Clinicians and patients perspectives on follow-up care and eHealth support after allogeneic hematopoietic stem cell transplantation: A mixed-methods contextual analysis as part of the SMILe study

Leppla, Lynn; Mielke, Juliane; Mauthner, Oliver; Teynor, Alexandra; Valenta, Sabine; Vanhoof, Jasper; Dobbels, Fabienne; Berben, Lut; Zeiser, Robert; Engelhardt, Monika; Geest, Sabina De; team, SMILe study

doi:10.1016/j.ejon.2020.101723

Cited by 41 publications

(90 citation statements)

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“…That analysis also included qualitative data, namely individual interviews with another ten alloSCT patients and three alloSCT clinician focus groups. The detailed description of the methods and results of this contextual analysis were recently published elsewhere [36]. It studied all relevant contextual aspects of the proposed integrated model of care, e.g., socio-cultural aspects at the micro (i.e., patient) and meso (i.e., transplant center) levels.…”

Section: Guiding Methodsologymentioning

confidence: 99%

“…The contextual analysis data of our preliminary work (see Guiding methodology section) [36] indicated that alloSCT patients were aware of the importance of following the medication regimen closely, especially when family, friends and caregivers were involved in medication management. According to clinicians, medication adherence was not systematically assessed at the studied transplant center.…”

Section: Bcw Stage 1: Understand the Behaviormentioning

confidence: 99%

“…According to clinicians, medication adherence was not systematically assessed at the studied transplant center. They also acknowledged a need for a person such as an Advanced Practice Nurse (APN) to coordinate follow-up, i.e., a CC [36]. The insights obtained from the literature review and contextual analysis enabled us to define the problem in behavioral terms (Table 1).…”

Section: Bcw Stage 1: Understand the Behaviormentioning

confidence: 99%

“…The entire health and health-related network surrounding adult patients after alloSCT (family, friends, health care professionals, ...) [36]. Community dwelling adult post-alloSCT patients…”

Section: Bcw Step 2: Select Target Behaviormentioning

confidence: 99%

“…As the third step is to examine the selected behaviors (in our case, two) both from the patient's perspective and within the context of the surrounding system [34], we specified each in terms of who, what, when, where, how, how often and with whom they occurred. This choice of details was based on previously evaluated evidence from the literature [12,13,41], but mainly on our contextual analysis [36] and our research team's clinical expertise.…”

Section: Bcw Step 3: Specify the Target Behaviormentioning

confidence: 99%

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Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project

Ribaut

Leppla

Teynor

et al. 2020

BMC Health Serv Res

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Background: Medication adherence to immunosuppressants in allogeneic stem cell transplantation (alloSCT) is essential to achieve favorable clinical outcomes (e.g. control of Graft-versus-Host Disease). Over 600 apps supporting medication adherence exist, yet they lack successful implementation and sustainable use likely because of lack of end-user involvement and theoretical underpinnings in their development and insufficient attention to implementation methods to support their use in real-life settings. Medication adherence has three phases: initiation, implementation and persistence. We report the theory-driven development of an intervention module to support medication adherence (implementation and persistence phase) in alloSCT outpatients as a first step for future digitization and implementation in clinical setting within the SMILe project (Development, implementation and testing of an integrated care model in allogeneic SteM cell transplantatIon faciLitated by eHealth). Methods: We applied Michie's Behavior Change Wheel (BCW) and the Capability-Opportunity-Motivation and Behavior (COM-B) model using three suggested stages followed by one stage added by our team regarding preparation for digitization of the intervention: (I) Defining the problem in behavioral terms; (II) Identifying intervention options; (III) Identifying content and implementation options; (IV) SMILe Care Model Prototype Development. Scientific evidence, data from a contextual analysis and patients'/caregivers' and clinical experts' inputs were compiled to work through these steps.

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Section: Guiding Methodsologymentioning

confidence: 99%

Section: Bcw Stage 1: Understand the Behaviormentioning

confidence: 99%

Section: Bcw Stage 1: Understand the Behaviormentioning

confidence: 99%

Section: Bcw Step 2: Select Target Behaviormentioning

confidence: 99%

Section: Bcw Step 3: Specify the Target Behaviormentioning

confidence: 99%

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Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project

Ribaut

Leppla

Teynor

et al. 2020

BMC Health Serv Res

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Development of an integrated model of care for allogeneic stem cell transplantation facilitated by eHealth—the SMILe study

Leppla

Schmid

Valenta

et al. 2021

Support Care Cancer

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Purpose Allogeneic stem cell transplantation would benefit from re-engineering care towards an integrated eHealth-facilitated care model. With this paper we aim to: (1) describe the development of an integrated care model (ICM) in allogeneic SteM-cell-transplantatIon faciLitated by eHealth (SMILe) by combining implementation, behavioral, and computer science methods (e.g., contextual analysis, Behavior Change Wheel, and user-centered design combined with agile software development); and (2) describe that model’s characteristics and its application in clinical practice. Methods The SMILe intervention’s development consisted of four steps, with implementation science methods informing each: (1) planning its set-up within a theoretical foundation; (2) using behavioral science methods to develop the content; (3) choosing and developing its delivery method (human/technology) using behavioral and computer science methods; and (4) describing its characteristics and application in clinical practice. Results The SMILe intervention is embedded within the eHealth enhanced Chronic Care Model, entailing four self-management intervention modules, targeting monitoring and follow-up of important medical and symptom-related parameters, infection prevention, medication adherence, and physical activity. Interventions are delivered partly face-to-face by a care coordinator embedded within the transplant team, and partly via the SMILeApp that connects patients to the transplant team, who can monitor and rapidly respond to any relevant changes within 1 year post-transplant. Conclusion This paper provides stepwise guidance on how implementation, behavioral, and computer science methods can be used to develop interventions aiming to improve care for stem cell transplant patients in real-world clinical settings. This new care model is currently being tested in a hybrid I effectiveness-implementation trial.

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Adherence management in transplantation

Geest

Ribaut

Denhaerynck

et al. 2021

Psychosocial Aspects of Chronic Kidney Disease

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Clinicians and patients perspectives on follow-up care and eHealth support after allogeneic hematopoietic stem cell transplantation: A mixed-methods contextual analysis as part of the SMILe study

Abstract: on behalf of the SMILe study team, Clinicians and patients perspectives on follow-up care and eHealth support after allogeneic hematopoietic stem cell transplantation: A mixed-methods contextual analysis as part of the SMILe study,

Cited by 41 publications

References 54 publications

Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project

Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project

Development of an integrated model of care for allogeneic stem cell transplantation facilitated by eHealth—the SMILe study

Adherence management in transplantation

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