A Clinically Integrated mHealth App and Practice Model for Collecting Patient-Reported Outcomes between Visits for Asthma Patients: Implementation and Feasibility.

Appl Clin Inform

Division of General Internal Medicine, Department of Health Policy and Management, Brigham and Women's Hospital, Harvard Chan School of Public Health, Boston, Massachusetts, United States.

Published: October 2019

AI Article Synopsis

  • Clinically integrated mHealth apps can effectively support chronic disease management, particularly for asthma symptom monitoring, with high patient engagement and adherence rates.
  • The study involved 26 patients and several healthcare professionals over 25 weeks, with a notable 92% retention rate among patients and an 84% average completion rate of weekly questionnaires.
  • Feedback from both patients and clinicians highlighted benefits such as increased asthma awareness, improved connectivity with providers, and minimal added workload for healthcare staff, suggesting a promising model for future implementation in chronic disease care.

Article Abstract

Objective: Mobile health (mHealth) apps may prove to be useful tools for supporting chronic disease management. We assessed the feasibility of implementing a clinically integrated mHealth app and practice model to facilitate between-visit asthma symptom monitoring as per guidelines and with the help of patient-reported outcomes (PRO).

Methods: We implemented the intervention at two pulmonary clinics and conducted a mixed-methods analysis of app usage data and semi-structured interview of patients and clinician participants over a 25-week study period.

Results: Five physicians, 1 physician's assistant, 1 nurse, and 26 patients participated. Twenty-four patients (92%) were still participating in the intervention at the end of the 25-week study period. On average, each patient participant completed 21 of 25 questionnaires (84% completion rate). Weekly completion rates were higher for participants who were female (88 vs. 73%, = 0.02) and obtained a bachelor's degree level or higher (94 vs. 74%,  = 0.04). On average, of all questionnaires, including both completed and not completed (25 weekly questionnaires times 26 patient participants), 25% had results severe enough to qualify for a callback from a nurse; however, patients declined this option in roughly half of the cases in which they were offered the option. We identified 6 key themes from an analysis of 21 patients and 5 clinician interviews. From the patient's perspective, these include more awareness of asthma, more connected with provider, and app simplicity. From the clinician's perspective, these include minimal additional work required, facilitating triage, and informing conversations during visits.

Conclusion: Implementation of a clinically integrated mHealth app and practice model can achieve high patient retention and adherence to guideline-recommended asthma symptom monitoring, while minimally burdening clinicians. The intervention has the potential for scaling to primary care and reducing utilization of urgent and emergency care.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795530PMC
http://dx.doi.org/10.1055/s-0039-1697597DOI Listing

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