Abstract
BackgroundDeath and disability from coronary heart disease (CHD) can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system.ObjectiveThe aim of this study was to develop an Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of iCARE.MethodsWe developed iCARE based on a user-centered design approach, which included 4 phases: (1) function design, (2) iterative design, (3) expert inspections and walkthroughs of the prototypes, and (4) usability testing with end users. The usability testing of iCARE included 2 stages: stage I, which included a task analysis and a usability evaluation (January to March 2019) of the iCARE patient app using the modified Health Information Technology Usability Survey (Health-ITUES); and stage II (June 2020), which used the Health-ITUES among end users who used the app for 6 months. The end users were individuals with a confirmed diagnosis of CHD from 2 university-affiliated hospitals in Beijing, China.ResultsiCARE consists of a patient app, a care provider app, and a cloud platform. It has a set of algorithms that trigger tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For stage I usability testing, 88 hospitalized patients (72% [63/88] male; mean age 60 [SD 9.9] years) with CHD were included in the study. The mean score of the usability testing was 90.1 (interquartile range 83.3-99.0). Among enrolled participants, 90% (79/88) were satisfied with iCARE; 94% (83/88) and 82% (72/88) reported that iCARE was useful and easy to use, respectively. For stage II usability testing, 61 individuals with CHD (85% [52/61] male; mean age 53 [SD 8.2] years) who were from an intervention arm and used iCARE for at least six months were included. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 89% (54/61) were satisfied with the use of iCARE, 93% (57/61) perceived it as useful, and 70% (43/61) as easy to use.ConclusionsThis study developed an intelligent, individualized, evidence-based, and theory-driven app (iCARE) to improve patients’ adherence to health behaviors and medication management. iCARE was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of CHD.Trial RegistrationChinese Clinical Trial Registry ChiCTR-INR-16010242; https://tinyurl.com/2p8bkrew
Highlights
Coronary heart disease (CHD) is the leading cause of cardiovascular death, accounting for 7.3 million annual deaths worldwide [1,2], with about 130,000 being reported from China alone [3]
This study developed an intelligent, individualized, evidence-based, and theory-driven app to improve patients’ adherence to health behaviors and medication management. Individualized Cardiovascular App for Risk Elimination (iCARE) was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of coronary heart disease (CHD)
In light of the imperative needs for health behavior modification and medication management among individuals with CHD, we developed an Intelligent Individualized Cardiovascular App for Risk Elimination through facilitating healthy behavior and medication adherence. iCARE was designed to address the gaps in conventional interventions, in which multiple CHD-related risk factors were managed through real-time monitoring, person-centered care, and automatic tailored feedback
Summary
Coronary heart disease (CHD) is the leading cause of cardiovascular death, accounting for 7.3 million annual deaths worldwide [1,2], with about 130,000 being reported from China alone [3]. In large international studies from Europe and China, such as the EUROASPIRE IV and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) Project, over half of patients with CHD had substantial unhealthy behaviors (50%-77%), with a large proportion of patients not adhering to prescribed preventive medications (45%-83%) [8,10,12-16]. Effective intervention targeting adherence to healthy behaviors and medications requires strategies to be implemented in addressing multiple CHD-related risk factors [17]. As reported by previous studies, evidence-based interventions with incorporation of real-time monitoring, person-centered care, and tailored feedback are essential to ensure affordable and sustainable long-term benefits [17-21]. It is difficult for conventional interventions to provide real-time monitoring; these interventions are unable to deliver tailored feedback and person-centered care [13-15]. Adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
