Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 8, 2018
Date Accepted: Nov 3, 2018
(closed for review but you can still tweet)
Towards Minimally Disruptive Medicine: Assessing the need for Mobile Healthcare (mHealthcare) in Monitoring the Diabetic Lower Extremity
ABSTRACT
Background:
Complications of the diabetic lower extremity often result when monitoring is infrequent, and often result in serious sequelae like amputation and even death.
Objective:
To develop an effective solution to the problem of infrequent monitoring, we evaluated 1) the self-management routines of a group of diabetic patients in order to better understand the barriers to monitoring in this patient population, 2) patient and clinician opinion on the use of mobile healthcare (mHealth) in this space.
Methods:
Patients with diabetic foot ulcers (DFUs) in Toronto, Canada completed a 25-item questionnaire addressing their foot care practices, mobile phone use, and views on mHealth. Wound care clinicians across Canada were also surveyed using a 9-item questionnaire.
Results:
Of the 115 patients surveyed, 51.3% spend less than a minute checking their feet, and 15% of patients find it difficult to see their doctor or get to the hospital regularly. Mobile phone use was widespread in our cohort (80.4% of respondents). Of mobile phone users, 73.1% would use a device on their phone to help them check their feet. 242 clinicians completed the questionnaire, and only 3.5% of clinicians were familiar with mHealth. Importantly, 92% of clinicians expressed interest in using mHealth to monitor their patients between visits.
Conclusions:
Patient education/motivation and clinician training were identified as the major barriers to mHealth use in the diabetic lower extremity, which is a promising solution to the problem of infrequent monitoring.
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