Using a Commercially Available App for the Self-Management of Hypertension: Acceptance and Usability Study in Saudi Arabia

Abstract

Background The use of smartphone apps to assist in the self-management of hypertension is becoming increasingly common, but few commercially available apps have the potential to be effective along with adequate security and privacy measures in place. In a previous study, we identified 5 apps that are potentially effective and safe, and based on the preferences of doctors and patients, one (Cora Health) was selected as the most suitable app for use in a Saudi context. However, there is currently no evidence of its usability and acceptance among potential users. Indeed, there has been little research into the usability and acceptance of hypertension apps in general, and less research considers this in the Gulf Region. Objective This study aims to evaluate the acceptance and usability of the selected app in the Saudi context. Methods This study used a mixed methods approach with 2 studies: a usability test involving patients in a controlled setting performing predefined tasks and a real-world usability study where patients used the app for 4 weeks. In the usability test, participants were asked to think aloud while performing the tasks, and an observer recorded the number of tasks they completed. At the end of the real-world pilot study, participants were interviewed, and the mHealth App Usability Questionnaire was completed. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data. Results In total, 10 patients completed study 1. The study found that app usability was moderate and that participants needed some familiarization time before they could use the app proficiently. Some usability issues were revealed, related to app accessibility and navigation, and a few tasks remained uncompleted by most people. A total of 20 patients completed study 2, with a mean age of 51.6 (SD 11.7) years. Study 2 found that the app was generally acceptable and easy to use, with some similar usability issues identified. Participants stressed the importance of practice and training to use it more easily and proficiently. Participants had a good engagement level with 48% retention at the end of study 2, with most participants’ engagement being classed as meaningful. The most recorded data were blood pressure, followed by stress and medication, and the most accessed feature was viewing graphs of data trends. Conclusions This study shows that a commercially available app can be usable and acceptable in the self-management of hypertension but also found a considerable number of possibilities for improvement, which needs to be considered in future app development. The results show that there is potential for a commercially available app to be used in large-scale studies of hypertension self-management if suggestions for improvements are addressed.

Comparing the Acceptance of Mobile Hypertension Apps for Disease Management Among Patients Versus Clinical Use Among Physicians: Cross-sectional Survey

“…Accordingly, a qualitative study by Morrissey et al [ 53 ] also highlighted concerns regarding the risks of health apps used to improve medication adherence and the need for promote eHealth literacy among hypertensive patients. Regarding the real-world assessment of apps, a mixed methods study by Allessa et al [ 34 ] showed that apps for self-management of hypertension can be functional and acceptable to users, but they can also be considerably improved through training [ 34 ], which corresponds to UTAUT determinants like performance and effort expectancy as well as facilitating conditions.…”

“…Patients and physicians differ in several aspects regarding their acceptance of hypertension apps, especially based on their motivations or reasons to use these apps. For patients, the focus is on managing their own disease to avoid health deterioration [ 12 , 34 ]. Thus, acceptance of health apps crucially depends on whether disease-specific needs are met [ 12 , 15 ].…”

Evaluation of the Wateen App in the Blood-Donation Process in Saudi Arabia

“…These findings are in line with prior research, which has found that older users may be less engaged and/or experience greater issues with technological interventions. 22–24 Some concerns were raised by healthcare professionals regarding app accessibility, for example, the lack of a zoom feature and inability to change font sizes, which may hinder older people or people with impaired vision. Whilst these accessibility issues are likely to affect older people disproportionately, this population also has a higher frequency of underlying health conditions, meaning they are less likely to donate blood anyway.…”

“…In the meantime, training could enable older users to engage more with this app, and other e-health technologies. 22 , 26 Ouhbi et al showed that very few donation apps are available in multiple languages, limiting the number of potential donors they can reach. 14 , 15 The present research also found that widening the language provision of the Wateen app beyond Arabic and English could increase its accessibility and user base.…”

“…The lack of training required to use e-health apps is associated with high levels of usability. 22 , 27 …”