Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 11, 2018
Open Peer Review Period: Dec 14, 2018 - Feb 8, 2019
Date Accepted: Sep 26, 2019
(closed for review but you can still tweet)
Adherence Radar - Digital Capabilities and Attitudes towards Digital Adherence Solutions: A Grounded Theory Approach with Patients treated with Novel Anticoagulants
ABSTRACT
Background:
Non-adherence to medication is a driver of morbidity and mortality and becomes worse when patients with chronic diseases have to adhere to complex medication regiments. Digital technology might help, but despite numerous solutions being developed, none currently is widely used and acceptance rates remain low especially among the elderly.
Objective:
We aimed to better understand and operationalize how new digital solutions can be evaluated. Particularly, the goal was to identify factors that help digital approaches targeting adherence to become more widely accepted.
Methods:
A qualitative study, with a conceptual "Grounded Theory" approach, was conducted. In focus were patients 65 and above with an indication for anticoagulation. Face-to-face interviews were conducted, recorded, and anonymized. After coding the interviews, categories were generated, discussed and combined to several theses until saturation of the statements was reached.
Results:
Methodological approach led to the finding that after 20 (n=77) patient interviews, saturation of statements was reached. Average patient’s age was 75 years with 50% of subjects being female. The data identified the five main categories “Diseases/Medicine”, “Technology”, “Autonomy”, “Patient Narrative”, and “Attitude Toward Technologies”, each including positive and negative subcategories. Main- and subcategories were summarized as “Adherence Radar” which can be seen as a framework to assess the potential of adherence solutions in a process of prototyping and can be applied to all adherence tools in a holistic manner.
Conclusions:
The “Adherence Radar” can be used to increase the acceptance rate of digital solutions targeting adherence. For a patient centric design the application should be adapted to individual patient’s needs. This should be based, according to our results, on gender as well as educational background and the individual physician-patient relationship. If done right, digital adherence solutions could become a new corner stone for the treatment of chronically ill.
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