A digital self-care intervention for Ugandan patients with heart failure and their clinicians: User-centred design and usability study. (September 2022)

• Record Type: Journal Article
• Authors: Hearn, Jason; Wali, Sahr; Birungi, Patience; Cafazzo, Joseph A; Ssinabulya, Isaac; Akiteng, Ann R; Ross, Heather J; Seto, Emily; Schwartz, Jeremy I
• Is Part Of: Digital health. Volume 8(2022)
• Publication Date: 2022-09
• Subjects: Cardiovascular disease -- digital health -- general -- education -- lifestyle -- cardiology -- medicine -- remote patient monitoring -- personalized medicine; Medical care -- Data processing -- Periodicals; Medical informatics -- Periodicals; 362.10285
• DOI: 10.1177/20552076221129064
• Languages: English
• ISSNs: 2055-2076

Abstract

Background: The prevalence of heart failure (HF) is increasing in Uganda. Ugandan patients with HF report receiving limited information about their illness and associated self-care behaviours. Interventions targeted at improving HF self-care have been shown to improve patient quality of life and reduce hospitalizations in high-income countries. However, such interventions remain underutilized in resource-limited settings like Uganda. This study aimed to develop a digital health intervention that enables improved self-care amongst HF patients in Uganda. Methods: We implemented a user-centred design (UCD) process to develop a self-care intervention entitled Medly Uganda . The ideation phase comprised a scoping review and preliminary data collection amongst HF patients and clinicians in Uganda. An iterative design process was then used to advance an initial prototype into a functional digital health intervention. The evaluation phase involved usability testing of the intervention amongst Ugandan patients with HF and their clinicians. Results: Medly Uganda is a digital health intervention that allows patients to report daily HF symptoms, receive tailored treatment advice and connect with a clinician when showing signs of decompensation. The system harnesses Unstructured Supplementary Service Data (USSD) technology that is already widely used in Uganda for mobile phone-based financial transactions. Usability testing showed Medly Uganda to be both acceptable and feasible amongst clinicians, patients and caregivers. Conclusions: Medly Uganda is a functional digital health intervention with demonstrated acceptability and feasibility in enabling Ugandan HF patients to better care for themselves. We are hopeful that the system will improve self-care efficacy amongst HF patients in Uganda.