Patient Engagement Tool Research Articles

Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level DecisionMaking: A Systematic Review

Background: Patient, public, consumer, and community (P2C2) engagement in organization-, community-, and systemlevel healthcare decision-making is increasing globally, but its formal evaluation remains challenging. To define a taxonomy of possible P2C2 engagement metrics and compare existing evaluation tools against this taxonomy, we conducted a systematic review. Methods: A broad search strategy was developed for English language publications available from January 1962 through April 2015 in PubMed, Embase, Sociological s, PsycINFO, EconLit, and the gray literature. A publication was excluded if: (1) the setting was not healthcare delivery (ie, we excluded non-health sectors, such as urban planning; research settings; and public health settings not involving clinical care delivery); (2) the P2C2 engagement was episodic; or (3) the concept of evaluation or possible evaluation metrics were absent. To be included as an evaluation tool, publications had to contain an evaluative instrument that could be employed with minimal modification by a healthcare organization. Results: A total of 199 out of 3953 publications met exclusion and inclusion criteria. These were qualitatively analyzed using inductive content analysis to create a comprehensive taxonomy of 116 possible metrics for evaluating P2C2 engagement. 44 outcome metrics were grouped into three domains (internal, external, and aggregate outcomes) that included six subdomains: impact on engagement participants, impact on services provided by the healthcare organization, impact on the organization itself, influence on the broader public, influence on population health, and engagement cost-effectiveness. The 72 process metrics formed four domains (direct process metrics; surrogate process metrics; aggregate process metrics; and preconditions for engagement) that comprised sixteen subdomains. We identified 23 potential tools for evaluating P2C2 engagement. The identified tools were published between 1973-2015 and varied in their coverage of the taxonomy, methodology used (qualitative, quantitative, or mixed), and intended evaluators (organizational leaders, P2C2 participants, external evaluators, or some combination). Parts of the metric taxonomy were absent from all tools. Conclusions: By comprehensively mapping potential outcome and process metrics as well as existing P2C2 engagement tools, this review supports high-quality P2C2 engagement globally by informing the selection of existing evaluation tools and identifying gaps where new tools are needed. Systematic Review Registration: PROSPERO registration number CRD42015020317.

PDB67 - Characterization of Patient Activation, Clinical Assessments, and Patient Reported Outcomes in T2DM Patients

Characterize baseline clinical and patient-centric characteristics of type 2 diabetes mellitus (T2DM) patients who met criteria for an online patient engagement tool. This study analyzed pooled baseline data from T2DM patients identified for a prospective evaluation of an online patient engagement tool at two sites; Henry Ford Health System and Northwell Health. Patients were eligible if they were ≥18 years of age, diagnosed with T2DM, and had a baseline Patient Activation Measure (PAM) level 2 ‘Becoming Aware’ or 3 ‘Taking Action’. Clinical assessments and patient reported outcomes (PROs) were collected online and described using summary statistics. 662 participants consented and provided PAM data, with 15.9% and 48.8% at PAM levels 2 and 3, respectively. Patients at levels 1 (5.4%) and 4 (29.9%) were ineligible. 363 patients met all eligibility criteria for this analysis. Participants were primarily white (58.4%), females (59.0%) with a mean age of 57.4 (SD: 11.1) years and PAM level of 3 (76.6%). Mean time since diagnosis of T2DM was 10.4 (SD: 8.3) years. The most common comorbidities were hypertension and hypercholesterolemia/hyperlipidemia (20.7% each). 39.4% of patients had hemoglobin A1c ≥8.0% (mean: 8.0%, SD: 1.8) and mean body mass index (BMI) was 36.3 (SD: 7.4) kg/m2, with 80.2% being considered obese (BMI ≥30 kg/m2). Mean physical and mental component summary scores from the Short Form 12 were 40.9 (SD: 16.1) and 44.9 (SD: 17.1), respectively, indicating impaired functioning in each dimension. Mean Diabetes Distress Scale scores indicated moderate regimen-related distress (3.1, SD: 1.2) and emotional burden (2.7, SD: 1.2), suggesting clinical attention is necessary. Clinical measurements and PROs in our population of T2DM patients with PAM level 2/3 suggest a need for clinical and lifestyle intervention. Further research is needed to confirm appropriate clinical intervention and the potential effectiveness of targeted patient engagement tools.

Recommendations for patient engagement in patient-oriented emergency medicine research.

