Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.
Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
JMIR Dermatol. 2021 May 10;4(1):e26673. doi: 10.2196/26673.
In Denmark, patients with psoriasis undergoing biological treatment have regular follow-ups, typically every 3 months. This may pose a challenge for patients who live far away from the hospital. Mobile health (mHealth) is a promising and reliable tool for the long-term management of patients with psoriasis undergoing biological treatment because the disease course can be properly monitored. Despite recent developments in mHealth, the full potential of teledermatology remains to be tapped by newer, more attractive forms of services focused on patients' needs.
This study aims to design and develop an mHealth app to support the self-management of patients with psoriasis using a participatory design.
Using participatory design, we conducted 1 future workshop, 4 mock-up workshops, and 1 prototype test with patients and health care professionals to co-design a prototype. The process was iterative to ensure that all stakeholders would provide input into the design and outcome; this approach enabled continuous revision of the prototype until an acceptable solution was agreed upon. Data were analyzed according to the steps-plan, act, observe, and reflect-in the methodology of participatory design.
Health care professionals and patients emphasized the importance of a more patient-centered approach, focusing on the communication and maintenance of relationships. Patients perceived consultations to be impersonal and repetitive and wanted the opportunity to contribute to the agenda while attending a consultation. Patients also stated they would prefer not to attend visits in person every 3 months. On the basis of these findings, we designed an mHealth app that could replace in-person visits and support patients at in-person visits. Video consultations, self-monitoring, and registration of patient-reported outcome data were embedded in the app.
Using participatory design facilitated mutual learning and democratic processes that gave end users a significant influence over the solution. Despite the advantages of using participatory design in developing mHealth solutions, organizational conditions may still represent a barrier to the optimization of solutions.
在丹麦，接受生物治疗的银屑病患者需要定期随访，通常每 3 个月一次。这对于远离医院的患者来说可能是一个挑战。移动医疗（mHealth）是一种有前途且可靠的工具，可用于长期管理接受生物治疗的银屑病患者，因为可以对疾病过程进行适当的监测。尽管 mHealth 最近取得了一些进展，但通过专注于患者需求的更新、更具吸引力的服务形式，仍有潜力进一步挖掘远程医疗的潜力。
本研究旨在使用参与式设计设计和开发一款 mHealth 应用程序，以支持银屑病患者的自我管理。
使用参与式设计，我们与患者和医疗保健专业人员一起进行了 1 次未来研讨会、4 次模拟研讨会和 1 次原型测试，以共同设计原型。该过程是迭代的，以确保所有利益相关者都能为设计和结果提供投入；这种方法使原型能够不断修订，直到达成可接受的解决方案。根据参与式设计方法论中的步骤——计划、行动、观察和反思，对数据进行了分析。
医疗保健专业人员和患者强调了更以患者为中心的方法的重要性，重点是沟通和关系的维护。患者认为咨询缺乏人情味且重复性高，希望有机会在咨询时为议程做出贡献。患者还表示，他们宁愿不必每 3 个月亲自就诊。基于这些发现，我们设计了一款 mHealth 应用程序，可以替代面对面就诊，并在面对面就诊时为患者提供支持。视频咨询、自我监测和患者报告结局数据的登记都嵌入到应用程序中。
使用参与式设计促进了相互学习和民主进程，使最终用户对解决方案产生了重大影响。尽管参与式设计在开发 mHealth 解决方案方面具有优势，但组织条件可能仍然是优化解决方案的障碍。
