RCT. A tablet computer, an automatic glucometer, and an automatic sphygmomanometer At home A sample of 9 patients Age: 52–74 years (mean 62 years) Gender: 4 women and 5 men Diagnosis: Type 2 diabetes mellitus for at least 12 months.…”

Section: Resultsmentioning

confidence: 99%

“…A frequent need to recharge was also reported as a disadvantage [ 38 ]. Technical challenges lead to a feeling of frustration, and dissatisfaction with the device or solution [ 40 , 46 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…One patient continuing stroke rehabilitation stated: «The keyboard is that frustrating I just couldn't be bothered trying to get it to work because it wouldn't» [40]. Other challenges reported by patients were oximetry transmission, device fault, mobile signal loss, immobility of the device, and difficulties placing the device on the body [40,41,46]. One study found that the device only functioned with wired internet that had to be connected through a cable through the telephone port in a patient's house, which was reported as a problem by patients [46].…”

Section: Technical Featuresmentioning

confidence: 99%

“…Other challenges reported by patients were oximetry transmission, device fault, mobile signal loss, immobility of the device, and difficulties placing the device on the body [40,41,46]. One study found that the device only functioned with wired internet that had to be connected through a cable through the telephone port in a patient's house, which was reported as a problem by patients [46]. In another study, the modems reportedly took a long time to send the data and sometimes did not actually send the data at all, leading to patients not being able to use the solution [41].…”

Section: Technical Featuresmentioning

confidence: 99%

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Patient experiences with technology enabled care across healthcare settings- a systematic review

Leonardsen

Hardeland

Helgesen

et al. 2020

BMC Health Serv Res

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Background: Healthcare services are facing extensive challenges due to the increased proportion of elderly persons and persons with chronic disease. Technology enabled care (TEC) is a collective term for telecare, telehealth, telemedicine, mobile (m)-, digital-and electronic (e) health services. TEC is increasingly seen as a solution to many of the challenges facing the health sector. Patient perspectives may provide a useful evaluation tool for new healthcare technologies that have limited clinical data to support their effectiveness. More studies need to be done to better understand the acceptance of technology in healthcare. This review aim to summarize empirical studies exploring patient experiences with TEC. Findings in this study can be used to better understand what is needed to develop, implement and improve such services. Methods: Systematic searches were conducted in the Pubmed, Psycinfo, Cinahl, Embase, Cochrane systematic reviews and Cochrane clinical trials databases. These studies were systematically reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, subjected to quality appraisals using the Critical Appraisal Skills Program (CASP), and synthesized via integrative analysis. Results: After removal of duplicates, languages other than English, and non-scientific records, 4087 titles and abstracts were screened. After assessment against inclusion and exclusion criteria, 69 records were screened in fulltext, and underwent quality appraisal. 21 records were included in the integrative analysis. Patients' experiences with TEC related to 1) technological features, namely functionality and appearance, and 2) evolving independence, namely empowerment, autonomy and security. Technological challenges lead to frustrations and negative experiences, while a stigmatizing appearance lead to patients not using the solution. Through the use of TECs, patients felt more empowered, learning about their condition, increasing awareness to their symptoms and treatment, and feeling more safe and self-efficient. Patient participation was seen as a central aspect of the development of the TECT, as well as when using it. Conclusion: This review deepens the understanding of patients' experiences with technology enabled care solutions. Patients' experiences not only relate to the practical/technical element of the device or solution, but to how this impact on their everyday life. Patient participation in development and planned use of such solutions should be considered an integral part in healthcare quality initiatives.

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The Bigger Picture of Digital Interventions for Pain, Anxiety and Stress: A Systematic Review of 1200+ Controlled Trials

Khalili-Mahani

Tran

2022

Digital Human Modeling and Applications in Health, Safety, Ergonomics and Risk Management. Health, Operations Management, and D

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The aim of this systematic scoping review was to gain a better understanding of research trends in digital mental health care. We focused on comorbid conditions: depression, anxiety, and pain–which continue to affect an estimated 20% of world population and require complex and continuous social and medical care provisions. We searched all randomized controlled trials on PubMed until May 2021 for any articles that used a form of information and communication technology (ICT) in relation to primary outcomes anxiety, pain, depression, or stress. From 1285 articles that satisfied the inclusion criteria, 890 were randomized trials with nearly 70% satisfactory outcomes. For depression and anxiety, the most frequently reported, were web-based, or mobile apps used for self-monitoring, and guided interventions. For pain, VR-based interventions or games were more prevalent, especially as tools for distraction, or as stimuli for mechanistic studies of pain or anxiety. We discuss gaps in knowledge and challenges that relate to the human factors in digital health applications, and underline the need for a practical and conceptual framework for capturing and reporting such variations.

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

Cited by 13 publications

References 26 publications

Patient Empowerment Using Electronic Telemonitoring With Telephone Support in the Transition to Insulin Therapy in Adults With Type 2 Diabetes: Observational, Pre-Post, Mixed Methods Study

Patient Empowerment Using Electronic Telemonitoring With Telephone Support in the Transition to Insulin Therapy in Adults With Type 2 Diabetes: Observational, Pre-Post, Mixed Methods Study

Patient experiences with technology enabled care across healthcare settings- a systematic review

The Bigger Picture of Digital Interventions for Pain, Anxiety and Stress: A Systematic Review of 1200+ Controlled Trials

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