Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 25, 2019
Date Accepted: Feb 4, 2020
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An Integrated Care Intervention Supported by a Mobile Health Tool in Patients Using Noninvasive Ventilation at Home: Randomized Controlled Trial
ABSTRACT
Background:
Home-based noninvasive ventilation has proven cost-effective. But, adherence to therapy still constitutes a common clinical problem. We hypothesized that a behavioral intervention supported by mHealth can enhance patients’ self-efficacy. It is widely accepted that mHealth-supported services might enhance productive interactions among the stakeholders involved in home-based respiratory therapies.
Objective:
To measure changes in self-efficacy in patients with chronic respiratory failure due to diverse etiologies, during a follow-up period of three months after the intervention. Ancillary objectives were assessment of usability and acceptability of the mobile app, as well as to learn on its potential contribution to enhance collaborative work among stakeholders.
Methods:
A single blinded, single center, randomized controlled trial was performed on 67 adult patients with chronic respiratory failure undergoing home-based noninvasive ventilation, between February and June 2019. In the intervention group, a psychologist delivered a face-to-face motivational intervention. Follow-up was supported by a mobile app, which allowed patients to report the number of hours of daily use and problems with the therapy. Advice was automatically delivered by the mobile app in case a problem was reported. The control group received usual care.
Results:
Self-efficacy did not show differences after the intervention (mean[SD]=3.4[0.6] vs 3.4[0.5], P=.51). No changes were observed neither in adherence to therapy nor quality of life. Overall, the mHealth tool showed good usability score, 78; high acceptance rate, 7.5/10; user friendliness, 8.2/10; and, the ability to use the app without assistance displayed a mean score of 8.5/10. Patients’ perception of continuity of care and person-centered care showed high scores.
Conclusions:
The integrated care intervention supported by the mobile app did not improve patients’ self-management. However, the high acceptance of the mobile app might indicate potential for enhanced communication among stakeholders. The study contributed to identify key elements required for mHealth tools to provide effective support to collaborative work and personalized care. Clinical Trial: NCT03932175 (clinicaltrials.gov, April 30, 2019)
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