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

Barnaby C. Reeves; Robin Wickens; Sean R. O’Connor; Eleanor Alma Gidman; E. Ward; Charlene Treanor; Tunde Peto; Ben J l Burton; Paul C Knox; Andrew Lotery; Sobha Sivaprasad; Michael Donnelly; Chris A. Rogers; Ruth E Hogg

doi:10.1136/bmjopen-2023-077196

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

Barnaby C. Reeves^*, Robin Wickens, Sean R. O’Connor, Eleanor Alma Gidman, E. Ward, Charlene Treanor, Tunde Peto, Ben J l Burton, Paul C Knox, Andrew Lotery, Sobha Sivaprasad, Michael Donnelly, Chris A. Rogers, Ruth E Hogg

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

28 Downloads (Pure)

Abstract

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.

Original language	English
Article number	e077196
Number of pages	9
Journal	BMJ Open
Volume	14
Issue number	3
DOIs	https://doi.org/10.1136/bmjopen-2023-077196
Publication status	Published - 07 Mar 2024

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2024.

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmjopen-2023-077196Licence: CC BY-NC

Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home
Copyright 2024 the authors. This is an open access Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 568 KBLicence: CC BY-NC

Cite this

Reeves, B. C., Wickens, R., O’Connor, S. R., Gidman, E. A., Ward, E., Treanor, C., Peto, T., Burton, B. J. L., Knox, P. C., Lotery, A., Sivaprasad, S., Donnelly, M., Rogers, C. A., & Hogg, R. E. (2024). 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, 14(3), Article e077196. https://doi.org/10.1136/bmjopen-2023-077196

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

abstract = "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. SettingSix 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.",

author = "Reeves, {Barnaby C.} and Robin Wickens and O{\textquoteright}Connor, {Sean R.} and Gidman, {Eleanor Alma} and E. Ward and Charlene Treanor and Tunde Peto and Burton, {Ben J l} and Knox, {Paul C} and Andrew Lotery and Sobha Sivaprasad and Michael Donnelly and Rogers, {Chris A.} and Hogg, {Ruth E}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024.",

year = "2024",

month = mar,

day = "7",

doi = "10.1136/bmjopen-2023-077196",

language = "English",

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Reeves, BC, Wickens, R, O’Connor, SR, Gidman, EA, Ward, E, Treanor, C, Peto, T, Burton, BJL, Knox, PC, Lotery, A, Sivaprasad, S, Donnelly, M, Rogers, CA & Hogg, RE 2024, '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, vol. 14, no. 3, e077196. https://doi.org/10.1136/bmjopen-2023-077196

TY - JOUR

T1 - Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home

AU - Reeves, Barnaby C.

AU - Wickens, Robin

AU - O’Connor, Sean R.

AU - Gidman, Eleanor Alma

AU - Ward, E.

AU - Treanor, Charlene

AU - Peto, Tunde

AU - Burton, Ben J l

AU - Knox, Paul C

AU - Lotery, Andrew

AU - Sivaprasad, Sobha

AU - Donnelly, Michael

AU - Rogers, Chris A.

AU - Hogg, Ruth E

PY - 2024/3/7

Y1 - 2024/3/7

N2 - 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. SettingSix 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.

AB - 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. SettingSix 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.

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DO - 10.1136/bmjopen-2023-077196

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C2 - 38453199

AN - SCOPUS:85187151165

SN - 2044-6055

VL - 14

JO - BMJ Open

JF - BMJ Open

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M1 - e077196

ER -

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

Abstract

Bibliographical note

ASJC Scopus subject areas

UN SDGs

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