Faculty of Medicine, Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, UK.
School of Psychology, Cardiff Fertility Studies Research Group, Cardiff University, Cardiff, UK.
Hum Reprod. 2022 May 3;37(5):1007-1017. doi: 10.1093/humrep/deac046.
Is it possible to develop a patient smartphone application for medically assisted reproduction (MAR) that is acceptable to patients and fertility staff?
Staff and patients responded positively to the MediEmo smartphone application, perceiving it to be acceptable and feasible to implement in a busy clinic.
Digital tools are increasingly popular to provide practical, administrative and psychological support alongside medical treatments. Apps and other digital tools have been developed for use alongside MAR but there is very limited research on the development or acceptability and feasibility of these tools.
STUDY DESIGN, SIZE, DURATION: Mixed methods research. This article outlines the development phase of the MediEmo smartphone app, which was guided by the Medical Research Council development framework for complex interventions. The resulting MediEmo app was then implemented into a single centre for MAR in the UK, acceptability evaluated and feasibility explored among 1106 potential participants undertaking IVF cycles.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Consultation and data collection took part at a single mid-sized urban fertility clinic. Development of the MediEmo smartphone application took place during 2013 to 2017. Implementation of the MediEmo took place from June 2017 to September 2020. The MediEmo app comprises three functions (six features) namely medication management (medication timeline, messaging), mood management (emotional tracking, coping support) and functional support (frequently asked questions, symptom checker). Data on age, fertility diagnosis, anti-Müllerian hormone level were collected about the users of the MediEmo in addition to MediEmo usage data and attitudes towards the MediEmo smartphone application.
Informed by the developmental process described, MediEmo is an app combining patient medication diary management and ease of integration into clinic systems with emotional support, emotional tracking and data capture. This study demonstrates acceptability and feasibility of MediEmo, with good uptake (79.8%), mood data sensitivity and reliability and positive feedback.
LIMITATIONS, REASONS FOR CAUTION: Single centre, small number of users in questionnaire studies.
The findings suggest smartphone apps can contribute to fertility care and that patient engagement is high. Evaluation of any apps introduced into clinical pathways should be encouraged to promote development of the most useful digital tools for fertility patients.
STUDY FUNDING/COMPETING INTEREST(S): This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Outside of the submitted work, J.B. reports personal speaker fees from Merck KGaA, Darmstadt, Germany, Merck AB an affiliate of Merck KGaA, Darmstadt Germany, Theramex, MedThink China, Ferring Pharmaceuticals A/S, grant from Merck Serono Ltd, outside the submitted work and that she is co-developer of Fertility Quality of Life (FertiQoL) and MediEmo app; N.M and C.Y are minority shareholders and J.B.'s University (Cardiff University) owns one third of shares. None of the shareholders benefitted financially from MediEmo. I.R., C.H. and K.Y.B.N. declare no conflicts of interest.
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是否有可能为医学辅助生殖（MAR）开发一款患者智能手机应用程序，让患者和生育医护人员都能接受？
医护人员和患者对 MediEmo 智能手机应用程序反应积极，认为该应用程序在繁忙的诊所中具有可接受性和实施可行性。
数字工具越来越受欢迎，可提供医疗治疗之外的实用、行政和心理支持。已经开发了一些应用程序和其他数字工具来配合 MAR 使用，但这些工具的开发或可接受性和可行性方面的研究非常有限。
研究设计、规模和持续时间：混合方法研究。本文概述了 MediEmo 智能手机应用程序的开发阶段，该阶段由医疗研究委员会针对复杂干预措施的开发框架指导。随后，将开发的 MediEmo 应用程序在英国的一家 MAR 中心实施，对 1106 名接受试管婴儿周期治疗的潜在参与者进行了可接受性评估和可行性探索。
参与者/材料、地点和方法：咨询和数据收集在一个中等规模的城市生育诊所进行。MediEmo 智能手机应用程序的开发于 2013 年至 2017 年进行。MediEmo 的实施于 2017 年 6 月至 2020 年 9 月进行。MediEmo 应用程序包括三个功能（六个功能），即药物管理（药物时间表、消息传递）、情绪管理（情绪跟踪、应对支持）和功能支持（常见问题解答、症状检查器）。除了 MediEmo 的使用数据和对该智能手机应用程序的态度外，还收集了使用 MediEmo 的用户的年龄、生育诊断、抗苗勒氏管激素水平等数据。
根据所描述的发展过程，MediEmo 是一款应用程序，它将患者的药物日记管理与轻松集成到诊所系统与情绪支持、情绪跟踪和数据捕获相结合。本研究证明了 MediEmo 的可接受性和可行性，其使用率高（79.8%），情绪数据灵敏度和可靠性高，反馈积极。
局限性、谨慎的原因：单中心，问卷调查研究的参与者人数较少。
研究结果表明，智能手机应用程序可以为生育护理做出贡献，并且患者参与度很高。应鼓励对引入临床路径的任何应用程序进行评估，以促进为生育患者开发最有用的数字工具。
研究资金/利益冲突：本研究未从任何公共、商业或非营利部门的任何资助机构获得任何特定的资助。除了提交的工作外，J.B. 报告了来自德国默克股份有限公司、默克有限公司（Merck AB）、丹麦法罗群岛、Ferring 制药公司、Theramex、MedThink China 的演讲费，是 FertiQoL 和 MediEmo 应用程序的共同开发者；N.M 和 C.Y 是少数股东，J.B. 的大学（卡迪夫大学）拥有三分之一的股份。没有股东从 MediEmo 中获得经济利益。I.R.、C.H. 和 K.Y.B.N. 没有利益冲突。
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