- When creating chronic disease management apps for adolescent patients, it’s important for developers to keep parent and clinician opinions in mind, says a study published in the Journal of Medical Internet Research.
According to the research team, teens are often on the cusp of being able to manage their chronic diseases on their own, and that mHealth apps can be useful aids for them. However, because these patients are still minors, it’s important that their parents and clinicians can support their self-management efforts.
In order for that to happen, mHealth apps should have their interests in mind, too, the researchers said.
“Self-management support should be provided to families in between medical visits, using a style that reflects individual needs and with an understanding that youth with asthma generally take on greater self-care autonomy with age,” the researchers said.
“The asthma care process should involve collaboration between the clinician, the patient, and his/her parents.”
To test that theory, the research team introduced two small focus groups – on with 20 parents and one with six clinicians – to two different mHealth apps designed for adolescent patients with asthma.
After one week of use, researchers asked parents and clinicians to complete a qualitative survey about the most and least useful features on the app with the intention of understanding how these tools can be valuable for all stakeholders.
Overall, both parents and clinicians valued features targeted toward treatment monitoring and supervision, patient education, and patient-provider communication and data sharing. However, parents and clinicians valued each theme to a different extent.
For example, parents were interested in information sharing and the ability to access clinician feedback through the apps. Parents reported that increased information sharing and communication could help their child be more adherent to their treatment plans and might also reduce doctor’s office visits.
While clinicians shared these views, they had reservations, primarily related to privacy and security, and expressed a need for strong technical safeguards to ensure the apps are safe.
Conversely, there were features clinicians valued more than parents, such as medication reminders. Clinicians largely reported that these functions were useful in facilitating medication adherence, while parents saw little use for them.
According to the researchers, divergences like this one are helpful in informing future mHealth app development.
“Parents ranked the reminder feature lower than clinicians, and in this example, where usefulness ratings differ among parents and clinicians, incorporating both views may lead to a design decision to allow users to hide the medication reminder feature, based on user preference,” the researchers explained.
Areas in which parents and clinicians agreed also yielded valuable insights, the researchers said. For example, both focus groups stated that the patient education features on the app were extremely valuable.
“Collectively, these findings plus theme findings related to monitoring/supervision and communication/information sharing offer support for integrating information, decision support, and social support components, a needed methodological app template,” the researchers said.
Focus group participants also offered suggestions for features that were not yet a part of the two apps they tested including a tutorial for correct inhaler use, refill reminders, pop-up reminders for a medication log, and evidence-based management tips.
Overall, the researchers say these insights highlight the importance of parent and clinician assistance in pediatric patient self-management. Utilizing an mHealth app is an effective model for building that support network, they say, because it allows adolescent patients to connect in a manner that is meaningful for all stakeholders.
In order to effectively develop a valuable patient engagement app for adolescent patients, the researchers concluded that parent and clinician input is vital.
“These and other study findings based on different stakeholder perspectives support research suggesting the need for a team approach involving parents and health professionals in the design, development, and evaluation of adolescent-centered asthma self-management apps,” the researchers said.
“Involving parents and clinicians in asthma app planning, development, and intervention activities is likely to result in more widely accepted, understood, and effective adolescent asthma self-management apps.”