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Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study

BACKGROUND: Mobile health (mHealth) interventions for self-management are a promising way to meet the needs of patients with chronic diseases in primary care practices. Therefore, an mHealth intervention, TelePraCMan, was developed and evaluated for patients with type 2 diabetes mellitus, chronic ob...

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Autores principales: Breckner, Amanda, Litke, Nicola, Göbl, Linda, Wiezorreck, Lars, Miksch, Antje, Szecsenyi, Joachim, Wensing, Michel, Weis, Aline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459841/
https://www.ncbi.nlm.nih.gov/pubmed/36006666
http://dx.doi.org/10.2196/34786
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author Breckner, Amanda
Litke, Nicola
Göbl, Linda
Wiezorreck, Lars
Miksch, Antje
Szecsenyi, Joachim
Wensing, Michel
Weis, Aline
author_facet Breckner, Amanda
Litke, Nicola
Göbl, Linda
Wiezorreck, Lars
Miksch, Antje
Szecsenyi, Joachim
Wensing, Michel
Weis, Aline
author_sort Breckner, Amanda
collection PubMed
description BACKGROUND: Mobile health (mHealth) interventions for self-management are a promising way to meet the needs of patients with chronic diseases in primary care practices. Therefore, an mHealth intervention, TelePraCMan, was developed and evaluated for patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, high blood pressure, or heart failure in a German primary care setting. TelePraCMan entails a symptom diary, an appointment manager, a manager to document goals, and a warning system. The app should foster the self-management of participating patients. OBJECTIVE: We aimed to examine the effects of TelePraCMan on patient activation and quality of life and explored the underlying contextual factors, impacts, and degree of implementation. METHODS: In a prospective observational study design, we collected data by using interviews and written questionnaires from participating patients (intervention and control groups) and primary care workers (physicians and practice assistants). The primary outcomes of interest were patient-reported quality of life (12-Item Short Form Survey) and patient activation (patient activation measure). The quantitative analysis focused on differences between patients in the intervention and control groups, as well as before (T0) and after (T1) the intervention. Interviews were analyzed by using qualitative content analysis via MAXQDA (VERBI GmbH). RESULTS: At baseline, 25 patients and 24 primary care workers completed the questionnaire, and 18 patients and 21 primary care workers completed the follow-up survey. The patients were predominantly male and, on average, aged 64 (SD 11) years (T0). The primary care workers were mostly female (62%) and, on average, aged 47 (SD 10) years (T0). No differences were observed in the outcomes before and after the intervention or between the intervention and control groups. In the additional interviews, 4 patients and 11 primary care workers were included. The interviewees perceived that the intervention was useful for some patients. However, contextual factors and problems with implementation activities negatively affected the use of the app with patients. The main reasons for the low participation were the COVID-19 pandemic and the target group, which seemed to have less interest in mHealth; the interviewees attributed this to the older age of patients. However, the respondents felt that the app would be better accepted in 5 or 10 years. CONCLUSIONS: Although the TelePraCMan app was rated as very good and important by the participants, few patients used it. The digital intervention was hardly implemented and had limited impact in the current setting of German primary care. TRIAL REGISTRATION: German Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85
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spelling pubmed-94598412022-09-10 Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study Breckner, Amanda Litke, Nicola Göbl, Linda Wiezorreck, Lars Miksch, Antje Szecsenyi, Joachim Wensing, Michel Weis, Aline JMIR Form Res Original Paper BACKGROUND: Mobile health (mHealth) interventions for self-management are a promising way to meet the needs of patients with chronic diseases in primary care practices. Therefore, an mHealth intervention, TelePraCMan, was developed and evaluated for patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, high blood pressure, or heart failure in a German primary care setting. TelePraCMan entails a symptom diary, an appointment manager, a manager to document goals, and a warning system. The app should foster the self-management of participating patients. OBJECTIVE: We aimed to examine the effects of TelePraCMan on patient activation and quality of life and explored the underlying contextual factors, impacts, and degree of implementation. METHODS: In a prospective observational study design, we collected data by using interviews and written questionnaires from participating patients (intervention and control groups) and primary care workers (physicians and practice assistants). The primary outcomes of interest were patient-reported quality of life (12-Item Short Form Survey) and patient activation (patient activation measure). The quantitative analysis focused on differences between patients in the intervention and control groups, as well as before (T0) and after (T1) the intervention. Interviews were analyzed by using qualitative content analysis via MAXQDA (VERBI GmbH). RESULTS: At baseline, 25 patients and 24 primary care workers completed the questionnaire, and 18 patients and 21 primary care workers completed the follow-up survey. The patients were predominantly male and, on average, aged 64 (SD 11) years (T0). The primary care workers were mostly female (62%) and, on average, aged 47 (SD 10) years (T0). No differences were observed in the outcomes before and after the intervention or between the intervention and control groups. In the additional interviews, 4 patients and 11 primary care workers were included. The interviewees perceived that the intervention was useful for some patients. However, contextual factors and problems with implementation activities negatively affected the use of the app with patients. The main reasons for the low participation were the COVID-19 pandemic and the target group, which seemed to have less interest in mHealth; the interviewees attributed this to the older age of patients. However, the respondents felt that the app would be better accepted in 5 or 10 years. CONCLUSIONS: Although the TelePraCMan app was rated as very good and important by the participants, few patients used it. The digital intervention was hardly implemented and had limited impact in the current setting of German primary care. TRIAL REGISTRATION: German Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85 JMIR Publications 2022-08-25 /pmc/articles/PMC9459841/ /pubmed/36006666 http://dx.doi.org/10.2196/34786 Text en ©Amanda Breckner, Nicola Litke, Linda Göbl, Lars Wiezorreck, Antje Miksch, Joachim Szecsenyi, Michel Wensing, Aline Weis. Originally published in JMIR Formative Research (https://formative.jmir.org), 25.08.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Breckner, Amanda
Litke, Nicola
Göbl, Linda
Wiezorreck, Lars
Miksch, Antje
Szecsenyi, Joachim
Wensing, Michel
Weis, Aline
Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title_full Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title_fullStr Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title_full_unstemmed Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title_short Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
title_sort effects and processes of an mhealth intervention for the management of chronic diseases: prospective observational study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459841/
https://www.ncbi.nlm.nih.gov/pubmed/36006666
http://dx.doi.org/10.2196/34786
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