Abstract
BackgroundPostdischarge interventions are limited in patients with acute coronary syndrome (ACS) due to few scheduled visits to outpatient clinics and travel from remote areas. Smartphones have become a viable lifestyle technology to deliver educational and health interventions following discharge from hospital.ObjectiveThe purpose of this study was to identify the requirements for the delivery of a mobile health intervention for the postdischarge management of patients with ACS via a multidisciplinary focus group.MethodsWe conducted a focus group among health care professionals (n=10) from a large metropolitan hospital in May 2017. These participants from a multidisciplinary team contributed to a 1-hour discussion by responding to 8 questions relating to the applicability of smartphone-based educational and health interventions. Descriptive statistics of the focus group data were analyzed using SPSS. The qualitative data were analyzed according to relevant themes extracted from the focus group transcription, using a qualitative description software program (NVivo 11) and an ontology-based concept mapping approach.ResultsThe mean age of the participants was 47 (SD 8) years: 3 cardiologists; 2 nurse practitioners; 2 clinical nurses; 2 research scientists; and 1 physiotherapist. Of these participants, 70% (7/10) had experience using electronic health intervention during their professional practice. A total of 7 major themes and their subthemes emerged from the qualitative analysis. Health care providers indicated that comprehensive education on diet, particularly providing daily meal plans, is critical for patients with ACS. In terms of ACS symptoms, a strong recommendation was to focus on educating patients instead of daily monitoring of chest pain and shortness of breathing due to subjectivity and insufficient information for clinicians. Participants pointed that monitoring health measures such as blood pressure and body weight may result in increased awareness of patient physical health, yet may not be sufficient to support patients with ACS via the smartphone-based intervention. Therefore, monitoring pain and emotional status along with other health measures was recommended. Real-time support via FaceTime or video conferencing was indicated as motivational and supportive for patient engagement and self-monitoring. The general demographics of patients with ACS being older, having a low educational level, and a lack of computer skills were identified as potential barriers for engagement with the smartphone-based intervention.ConclusionsA smartphone-based program that incorporates the identified educational materials and health interventions would motivate patients with ACS to engage in the multidisciplinary intervention and improve their health outcomes following discharge from hospital.
Highlights
Information and communication technologies are changing the form and quality of the delivery of health-related services, commonly known as electronic health
A smartphone-based program that incorporates the identified educational materials and health interventions would motivate patients with acute coronary syndrome (ACS) to engage in the multidisciplinary intervention and improve their health outcomes following discharge from hospital
MHealth applications play a significant role in shaping the future of the health care delivery system and have captured the attention of health care stakeholders. Mobile health (mHealth) interventions range from sending simple short message service (SMS) text message reminders to attend health care appointments and downloading health-related applications for use on mobile phones, to more complex technology that records real-time patient-generated data from wearable and nonwearable sensors
Summary
Information and communication technologies are changing the form and quality of the delivery of health-related services, commonly known as electronic health (eHealth). Cheap, and convenient devices [4,5], smartphones make good candidates for the delivery of behavioral interventions [4,5] They offer the opportunity to bring behavioral interventions into important real-life contexts, which facilitate decision making and self-management of patients with chronic conditions [5,6]. In addition to facilitating the sharing of behavioral and clinical data with health care professionals or peers, smartphones use internal sensors to infer contexts such as user location, movement, and emotion [7,8]. This facilitates continuous and automated tracking of health-related behaviors to provide timely and tailored interventions for patients. Smartphones have become a viable lifestyle technology to deliver educational and health interventions following discharge from hospital
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