To make pragmatic recommendations on best practices for the engagement of patients in emergency medicine (EM) research. We created a panel of expert Canadian EM researchers, physicians, and a patient partner to develop our recommendations. We used mixed methods consisting of 1) a literature review; 2) a survey of Canadian EM researchers; 3) qualitative interviews with key informants; and 4) feedback during the 2017 Canadian Association of Emergency Physicians (CAEP) Academic Symposium. We synthesized our literature review into categories including identification and engagement, patients' roles, perceived benefits, harms, and barriers to patient engagement; 40/75 (53% response rate) invited researchers completed our survey. Among respondents, 58% had engaged patients in research, and 83% intended to engage patients in future research. However, 95% stated that they need further guidance to engage patients. Our qualitative interviews revealed barriers to patient engagement, including the need for training and patient partner recruitment.Our panel recommends 1) an overarching positive recommendation to support patient engagement in EM research; 2) seven policy-level recommendations for CAEP to support the creation of a national patient council, to develop, adopt and adapt training material, guidelines, and tools for patient engagement, and to support increased patient engagement in EM research; and 3) nine pragmatic recommendations about engaging patients in the preparatory, execution, and translational phases of EM research. Patient engagement can improve EM research by helping researchers select meaningful outcomes, increase social acceptability of studies, and design knowledge translation strategies that target patients' needs.

The electronic health record as a patient engagement tool: mirroring clinicians' screen to create a shared mental model.

ObjectiveElectronic health records (EHRs) in physician offices can both enhance and detract from the patient experience. Best practices have emerged focusing on screen sharing. We sought to determine if adding a second monitor, mirroring the EHR for patients, would be welcome and useful for patients and clinicians.Materials and MethodsThis mixed-method study was conducted in a general medicine clinic from March to June 2016. Clinicians and patients met in a specially equipped exam room with a patient-facing monitor. Visits were video-recorded to assess time spent viewing the EHR and followed by interviews, which were transcribed and analyzed using established qualitative methods.ResultsEight clinicians and 24 patients participated. Main themes included the second screen serving as a catalyst for patient engagement, augmenting the clinic visit in a meaningful way, improving transparency of the care process and documentation, and providing a substantially different experience for patients than a shared single screen. Concerns and suggestions for improvement were also reported. Quantitative results showed high patient engagement times with the EHR (25% of the visit length) compared to reports in previous studies. The median satisfaction score was 5 out of 5 for patients and 3.3 out of 5 for clinicians.Discussion and ConclusionProviding patient access to the EHRs with this design was linked with several benefits including improved patient engagement, education, transparency, comprehension, and trust. Future studies should explore how best to display information in such screens for patients and identify impact on care, safety, and quality.

Managing Patient-Generated Health Data Through Mobile Personal Health Records: Analysis of Usage Data

BackgroundPersonal health records (PHRs) and mHealth apps are considered essential tools for patient engagement. Mobile PHRs (mPHRs) can be a platform to integrate patient-generated health data (PGHD) and patients’ medical information. However, in previous studies, actual usage data and PGHD from mPHRs have not been able to adequately represent patient engagement.ObjectiveBy analyzing 5 years’ PGHD from an mPHR system developed by a tertiary hospital in South Korea, we aimed to evaluate how PGHD were managed and identify issues in PGHD management based on actual usage data. Additionally, we analyzed how to improve patient engagement with mPHRs by analyzing the actively used services and long-term usage patterns.MethodsWe gathered 5 years (December 2010 to December 2015) of log data from both hospital patients and general users of the app. We gathered data from users who entered PGHD on body weight, blood pressure (BP), blood glucose levels, 10-year cardiovascular disease (CVD) risk, metabolic syndrome risk, medication schedule, insulin, and allergy. We classified users according to whether they were patients or general users based on factors related to continuous use (≥28 days for weight, BP, and blood glucose, and ≥180 days for CVD and metabolic syndrome), and analyzed the patients’ characteristics. We compared PGHD entry counts and the proportion of continuous users for each PGHD by user type.ResultsThe total number of mPHR users was 18,265 (patients: n=16,729, 91.59%) with 3620 users having entered weight, followed by BP (n=1625), blood glucose (n=1374), CVD (n=764), metabolic syndrome (n=685), medication (n=252), insulin (n=72), and allergy (n=61). Of those 18,256 users, 3812 users had at least one PGHD measurement, of whom 175 used the PGHD functions continuously (patients: n=142, 81.14%); less than 1% of the users had used it for more than 4 years. Except for weight, BP, blood glucose, CVD, and metabolic syndrome, the number of PGHD records declined. General users’ continuous use of PGHD was significantly higher than that of patients in the blood glucose (P<.001) and BP (P=.03) functions. Continuous use of PGHD in health management (BP, blood glucose, and weight) was significantly greater among older users (P<.001) and men (P<.001). In health management (BP, weight, and blood glucose), overall chronic disease and continuous use of PGHD were not statistically related (P=.08), but diabetes (P<.001) and cerebrovascular diseases (P=.03) were significant.ConclusionsAlthough a small portion of users managed PGHD continuously, PGHD has the potential to be useful in monitoring patient health. To realize the potential, specific groups of continuous users must be identified, and the PGHD service must target them. Further evaluations for the clinical application of PGHD, feedback regarding user interfaces, and connections with wearable devices are needed.

