Factors determining patients' intentions to use point-of-care testing medical devices for self-monitoring: the case of international normalized ratio self-testing

Abstract

PurposeTo identify factors that determine patients’ intentions to use point-of-care medical devices, ie, portable coagulometer devices for self-testing of the international normalized ratio (INR) required for ongoing monitoring of blood-coagulation intensity among patients on long-term oral anticoagulation therapy with vitamin K antagonists, eg, warfarin.MethodsA cross-sectional study that applied the technology-acceptance model through a self-completed questionnaire, which was administered to a convenience sample of 125 outpatients attending outpatient anticoagulation services at a district general hospital in London, UK. Data were analyzed using descriptive statistics, factor analyses, and structural equation modeling.ResultsThe participants were mainly male (64%) and aged ≥ 71 years (60%). All these patients were attending the hospital outpatient anticoagulation clinic for INR testing; only two patients were currently using INR self-testing, 84% of patients had no knowledge about INR self-testing using a portable coagulometer device, and 96% of patients were never offered the option of the INR self-testing. A significant structural equation model explaining 79% of the variance in patients’ intentions to use INR self-testing was observed. The significant predictors that directly affected patients’ intention to use INR self-testing were the perception of technology (β = 0.92, P < 0.001), trust in doctor (β = −0.24, P = 0.028), and affordability (β = 0.15, P = 0.016). In addition, the perception of technology was significantly affected by trust in doctor (β = 0.43, P = 0.002), age (β = −0.32, P < 0.001), and affordability (β = 0.23, P = 0.013); thereby, the intention to use INR self-testing was indirectly affected by trust in doctor (β = 0.40), age (β = −0.29), and affordability (β = 0.21) via the perception of technology.ConclusionPatients’ intentions to use portable coagulometers for INR self-testing are affected by patients’ perceptions about the INR testing device, the cost of device, trust in doctors/clinicians, and the age of the patient, which need to be considered prior to any intervention involving INR self-testing by patients. Manufacturers should focus on increasing the affordability of INR testing devices for patients’ self-testing and on the potential role of medical practitioners in supporting use of these medical devices as patients move from hospital to home testing.

Determinants of Intention to Use Mobile Phone Caller Tunes to Promote Voluntary Blood Donation: Cross-Sectional Study (Preprint)

“…We applied the original TAM and extended TAM in a new context (i.e., mobile phone caller tunes for blood donation), which is distinct from prior studies targeting health information systems. Our findings are consistent with those of many studies showing that perceived ease of use and perceived usefulness are significant predictors of behavioral intention [25,31,35,36]. Our study supports others that have showed significant positive relationship between cost and intention to use information technology [36,38].…”

“…The findings mirror studies elsewhere that found significant relationship between perceived usefulness and attitudes to a health information [25,33,34] and intention to use technology [25,31,35,36]; and significant relationships between perceived ease of use significantly and attitudes to technology [26][27][28][29][30] and perceived usefulness of the technology [31][32][33]35].…”

“…Given that making caller tunes free to download was statistically significant in increasing intention to use caller tunes among only non-blood donors with no caller tunes, intervention designers would need to ensure that caller tunes for promoting blood donation become free. For example, affordability was found to be a statistically significant predictor of intention to use portable coagulometer devices for self-testing of the international normalized ratio (INR) among outpatients attending outpatient anticoagulation services [36].…”

“…The belief that a given technology is useful could make people develop attitudes to using it, and/or increase their intention to use it. For example, studies show significant relationship between perceived usefulness and attitudes to a health information [25,33,34] and intention to use technology [25,31,35,36].…”

“…For example, affordability has been found to influence patients' intention to use point-of-care medical devices for medical testing [36]. Moreover, cost negatively influences adoption of mobile health services [38].…”