Feasibility of ADappt: towards personalized communication and prediction in early Alzheimer’s disease in memory clinics

Abstract

AbstractBackgroundADappt is a Web‐based toolkit (www.ADappt.health) to support personalized communication and prediction in memory clinics. In the context of an iterative development process with professionals, patients, and care partners, we assessed feasibility, satisfaction, and usability of ADappt in the clinical workflow.MethodWe conducted a feasibility pilot in four Dutch memory clinics. Three neurologists, one geriatrician, two specialized nurses and two medical doctors (12±7y clinical experience) participated and recruited 21 patients (69±8yrs, 19%F) and 21 care partners (60±15yrs, 81%F). For professionals, ADappt‐modules comprised a 1) topic list, 2) shared decision‐making conversation guide, 3) overview of diagnostic tests, and 4) risk calculation tool. Prior to their visit, patients and care partners were informed about ADappt‐patient tools: 1) educational video‐animations, and 2) question prompt list. All participants completed questionnaires on feasibility, satisfaction, and usability after the first (n = 17) and/or the disclosure (n = 7) consultation. Professionals were interviewed afterward.ResultProfessionals reported good usability (68±14, range 50‐83, System Usability Scale, 0‐100) and high satisfaction (71±10, range 50‐85, scale 0‐100). They most often used the overview of diagnostic tests (67%) and reported this module as most helpful (3.8±0.4, range 3‐4, scale 1‐5). Patients and care partners were highly satisfied with the clinician‐patient consultations in general (81±14, range 50‐100, Patient Satisfaction Questionnaire, scale 0‐100). Of those who reported to know and have used the patient tools (54%), 97% would recommend them, whereby most used the question prompt list (84%) and a smaller proportion the video‐animations (64%). Recommendations from the interviews to improve feasibility include: 1) the development of more concrete instructions for professionals on how to use ADappt, and 2) a better alignment of patient tools with the patient journey and general information provided by that particular memory clinic.ConclusionStakeholders reported good usability and high satisfaction regarding ADappt. Points of attention to foster feasibility in the clinical workflow are: 1) improved training for professionals and 2) improving the accessibility of patient tools. We take these matters into account while preparing for the next step: a prospective validation study in the memory clinic setting to study the influence of ADappt on patient satisfaction.