Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study

BackgroundHeart failure (HF) is associated with high mortality rates and high costs, and self-care is crucial in the management of the condition. Telehealth can promote patients’ self-care while providing frequent feedback to their health care providers about the patient’s compliance and symptoms. A...

Full description

Bibliographic Details
Main Authors: Apergi, Lida Anna, Bjarnadottir, Margret V, Baras, John S, Golden, Bruce L, Anderson, Kelley M, Chou, Jiling, Shara, Nawar
Format: Article
Language:English
Published: JMIR Publications 2021-04-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2021/4/e24646
_version_ 1818917825378516992
author Apergi, Lida Anna
Bjarnadottir, Margret V
Baras, John S
Golden, Bruce L
Anderson, Kelley M
Chou, Jiling
Shara, Nawar
author_facet Apergi, Lida Anna
Bjarnadottir, Margret V
Baras, John S
Golden, Bruce L
Anderson, Kelley M
Chou, Jiling
Shara, Nawar
author_sort Apergi, Lida Anna
collection DOAJ
description BackgroundHeart failure (HF) is associated with high mortality rates and high costs, and self-care is crucial in the management of the condition. Telehealth can promote patients’ self-care while providing frequent feedback to their health care providers about the patient’s compliance and symptoms. A number of technologies have been considered in the literature to facilitate telehealth in patients with HF. An important factor in the adoption of these technologies is their ease of use. Conversational agent technologies using a voice interface can be a good option because they use speech recognition to communicate with patients. ObjectiveThe aim of this paper is to study the engagement of patients with HF with voice interface technology. In particular, we investigate which patient characteristics are linked to increased technology use. MethodsWe used data from two separate HF patient groups that used different telehealth technologies over a 90-day period. Each group used a different type of voice interface; however, the scripts followed by the two technologies were identical. One technology was based on Amazon’s Alexa (Alexa+), and in the other technology, patients used a tablet to interact with a visually animated and voice-enabled avatar (Avatar). Patient engagement was measured as the number of days on which the patients used the technology during the study period. We used multiple linear regression to model engagement with the technology based on patients’ demographic and clinical characteristics and past technology use. ResultsIn both populations, the patients were predominantly male and Black, had an average age of 55 years, and had HF for an average of 7 years. The only patient characteristic that was statistically different (P=.008) between the two populations was the number of medications they took to manage HF, with a mean of 8.7 (SD 4.0) for Alexa+ and 5.8 (SD 3.4) for Avatar patients. The regression model on the combined population shows that older patients used the technology more frequently (an additional 1.19 days of use for each additional year of age; P=.004). The number of medications to manage HF was negatively associated with use (−5.49; P=.005), and Black patients used the technology less frequently than other patients with similar characteristics (−15.96; P=.08). ConclusionsOlder patients’ higher engagement with telehealth is consistent with findings from previous studies, confirming the acceptability of technology in this subset of patients with HF. However, we also found that a higher number of HF medications, which may be correlated with a higher disease burden, is negatively associated with telehealth use. Finally, the lower engagement of Black patients highlights the need for further study to identify the reasons behind this lower engagement, including the possible role of social determinants of health, and potentially create technologies that are better tailored for this population.
first_indexed 2024-12-20T00:40:13Z
format Article
id doaj.art-dae4ec27ff1d4d86833e5a406f76562c
institution Directory Open Access Journal
issn 2291-5222
language English
last_indexed 2024-12-20T00:40:13Z
publishDate 2021-04-01
publisher JMIR Publications
record_format Article
series JMIR mHealth and uHealth
spelling doaj.art-dae4ec27ff1d4d86833e5a406f76562c2022-12-21T19:59:38ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222021-04-0194e2464610.2196/24646Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison StudyApergi, Lida AnnaBjarnadottir, Margret VBaras, John SGolden, Bruce LAnderson, Kelley MChou, JilingShara, NawarBackgroundHeart failure (HF) is associated with high mortality rates and high costs, and self-care is crucial in the management of the condition. Telehealth can promote patients’ self-care while providing frequent feedback to their health care providers about the patient’s compliance and symptoms. A number of technologies have been considered in the literature to facilitate telehealth in patients with HF. An important factor in the adoption of these technologies is their ease of use. Conversational agent technologies using a voice interface can be a good option because they use speech recognition to communicate with patients. ObjectiveThe aim of this paper is to study the engagement of patients with HF with voice interface technology. In particular, we investigate which patient characteristics are linked to increased technology use. MethodsWe used data from two separate HF patient groups that used different telehealth technologies over a 90-day period. Each group used a different type of voice interface; however, the scripts followed by the two technologies were identical. One technology was based on Amazon’s Alexa (Alexa+), and in the other technology, patients used a tablet to interact with a visually animated and voice-enabled avatar (Avatar). Patient engagement was measured as the number of days on which the patients used the technology during the study period. We used multiple linear regression to model engagement with the technology based on patients’ demographic and clinical characteristics and past technology use. ResultsIn both populations, the patients were predominantly male and Black, had an average age of 55 years, and had HF for an average of 7 years. The only patient characteristic that was statistically different (P=.008) between the two populations was the number of medications they took to manage HF, with a mean of 8.7 (SD 4.0) for Alexa+ and 5.8 (SD 3.4) for Avatar patients. The regression model on the combined population shows that older patients used the technology more frequently (an additional 1.19 days of use for each additional year of age; P=.004). The number of medications to manage HF was negatively associated with use (−5.49; P=.005), and Black patients used the technology less frequently than other patients with similar characteristics (−15.96; P=.08). ConclusionsOlder patients’ higher engagement with telehealth is consistent with findings from previous studies, confirming the acceptability of technology in this subset of patients with HF. However, we also found that a higher number of HF medications, which may be correlated with a higher disease burden, is negatively associated with telehealth use. Finally, the lower engagement of Black patients highlights the need for further study to identify the reasons behind this lower engagement, including the possible role of social determinants of health, and potentially create technologies that are better tailored for this population.https://mhealth.jmir.org/2021/4/e24646
spellingShingle Apergi, Lida Anna
Bjarnadottir, Margret V
Baras, John S
Golden, Bruce L
Anderson, Kelley M
Chou, Jiling
Shara, Nawar
Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
JMIR mHealth and uHealth
title Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
title_full Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
title_fullStr Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
title_full_unstemmed Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
title_short Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study
title_sort voice interface technology adoption by patients with heart failure pilot comparison study
url https://mhealth.jmir.org/2021/4/e24646
work_keys_str_mv AT apergilidaanna voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT bjarnadottirmargretv voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT barasjohns voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT goldenbrucel voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT andersonkelleym voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT choujiling voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy
AT sharanawar voiceinterfacetechnologyadoptionbypatientswithheartfailurepilotcomparisonstudy