|مجال التميز||تميز دراسي وبحثي|
|عنوان البحث:||Using a Commercially Available App for the Self-Management of Hypertension: Acceptance and Usability Study in Saudi Arabia|
|رابط إلى البحث:||https://mhealth.jmir.org/2021/2/e24177|
|موجز عن البحث:||
Background: The use of smartphone apps to assist in the self-management of hypertension is becoming increasingly common, but few commercially available apps have the potential to be effective along with adequate security and privacy measures in place. In a previous study, we identified 5 apps that are potentially effective and safe, and based on the preferences of doctors and patients, one (Cora Health) was selected as the most suitable app for use in a Saudi context. However, there is currently no evidence of its usability and acceptance among potential users. Indeed, there has been little research into the usability and acceptance of hypertension apps in general, and less research considers this in the Gulf Region.
Objective: This study aims to evaluate the acceptance and usability of the selected app in the Saudi context.
Methods: This study used a mixed methods approach with 2 studies: a usability test involving patients in a controlled setting performing predefined tasks and a real-world usability study where patients used the app for 4 weeks. In the usability test, participants were asked to think aloud while performing the tasks, and an observer recorded the number of tasks they completed. At the end of the real-world pilot study, participants were interviewed, and the mHealth App Usability Questionnaire was completed. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data.
Results: In total, 10 patients completed study 1. The study found that app usability was moderate and that participants needed some familiarization time before they could use the app proficiently. Some usability issues were revealed, related to app accessibility and navigation, and a few tasks remained uncompleted by most people. A total of 20 patients completed study 2, with a mean age of 51.6 (SD 11.7) years. Study 2 found that the app was generally acceptable and easy to use, with some similar usability issues identified. Participants stressed the importance of practice and training to use it more easily and proficiently. Participants had a good engagement level with 48% retention at the end of study 2, with most participants’ engagement being classed as meaningful. The most recorded data were blood pressure, followed by stress and medication, and the most accessed feature was viewing graphs of data trends.
Conclusions: This study shows that a commercially available app can be usable and acceptable in the self-management of hypertension but also found a considerable number of possibilities for improvement, which needs to be considered in future app development. The results show that there is potential for a commercially available app to be used in large-scale studies of hypertension self-management if suggestions for improvements are addressed.
|عنوان البحث:||What Influences the Implementation of Shared Decision Making: An Umbrella Review|
|رابط إلى البحث:||https://www.sciencedirect.com/science/article/abs/pii/S0738399120304365?via%3Dihub|
|موجز عن البحث:||
Objective: To provide a cogent summation of the evidence base of the key barriers and facilitators to implementing shared decision making (SDM).
Methods: An umbrella review of existing reviews on SDM was adopted. Databases were searched from 1997 to December 2018. Studies were included if they performed a review of barriers and facilitators to SDM. Results: 7 eligible reviews were identified. The five themes identified were: patient factors, professional factors, environmental factors, relationship factors, and factors related to information provision. Lack of time was the main factor hindering the implementation of SDM. Encouragement and motivation of providers to use SDM was a significant enabler of SDM implementation.
Conclusions: The provision of time and resources are insufficient if not accompanied by efforts to support and motivate providers to use SDM.
Practice implications: Healthcare providers need to be educated on the importance of building a relationship with their patients. To enhance this relationship, physicians may need to improve their interaction skills. They need to be curious and explore their patients’ preferences, listen to them and respect their opinions, explain options and outcomes, and encourage them to participate in the decision making.
|عنوان البحث:||Views of stakeholders on factors influencing shared decision-making in the Eastern Mediterranean Region: a systematic review|
|رابط إلى البحث:||http://www.emro.who.int/in-press/reviews/views-of-stakeholders-on-factors-influencing-shared-decision-making-in-the-eastern-mediterranean-region-a-systematic-review.html|
|موجز عن البحث:||
Background: Shared decision-making (SDM) is advocated as a key component of patient-centred care and associated with many benefits that improve patient outcomes. However, SDM is not yet embedded in clinical practice and confronts many barriers that hinder its implementation especially in countries of the World Health Organization (WHO) Eastern Mediterranean Region.
Aims: We conducted a systematic review to identify and understand factors influencing SDM in the Region.
Methods: We searched PsycINFO, CINAHL, PubMed, Medline, Scopus and Saudi Digital Library for articles published between 1997 and February 2019. Studies conducted in the Region that reported barriers, facilitators, experiences, expectations and attitudes to SDM were included. The Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of the studies in this review.
Results: Of the 1813 initial articles retrieved, 18 eligible articles were identified. The main factors that emerged were grouped under three broad themes: participant factors (pa-tients/families and physicians); consultation factors (relationship between participants, en-gaging patients, evaluating preferences, introducing options, providing information, and de-cision making); and healthcare system factors (organizational characteristics, time con-straints, continuity of care, and healthcare resources).
