Dang Thu Ha, Wickramasinghe Nilmini, Forkan Abdur Rahim Mohammad, Jayaraman Prem Prakash, Burbury Kate, O'Callaghan Clare, Whitechurch Ashley, Schofield Penelope
Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.
Digital Cancer Care Innovation, Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
JMIR Cancer. 2024 Apr 3;10:e46979. doi: 10.2196/46979.
Medication nonadherence negatively impacts the health outcomes of people with cancer as well as health care costs. Digital technologies present opportunities to address this health issue. However, there is limited evidence on how to develop digital interventions that meet the needs of people with cancer, are perceived as useful, and are potentially effective in improving medication adherence.
The objective of this study was to co-design, develop, and preliminarily evaluate an innovative mobile health solution called Safety and Adherence to Medication and Self-Care Advice in Oncology (SAMSON) to improve medication adherence among people with cancer.
Using the 4 cycles and 6 processes of design science research methodology, we co-designed and developed a medication adherence solution for people with cancer. First, we conducted a literature review on medication adherence in cancer and a systematic review of current interventions to address this issue. Behavioral science research was used to conceptualize the design features of SAMSON. Second, we conducted 2 design phases: prototype design and final feature design. Last, we conducted a mixed methods study on patients with hematological cancer over 6 weeks to evaluate the mobile solution.
The developed mobile solution, consisting of a mobile app, a web portal, and a cloud-based database, includes 5 modules: medication reminder and acknowledgment, symptom assessment and management, reinforcement, patient profile, and reporting. The quantitative study (n=30) showed that SAMSON was easy to use (21/27, 78%). The app was engaging (18/27, 67%), informative, increased user interactions, and well organized (19/27, 70%). Most of the participants (21/27, 78%) commented that SAMSON's activities could help to improve their adherence to cancer treatments, and more than half of them (17/27, 63%) would recommend the app to their peers. The qualitative study (n=25) revealed that SAMSON was perceived as helpful in terms of reminding, supporting, and informing patients. Possible barriers to using SAMSON include the app glitches and users' technical inexperience. Further needs to refine the solution were also identified. Technical improvements and design enhancements will be incorporated into the subsequent iteration.
This study demonstrates the successful application of behavioral science research and design science research methodology to design and develop a mobile solution for patients with cancer to be more adherent. The study also highlights the importance of applying rigorous methodologies in developing effective and patient-centered digital intervention solutions.
用药依从性差会对癌症患者的健康结果以及医疗成本产生负面影响。数字技术为解决这一健康问题提供了机遇。然而，关于如何开发满足癌症患者需求、被认为有用且可能有效提高用药依从性的数字干预措施的证据有限。
本研究的目的是共同设计、开发并初步评估一种名为“肿瘤学中药物安全与依从性及自我护理建议”（SAMSON）的创新移动健康解决方案，以提高癌症患者的用药依从性。
我们使用设计科学研究方法的4个周期和6个流程，为癌症患者共同设计并开发了一种用药依从性解决方案。首先，我们对癌症患者的用药依从性进行了文献综述，并对当前解决该问题的干预措施进行了系统综述。行为科学研究被用于构思SAMSON的设计特征。其次，我们进行了2个设计阶段：原型设计和最终功能设计。最后，我们对血液系统癌症患者进行了为期6周的混合方法研究，以评估该移动解决方案。
开发的移动解决方案由一个移动应用程序、一个门户网站和一个基于云的数据库组成，包括5个模块：用药提醒与确认、症状评估与管理、强化、患者资料和报告。定量研究（n = 30）表明，SAMSON易于使用（21/27，78%）。该应用程序具有吸引力（18/27，67%）、信息丰富、增加了用户互动且组织良好（19/27，70%）。大多数参与者（21/27，78%）表示，SAMSON的活动有助于提高他们对癌症治疗的依从性，其中超过一半（17/27，63%）的人会向同龄人推荐该应用程序。定性研究（n = 25）表明，SAMSON在提醒、支持和告知患者方面被认为是有帮助的。使用SAMSON的可能障碍包括应用程序故障和用户缺乏技术经验。还确定了进一步完善该解决方案的需求。技术改进和设计增强将纳入后续迭代。
本研究证明了行为科学研究和设计科学研究方法在设计和开发一种使癌症患者更具依从性的移动解决方案中的成功应用。该研究还强调了在开发有效且以患者为中心的数字干预解决方案中应用严格方法的重要性。
