Format

Send to

Choose Destination
BMC Med Inform Decis Mak. 2017 Jul 10;17(1):102. doi: 10.1186/s12911-017-0481-x.

The development and feasibility of a personal health-optimization system for people with bipolar disorder.

Author information

1
Faculty of Medicine, University of Oslo, Postbox 1072, Blindern, N-0316, Oslo, Norway.
2
Norwegian Institute of Public Health, Postbox 4404, Nydalen, N-0403, Oslo, Norway.
3
Department of Medicine and Healthcare, South-Eastern Norway Regional Health Authority, Postbox 404, N-2303, Hamar, Norway.
4
Faculty of Medicine, University of Oslo, Postbox 1072, Blindern, N-0316, Oslo, Norway. kari.nytroen@medisin.uio.no.
5
Department of Medicine and Healthcare, South-Eastern Norway Regional Health Authority, Postbox 404, N-2303, Hamar, Norway. kari.nytroen@medisin.uio.no.
6
Oslo University Hospital, Postbox 4950, Nydalen, N-0424, Oslo, Norway. kari.nytroen@medisin.uio.no.
7
Department of Medicine, University Hospital of North Norway, Postbox 6050, N-9037, Langnes, Tromsø, Norway.
8
Norwegian University of Science and Technology, N-7491, Trondheim, Norway.

Abstract

BACKGROUND:

People with bipolar disorder often experience ill health and have considerably reduced life expectancies. Suboptimal treatment is common and includes a lack of effective medicines, overtreatment, and non-adherence to medical interventions and lifestyle measures. E- and m-health applications support patients in optimizing their treatment but often exhibit conceptual and technical shortcomings. The objective of this work was to develop and test the usability of a system targeting suboptimal treatment and compare the service to other genres and strategies.

METHODS:

Based on the frameworks of shared decision-making, multi-criteria decision analysis, and single-subject research design, we interviewed potential users, reviewed research and current approaches, and created a first version using a rapid prototyping framework. We then iteratively improved and expanded the service based on formative usability testing with patients, healthcare providers, and laypeople from Norway, the UK, and Ukraine. The evidence-based health-optimization system was developed using systematic methods. The System Usability Scale and a questionnaire were administered in formative and summative tests. A comparison of the system to current standards for clinical practice guidelines and patient decision aids was performed.

RESULTS:

Seventy-eight potential users identified 82 issues. Driven by user feedback, the limited first version was developed into a more comprehensive system. The current version encompasses 21 integrated core features, supporting 6 health-optimization strategies. One crucial feature enables patients and clinicians to explore the likely value of treatments based on mathematical integration of self-reported and research data and the patient's preferences. The mean ± SD (median) system usability score of the patient-oriented subsystem was 71 ± 18 (73). The mean ± SD (median) system usability score in the summative usability testing was 78 ± 18 (75), well above the norm score of 68. Feedback from the questionnaire was generally positive. Eighteen out of 23 components in the system are not required in international standards for patient decision aids and clinical practice guidelines.

CONCLUSION:

We have developed the first evidence-based health-optimization system enabling patients, clinicians, and caregivers to collaborate in optimizing the patient's health on a shared platform. User tests indicate that the feasibility of the system is acceptable.

KEYWORDS:

Adherence; Bipolar disorder; Clinical decision support system; Clinical practice guideline; Compliance; E-health; M-health; Patient decision aid; Patient participation tool; Shared decision-making

PMID:
28693482
PMCID:
PMC5504814
DOI:
10.1186/s12911-017-0481-x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central Icon for Norwegian BIBSYS system
Loading ...
Support Center