Bradway Meghan, Giordanengo Alain, Joakimsen Ragnar, Hansen Anne Helen, Grøttland Astrid, Hartvigsen Gunnar, Randine Pietro, Årsand Eirik
Norwegian Center for E-health Research, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, University of Tromsø-The Arctic University of Norway, Tromsø, Norway.
JMIR Res Protoc. 2020 Feb 10;9(2):e16657. doi: 10.2196/16657.
There is rising demand for health care's limited resources. Mobile health (mHealth) could be a solution, especially for those with chronic illnesses such as diabetes. mHealth can increases patients' options to self-manage their health, improving their health knowledge, engagement, and capacity to contribute to their own care decisions. However, there are few solutions for sharing and presenting patients' mHealth data with health care providers (HCPs) in a mutually understandable way, which limits the potential of shared decision making.
Through a six-month mixed method feasibility study in Norway, we aim to explore the impacts that a system for sharing patient-gathered data from mHealth devices has on patients and HCPs during diabetes consultations.
Patients with diabetes will be recruited through their HCPs. Participants will use the Diabetes Diary mobile phone app to register and review diabetes self-management data and share these data during diabetes consultations using the FullFlow data-sharing system. The primary outcome is the feasibility of the system, which includes HCP impressions and expectations (prestudy survey), usability (System Usability Scale), functionalities used and data shared during consultations, and study-end focus group meetings. Secondary outcomes include a change in the therapeutic relationship, patient empowerment and wellness, health parameters (HbA1c and blood pressure), and the patients' own app-registered health measures (blood glucose, medication, physical activity, diet, and weight). We will compare measures taken at baseline and at six months, as well as data continuously gathered from the app. Analysis will aim to explain which measures have changed and how and why they have changed during the intervention.
The Full Flow project is funded for 2016 to 2020 by the Research Council of Norway (number 247974/O70). We approached 14 general practitioner clinics (expecting to recruit 1-2 general practitioners per clinic) and two hospitals (expecting to recruit 2-3 nurses per hospital). By recruiting through the HCPs, we expect to recruit 74 patients with type 2 and 33 patients with type 1 diabetes. Between November 2018 and July 2019, we recruited eight patients and 15 HCPs. During 2020, we aim to analyze and publish the results of the collected data from our patient and HCP participants.
We expect to better understand what is needed to be able to share data. This includes potential benefits that sharing patient-gathered data during consultations will have on patients and HCPs, both individually and together. By measuring these impacts, we will be able to present the possibilities and challenges related to a system for sharing mHealth data for future interventions and practice. Results will also demonstrate what needs to be done to make this collaboration between HCPs and patients successful and subsequently further improve patients' health and engagement in their care.
对医疗保健有限资源的需求不断增加。移动健康（mHealth）可能是一种解决方案，特别是对于患有糖尿病等慢性病的患者。移动健康可以增加患者自我管理健康的选择，提高他们的健康知识、参与度以及参与自身护理决策的能力。然而，很少有解决方案能够以双方都能理解的方式与医疗保健提供者（HCP）共享和展示患者的移动健康数据，这限制了共同决策的潜力。
通过在挪威进行为期六个月的混合方法可行性研究，我们旨在探讨一个用于共享从移动健康设备收集的患者数据的系统在糖尿病会诊期间对患者和医疗保健提供者的影响。
将通过医疗保健提供者招募糖尿病患者。参与者将使用“糖尿病日记”手机应用程序注册和查看糖尿病自我管理数据，并在糖尿病会诊期间使用FullFlow数据共享系统共享这些数据。主要结果是该系统的可行性，包括医疗保健提供者的印象和期望（研究前调查）、可用性（系统可用性量表）、会诊期间使用的功能和共享的数据，以及研究结束时的焦点小组会议。次要结果包括治疗关系的变化、患者赋权和健康状况、健康参数（糖化血红蛋白和血压），以及患者自己在应用程序中记录的健康指标（血糖、药物治疗、身体活动、饮食和体重）。我们将比较基线时和六个月时采取的措施，以及从应用程序持续收集的数据。分析旨在解释哪些措施发生了变化，以及在干预期间它们是如何变化的以及为什么会变化。
Full Flow项目由挪威研究理事会在2016年至2020年资助（编号247974/O70）。我们联系了14家全科医生诊所（预计每家诊所招募1 - 2名全科医生）和两家医院（预计每家医院招募2 - 3名护士）。通过通过医疗保健提供者进行招募，我们预计招募74名2型糖尿病患者和33名1型糖尿病患者。在2018年11月至2019年7月期间，我们招募了8名患者和15名医疗保健提供者。在2020年，我们旨在分析并公布从患者和医疗保健提供者参与者收集的数据结果。
我们期望更好地了解共享数据需要具备哪些条件。这包括在会诊期间共享患者收集的数据对患者和医疗保健提供者个体及双方共同产生的潜在益处。通过衡量这些影响，我们将能够展示与移动健康数据共享系统相关的可能性和挑战，以供未来的干预措施和实践参考。结果还将表明为使医疗保健提供者与患者之间的这种合作取得成功并进而进一步改善患者健康和提高其对护理的参与度需要做些什么。
