The development and feasibility of a personal health-optimization system for people with bipolar disorder

BMC Medical Informatics and Decision Making

Research Article

Simone Kienlin¹  Kari Nytrøen²  Magne Nylenna³  Øystein Eiring⁴  Soudabeh Khodambashi⁵ 

[1] Department of Medicine and Healthcare, South-Eastern Norway Regional Health Authority, Postbox 404, N-2303, Hamar, Norway;Department of Medicine, University Hospital of North Norway, Postbox 6050, N-9037, Langnes, Tromsø, Norway;Faculty of Medicine, University of Oslo, Postbox 1072, N-0316, Blindern, Oslo, Norway;Department of Medicine and Healthcare, South-Eastern Norway Regional Health Authority, Postbox 404, N-2303, Hamar, Norway;Oslo University Hospital, Postbox 4950, N-0424, Nydalen, Oslo, Norway;Faculty of Medicine, University of Oslo, Postbox 1072, N-0316, Blindern, Oslo, Norway;Norwegian Institute of Public Health, Postbox 4404, N-0403, Nydalen, Oslo, Norway;Faculty of Medicine, University of Oslo, Postbox 1072, N-0316, Blindern, Oslo, Norway;Norwegian Institute of Public Health, Postbox 4404, N-0403, Nydalen, Oslo, Norway;Department of Medicine and Healthcare, South-Eastern Norway Regional Health Authority, Postbox 404, N-2303, Hamar, Norway;Norwegian University of Science and Technology, N-7491, Trondheim, Norway;

关键词: Shared decision-making;    Patient decision aid;    Clinical decision support system;    Patient participation tool;    Compliance;    Adherence;    E-health;    M-health;    Bipolar disorder;    Clinical practice guideline;   

DOI  :  10.1186/s12911-017-0481-x

 received in 2016-09-30, accepted in 2017-06-02,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPeople with bipolar disorder often experience ill health and have considerably reduced life expectancies. Suboptimal treatment is common and includes a lack of effective medicines, overtreatment, and non-adherence to medical interventions and lifestyle measures. E- and m-health applications support patients in optimizing their treatment but often exhibit conceptual and technical shortcomings. The objective of this work was to develop and test the usability of a system targeting suboptimal treatment and compare the service to other genres and strategies.MethodsBased on the frameworks of shared decision-making, multi-criteria decision analysis, and single-subject research design, we interviewed potential users, reviewed research and current approaches, and created a first version using a rapid prototyping framework. We then iteratively improved and expanded the service based on formative usability testing with patients, healthcare providers, and laypeople from Norway, the UK, and Ukraine. The evidence-based health-optimization system was developed using systematic methods. The System Usability Scale and a questionnaire were administered in formative and summative tests. A comparison of the system to current standards for clinical practice guidelines and patient decision aids was performed.ResultsSeventy-eight potential users identified 82 issues. Driven by user feedback, the limited first version was developed into a more comprehensive system. The current version encompasses 21 integrated core features, supporting 6 health-optimization strategies. One crucial feature enables patients and clinicians to explore the likely value of treatments based on mathematical integration of self-reported and research data and the patient’s preferences. The mean ± SD (median) system usability score of the patient-oriented subsystem was 71 ± 18 (73). The mean ± SD (median) system usability score in the summative usability testing was 78 ± 18 (75), well above the norm score of 68. Feedback from the questionnaire was generally positive. Eighteen out of 23 components in the system are not required in international standards for patient decision aids and clinical practice guidelines.ConclusionWe have developed the first evidence-based health-optimization system enabling patients, clinicians, and caregivers to collaborate in optimizing the patient’s health on a shared platform. User tests indicate that the feasibility of the system is acceptable.

【 授权许可】

CC BY   
© The Author(s). 2017