Conclusions: There is growing interest in SDM in several countries in the Region. However, there are many existing barriers that hinder the implementation of SDM. These need to be addressed before SDM can be fully adopted in these countries.
|عنوان البحث:||Smartphone Apps to Support Self-Management of Hypertension: Review and Content Analysis|
|رابط إلى البحث:||https://mhealth.jmir.org/2019/5/e13645/|
|موجز عن البحث:||
Background: Hypertension is a widespread chronic disease, and its effective treatment requires self-management by patients. Health-related apps provide an effective way of supporting hypertension self-management. However, the increasing range and variety of hypertension apps available on the market, owing to the global growth in apps, creates the need for patients and health care professionals to be informed about the effectiveness of these apps and the levels of privacy and security that they provide.
Objective: This study aimed to describe and assess all available apps supporting hypertension self-management in the most popular app stores and investigate their functionalities.
Methods: In January 2018, the UK Apple and Google Play stores were scanned for all free and paid apps supporting hypertension self-management. Apps were included if they were in English, had functionality supporting hypertension self-management, and targeted adult users with hypertension. The included apps were downloaded, and their functionalities were investigated. Behaviour change techniques (BCTs) linked with the theoretical domain framework (TDF) underpinning potentially effective apps were independently coded by two reviewers. The data privacy and security of the apps were also independently assessed.
Results: A total of 186 hypertension apps that met the inclusion criteria were included in this review. The majority of these apps had only one functionality (n=108), while the remainder offered different combinations of functionalities. A small number of apps had comprehensive functionalities (n=30) that are likely to be more effective in supporting hypertension self-management. Most apps lacked a clear theoretical basis, and 24 BCTs identified in these 30 apps were mapped to 10 TDF mechanisms of actions. On an average, 18.4 BCTs were mapped to 6 TDF mechanisms of actions that may support hypertension self-management behaviors. There was a concerning absence of evidence related to the effectiveness and usability of all 186 apps, and involvement of health care professionals in the app development process was minimal. Most apps did not meet the current standards of data security and privacy.
Conclusions: Despite the widespread accessibility and availability of smartphone apps with a range of combinations of functionalities that can support the self-management of hypertension, only a small number of apps are likely to be effective. Many apps lack security measures as well as a clear theoretical basis and do not provide any evidence concerning their effectiveness and usability. This raises a serious issue, as health professionals and those with hypertension have insufficient information to make decisions on which apps are safe and effective.
|عنوان البحث:||Mobile Apps to Support the Self-Management of Hypertension: Systematic Review of Effectiveness, Usability, and User Satisfaction|
|رابط إلى البحث:||https://mhealth.jmir.org/2018/7/e10723/|
|موجز عن البحث:||
Background: Hypertension is a chronic disease that is considered to be a public health problem and requires efforts by patients to manage themselves. The global growth in the use of mobile phones and tablets has been accompanied by the increased use of health apps. Many of these apps support the self-management of hypertension and, therefore, they have the potential benefits of lowering blood pressure. Despite this, there is currently a lack of evidence for their effectiveness, usability, and patient satisfaction with their use.
Objective: A systematic review was conducted to assess the effectiveness of apps in lowering blood pressure, as well as their usability and patients’ satisfaction with their use.
Methods: We conducted searches in the following databases: MEDLINE (OVID), EMBASE (OVID), PsycINFO (OVID), CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), IEEE Xplore ASSIAN, Google Scholar and the main Arabic databases Al Manhal, AskZad, and Mandumah. We looked for studies that used apps in the self-management of hypertension from 2008-2016. We also checked the reference lists of the review papers and all the primary studies for additional references.
Results: A total of 21 studies with a total of 3112 participants were included in the review. Of the 14 studies that assessed the effectiveness of the apps in lowering blood pressure, 10 (71.4%) studies (6 RCTs and 4 nonrandomized studies) reported that using the apps led to significant decreases in blood pressure and seemed to be effective in the self-management of hypertension. Of these 10, only 2 (20%) RCTs and 3 (30%) nonrandomized studies had a low–moderate risk of bias. The results of this review are inconclusive regarding which combinations of functionalities would be most effective in lowering blood pressure because of variation in the studies’ quality, but the data suggest that apps incorporating more comprehensive functionalities are likely to be more effective. In all the studies that assessed the usability of the apps and users’ acceptance of them, all the apps seemed to be accepted and easy to use.