Using Patient Portals to Increase Engagement in Patients with Cancer.

To review patient portals which serve as a tool for patient engagement by increasing access to electronic health care information and expanding ways to communicate with health care providers. Reviews of the literature and first-hand experience. Meaningful Use requirements propelled the design and development of patient portals in recent years. Patient engagement in oncology can improve quality of life and outcomes. Oncology nurses facilitate patient adoption of patient portals and support usage. Patient education helps manage communication expectations and understanding of online medical information.

Impact of a patient engagement tool on preventive service uptake

BackgroundWe studied whether integrating the US Department of Health and Human Services’ myHealthfinder tool, an interactive tool that recommends preventive services, into CVS Health's digital platforms could increase preventive service uptake at its retail clinic, MinuteClinic. MethodsWe used a quasi-experimental, pre-post, difference-in-differences design. In a web-based campaign, consumers in “exposed” states visiting CVS pharmacy and MinuteClinic websites could view and use the myHealthfinder tool. Consumers in “unexposed” states could not. A September 26, 2015 email campaign to registered MinuteClinic patients in exposed states described and included links to the myhealthfinder tool. We assessed consumer engagement with the myHealthfinder tool via number of website visits, myHealthfinder sessions, and myHealthfinder recommendations delivered. Using the difference-in-differences approach, we assessed mean changes in influenza, pneumococcal, and/or hepatitis A vaccine uptake, as well as other preventive services, per clinic, per month at MinuteClinics. ResultsIn exposed states, 39,225 (1.6%) website visits included myhealthfinder use, and 13,688 personalized recommendations for preventive services were delivered. The web-based campaign was associated with an increase in mean pneumococcal vaccines (1.19 vaccines per clinic per month; 95% CI, 0.11–2.28). The email campaign resulted in a 5% increase in influenza vaccines (74.83 vaccines per clinic per month; 1.65–148.02). The myhealthfinder campaigns did not significantly change preventive service uptake for any of the other services at MinuteClinics. ConclusionsOur findings highlight the potential role of personalized patient education tools and public-private partnerships to communicate about preventive care. Getting patients to act on these recommendations was more difficult.

Effectiveness of Internet-based interventions in managing chemotherapy-related symptoms in patients with cancer: a systematic literature review.

The aims of this review were to (1) examine the effectiveness of Internet-based interventions on cancer chemotherapy-related physical symptoms (severity and/or distress) and health-related quality of life (HRQOL) outcomes and (2) identify the design elements and processes for implementing these interventions in oncology practices. A systematic review was performed. The Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, CINAHL, and PsycINFO were searched for studies dating from January 2000 through to October 2016. Based on pre-determined selection criteria, data was extracted from eligible studies. Methodological quality of studies was assessed using an adapted version of the Cochrane Collaboration Back Review Group checklist. The literature search yielded 1766 studies of which only six RCTs fulfilled the eligibility criteria. Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included tailored information, education, self-management support, and communication with clinicians. Five studies measured symptom distress and four of them reported statistically significant differences between study groups. Of the three studies that measured HRQOL, two reported improvement (or no deterioration over time) for the intervention group. However, several methodological issues including high attrition rates, poor adherence to interventions, and use of non-validated measures affect confidence in the strength of evidence. Despite the evidence in support of using the Internet as a worthwhile tool for effective patient engagement and self-management of chemotherapy-related symptoms outside clinic visits, methodological limitations in the evidence base require further well-planned and quality research.

Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial.

As pregnant mothers increasingly engage in shared decision making regarding prenatal decisions, such as induction of labor, the patient's level of activation may influence pregnancy outcomes. One potential tool to increase patient activation in the clinical setting is mobile applications. However, research is limited in comparing mobile apps with other modalities of patient education and engagement tools. This study was designed to test the effectiveness of a mobile app as a replacement for a spiral notebook guide as a patient education and engagement tool in the prenatal clinical setting. This randomized controlled trial was conducted in the Women's Health Clinic and Family Health Clinic of three hospitals. Repeated-measures analysis of covariance was used to test intervention effects in the study sample of 205 patients. Mothers used a mobile app interface to more frequently record information about their pregnancy; however, across time, mothers using a mobile app reported a significant decrease in patient activation. The unexpected negative effects in the group of patients randomized to the mobile app prompt these authors to recommend that health systems pause before distributing their own version of mobile apps that may decrease patient activation. Mobile apps can be inherently empowering and engaging, but how a system encourages their use may ultimately determine their adoption and success.

Effect of a patient engagement tool on positive airway pressure adherence: analysis of a German healthcare provider database

Objective/backgroundThis study investigated the addition of a real-time feedback patient engagement tool on positive airway pressure (PAP) adherence when added to a proactive telemedicine strategy. Patients/methodsData from a German healthcare provider (ResMed Healthcare Germany) were retrospectively analyzed. Patients who first started PAP therapy between 1 September 2009 and 30 April 2014, and were managed using telemedicine (AirView™; proactive care) or telemedicine + patient engagement tool (AirView™ + myAir™; patient engagement) were eligible. Patient demographics, therapy start date, sleep-disordered breathing indices, device usage hours, and therapy termination rate were obtained and compared between the two groups. ResultsThe first 500 patients managed by telemedicine-guided care and a patient engagement tool were matched with 500 patients managed by telemedicine-guided care only. The proportion of nights with device usage ≥4 h was 77 ± 25% in the patient engagement group versus 63 ± 32% in the proactive care group (p < 0.001). Therapy termination occurred less often in the patient engagement group (p < 0.001). The apnea-hypopnea index was similar in the two groups, but leak was significantly lower in the patient engagement versus proactive care group (2.7 ± 4.0 vs 4.1 ± 5.3 L/min; p < 0.001). ConclusionsAddition of a patient engagement tool to telemonitoring-guided proactive care was associated with higher device usage and lower leak. This suggests that addition of an engagement tool may help improve PAP therapy adherence and reduce mask leak.

Barriers to MACRA among a cohort of community oncologists.

6613 Background: Value Based Care (VBC) initiatives specifically the Medicare and CHIP Reauthorization Act (MACRA), which includes Medicare Incentive Payment System (MIPS) and Alternative Payment Models (APMs), present challenges for community oncologists. Understanding barriers associated with implementation and compliance are essential for optimal execution. Methods: Using audience response technology, 52 community oncologists and 26 practice managers (PMs) of diverse geography, practice type and affiliations were surveyed in November 2016. Results: Of the attendees, 43% were participating in commercial payer VBC while 33% were participating in the Oncology Care Model (OCM), an APM. Reasons for non-participation: Cost of drugs 58%; data transparency 42%; human resources 33%; technology 29%. The majority of attendees stated limited awareness of MACRA reporting requirements. Once reporting was explained, the stated challenges to MACRA implementation included: inability to measure and track costs 76%; problematic quality improvement activities 56%; lack of patient engagement tools 52%; concern about interpreting CMS reports 52%; meeting meaningful use requirements 33%. In regard to preparation: 52% had survivorship or palliative care plans, 39% made infrastructure investments, and 23% were utilizing clinical pathways. Although 54% stated use of data analytics to maximize efficiency and profitability, half of these were not satisfied with ease of data extraction or output. One third opined that patient satisfaction was irrelevant to quality of care. In the end, nearly half stated reporting requirements could be managed; but 98% stated they were unwilling to assume downside financial risks for hospital and emergency room visits. Conclusions: Identifying and eliminating barriers to MACRA (MIPS/APMs) implementation may be critical to program success. The main reasons for OCM non-participation were costs of drugs and data transparency. There is significant dissatisfaction with available reporting and data extraction tools. Willingness to assume 2-sided risk for total cost of care was identified as the greatest risk to APM adoption.

