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患者和临床医生对未来支持哮喘自我管理的物联网系统的展望:混合方法研究。

Patients' and Clinicians' Visions of a Future Internet-of-Things System to Support Asthma Self-Management: Mixed Methods Study.

机构信息

Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Tactuum Ltd, Glasgow, United Kingdom.

出版信息

J Med Internet Res. 2021 Apr 13;23(4):e22432. doi: 10.2196/22432.


DOI:10.2196/22432
PMID:33847592
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8080146/
Abstract

BACKGROUND: Supported self-management for asthma reduces acute attacks and improves control. The internet of things could connect patients to health care providers, community services, and their living environments to provide overarching support for self-management. OBJECTIVE: We aimed to identify patients' and clinicians' preferences for a future internet-of-things system and explore their visions of its potential to support holistic self-management. METHODS: In an exploratory sequential mixed methods study, we recruited patients from volunteer databases and charities' social media. We purposively sampled participants to interview them about their vision of the design and utility of the internet of things as a future strategy for supporting self-management. Respondents who were not invited to participate in the interviews were invited to complete a web-based questionnaire to prioritize the features suggested by the interviewees. Clinicians were recruited from professional networks. Interviews were transcribed and analyzed thematically using PRISMS self-management taxonomy. RESULTS: We interviewed 12 patients and 12 clinicians in the United Kingdom, and 140 patients completed the web-based questionnaires. Patients expressed mostly wanting a system to log their asthma control status automatically; provide real-time advice to help them learn about their asthma, identify and avoid triggers, and adjust their treatment. Peak flow (33/140, 23.6%), environmental (pollen, humidity, air temperature) (33/140, 23.6%), and asthma symptoms (25/140, 17.9%) were the specific data types that patient most wanted. Information about asthma and text or email access to clinical advice provided a feeling of safety for patients. Clinicians wanted automated objective data about the patients' condition that they could access during consultations. The potential reduction in face-to-face consultations was appreciated by clinicians which they perceived could potentially save patients' travel time and health service resources. Lifestyle logs of fitness regimes or weight control were valued by some patients but were of less interest to clinicians. CONCLUSIONS: An automated internet-of-things system that requires minimal input from the user and provides timely advice in line with an asthma action plan agreed by the patient with their clinician was preferred by most respondents. Links to asthma information and the ability to connect with clinicians by text or email were perceived by patients as features that would provide a sense of safety. Further studies are needed to evaluate the usability and effectiveness of internet-of-things systems in routine clinical practice.

摘要

背景:支持哮喘的自我管理可以减少急性发作并改善控制。物联网可以将患者与医疗保健提供者、社区服务以及他们的生活环境联系起来,为自我管理提供全面支持。

目的:我们旨在确定患者和临床医生对未来物联网系统的偏好,并探讨他们对物联网支持整体自我管理的潜力的看法。

方法:在一项探索性顺序混合方法研究中,我们从志愿者数据库和慈善机构的社交媒体中招募患者。我们有目的地对参与者进行抽样,以了解他们对物联网设计和用途的看法,以及将其作为未来支持自我管理策略的看法。没有被邀请参加访谈的受访者被邀请完成一个基于网络的问卷,对受访者提出的功能进行优先级排序。临床医生从专业网络中招募。对访谈进行转录,并使用 PRISMS 自我管理分类法进行主题分析。

结果:我们在英国采访了 12 名患者和 12 名临床医生,并完成了 140 名患者的网络问卷调查。患者主要希望系统能够自动记录他们的哮喘控制状况;提供实时建议,帮助他们了解自己的哮喘、识别和避免诱因以及调整治疗。峰值流量(140 人中的 33 人,23.6%)、环境(花粉、湿度、空气温度)(140 人中的 33 人,23.6%)和哮喘症状(140 人中的 25 人,17.9%)是患者最希望获得的特定数据类型。有关哮喘的信息以及文本或电子邮件访问临床建议为患者提供了安全感。临床医生希望能够在就诊期间访问患者病情的自动客观数据。临床医生欣赏潜在的面对面咨询减少,他们认为这可能节省患者的旅行时间和医疗服务资源。一些患者重视健身或体重控制的生活方式记录,但对临床医生的兴趣较小。

结论:大多数受访者更喜欢一个不需要患者输入大量信息,并且能够根据患者与临床医生商定的哮喘行动计划提供及时建议的自动化物联网系统。患者认为与哮喘信息的链接以及通过文本或电子邮件与临床医生联系的能力是提供安全感的功能。需要进一步研究来评估物联网系统在常规临床实践中的可用性和有效性。

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[10]
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