Swendeman Dallas, Farmer Shu, Mindry Deborah, Lee Sung-Jae, Medich Melissa
Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at UCLA, and Department of Epidemiology, UCLA Fielding School of Public Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA.
Center for Culture and Health, Department of Psychiatry and Biobehavioral Science, NPI-Semel Institute for Neuroscience, 760 Westwood Plaza, Box 62, Los Angeles, CA 90024-1759, USA.
J HIV AIDS. 2016 Oct;2(4). doi: 10.16966/2380-5536.127. Epub 2016 Jun 21.
In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination. Newly diagnosed and patients with co-morbidities were highest priorities for mobile application support. Facilitators included universal mobile phone ownership and use of smartphones or text messaging. Patient-level barriers included concerns about low motivation and financial instability for consistent use by some patients. Organizational barriers, cited primarily by physicians, included concerns about privacy protections, easy dashboard access, non-integrated electronic records, and competing burdens in limited appointment times. Psychosocial services providers were most supportive of the proposed mobile tools.
对来自洛杉矶县一家大型艾滋病诊所五个艾滋病医疗护理协调团队的医疗服务提供者(HCPs)进行了深入的定性访谈,这些团队包括医生、护士和心理社会服务提供者。医疗服务提供者报告了患者通过手机进行自我监测和通知以及为医疗服务提供者提供的基于网络的仪表板的潜在效用、可接受性和障碍。潜在益处包括:1)增强患者参与度、积极性、依从性和自我管理能力;2)改善医患关系和医疗服务提供者的护理协调。新诊断患者和患有合并症的患者是移动应用支持的最高优先事项。促进因素包括普遍拥有手机以及使用智能手机或短信。患者层面的障碍包括一些患者担心积极性不高和经济不稳定,难以持续使用。主要由医生提出的组织层面障碍包括对隐私保护、轻松访问仪表板、电子记录未整合以及在有限预约时间内负担过重的担忧。心理社会服务提供者最支持提议的移动工具。