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

BackgroundMobile 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 diabete...

Full description

Bibliographic Details
Main Authors: Amanda Breckner, Nicola Litke, Linda Göbl, Lars Wiezorreck, Antje Miksch, Joachim Szecsenyi, Michel Wensing, Aline Weis
Format: Article
Language:English
Published: JMIR Publications 2022-08-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2022/8/e34786
_version_ 1797734793995091968
author Amanda Breckner
Nicola Litke
Linda Göbl
Lars Wiezorreck
Antje Miksch
Joachim Szecsenyi
Michel Wensing
Aline Weis
author_facet Amanda Breckner
Nicola Litke
Linda Göbl
Lars Wiezorreck
Antje Miksch
Joachim Szecsenyi
Michel Wensing
Aline Weis
author_sort Amanda Breckner
collection DOAJ
description BackgroundMobile 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. ObjectiveWe 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. MethodsIn 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). ResultsAt 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. ConclusionsAlthough 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 RegistrationGerman Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85
first_indexed 2024-03-12T12:49:38Z
format Article
id doaj.art-7bf7b600909a4684b3553aac2e22cc38
institution Directory Open Access Journal
issn 2561-326X
language English
last_indexed 2024-03-12T12:49:38Z
publishDate 2022-08-01
publisher JMIR Publications
record_format Article
series JMIR Formative Research
spelling doaj.art-7bf7b600909a4684b3553aac2e22cc382023-08-28T22:57:03ZengJMIR PublicationsJMIR Formative Research2561-326X2022-08-0168e3478610.2196/34786Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational StudyAmanda Brecknerhttps://orcid.org/0000-0003-0777-5223Nicola Litkehttps://orcid.org/0000-0002-7123-7537Linda Göblhttps://orcid.org/0000-0002-1832-8560Lars Wiezorreckhttps://orcid.org/0000-0001-6861-1922Antje Mikschhttps://orcid.org/0000-0002-1644-6651Joachim Szecsenyihttps://orcid.org/0000-0002-4483-0028Michel Wensinghttps://orcid.org/0000-0001-6569-8137Aline Weishttps://orcid.org/0000-0001-7899-1789 BackgroundMobile 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. ObjectiveWe 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. MethodsIn 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). ResultsAt 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. ConclusionsAlthough 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 RegistrationGerman Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85https://formative.jmir.org/2022/8/e34786
spellingShingle Amanda Breckner
Nicola Litke
Linda Göbl
Lars Wiezorreck
Antje Miksch
Joachim Szecsenyi
Michel Wensing
Aline Weis
Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study
JMIR Formative Research
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
url https://formative.jmir.org/2022/8/e34786
work_keys_str_mv AT amandabreckner effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT nicolalitke effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT lindagobl effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT larswiezorreck effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT antjemiksch effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT joachimszecsenyi effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT michelwensing effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy
AT alineweis effectsandprocessesofanmhealthinterventionforthemanagementofchronicdiseasesprospectiveobservationalstudy