Exploring the user perceptions in the development and use of an MHealth app for Parkinson's Disease

Khardali, Amani 2021. Exploring the user perceptions in the development and use of an MHealth app for Parkinson's Disease. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Parkinson’s disease (PD) is a chronic, progressive disease of the nervous system caused by the degeneration of the dopaminergic neurons in the mid brain, PD specific patient-reported outcome measures (PROMs) allow the comprehensive evaluation of the PD symptoms and its treatment from patients’ perspective (e.g., UPDRs, NMSQuest, and PDQ39). While traditionally, paper versions of PROMs have been used to assess patients when they attend their regular clinic, this has not been regularly captured in a readily accessible format to show changes in symptoms over time. Technological advances offer alternative, simple ways to collect PROMs in a hospital setting in a timely manner. Electronic collection of PROMs (e-PROMS) has been variously introduced to improve the collection of patient’s data within clinics. However, there has been no published evaluation on the usefulness of such digital technology in the routine collection of patient data. In 2016, a prototype iPad-based app was developed and piloted by a group of specialists in PD at Cardiff University (neurologists and pharmacists) as an assessment tool to gather the information of people with Parkinson’s (PwPs) in a clinic setting. Despite positive feedback about using this iPad app, the need for further study was demonstrated to investigate the integration of this iPad app into regular clinical practice and evaluate how clinicians could utilize this information in their consultations. The aims of this thesis are therefore to: (1) understand the needs and preferences of PwPs, their carers, and healthcare professionals regarding the use of a smart-device-app to enhance data collection in clinical-setting, and (2) understand the needs and preferences of PwPs regarding medication management and the potential for a smart device app to assist. Multistage, mixed-methods studies were used involving PwPs, their carers, and healthcare professionals which identified the need for further patient-related information to be used during consultations in order to improve patients’ understanding of their condition, enhance communication during consultations, and support patients’ management. Stage 1: Focus groups were conducted with participants recruited from Parkinson's UK support groups by using purposive non-random sampling. Each session was audio-recorded, transcribed verbatim, coded, and analysed using thematic analysis. iv Stage 2: A mixed-methods study in two phases with PD healthcare professionals were conducted. In phase I, PD nurse specialists (PDNS) from the UK completed an 18-point survey and the data were analysed using descriptive statistics. The data was used to design and focus phase II in which semi-structured interviews were undertaken. Interviews were audio-recorded, transcribed verbatim, and analysed using the Consolidated Framework for Implementation Research. Stage 3: A mixed-methods study in two phases with PwP was conducted. In phase I, PwP completed a questionnaire including closed and open-ended questions exploring views to using electronic self-reporting was distributed to PwP across the UK. The data was used to design and focus phase II in which semi-structured interviews were undertaken. Interviews were audio-recorded, transcribed verbatim, and analysed using the thematic analysis. Findings from these studies reported that a mHealth app could be a useful intervention with the primary aim of focusing a consultation on the patients’ needs and enable improved medication management. A range of potential advantages were reported and some of concerns to mHealth app use were highlighted. The participants were supportive of the development and use of a mHealth app and a series of recommendations were produced that could aid the design and integration of such an intervention in clinical setting. Overall, the use of an mHealth app appears to be a useful and acceptable to facilitate data collection in clinical-setting and support patients with management of their medications.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Pharmacy
Subjects:	Q Science > Q Science (General)
Date of First Compliant Deposit:	9 August 2021
Last Modified:	02 Aug 2022 01:12
URI:	https://orca.cardiff.ac.uk/id/eprint/143238

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