Developing a Heart Transplantation Self-Management Support Mobile Health App in Taiwan: Qualitative Study

Abstract

Background Heart transplantation (HTx) is the most effective treatment for end-stage heart failure patients. After transplantation, patients face physiological, psychological, social, and other health care problems. Mobile health (mHealth) apps can change the delivery of conventional health care to ubiquitous care and improve health care quality. However, a dearth of mHealth apps exists for patients with HTx worldwide, including in Taiwan. Objective The aim of this study was to investigate the information needed and to develop a preliminary framework for an mHealth app for post-HTx patients. Methods A qualitative approach with individual in-depth interviews was conducted at a heart center in the regional hospital of northern Taiwan from June to November 2017. Patients that had undergone HTx and their health professionals were recruited for purposeful sampling. A semistructured interview guideline was used for individual interviews and transcribed. Thematic analysis was used for data analysis. Results A total of 21 subjects, including 17 patients and 4 health professionals, were recruited for the study. The following five major themes were identified: reminding, querying, experience sharing, diet, and expert consulting. Minor themes included a desire to use the app with artificial intelligence and integration with professional management. Conclusions An intelligent mHealth app that addresses the five main themes and integrates the processes of using a mobile app could facilitate HTx self-management for Taiwanese patients.

The Recent Advances of Mobile Healthcare in Cardiology Practice

“…Over the past decade, several studies have been published on mHealth treatment for heart failure ( 83 , 92 - 97 ). Most of published systematic reviews have mainly been focused on the effects of telephone support and traditional telehealth interventions using fixed-line technologies such as home tele-monitoring and video conferencing.…”

Pragmatic solutions to enhance self-management skills in solid organ transplant patients: systematic review and thematic analysis

“…These types of interventions are called remote patient symptom monitoring programs. In nine studies, the authors employed a mobile-based application to monitor patient signs and symptoms, enhance medication adherence, and send reminders or alerts [30][31][32][33][34][35][36][37][38]. In one study, a home-based remotely monitored intervention using wearable accelerometer devices was employed to promote post-transplant physical activity in patients [39].…”

“…Metrics related to system and program usage included ease of use (22 studies) [28, 32-35, 38, 40, 41, 44, 46, 49, 53, 58, 59, 61, 63, 65-69], usefulness (24 studies) [28, 29, 33-35, 38, 40, 41, 44-46, 48, 53, 58, 59, 63, 65-67], usage rate (nine studies) [33,38,40,41,55,58,[64][65][66], trustiness or reliability (11 studies) [28, 29, 32, 37, 41, 44-46, 48, 49, 61], adherence to system recommendation (10 studies) [28,29,33,38,41,45,65,67,68], acceptability (21 studies) [29, 33-35, 38, 40, 41, 45, 46, 48, 49, 53-55, 58, 61, 65, 66], and intention to use (17 studies) [29,30,34,35,37,38,40,41,48,49,58,61,64,65,67]. All of these indicators, based on their effectiveness in the reviewed studies, are described in Table 4.…”