Mobile health platform for self-management of pediatric cystic fibrosis: Impact on patient-centered care outcomes.

Mobile health Patient-centered care Patient-generated health data Satisfaction with care Shared decision-making

Journal

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
ISSN: 1873-5010
Titre abrégé: J Cyst Fibros
Pays: Netherlands
ID NLM: 101128966

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 09 12 2022
revised: 29 03 2023
accepted: 15 04 2023
medline: 28 11 2023
pubmed: 22 4 2023
entrez: 21 04 2023
Statut: ppublish

Résumé

Previously, we adapted a mobile health platform (Genia) to the needs of patients and families in a pediatric CF center in the United States. In this feasibility study, we tested the impact of Genia on measures of patient-centered care. In a one-group pre-post study with adolescents with CF and caregivers of children with CF, we tested Genia's effect over 6 months on patient satisfaction with chronic illness care (PACIC) and shared decision-making (CollaboRate). Feasibility and acceptability were assessed with exit interviews and app analytics. The intervention included 40 participants: 30 caregivers of children with CF age ≤14 years and 10 patients with CF age ≥15 years. The use of Genia was associated with increased satisfaction with care (p = 0.024), including delivery system and decision support (p = 0.017), goal setting (p = 0.006), and shared decision-making (p<0.001). The use of Genia was associated with nominal improvements in all QOL domains and symptom scales. The platform was feasible, with participants recording more than 4,400 observations (mean 84.2) and submitting 496 weekly reports (mean 13.8) and 70 quarterly reports (mean 1.8), and acceptable (95% retention rate). For participants, the most useful app feature was pre-visit reports (66.7%), and the top symptom trackers were those for cough (23.7%), appetite (21.1%), energy (18.4%), and medicines (18.4%). The use of Genia over 6 months was feasible, acceptable, and associated with improved measures of patient-centered care. Study results support wider use of Genia in clinical settings. Efficacy for clinical outcomes should be assessed in a randomized clinical trial.

Sections du résumé

BACKGROUND BACKGROUND
Previously, we adapted a mobile health platform (Genia) to the needs of patients and families in a pediatric CF center in the United States. In this feasibility study, we tested the impact of Genia on measures of patient-centered care.
METHODS METHODS
In a one-group pre-post study with adolescents with CF and caregivers of children with CF, we tested Genia's effect over 6 months on patient satisfaction with chronic illness care (PACIC) and shared decision-making (CollaboRate). Feasibility and acceptability were assessed with exit interviews and app analytics.
RESULTS RESULTS
The intervention included 40 participants: 30 caregivers of children with CF age ≤14 years and 10 patients with CF age ≥15 years. The use of Genia was associated with increased satisfaction with care (p = 0.024), including delivery system and decision support (p = 0.017), goal setting (p = 0.006), and shared decision-making (p<0.001). The use of Genia was associated with nominal improvements in all QOL domains and symptom scales. The platform was feasible, with participants recording more than 4,400 observations (mean 84.2) and submitting 496 weekly reports (mean 13.8) and 70 quarterly reports (mean 1.8), and acceptable (95% retention rate). For participants, the most useful app feature was pre-visit reports (66.7%), and the top symptom trackers were those for cough (23.7%), appetite (21.1%), energy (18.4%), and medicines (18.4%).
CONCLUSION CONCLUSIONS
The use of Genia over 6 months was feasible, acceptable, and associated with improved measures of patient-centered care. Study results support wider use of Genia in clinical settings. Efficacy for clinical outcomes should be assessed in a randomized clinical trial.

Identifiants

pubmed: 37085386
pii: S1569-1993(23)00113-3
doi: 10.1016/j.jcf.2023.04.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

823-829

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interests Andreas Hager is a founder of Upstream Dream, creator of the Genia app. Rikard Bergquist is a consultant for Upstream Dream. The other authors have no conflicts of interest related to the work.

Auteurs

Gabriela R Oates (GR)

Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: goates@uabmc.edu.

Cathy Mims (C)

Children's of Alabama, Birmingham, AL, USA.

Robin Geurs (R)

Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Rikard Bergquist (R)

Motivo Management, LLC, Reno, NV, USA; Upstream Dream AB, Stockholm, Sweden.

Andreas Hager (A)

Upstream Dream AB, Stockholm, Sweden.

Jennifer S Guimbellot (JS)

Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Anastasia M Hartzes (AM)

School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.

Hector H Gutierrez (HH)

Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

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