Acceptance and use of a smartphone application in cirrhosis

Abstract

Background and Aims:The development of cirrhosis-related smartphone applications for remote monitoring is increasing. Whether patients with cirrhosis will welcome such new technology, however, is uncertain. Methods: We prospectively enrolled patients with cirrhosis (N = 102) to determine predictors of acceptance and utilization of a smartphone application for cirrhosis management using a 12-item Technology Acceptance Model (TAM) survey. Patients were then shown the EncephalApp© and evaluated for their willingness to download and use the application. Results: Patients had a median age of 61.3 years and 63.7% had a history of hepatic decompensation. Intention to use the hypothetical application was associated with perceived usefulness (β: 0.4, 95% CI: 0.3-0.5) and the presence of a caregiver (β: 1.1, 95% CI: 0.2-2.0). Of the eligible participants, 71% agreed to download the EncephalApp© and the decision was influenced by computer anxiety, behavioural intent, caregiver presence and disease state factors. Actual usage was 32% and not associated with baseline characteristics or the technology acceptance model. Conclusions: Patient acceptance of smartphone applications for the management of cirrhosis is high and related to their attitudes towards technology and the presence of a caregiver. However, usage was low. Future research must employ behavioural interventions to optimize uptake and utilization of remote monitoring technology.

Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study

“…Only 25% of the patient-caregiver dyads who were approached in the hospital agreed to be randomly assigned to standard care or to one of the two health IT interventions. This rate is relatively lower than that of individuals who ultimately decided to download another app, EncephalApp, but was similar to the rate of individuals that ultimately used the technology in a recent study of outpatients with cirrhosis [10]. Unlike EncephalApp, which links to the Patient Buddy app, the regimen tested in our multisite trial involves daily entry of data related to medication adherence, weight, and a multipronged approach to orientation that unfolds over 30 days and includes an educational component.…”

Strategies to Improve Video Visit Use in Persons With Liver Disease

“…Others may know how to download the application but run into an additional barrier of not being able to recall or locate their log-in information. 7…”

“…Technology acceptance is influenced by its perceived usefulness, ease of use, prior experience, and general comfort with technology. 7,8 We identified 3 main barriers to video visit acceptance.…”

“…Caregivers are present for a majority of patients with chronic liver disease, 12 and their presence can potentially improve the patient's perceived technologic capability to navigate through the enrollment process. 7,16 Fostering Video Visit Acceptance Encouraging familiarity through experience and social network. Modifying patient familiarity, comfort, and acceptance of technology is challenging but achievable.…”

“…Understanding and overcoming the barriers for those who fail to connect to a video visit is essential to the success, maintenance, and equity of telemedicine. 7 Herein, we provide a framework for optimizing video visit uptake informed by our local single-center experience with hepatology care. We present our findings, identified barriers (Figure 1), and health care system and patientcentered solutions within the broader context of telehepatology research and organized around selected principles of technology acceptance and implementation.…”