Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
BMC Med Inform Decis Mak. 2022 Apr 7;22(1):95. doi: 10.1186/s12911-022-01833-6.
The aim of this study is to develop and assess usability of a web-based patient-tailored tool to support adherence to urate-lowering therapy (ULT) among gout patients in a clinical setting.
The content of the tool was based on the Integrated Change (I-Change) model. This model combines various socio-cognitive theories and assumes behavioral change is a result of becoming aware of the necessity of change by integrating pre-motivational, motivational, and post-motivational factors. An expert group (five gout experts, three health services researchers, and one health behavior expert) was assembled that decided in three meetings on the tool's specific content (assessments and personalized feedback) using information from preparatory qualitative studies and literature reviews. Usability was tested by a think aloud approach and validated usability questionnaires.
The I-Change Gout tool contains three consecutive sessions comprising 80 questions, 66 tailored textual feedback messages, and 40 tailored animated videos. Navigation through the sessions was determined by the patients' intention to adapt suboptimal ULT adherence. After the sessions, patients receive an overview of the personalized advices and plans to support ULT adherence. Usability testing among 20 gout patients that (ever) used ULT and seven healthcare professionals revealed an overall score for the tool of 8.4 ± 0.9 and 7.7 ± 1.0 (scale 1-10). Furthermore, participants reported a high intention to use and/or recommend the tool to others. Participants identified some issues for further improvement (e.g. redundant questions, technical issues, and text readability). If relevant, these were subsequently implemented in the I-Change Gout tool, to allow further testing among the following participants.
This study provides initial support for the usability by patients and healthcare professionals of the I-Change Gout tool to support ULT adherence behavior.
本研究旨在开发并评估一种基于网络的个体化工具，以支持临床环境中痛风患者降尿酸治疗（ULT）的依从性。
该工具的内容基于综合改变（I-Change）模型。该模型结合了多种社会认知理论，并假设行为改变是通过整合前动机、动机和后动机因素来认识到改变的必要性的结果。一个专家组（五名痛风专家、三名卫生服务研究人员和一名健康行为专家）被召集在一起，他们在三次会议上使用预备定性研究和文献综述的信息，决定了工具的具体内容（评估和个性化反馈）。通过出声思考法和验证性可用性问卷测试了可用性。
I-Change 痛风工具包含三个连续的部分，共包含 80 个问题、66 个个性化的文本反馈信息和 40 个个性化的动画视频。通过患者改变非最佳 ULT 依从性的意愿来确定各部分的导航。在完成各部分后，患者会收到个性化的 ULT 依从性支持建议和计划的概述。对 20 名曾使用 ULT 的痛风患者和 7 名医疗保健专业人员进行的可用性测试显示，工具的总体评分为 8.4±0.9 和 7.7±1.0（1-10 分制）。此外，参与者报告了使用和/或向他人推荐该工具的强烈意愿。参与者确定了一些需要进一步改进的问题（例如，冗余问题、技术问题和文本可读性）。如果相关，这些问题随后会在 I-Change 痛风工具中得到解决，以便在接下来的参与者中进行进一步测试。
本研究初步支持了患者和医疗保健专业人员对 I-Change 痛风工具的可用性，以支持 ULT 依从性行为。
