Engagement and Outcomes with Mobile Health Technology among Patients Hospitalized with Acute Venous Thromboembolism

Main Article Content

Horatio Holzer
Eric Goodlev
Julie Pearson
Sally Engelman
Dana Sperber
Andrew Dunn
Beth Raucher

Keywords

Venous thromboembolism, mobile health, transition of care, patient care management, mobile applications

Abstract

Mobile health (mHealth) technology can improve engagement and self-management, though few studies have assessed the factors associated with engagement of mHealth among hospitalized patients. We implemented a multi-faceted transitions of care (TOC) intervention consisting of a novel patient-facing smartphone application (app), text message medication reminders, and access to a patient navigator for patients hospitalized with venous thromboembolism. Overall, application uptake (36%) and engagement were low. Patients who downloaded the app were young (50.5 vs 66.1 years, P < 0.01) and had a lower burden of disease (Charlson score 3.97 vs 5.65, P = 0.048). Similarly, patients who engaged with the app were young (48.5 vs 57.6 years, P = 0.049) and had a lower burden of disease (Charlson score 3.12 vs 7.14, P = 0.033). Our findings suggest that design and implementation of mHealth applications will be challenging for hospitalized populations characterized by old age, numerous comorbidities, and high acuity.


Résumé
La technologie de santé mobile peut favoriser la participation et l’autogestion des patients, mais peu d’études évaluent les facteurs associés au recours à la santé mobile parmi les patients hospitalisés. Nous avons réalisé une intervention à multiples facettes de transition des soins qui comprend une application pour téléphone intelligent novatrice à l’intention des patients, des rappels par texto de prise de médicaments et un accès à une infirmière-pivot pour les patients hospitalisés en raison d’une thromboembolie veineuse. Dans l’ensemble, l’adhésion (36 %) et la participation à l’ap-plication sont faibles. Les patients qui ont téléchargé l’application sont plus jeunes (50,5 ans par rapport à 66,1 ans; p < 0,01) et leur fardeau de la maladie est moins lourd (score de Charlson de 3,97 par rapport à 5,65; p = 0,048). De même, les patients qui utilisent l’application sont plus jeunes (48,5 ans par rapport à 57,6 ans; p = 0,049) et leur fardeau de la maladie est moins lourd (score de Charlson de 3,12 par rapport à 7,14; p = 0,033). Nos résultats laissent supposer qu’il sera difficile de concevoir et de mettre en œuvre des applications de santé mobile pour les populations hospitalisées caractérisées par un âge avancé, de nombreuses affections comorbides et une acuité élevée.

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