Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study
BackgroundPatient engagement attrition in mobile health (mHealth) remote patient monitoring (RPM) programs decreases program benefits. Systemic disparities lead to inequities in RPM adoption and use. There is an urgent need to understand patients’ experiences with RPM in the...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2024-03-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2024/1/e51236 |
| _version_ | 1797254910452957184 |
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| author | Andrew W Liu William Brown, III Ndubuisi E Madu Ali R Maiorano Olivia Bigazzi Eli Medina Christopher Sorric Steven R Hays Anobel Y Odisho |
| author_facet | Andrew W Liu William Brown, III Ndubuisi E Madu Ali R Maiorano Olivia Bigazzi Eli Medina Christopher Sorric Steven R Hays Anobel Y Odisho |
| author_sort | Andrew W Liu |
| collection | DOAJ |
| description |
BackgroundPatient engagement attrition in mobile health (mHealth) remote patient monitoring (RPM) programs decreases program benefits. Systemic disparities lead to inequities in RPM adoption and use. There is an urgent need to understand patients’ experiences with RPM in the real world, especially for patients who have stopped using the programs, as addressing issues faced by patients can increase the value of mHealth for patients and subsequently decrease attrition.
ObjectiveThis study sought to understand patient engagement and experiences in an RPM mHealth intervention in lung transplant recipients.
MethodsBetween May 4, 2020, and November 1, 2022, a total of 601 lung transplant recipients were enrolled in an mHealth RPM intervention to monitor lung function. The predictors of patient engagement were evaluated using multivariable logistic and linear regression. Semistructured interviews were conducted with 6 of 39 patients who had engaged in the first month but stopped using the program, and common themes were identified.
ResultsPatients who underwent transplant more than 1 year before enrollment in the program had 84% lower odds of engaging (odds ratio [OR] 0.16, 95% CI 0.07-0.35), 82% lower odds of submitting pulmonary function measurements (OR 0.18, 95% CI 0.09-0.33), and 78% lower odds of completing symptom checklists (OR 0.22, 95% CI 0.10-0.43). Patients whose primary language was not English had 78% lower odds of engaging compared to English speakers (OR 0.22, 95% CI 0.07-0.67). Interviews revealed 4 prominent themes: challenges with devices, communication breakdowns, a desire for more personal interactions and specific feedback with the care team about their results, understanding the purpose of the chat, and understanding how their data are used.
ConclusionsCare delivery and patient experiences with RPM in lung transplant mHealth can be improved and made more equitable by tailoring outreach and enhancements toward non-English speakers and patients with a longer time between transplant and enrollment. Attention to designing programs to provide personalization through supplementary provider contact, education, and information transparency may decrease attrition rates. |
| first_indexed | 2024-04-24T21:57:28Z |
| format | Article |
| id | doaj.art-0e1acf90fa8849b4a8e1b40b391576b7 |
| institution | Directory Open Access Journal |
| issn | 2291-5222 |
| language | English |
| last_indexed | 2024-04-24T21:57:28Z |
| publishDate | 2024-03-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj.art-0e1acf90fa8849b4a8e1b40b391576b72024-03-20T14:00:33ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222024-03-0112e5123610.2196/51236Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods StudyAndrew W Liuhttps://orcid.org/0000-0001-8033-2598William Brown, IIIhttps://orcid.org/0000-0003-4322-4859Ndubuisi E Maduhttps://orcid.org/0009-0008-5222-6139Ali R Maioranohttps://orcid.org/0000-0002-4697-6186Olivia Bigazzihttps://orcid.org/0009-0008-0643-0163Eli Medinahttps://orcid.org/0000-0001-6189-7235Christopher Sorrichttps://orcid.org/0009-0007-5304-7426Steven R Hayshttps://orcid.org/0000-0002-2887-8451Anobel Y Odishohttps://orcid.org/0000-0003-0975-0812 BackgroundPatient engagement attrition in mobile health (mHealth) remote patient monitoring (RPM) programs decreases program benefits. Systemic disparities lead to inequities in RPM adoption and use. There is an urgent need to understand patients’ experiences with RPM in the real world, especially for patients who have stopped using the programs, as addressing issues faced by patients can increase the value of mHealth for patients and subsequently decrease attrition. ObjectiveThis study sought to understand patient engagement and experiences in an RPM mHealth intervention in lung transplant recipients. MethodsBetween May 4, 2020, and November 1, 2022, a total of 601 lung transplant recipients were enrolled in an mHealth RPM intervention to monitor lung function. The predictors of patient engagement were evaluated using multivariable logistic and linear regression. Semistructured interviews were conducted with 6 of 39 patients who had engaged in the first month but stopped using the program, and common themes were identified. ResultsPatients who underwent transplant more than 1 year before enrollment in the program had 84% lower odds of engaging (odds ratio [OR] 0.16, 95% CI 0.07-0.35), 82% lower odds of submitting pulmonary function measurements (OR 0.18, 95% CI 0.09-0.33), and 78% lower odds of completing symptom checklists (OR 0.22, 95% CI 0.10-0.43). Patients whose primary language was not English had 78% lower odds of engaging compared to English speakers (OR 0.22, 95% CI 0.07-0.67). Interviews revealed 4 prominent themes: challenges with devices, communication breakdowns, a desire for more personal interactions and specific feedback with the care team about their results, understanding the purpose of the chat, and understanding how their data are used. ConclusionsCare delivery and patient experiences with RPM in lung transplant mHealth can be improved and made more equitable by tailoring outreach and enhancements toward non-English speakers and patients with a longer time between transplant and enrollment. Attention to designing programs to provide personalization through supplementary provider contact, education, and information transparency may decrease attrition rates.https://mhealth.jmir.org/2024/1/e51236 |
| spellingShingle | Andrew W Liu William Brown, III Ndubuisi E Madu Ali R Maiorano Olivia Bigazzi Eli Medina Christopher Sorric Steven R Hays Anobel Y Odisho Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study JMIR mHealth and uHealth |
| title | Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study |
| title_full | Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study |
| title_fullStr | Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study |
| title_full_unstemmed | Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study |
| title_short | Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study |
| title_sort | patient engagement with and perspectives on a mobile health home spirometry intervention mixed methods study |
| url | https://mhealth.jmir.org/2024/1/e51236 |
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