Table 4

Summary of the six themes emerging from free-text feedback from professional users

What went wellThemes arising from free-text commentsWhat could be improved
Encouraged patients to acknowledge, take responsibility for and feel involved in their health problems/managementSystem empowers patients and puts them in control of their health/conditionDoubt the educational value
Saved (nurses and GP) appointments, patients’ time/inconvenience and resourcesUse of appointmentsTime not saved due to patient set-up time and anxieties, problems receiving texts, reviewing data and patients not returning equipment
Patients and professional users found Flo easyEase of usePatients and professional users struggled with Flo and equipment. Cross-cover was problematic
Patients are happy, interested, and value the feedback and flexibility. Professional users liked the flexibility of managing patients remotely, being able to send simple messages and having readings on recordAcceptability of the systemPatients not interested or anxious, responses fail/unreliable, no mobile reception. Little benefit over traditional methods, found the system complex/increased work. Wanted direct integration with patient records and to track patients after protocol end
Professionals valued protocols being compliant with national guidelines, enjoyed easier monitoring and felt patients enjoyed the improved support, better signposting and enhanced motivation. Short bursts of intervention with advice were valued (eg, AIM 01)Acceptability of protocol(s)Professionals criticised protocols for increasing patient anxiety, increasing workload and/or complexity, being ‘misleading’ at times, eg motivational texts posed as questions leading to patients attempting to respond and not fitting closely with national guidelines. Patients did not like frequent messages or messages about depression
Valued initial briefing session and demos, case studies, examples of how others are using Flo and the patient packSupport with using the systemMore support at the practice level to launch the service and educate staff about its use (eg, leaflets). Tardy Read code details
  • AIM, Advice & Interactive Messaging; Flo, Florence; GP, general practitioner.