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Supporting patient-clinician interaction in chronic HIV care - Design and development of a patient-reported outcomes software application.pdf
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Journal article
Supporting patient-clinician interaction in chronic HIV care: Design and development of a patient-reported outcomes software application
Journal of Medical Internet Research, Vol.23(7), e27861
2021
Abstract
Background:
The consideration of health-related quality of life (HRQL) is a hallmark of best practice in HIV care. Information technology offers an opportunity to more closely engage patients with chronic HIV infection in their long-term management and support a focus on HRQL. However, the implementation of patient-reported outcome (PRO) measures, such as HRQL in routine care, is challenged by the need to synthesize data generated by questionnaires, the complexity of collecting data between patient visits, and the integration of results into clinical decision-making processes.
Objective:
Our aim is to design and pilot-test a multimedia software platform to overcome these challenges and provide a vehicle to increase focus on HRQL issues in HIV management.
Methods:
A multidisciplinary team in France and Australia conducted the study with 120 patients and 16 doctors contributing to the design and development of the software. We used agile development principles, user-centered design, and qualitative research methods to develop and pilot the software platform. We developed a prototype application to determine the acceptability of the software and piloted the final version with 41 Australian and 19 French residents using 2 validated electronic questionnaires, the Depression, Anxiety and Stress Scale-21 Items, and the Patient Reported Outcomes Quality of Life-HIV.
Results:
Testing of the prototype demonstrated that patients wanted an application that was intuitive and without excessive instruction, so it felt effortless to use, as well as secure and discreet. Clinicians wanted the PRO data synthesized, presented clearly and succinctly, and clinically actionable. Safety concerns for patients and clinicians included confidentiality, and the potential for breakdown in communication if insufficient user training was not provided. The final product, piloted with patients from both countries, showed that most respondents found the application easy to use and comprehend. The usability testing survey administered found that older Australians had reduced scores for understanding the visual interface (P=.004) and finding the buttons organized (P=.02). Three-fourths of the respondents were concerned with confidentiality (P=.007), and this result was more prevalent in participants with higher anxiety and stress scores (P=.01), as measured by the Depression, Anxiety and Stress Scale-21 Items. These statistical associations were not observed in 15 French patients who completed the same questionnaire.
Conclusions:
Digital applications in health care should be safe and fit for purpose. Our software was acceptable to patients and shows potential to overcome some barriers to the implementation of PROs in routine care. The design of the clinicians’ interface presents a solution to the problem of voluminous data, both synthesizing and providing a snapshot of longitudinal data. The next stage is to conduct a randomized controlled trial to determine whether patients experience increased satisfaction with care and whether doctors perceive that they deliver better clinical care without compromising efficiency.
Details
- Title
- Supporting patient-clinician interaction in chronic HIV care: Design and development of a patient-reported outcomes software application
- Authors/Creators
- S. Herrmann (Author/Creator) - The University of Western AustraliaB. Power (Author/Creator) - Murdoch UniversityA. Rashidi (Author/Creator) - Edith Cowan UniversityM. Cypher (Author/Creator) - Murdoch UniversityF. Mastaglia (Author/Creator) - Murdoch UniversityA. Grace (Author/Creator) - Murdoch UniversityE. McKinnon (Author/Creator) - The Kids Research Institute AustraliaP. Sarrot (Author/Creator) - Patient-Centered Outcomes Research, Health Economics Clinical Trial Unit, Hospital Hotel-Dieu, AP-HP, University de Paris, Paris, France.C. Michau (Author/Creator) - Centre Hospitalier Saint-NazaireM. Skinner (Author/Creator) - Sir Charles Gairdner HospitalR. Desai (Author/Creator)M. Duracinsky (Author/Creator) - Patient-Centered Outcomes Research, Health Economics Clinical Trial Unit, Hospital Hotel-Dieu, AP-HP, University de Paris, Paris, France.
- Publication Details
- Journal of Medical Internet Research, Vol.23(7), e27861
- Publisher
- JMIR Publications
- Identifiers
- 991005544437207891
- Copyright
- © Susan Herrmann, Brad Power, Amineh Rashidi, Mark Cypher, Frank Mastaglia, Amy Grace, Elizabeth McKinnon, Pierre Sarrot, Christophe Michau, Matthew Skinner, Renae Desai, Martin Duracinsky
- Murdoch Affiliation
- School of Allied Health; College of Arts, Business, Law and Social Sciences
- Language
- English
- Resource Type
- Journal article
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