JMIR Publications

ABSTRACT

Background:

The management of multimorbidity is complex and patients have a high burden of disease. When symptoms of dementia also appear, it becomes even more difficult for patients to cope with their everyday lives and manage their diseases. Home-based telemonitoring may support elderly patients with multimorbidity and mild cognitive impairment (MCI) in their regular monitoring and self-management. So far, there has been no investigation into whether patients with MCI are able to operate a telemonitoring application independently to manage their own diseases. This question has become even more important during the current COVID-19 pandemic in order to maintain high quality medical care for this patient group.

Objective:

Within our study, we aimed to examine the following research questions: 1.How do patients with MCI assess the usability and functionalities of the telemonitoring application? 2.Was there an additional benefit for the patients with MCI using the telemonitoring application? 3.Were patients with MCI able to use the telemonitoring application independently and without restrictions? 4.To what extent does previous experience with smartphones, tablets and/or computers influence the perceived ease of use of the telemonitoring application?

Methods:

We conducted a formative evaluation of the telemonitoring application. Therefore, we carried out a qualitative study and conducted guided interviews. All interviews were audio-recorded, transcribed verbatim and analyzed using the method of structured content analysis by Mayring.

Results:

Twelve patients (8f, 4m) were interviewed; they had an average age of 78.7 years (SD 5.6) and an average Mini-Mental State Examination (MMSE) result of 24.5 (SD 1.6). The interviews lasted between 17 and 75 minutes (average: 41.8 minutes, SD 19.4). Nine patients (9/12) reported that the telemonitoring application was easy to use. All respondents assessed the functional scope as good or adequate. Desired functionalities mainly included more innovative and varying education material, better fit of the telemonitoring application for specific needs of patients with MCI, and a more individually tailored content. Ten patients (10/12) stated that the telemonitoring application had an additional benefit for them. Most frequently reported benefits included increased feeling of security, appreciation of regular monitoring of vital parameters, and increased independence due to telemonitoring. Eight (8/12) patients were able to operate the telemonitoring application independently. Participants found the application easy to use regardless of whether they had prior experience with smartphones, tablets or computers.

Conclusions:

The majority of examined patients with MCI was capable of operating the telemonitoring application independently. Comprehensive personal support from the start of use and appropriate design features are crucial components in attaining an independent use. Patients with MCI should increasingly be considered as a relevant user group of telemonitoring applications.