用于冠心病患者风险消除的智能个体化心血管应用程序(iCARE)：开发和可用性测试分析。

An Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) for Individuals With Coronary Heart Disease: Development and Usability Testing Analysis.

机构信息

School of Nursing, Capital Medical University, Beijing, China.

Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

出版信息

JMIR Mhealth Uhealth. 2021 Dec 13;9(12):e26439. doi: 10.2196/26439.

DOI:10.2196/26439

PMID:34898449

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8713096/

Abstract

BACKGROUND

Death and disability from coronary heart disease (CHD) can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system.

OBJECTIVE

The aim of this study was to develop an Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of iCARE.

METHODS

We developed iCARE based on a user-centered design approach, which included 4 phases: (1) function design, (2) iterative design, (3) expert inspections and walkthroughs of the prototypes, and (4) usability testing with end users. The usability testing of iCARE included 2 stages: stage I, which included a task analysis and a usability evaluation (January to March 2019) of the iCARE patient app using the modified Health Information Technology Usability Survey (Health-ITUES); and stage II (June 2020), which used the Health-ITUES among end users who used the app for 6 months. The end users were individuals with a confirmed diagnosis of CHD from 2 university-affiliated hospitals in Beijing, China.

RESULTS

iCARE consists of a patient app, a care provider app, and a cloud platform. It has a set of algorithms that trigger tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For stage I usability testing, 88 hospitalized patients (72% [63/88] male; mean age 60 [SD 9.9] years) with CHD were included in the study. The mean score of the usability testing was 90.1 (interquartile range 83.3-99.0). Among enrolled participants, 90% (79/88) were satisfied with iCARE; 94% (83/88) and 82% (72/88) reported that iCARE was useful and easy to use, respectively. For stage II usability testing, 61 individuals with CHD (85% [52/61] male; mean age 53 [SD 8.2] years) who were from an intervention arm and used iCARE for at least six months were included. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 89% (54/61) were satisfied with the use of iCARE, 93% (57/61) perceived it as useful, and 70% (43/61) as easy to use.

CONCLUSIONS

This study developed an intelligent, individualized, evidence-based, and theory-driven app (iCARE) to improve patients' adherence to health behaviors and medication management. iCARE was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of CHD.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR-INR-16010242; https://tinyurl.com/2p8bkrew.

摘要

背景

通过改善危险因素管理，可在很大程度上降低冠心病（CHD）导致的死亡和残疾。然而，坚持循证建议具有挑战性，需要在患者、医疗服务提供者和医疗体系层面采取干预措施。

目的

本研究旨在开发一种用于风险消除的个体化智能心血管应用程序（iCARE），以促进健康行为和预防药物的依从性，并测试 iCARE 的可用性。

方法

我们基于以用户为中心的设计方法开发了 iCARE，该方法包括 4 个阶段：（1）功能设计，（2）迭代设计，（3）专家对原型的检查和演练，以及（4）与最终用户进行可用性测试。iCARE 的可用性测试包括 2 个阶段：第 I 阶段包括使用经改良的健康信息技术可用性调查问卷（Health-ITUES）对 iCARE 患者应用程序进行任务分析和可用性评估（2019 年 1 月至 3 月）；第 II 阶段（2020 年 6 月）使用 Health-ITUES，评估使用该应用程序 6 个月的最终用户。最终用户是来自中国 2 所大学附属医院的确诊 CHD 患者。

结果

iCARE 由患者应用程序、医疗服务提供者应用程序和云平台组成。它具有一组算法，可以根据初始评估和通过手动输入或可穿戴设备进行健康监测的数据触发个性化反馈，并发送个性化干预措施。在第 I 阶段的可用性测试中，纳入了 88 名住院 CHD 患者（72%[63/88]为男性；平均年龄 60[9.9]岁）。可用性测试的平均得分为 90.1（四分位距 83.3-99.0）。在纳入的参与者中，90%（79/88）对 iCARE 感到满意；94%（83/88）和 82%（72/88）分别报告 iCARE 有用和易于使用。在第 II 阶段的可用性测试中，纳入了 61 名来自干预组且使用 iCARE 至少 6 个月的 CHD 患者（85%[52/61]为男性；平均年龄 53[8.2]岁）。基于问卷的总可用性测试平均得分为 89.0（四分位距 77.0-99.5）。在纳入的参与者中，89%（54/61）对 iCARE 的使用感到满意，93%（57/61）认为它有用，70%（43/61）认为它易于使用。