Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home

Objectives Remote monitoring of health has the potential to reduce the burden to patients of face-to-face appointments and make healthcare more efficient. Apps are available for patients to self-monitor vision at home, for example, to detect reactivation of age-related macular degeneration (AMD). De...

Full description

Saved in:
Bibliographic Details
Main Authors: Chris A Rogers, Andrew Lotery, Tunde Peto, Sobha Sivaprasad, Barnaby C Reeves, Michael Donnelly, Ruth E Hogg, E Ward, Ben J L Burton, Paul C Knox, Charlene Treanor, Seán R O’Connor, Robin Wickens, Eleanor Alma Gidman
Format: Article
Language:English
Published: BMJ Publishing Group 2024-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/3/e077196.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850195104730447872
author Chris A Rogers
Andrew Lotery
Tunde Peto
Sobha Sivaprasad
Barnaby C Reeves
Michael Donnelly
Ruth E Hogg
E Ward
Ben J L Burton
Paul C Knox
Charlene Treanor
Seán R O’Connor
Robin Wickens
Eleanor Alma Gidman
author_facet Chris A Rogers
Andrew Lotery
Tunde Peto
Sobha Sivaprasad
Barnaby C Reeves
Michael Donnelly
Ruth E Hogg
E Ward
Ben J L Burton
Paul C Knox
Charlene Treanor
Seán R O’Connor
Robin Wickens
Eleanor Alma Gidman
author_sort Chris A Rogers
collection DOAJ
description Objectives Remote monitoring of health has the potential to reduce the burden to patients of face-to-face appointments and make healthcare more efficient. Apps are available for patients to self-monitor vision at home, for example, to detect reactivation of age-related macular degeneration (AMD). Describing the challenges when implementing apps for self-monitoring of vision at home was an objective of the MONARCH study to evaluate two vision-monitoring apps on an iPod Touch (Multibit and MyVisionTrack).Design Diagnostic Test Accuracy study.Setting Six UK hospitals.Methods The study provides an example of the real-world implementation of such apps across health sectors in an older population. Challenges described include the following: (1) frequency and reason for incoming calls made to a helpline and outgoing calls made to participants; (2) frequency and duration of events responsible for the tests being unavailable; and (3) other technical and logistical challenges.Results Patients (n=297) in the study were familiar with technology; 252/296 (85%) had internet at home and 197/296 (67%) had used a smartphone. Nevertheless, 141 (46%) called the study helpline, more often than anticipated. Of 435 reasons for calling, all but 42 (10%) related to testing with the apps or hardware, which contributed to reduced adherence. The team made at least one call to 133 patients (44%) to investigate why data had not been transmitted. Multibit and MyVisionTrack apps were unavailable for 15 and 30 of 1318 testing days for reasons which were the responsibility of the app providers. Researchers also experienced technical challenges with a multiple device management system. Logistical challenges included regulations for transporting lithium-ion batteries and malfunctioning chargers.Conclusions Implementation of similar technologies should incorporate a well-resourced helpline and build in additional training time for participants and troubleshooting time for staff. There should also be robust evidence that chosen technologies are fit for the intended purpose.Trial registration number ISRCTN79058224.
format Article
id doaj-art-6cefbd8003cd412b9dc785a41a0f7db6
institution OA Journals
issn 2044-6055
language English
publishDate 2024-03-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-6cefbd8003cd412b9dc785a41a0f7db62025-08-20T02:13:51ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-077196Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at homeChris A Rogers0Andrew Lotery1Tunde Peto2Sobha Sivaprasad3Barnaby C Reeves4Michael Donnelly5Ruth E Hogg6E Ward7Ben J L Burton8Paul C Knox9Charlene Treanor10Seán R O’Connor11Robin Wickens12Eleanor Alma Gidman13Bristol Trials Centre, University of Bristol, Bristol, UK4 Faculty of Medicine, University of Southampton, Southampton, UK1 Centre for Public Health, Queen`s University Belfast Faculty of Medicine Health and Life Sciences, Belfast, UKMoorfields Eye Hospital City Road Campus, London, UKBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UKCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen`s University Belfast, Belfast, UKCentre for Public Health, Queen`s University Belfast, Belfast, UKBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UKJames Paget University Hospitals NHS Trust, Liverpool, UKUniversity of Liverpool, Liverpool, UKCentre for Public Health, Queen`s University Belfast, Belfast, UKCentre for Public Health, Queen`s University Belfast, Belfast, UKBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UKBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UKObjectives Remote monitoring of health has the potential to reduce the burden to patients of face-to-face appointments and make healthcare more efficient. Apps are available for patients to self-monitor vision at home, for example, to detect reactivation of age-related macular degeneration (AMD). Describing the challenges when implementing apps for self-monitoring of vision at home was an objective of the MONARCH study to evaluate two vision-monitoring apps on an iPod Touch (Multibit and MyVisionTrack).Design Diagnostic Test Accuracy study.Setting Six UK hospitals.Methods The study provides an example of the real-world implementation of such apps across health sectors in an older population. Challenges described include the following: (1) frequency and reason for incoming calls made to a helpline and outgoing calls made to participants; (2) frequency and duration of events responsible for the tests being unavailable; and (3) other technical and logistical challenges.Results Patients (n=297) in the study were familiar with technology; 252/296 (85%) had internet at home and 197/296 (67%) had used a smartphone. Nevertheless, 141 (46%) called the study helpline, more often than anticipated. Of 435 reasons for calling, all but 42 (10%) related to testing with the apps or hardware, which contributed to reduced adherence. The team made at least one call to 133 patients (44%) to investigate why data had not been transmitted. Multibit and MyVisionTrack apps were unavailable for 15 and 30 of 1318 testing days for reasons which were the responsibility of the app providers. Researchers also experienced technical challenges with a multiple device management system. Logistical challenges included regulations for transporting lithium-ion batteries and malfunctioning chargers.Conclusions Implementation of similar technologies should incorporate a well-resourced helpline and build in additional training time for participants and troubleshooting time for staff. There should also be robust evidence that chosen technologies are fit for the intended purpose.Trial registration number ISRCTN79058224.https://bmjopen.bmj.com/content/14/3/e077196.full
spellingShingle Chris A Rogers
Andrew Lotery
Tunde Peto
Sobha Sivaprasad
Barnaby C Reeves
Michael Donnelly
Ruth E Hogg
E Ward
Ben J L Burton
Paul C Knox
Charlene Treanor
Seán R O’Connor
Robin Wickens
Eleanor Alma Gidman
Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
BMJ Open
title Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
title_full Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
title_fullStr Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
title_full_unstemmed Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
title_short Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
title_sort descriptive study of the challenges when implementing an app for patients with neovascular age related macular degeneration to monitor their vision at home
url https://bmjopen.bmj.com/content/14/3/e077196.full
work_keys_str_mv AT chrisarogers descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT andrewlotery descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT tundepeto descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT sobhasivaprasad descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT barnabycreeves descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT michaeldonnelly descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT ruthehogg descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT eward descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT benjlburton descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT paulcknox descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT charlenetreanor descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT seanroconnor descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT robinwickens descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome
AT eleanoralmagidman descriptivestudyofthechallengeswhenimplementinganappforpatientswithneovascularagerelatedmaculardegenerationtomonitortheirvisionathome