JMIR Publications

ABSTRACT

Background:

Emphasis on outpatient pediatric surgical procedures places the burden of responsibility for post-operative pain management on parents/guardians. Panda is a smartphone application (app) that provides scheduled medication alerts and allows parents to track their child’s pain and medication administration. We have previously tested and optimized the usability and feasibility of Panda within the hospital setting.

Objective:

The purpose of this study was to evaluate and optimize the feasibility of Panda for use at home, based on alert response compliance (response to any medication notification within 1 hour) and parents’ satisfaction.

Methods:

Parents/guardians of children undergoing day surgery were recruited to use Panda at home for 1-7 days to manage their scheduled medications and to assess their child’s pain. After surgery, a research assistant guided parents through app setup before independent use at home. We aimed to recruit ten child/caregiver pairs in each of three rounds of evaluation. Each user’s compliance with the recommended medication alerts was analyzed through audit-trail data generated during the use of the app. We used the Computer System Usability Questionnaire (CSUQ) and a post-study phone interview to evaluate the app’s ease of use and identify major barriers to adoption. Suggestions provided during the interviews were used to improve the app between each round.

Results:

Twenty-nine child/caregiver pairs participated in 3 rounds, using the app for 1-5 days. Alert response compliance (response to any medication notification within 1 hour) improved as the study progressed: participants responded to 30% (22-33) (median, interquartile range) of alerts within 1 hour in Round 1, and subsequently to 60% (44 – 64) in Round 2 and 64% (56 – 72) in Round 3 (P = .005); similarly, response times decreased from 131 (77 – 158) minutes in Round 1 to 31 (18 – 61) minutes in Round 2 and 10 (2 – 14) minutes in Round 3 (P = .002). Analysis of interview feedback from the first 2 rounds revealed usability issues, such as complaints of too many pages and trouble hearing app alerts, which were addressed to streamline app function, as well as improve visual appearance and audible alerts.

Conclusions:

It is feasible for parents/guardians to use Panda at home to manage their child’s medication schedule and track their pain. Simple modifications to the apps alert sounds and user interface improved response times.