How Health Care Professionals Evaluate a Digital Intervention to Improve Medication Adherence: Qualitative Exploratory Study.
How Health Care Professionals Evaluate a Digital Intervention to Improve Medication Adherence: Qualitative Exploratory Study.
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DOI：
10.2196/humanfactors.8948
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发表时间：
2018-02-20
影响因子：
2.7
通讯作者：
Melles, Marijke
中科院分区：
文献类型：
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作者：
Thomson, Karen;Brouwers, Corline;Melles, Marijke
背景：药物依从性对许多慢性病造成严重且难以解决的问题。促进患者参与和共享决策 (SDM) 的电子健康 (eHealth) 应用程序可能是提高药物依从性的一种新方法。 目的：本研究的目的是调查医疗保健专业人员对新开发的旨在提高药物依从性的数字应用程序的看法。选择家族性高胆固醇血症（FH）作为案例。方法：与患者和医疗保健专业人员共同设计了基于网络的电子健康应用程序 MIK 原型。在对患者进行用户测试后，我们对来自 6 家不同医院的 12 名医生进行了半结构化访谈和用户测试，以研究 MIK 提供的功能如何帮助医生进行咨询以及如何将其融入到日常临床实践中。定性主题分析用于确定涵盖医生评估的主题。结果：根据访谈数据，确定了 3 个主题，分别是（1）对医患合作的感知影响； (2) 患者对药物依从性的理解和自我管理的感知影响； (3) 对临床决策和工作流程的感知影响。结论：eHealth 应用程序 MIK 似乎有潜力改善患者和医生之间在协作和患者参与方面的咨询。基于 SDM 概念的电子健康应用程序对于改善服药行为和临床结果的影响尚待评估。见解将有助于进一步开发电子医疗应用程序，旨在通过患者参与和 SDM 来改善自我管理。
BACKGROUND: Medication nonadherence poses a serious and a hard-to-tackle problem for many chronic diseases. Electronic health (eHealth) apps that foster patient engagement and shared decision making (SDM) may be a novel approach to improve medication adherence.OBJECTIVE: The aim of this study was to investigate the perspective of health care professionals regarding a newly developed digital app aimed to improve medication adherence. Familial hypercholesterolemia (FH) was chosen as a case example.METHODS: A Web-based prototype of the eHealth app-MIK-was codesigned with patients and health care professionals. After user tests with patients, we performed semistructured interviews and user tests with 12 physicians from 6 different hospitals to examine how the functionalities offered by MIK could assist physicians in their consultation and how they could be integrated into daily clinical practice. Qualitative thematic analysis was used to identify themes that covered the physicians' evaluations.RESULTS: On the basis of the interview data, 3 themes were identified, which were (1) perceived impact on patient-physician collaboration; (2) perceived impact on the patient's understanding and self-management regarding medication adherence; and (3) perceived impact on clinical decisions and workflow.CONCLUSIONS: The eHealth app MIK seems to have the potential to improve the consultation between the patient and the physician in terms of collaboration and patient engagement. The impact of eHealth apps based on the concept of SDM for improving medication-taking behavior and clinical outcomes is yet to be evaluated. Insights will be useful for further development of eHealth apps aimed at improving self-management by means of patient engagement and SDM.