Post Elana, Faurot Keturah, Kadro Zachary O, Hill Jacob, Nguyen Catharine, Asher Gary N, Gaylord Susan, Corbett Amanda
Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
School of Medicine, Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Glob Adv Health Med. 2022 Jan 27;11:21649561221075268. doi: 10.1177/21649561221075268. eCollection 2022.
More than 170 million adults use dietary supplements (DS) in the United States, which can have both benefit and harm to patient health. DS use is often poorly documented in the medical record and can pose health risks if not properly communicated with providers. Reasons for poor DS documentation include low disclosure rates, time constraints of clinical encounters, and providers' failure to inquire about DS use. This study was conducted to assess patients' views on the facilitators and barriers to using a mobile health (mHealth) application (app) to collect and share DS information with their healthcare providers.
Utilizing a theory-based conceptual model, we conducted 7 patient focus groups (FGs) to assess opinions on DS safety, provider communication, comfort with technology use, and our proposed mHealth app. Participants were recruited from the general public and through patient advisory groups. Patient views will inform the creation of an mHealth app to improve DS patient-provider communication and tracking and reconciliation in the electronic medical record (EMR).
Overall, participants believe their DS information is inaccurately represented in the EMR, leading to safety concerns and negatively impacting overall quality of care. Participants desired an app designed with (1) Health Insurance Portability and Accountability Act (HIPAA) compliance; (2) ease of use for a variety of technical efficacy levels; (3) access to reliable DS information, including a DS-drug interaction checker; and (4) integration with the EMR.
An app to simplify and improve DS entry and reconciliation was of interest to patients, as long as it maintained health autonomy and privacy and possessed key valuable features.
在美国，超过1.7亿成年人使用膳食补充剂（DS），其对患者健康既有益处也有危害。DS的使用在病历中往往记录不佳，如果与医疗服务提供者沟通不当，可能会带来健康风险。DS记录不佳的原因包括披露率低、临床诊疗的时间限制以及医疗服务提供者未询问DS的使用情况。本研究旨在评估患者对于使用移动健康（mHealth）应用程序（app）收集并与医疗服务提供者共享DS信息的促进因素和障碍的看法。
利用基于理论的概念模型，我们开展了7个患者焦点小组（FGs），以评估对DS安全性、与医疗服务提供者的沟通、对技术使用的舒适度以及我们提议的mHealth应用程序的意见。参与者从普通公众以及患者咨询小组中招募。患者的意见将为创建一个mHealth应用程序提供参考，以改善DS在患者与医疗服务提供者之间的沟通以及电子病历（EMR）中的跟踪与核对。
总体而言，参与者认为他们的DS信息在EMR中表述不准确，这引发了安全担忧，并对整体护理质量产生负面影响。参与者希望应用程序具备以下设计特点：（1）符合《健康保险流通与责任法案》（HIPAA）；（2）对于各种技术水平的用户都易于使用；（3）能够获取可靠的DS信息，包括DS与药物相互作用检查器；（4）与EMR集成。
一款简化并改善DS录入与核对的应用程序受到患者关注，只要它能维护健康自主权和隐私并具备关键的有价值功能。
