Frontiers in Public Health (Sep 2015)
DEVELOPING A SMARTPHONE APPLICATION TO IMPROVE CARE AND OUTCOMES IN ADOLESCENT ARTHRITIS THROUGH PATIENT INPUT
Abstract
Background: Juvenile idiopathic arthritis (JIA) affects around 1 in 1,000 young people (YP) in the UK. Flare-ups of JIA cause joint pain and swelling, and are often accompanied with fatigue, stiffness, sleep problems, higher negative emotions, and reduced participation in activities. As a result, JIA can negatively impact educational, psychosocial, and physical development and wellbeing, especially during puberty. In addition, missing medications, poor clinic attendance, as well as low levels of physical activity complicate the management of this disease in adolescence. Using smartphone technologies to engage YP with their care has the potential to improve health outcomes for this age group. No such smartphone app has yet been developed in collaboration with YP with JIA and consultations with Healthcare Professionals (HCPs). Aims: To develop a smartphone app that facilitates collection of information deemed important by YP with JIA and clinicians involved in their care. Methods: Phase 1 carried out five focus groups (FGs): two with YP (one with 10- to 15-year olds and one with 16- to 24-year olds), one with parents, and two with HCPs working in paediatric and adult rheumatology. Participants were guided by semi-structured interview questions focusing on how to develop an interesting and easy-to-use app that can help YP improve self-management and increase understanding and adherence to treatment. Phase 2 developed the app by integrating participants’ ideas and suggestions. The app’s acceptability and usability were then evaluated through four FGs: two with YP (one with 10- to 14-year olds and one with 16- to 23-year olds) and two with HCPs. Participants were provided with the app on a smartphone and were asked to navigate through its various features. Participants’ perceptions of the app and suggestions for improvements were sought via qualitative interview responses and user observations. Results: Qualitative content analysis was used to identify five major themes that informed the development of the app. First was Monitoring Information, which included JIA-related symptoms, mood and stress, exercise, missed medications, medication side-effects, and completing the health assessment questionnaire. Second was Setting Reminders for medications and appointments. Third theme was Education and Support, such as including practical advice and links to social support groups. Fourth theme pertains to Motivating Factors for Using the App, such as providing feedback for personal input and having a rewards system. The last theme relates to the Design for the App, such as how to make it visually appealing and easy to navigate. Qualitative feedbacks from CYP and HCPs during phase 2 indicated that the app is acceptable, comprehensive, interesting, and useful. Conclusions: The current study employed a qualitative user-centered approach to develop an acceptable and developmentally appropriate smartphone application that can benefit YP with JIA. Current qualitative data showed that complementing traditional therapies with new mobile technology may be an affordable and effective method to improve patient’s understanding of their condition and help YP become more independent in their own healthcare. Collecting more frequent and accurate data using the app may also improve treatments and interactions between patients and HCPs, which optimizes health and wellbeing.
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