Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 28, 2020
Date Accepted: Feb 19, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Conversational agent technology adoption by patients with heart failure
ABSTRACT
Background:
Heart failure (HF) is a condition linked to high mortality rates, and high costs. Telehealth can help those with HF manage their condition and provide frequent feedback to their healthcare providers.
Objective:
The aim of this paper is to study the engagement of HF patients with conversational agent technology. In particular, we investigate which patient characteristics are linked to increased technology usage.
Methods:
We use data from two separate HF patient groups that used different telehealth technology over a 90-day period. Each group used a different type of conversational agent technology, but the scripts that the two technologies followed were identical. One technology was based on Amazon’s Alexa (called Alexa+), and the other one used an avatar through a tablet (called Avatar). We measure patient engagement as the number of days that the patients used the conversational agent during the study period. We use multiple linear regression to model engagement with the technology based on patients’ demographic, clinical, and technology-related characteristics.
Results:
Both populations were predominantly male, black, had an average age close to 55 years, and had HF for an average of 7 years. The only patient characteristic that was statistically different between the two populations was the number of medications they took to manage heart failure with a mean of 8.7 (SD 4.0) for Alexa+, and 5.8 (SD 3.4) for Avatar patients. The regression model on the combined population showed older patients used the technology more frequently (an additional 1.15 days of use for each additional year of age, P-value =.004). The number of medications to manage HF was negatively associated with use (P-value = .008) and black patients used the technology less frequently compared to other patients with similar characteristics (P-value = .073).
Conclusions:
Older patients showing higher engagement when using telehealth is consistent with findings from previous studies. However, we also found that higher number of HF medications, which may be correlated with higher disease burden is negatively associated with telehealth usage. Clinical Trial: NCT03707275
Citation