Conclusions: Most of the studies reported that apps might be effective in lowering blood pressure and are accepted by users. However, these findings should be interpreted with caution, as most of the studies had a high risk of bias. More well-designed, large-scale studies are required to evaluate the real effect of using apps in lowering blood pressure and to identify the most effective functionality combinations for lowering blood pressure.
|عنوان المؤتمر:||ICHIHIM 2020: XIV. International Conference on Health Informatics and Health Information Management|
|مكان الإنعقاد:||London. UK|
|طبيعة المشاركة:||Oral presentation|
|عنوان المشاركة:||Patient and doctor attitudes towards, and acceptance of, the use of hypertension apps in Saudi Arabia|
Background: Smartphone applications (apps) are becoming an increasingly common method to support self-management of hypertension. Despite the increasing number of different hypertension apps available on the market, very few of them are safe and effective, and to authors’ best knowledge there is no evidence about which apps are suitable for a specific context. This creates a need to elicit patients’ and doctors’ views toward using apps in the self-management of hypertension and to identify which apps would be most suitable for use. In a previous study, we have identified 5 apps that are considered safe and effective. The aim of this study was to select one app that is most suitable for the Saudi Arabian context.
Method: This was an exploratory qualitative study. People with hypertension and doctors were purposively sampled from 2 hospitals and 2 primary care centres in Saudi Arabia. Both sets of participants were shown video recordings of the apps and were interviewed in focus groups and individual interviews, respectively. Framework analysis of the data was carried out, and data saturation was reached.
Results: A total of 22 patients were interviewed and engaged in 4 focus groups, and 12 doctors were interviewed, with a mean of age of 50.2 and 40, respectively. The results showed that both patients and doctors were interested in using apps to support self-management, and they expressed expected useful features, e.g., self-monitoring of Blood Pressure (BP). A few potential concerns were raised regarding app usability. Due to a lack of awareness of available apps and their suitability, patients had no prior use of health apps, and doctors had never recommended these apps for patients before. Participants generally preferred apps that provided self-monitoring of BP and other data, color-coded feedback with supplementary text, different reminders for different activities, and information about hypertension and its risks. They also preferred apps that were easy to navigate and had a suitable color-scheme. Three apps were considered more suitable than the others, based on the functionalities and benefits they offer and their usability. When participants were asked to rate the apps, Cora health app was rated as most suitable within the Saudi context. Two-thirds of doctors and most patients believed that Qardio heart health app and Braun healthy heart app are less recommendable or useful because they lack broader features like education and have poorer displays, in contrast to those apps offering a greater depth of features and detail.
Conclusion: Participants were interested in using apps to support the self-management of hypertension. By presenting the pros and cons of each of the five apps, it is shown that three apps are more suitable than others, with app 3 being the most suitable based on participants’ rates. In the next study, we implement this app in Saudi Arabia and evaluate its use and usability in a field trial.
|عنوان المؤتمر:||15th AAATE Conference GLOBAL CHALLENGES IN ASSISTIVE TECHNOLOGY|
|مكان الإنعقاد:||Bologna. Italy|
|طبيعة المشاركة:||Oral presentation|
|عنوان المشاركة:||Smartphones Apps to Support the SelfManagement of Hypertension: identification of the most suitable apps|
Background: Hypertension is a common chronic disease in adults that requires effective patients’ self-management. Smartphone apps provide considerable potential to play a key role in self-management, evident in the huge number of apps that have become available over the past few years. However, the increasing number of different blood pressure (BP) apps available on the market creates the urgent need for physicians and patients to be made aware of their effectiveness, and the levels of security and privacy that they offer. This will help to identify apps that are useful and safe.
Method: Two studies were conducted to evaluate apps for supporting the self-management of hypertension. Firstly, a systematic review was conducted, including articles from the years 2008 to 2017 that investigated and assessed functionalities of hypertension self-management apps and their effectiveness. Secondly, in January 2018, a content analysis study was undertaken, scanning the most popular UK app stores (Apple and Google Play stores) and describing all available paid and free apps supporting hypertension self-management and examining their functionalities. A privacy and security assessment of potentially effective apps was also performed. Key results: The systematic review included a total of 21 articles, evaluating 14 apps between them. This review indicated that apps have a generally positive effect on controlling BP. Due to inconsistencies in the design and quality of the articles, there is no decisive evidence about which of the functionality combinations are most effective. However, it is clear that apps are likely to be more effective when they have more comprehensive functionalities. Most apps in this review were study-specific, that is, they were developed solely for the purpose of the study. This is in contrast to the scores of commercial apps available on app stores. Indeed, the content analysis study identified 186 such apps. There was a lack of evidence in relation to all available apps regarding their usability, effectiveness, and the involvement of health professionals in the development process. Furthermore, only few apps possessed comprehensive functionalities (n=30). Most of them did not meet current criteria regarding data privacy and security and lacked a clear theoretical basis. These findings raise a serious issue for physicians and patients attempting to find a suitable app for the self-management of hypertensions. Eight apps were identified that appeared to be effective, whilst also meeting current standards of security and privacy levels.
Conclusion: Despite the wide availability of apps to support self-management of hypertensive patients, and a corresponding body of research into such apps, relatively few apps are effective in supporting self-management of hypertension and protecting users’ personal data