Feasibility and Usability of a Mobile App-Based Interactive Care Plan for Migraine in a Community Neurology Practice: Development and Pilot Implementation Study

被引:1
作者
Young, Nathan P. [1 ,2 ,9 ]
Ridgeway, Jennifer L. [3 ]
Haddad, Tufia C. [4 ,5 ]
Harper, Sarah B. [5 ]
Philpot, Lindsey M. [6 ,7 ]
Christopherson, Laura A. [5 ]
McColley, Samantha M. [5 ,8 ]
Phillips, Sarah A. [5 ]
Brown, Julie K. [5 ]
Zimmerman, Kelly S. [2 ]
Ebbert, Jon [6 ]
机构
[1] Mayo Clin, Dept Neurol, Rochester, MN USA
[2] Mayo Clin, Integrated Commun Specialty Practice, Rochester, MN USA
[3] Mayo Clin, Div Hlth Care Delivery Res, Rochester, MN USA
[4] Mayo Clin, Dept Oncol, Rochester, MN USA
[5] Mayo Clin, Ctr Digital Hlth, Rochester, MN USA
[6] Mayo Clin, Commun Internal Med, Rochester, MN USA
[7] Mayo Clin, Qualitat Hlth Sci, Rochester, MN USA
[8] Mayo Clin, Clin Informat & Practice Support, Rochester, MN USA
[9] Mayo Clin, Integrated Commun Specialty Practice, 200 First St SW, Rochester, MN 55902 USA
关键词
migraine; mobile app; smartphone; care model; feasibility; usability; digital health; remote monitoring; care plan; pilot; mobile; health; mHealth; mobile phone; patient-reported outcomes; SEVERE HEADACHE; POPULATION; PREVALENCE; DIAGNOSIS; BURDEN;
D O I
10.2196/48372
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Migraine is a common and major cause of disability, poor quality of life, and high health care use. Access to evidence-based migraine care is limited and projected to worsen. Novel mobile health app-based tools may effectively deliver migraine patient education to support self-management, facilitate remote monitoring and treatment, and improve access to care. The risk that such an intervention may increase the care team workload is a potential implementation barrier. Objective: This study aims to describe a novel electronic health record-integrated mobile app-based Migraine Interactive Care Plan (MICP) and evaluate its feasibility, usability, and impact on care teams in a community neurology practice. Methods: Consecutive enrollees between September 1, 2020, and February 16, 2022, were assessed in a single-arm observational study of usability, defined by 74.3% (127/171) completing >= 1 assigned task. Task response rates, rate and type of care team escalations, and patient-reported outcomes were summarized. Patients were prospectively recruited and randomly assigned to routine care with or without the MICP from September 1, 2020, to September 1, 2021. Feasibility was defined by equal to or fewer downstream face-to-face visits, telephone contacts, and electronic messages in the MICP cohort. The Wilcoxon rank-sum test was used to compare continuous variables, and the chi-square test was used for categorical variables for those with at least 3 months of follow-up. Results: A total of 171 patients were enrolled, and of these, 127 (74.3%) patients completed >= 1 MICP-assigned task. Mean escalations per patient per month was 0.9 (SD 0.37; range 0-1.7). Patient-confirmed understanding of the educational materials ranged from 26.6% (45/169) to 56.2% (95/169). Initial mean headache days per week was 4.54 (SD 2.06) days and declined to 2.86 (SD 1.87) days at week 26. The percentage of patients reporting favorable satisfaction increased from a baseline of 35% (20/57) to 83% (15/18; response rate of 42/136, 30.9% to 28/68, 41%) over the first 6 months. A total of 121 patients with MICP were compared with 62 patients in the control group. No differences were observed in the rate of telephone contacts or electronic messages. Fewer face-to-face visits were observed in the MICP cohort (13/121, 10.7%) compared with controls (26/62, 42%; P<.001). Conclusions: We describe the successful implementation of an electronic health record-integrated mobile app-based care plan for migraine in a community neurology practice. We observed fewer downstream face-to-face visits without increasing telephone calls, medication refills, or electronic messages. Our findings suggest that the MICP has the potential to improve patient access without increasing care team workload and the need for patient input from diverse populations to improve and sustain patient engagement. Additional studies are needed to assess its impact in primary care.
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页数:16
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