Department of General Practice, Medical Clinic III, Medical Faculty, Technische Universität Dresden, Germany.
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany.
J Telemed Telecare. 2022 Jan;28(1):37-51. doi: 10.1177/1357633X20901400. Epub 2020 Feb 2.
Currently, there are only a small number of comprehensive study results on adherence and acceptance of telemonitoring applications (TMAs) regarding multi-morbid older patients. The ATMoSPHAERE study aimed to develop an information and communication platform for an intersectoral networking of, for example, general practitioners, therapists, social services and the multi-morbid older patient.
The study presented was designed as a longitudinal bicentric intervention study which focused on multi-morbid patients aged ≥65 years using home-based telemedical measurement and input devices. The development and testing of this TMA aimed to optimise patients' health care through intersectoral networking of all treating actors. Quantitative methods of data collection and analysis were used.
Patients who completed the study were significantly younger than drop-outs and non-participants. The mental health of study patients significantly improved between the beginning and end of TMA use. The main reason for non-participation in the study was the high time expenditure when participating in the study. No perceived (information) benefits for health and insufficient content variety were the main reasons for drop-out. Appropriateness and handling of TMAs must be aligned with the needs of the heterogeneous user group of multi-morbid patients in order to increase acceptance and the added value of TMAs. Telemonitoring hardware should be oriented on functional capabilities of the older target group. Telemonitoring software content requires an individual, disease-specific approach for patients. The TMA should be unobtrusively integrated into usual daily life and be used to an appropriate extent according to the underlying disease in order to avoid stressing patients. With regard to adherence concerning TMAs, it is crucial to provide a contact person who is always available for patients having problems handling TMAs. Health concerns and questions can thus be addressed early, providing a feeling of safety in the care process.
User acceptance of TMAs is an essential indicator and driver for use and for future implementation efforts in health care. In order to achieve maximum user centricity in development processes, patients must be involved as experts, co-designers and future users, considering their needs and perceptions.
目前，关于多病老年患者对远程监护应用（TMA）的依从性和接受度，仅有少量全面的研究结果。ATMoSPHAERE 研究旨在开发一个信息和通信平台，用于例如全科医生、治疗师、社会服务机构和多病老年患者之间的跨部门网络。
本研究设计为一项纵向双中心干预研究，重点关注使用家庭远程医疗测量和输入设备的≥65 岁多病患者。该 TMA 的开发和测试旨在通过所有治疗参与者的跨部门网络优化患者的医疗保健。使用了定量数据收集和分析方法。
完成研究的患者明显比中途退出和未参与的患者年轻。在 TMA 使用开始和结束之间，患者的心理健康显著改善。不参与研究的主要原因是参与研究的时间消耗高。不参与研究的主要原因是不认为（信息）对健康有益以及内容多样性不足。为了提高 TMA 的接受度和附加值，TMA 的适当性和处理方式必须符合多病患者这一异质用户群体的需求。远程监护硬件应根据老年目标群体的功能能力进行定位。远程监护软件内容需要针对患者的特定疾病制定个性化的方法。TMA 应不引人注目地融入日常生活中，并根据潜在疾病进行适当使用，以避免给患者带来压力。关于 TMA 的依从性，为处理 TMA 有困难的患者提供一位随时可用的联系人至关重要。这样可以及早解决健康问题和疑问，让患者在护理过程中感到安全。
TMA 的用户接受度是使用和未来医疗保健实施工作的重要指标和驱动力。为了在开发过程中实现最大的以用户为中心，必须让患者作为专家、共同设计者和未来用户参与进来，考虑到他们的需求和看法。