Seeing is Engaging: Vlogs as a Tool for Patient Engagement.

Seeing is Engaging: Vlogs as a Tool for Patient Engagement.

Patient centered care: A path to better health outcomes through engagement and activation.

Patient Activation and Health confidence are constructs to assess patient engagement and are utilized to encourage patient engagement. A health care provider may increase patient engagement further by utilizing behavior change theories and models such as the Trans-Theoretical Model of Change (TTM), Self-Determination Theory (SDT) and Motivational Interviewing (MI) to realize effective and lasting health behavior change by placing accountability increasingly on the patient/caregiver to choose to make changes in their health behavior on their terms. Reducing or eliminating harmful behaviors such as smoking and/or beginning or increasing beneficial health behaviors such as diet modification or performance of an exercise program, patients realize improved outcomes and better health. The purpose of this article is to define health confidence as a measurement tool for patient engagement, use the TTM as a measure of the patient's readiness to change, use TTM, SDT and MI as interventional approaches to effect patient change of behavior encouraged by physical therapists and incorporate the ICF as a means of identifying barriers and facilitators and incorporate the bio-psychosocial model for patient-centered care to improve health behavior, health and patient outcomes. Patient-centered care requires involvement of the patient and/or their caregiver at the center of the plan. Use of the International Classification of Functioning, Disability and Health (ICF) to identify facilitators and barriers unique to the patient/caregiver offers another opportunity to successfully engage the patient by incorporating the patient's bio-psychosocial support system into care delivery and for sustainability. The ICF is a taxonomy and classification system that prompts clinicians to identify environmental factors (facilitators and barriers) that will influence the patient's ability to perform during therapy session and to sustain the interventions and employ suggestions outside of formal therapy sessions. Using the facilitators to encourage sustainable change and removing barriers, patients are more likely to realize positive health behavior change and in turn demonstrate improved outcomes and health as a result of physical therapy intervention.

Correlation of digital health use and chronic pain coping strategies.

Digital health is an increasingly popular tool for patient engagement, having shown great success in arenas such as medication adherence, management of chronic conditions, and patient safety. Given the growth of chronic pain diagnoses, it is imperative to find new technologies to improve care for this particular population. Little research has catalogued the use of digital health in the chronic pain patient population. This manuscript's objective was to describe current patterns of digital health usage among chronic pain patients and how digital health use correlates with health care utilization and health outcomes. A cross-sectional survey was administered to patients with a self-identified chronic pain diagnosis participating in 'Patients Like Me'® (PLM), an organization that directly collects data from patients experiencing chronic health conditions, with emphasis on patient-centered outcomes and experiences interacting with the health care system. Validated measures of healthcare utilization, chronic pain management, and digital health use were adapted for the survey. Digital health was defined as the use of online sites, social media, and mobile phone applications before, during, or after healthcare utilization. Descriptive statistics, chi square tests, logistic regression, and linear regression were used as appropriate for analysis. Among 565 respondents (mean age 51.3, 87.2% female, 45.7% publicly insured), most participants (89.5%) reported some digital health use. Females and users below the age of 50 were more likely to use multiple forms of digital health. Healthcare utilization, education level, and race/ethnicity did not correlate with digital health use. Patients using more types of digital health reported significantly higher levels of pain coping skills in the realms of social support, relaxation, and exercise. Digital health use is common among a wide range of patients with chronic pain diagnoses. The use of multiple forms of digital health is associated with improved chronic pain coping mechanisms. Future work should explore the directional relationship between digital health tools and chronic pain coping skills, as well as which components of digital health have the most effect on chronic pain management and other patient-centered outcomes.

Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics

ObjectivesPublic and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be...

The quest for engaging AmI: Patient engagement and experience design tools to promote effective assisted living

Recent research highlights that patient engagement, conceived as a patient’s behavioral, cognitive and emotional commitment to his own care management, is a key issue while implementing new technologies in the healthcare process. Indeed, eHealth interventions may systematically fail when the patient’s subjective experience has not been taken into consideration since the first steps of the technology design. In the present contribution, we argue that such an issue is more and more crucial as regarded to the field of Ambient Intelligence (AmI). Specifically, the exact concept of technologies embedded in the patients’ surrounding environment implies a strong impact on their everyday life, which can be perceived as a limitation to autonomy and privacy, and therefore refused or even openly opposed by the final users. The present contribution tackles this issue directly, highlighting: (1) a theoretical framework to include patient engagement in the design of AmI technologies; (2) assessment measures for patient engagement while developing and testing the effectiveness of AmI prototypes for healthcare. Finally (3) this contribution provides an overview of the main issues emerging while implementing AmI technologies and suggests specific design solutions to address them.

