Photonics Technology and Bioengineering Department, Life Supporting Technologies Group, Universidad Politécnica de Madrid, Madrid, Spain.
ITACA, Universitat Politècnica de València, Valencia, Spain.
J Med Syst. 2019 Nov 18;44(1):2. doi: 10.1007/s10916-019-1472-5.
Heterogeneity of people with diabetes makes maintaining blood glucose control and achieving therapy adherence a challenge. It is fundamental that patients get actively involved in the management of the disease in their living environments. The objective of this paper is to evaluate the use and acceptance of a self-management system for diabetes developed with User Centered Design Principles in community settings. Persons with diabetes and health professionals were involved the design, development and evaluation of the self-management system; which comprised three iterative cycles: scenario definition, user archetype definition and system development. A comprehensive system was developed integrating modules for the management of blood glucose levels, medication, food intake habits, physical activity, diabetes education and messaging. The system was adapted for two types of principal users (personas): Type 1 Diabetes user and Type 2 Diabetes user. The system was evaluated by assessing the use, the compliance, the attractiveness and perceived usefulness in a multicenter randomized pilot study involving 20 patients and 24 treating professionals for a period of four weeks. Usage and compliance of the co-designed system was compared during the first and the last two weeks of the study, showing a significantly improved behaviour of patients towards the system for each of the modules. This resulted in a successful adoption by both type of personas. Only the medication module showed a significantly different use and compliance (p= 0.01) which can be explained by the different therapeutic course of the two types of diabetes. The involvement of patients to make their own decisions and choices form design stages was key for the adoption of a self-management system for diabetes.
糖尿病患者的个体差异使得控制血糖和实现治疗依从性成为挑战。让患者在日常生活环境中积极参与疾病管理至关重要。本文旨在评估在社区环境中使用和接受基于用户为中心的设计原则开发的糖尿病自我管理系统。糖尿病患者和医疗保健专业人员参与了自我管理系统的设计、开发和评估；该系统包括三个迭代周期：情景定义、用户原型定义和系统开发。一个综合系统被开发出来，集成了血糖管理、药物、饮食摄入习惯、身体活动、糖尿病教育和信息传递模块。该系统适用于两种主要用户（人物角色）：1 型糖尿病用户和 2 型糖尿病用户。该系统通过评估在涉及 20 名患者和 24 名治疗专业人员的为期四周的多中心随机试点研究中的使用、依从性、吸引力和感知有用性来进行评估。在研究的第一周和最后两周比较了共同设计系统的使用和依从性，结果表明患者对每个模块的系统行为都有显著改善。这导致两种人物角色都成功采用了该系统。只有药物模块显示出使用和依从性的显著差异（p=0.01），这可以解释为两种类型的糖尿病的治疗过程不同。从设计阶段开始，让患者参与做出自己的决策和选择是采用糖尿病自我管理系统的关键。
