RT Journal Article
SR Electronic
T1 Usability and feasibility assessment of a smartphone application (Suhriday) for heart failure self-care remote monitoring in an Indian tertiary health care setting: a pilot mixed-methods study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e056962
DO 10.1136/bmjopen-2021-056962
VO 12
IS 8
A1 Bylappa, Bhuvana Kolar
A1 Kamath, Deepak Y
A1 Josephine, Immaculate Sheela
A1 Shaikh, Jabraan
A1 Kamath, Anant
A1 Rioniz, Preethi
A1 Kulkarni, Shruthi
A1 Varghese, Kiron
A1 Xavier, Denis
YR 2022
UL http://bmjopen.bmj.com/content/12/8/e056962.abstract
AB Background/objectives Remote monitoring as a component of chronic heart failure (CHF) management programmes has demonstrated utility in reducing the risk of rehospitalisation and mortality. There is little evidence on mobile health app facilitated remote monitoring in India. We conducted a pilot usability and feasibility assessment of a smartphone-based application (Suhriday) to remotely monitor patients with CHF.Methods We used a mixed-methods design. Usability testing consisted of the think-aloud approach followed by semistructured in-depth interviews (SSIs) and a satisfaction questionnaire. Feasibility testing was done using acceptability and user satisfaction questionnaires in addition to SSIs. We trained five purposively sampled patients with CHF (based on health literacy and gender) and their caregivers (n=10) in self-care monitoring and app use. Usability was assessed using metrics such as task completion, time required for task completion and user satisfaction using Brooke’s System Usability Scale (SUS). Content analysis of the transcripts with deductive coding was performed for both usability and feasibility interviews. The number and types of medical alerts transmitted through the app were captured and escalated to the treating team.Results Critical tasks involving (1) opening the app and identifying task list, (2) reporting blood pressure, weight, heart rate and fluid intake and (3) reporting symptoms were completed within 60 s by four patients. Median (IQR) SUS score was 85 (75–92.5) indicating high level of usability. There were 62 alerts from four patients over 4 weeks, with 36 (58.1%) excess fluid intake alerts and 16 (25.8%) blood pressure variations being the most frequent. One participant had challenges using the app and was monitored through active phone calls.Conclusion Overall usability and satisfaction with Suhriday were good and we were able to remotely manage patients. However, patients with limited health literacy and those facing technological challenges required active structured telephone support.Data are available on reasonable request. Currently, we have not deposited the raw data in an open access repository. However, we are willing to share the raw data with all interested investigators. Interested investigators may send an email to corresponding author with the brief write up of the research question, objectives and ethics approval for the proposal.