Lifestyle Medicine in an Academic/Hospital Context.

The effective integration of lifestyle medicine into allopathic practices is an evolving necessity driven by limited resources and escalating costs. Efforts in the Florida Hospital system graduate medical education (GME) department to meet this challenge may be instructive to others. Efforts include the hiring of an experienced dietician with a focus on a whole food plant based diet and a patient engagement tool to identify areas where patients are ready to make change. Billing is done using existing finance structure with the goal of decreasing the overall cost of providing care within a Clinically Integrated Network (CIN) context. Additionally, one GME clinician's experience in clinical lifestyle based intervention identifies and comments on several practical clinical factors for bringing effective behavior change to individual patients: patient readiness, a knowledgeable health care provider, adequate time, as well as the effectiveness of the intervention.

A5090 - Effect of a Mobile Health Patient Engagement Tool for Postoperative care of Bariatric Surgery Patients

A5090 - Effect of a Mobile Health Patient Engagement Tool for Postoperative care of Bariatric Surgery Patients

Feasibility of the "Bring Your Own Device" Model in Clinical Research: Results from a Randomized Controlled Pilot Study of a Mobile Patient Engagement Tool.

BackgroundRising rates of smartphone ownership highlight opportunities for improved mobile application usage in clinical trials. While current methods call for device provisioning, the "bring your own device” (BYOD) model permits participants to use personal phones allowing for improved patient engagement and lowered operational costs. However, more evidence is needed to demonstrate the BYOD model’s feasibility in research settings.ObjectiveTo assess if CentrosHealth, a mobile application designed to support trial compliance, produces different outcomes in medication adherence and application engagement when distributed through study-provisioned devices compared to the BYOD model.Methods87 participants were randomly selected to use the mobile application or no intervention for a 28-day pilot study at a 2:1 randomization ratio (2 intervention: 1 control) and asked to consume a twice-daily probiotic supplement. The application users were further randomized into two groups: receiving the application on a personal "BYOD” or study-provided smartphone. In-depth interviews were performed in a randomly-selected subset of the intervention group (five BYOD and five study-provided smartphone users).ResultsThe BYOD subgroup showed significantly greater engagement than study-provided phone users, as shown by higher application use frequency and duration over the study period. The BYOD subgroup also demonstrated a significant effect of engagement on medication adherence for number of application sessions (unstandardized regression coefficient beta=0.0006, p=0.02) and time spent therein (beta=0.00001, p=0.03). Study-provided phone users showed higher initial adherence rates, but greater decline (5.7%) than BYOD users (0.9%) over the study period. In-depth interviews revealed that participants preferred the BYOD model over using study-provided devices. ConclusionsResults indicate that the BYOD model is feasible in health research settings and improves participant experience, calling for further BYOD model validity assessment. Although group differences in medication adherence decline were insignificant, the greater trend of decline in provisioned device users warrants further investigation to determine if trends reach significance over time. Significantly higher application engagement rates and effect of engagement on medication adherence in the BYOD subgroup similarly imply that greater application engagement may correlate to better medication adherence over time.

Mobile application as a prenatal education and engagement tool: A randomized controlled pilot

ObjectivesResearch has shown that mobile applications provide a powerful alternative to traditional paper diaries; however, little data exists in comparing apps to the traditional mode of paper as a patient education and engagement tool in the clinical setting. This study was designed to compare the effectiveness of a mobile app versus a spiral-notebook guide throughout prenatal care. MethodsThis randomized (n=173) controlled pilot was conducted at an East Coast community hospital. Chi-square and repeated-measures analysis of variance was used to test intervention effects in the sample of 127 pregnant mothers who completed their prenatal care in the healthcare system. ResultsPatients who were distributed the mobile application used the tool to record information about pregnancy more frequently (p=.04) and developed greater patient activation (p=.02) than patients who were distributed notebooks. No difference was detected on interpersonal clinical communication. ConclusionA mobile application successfully activated a patient population in which self-management is a critical factor. Practice implicationsThis study shows that mobile apps can prompt greater use and result in more activated patients. Findings may be translated to other patient populations who receive recurring care for chronic disease.