#PatientEngagement

citizenportal.ai

Patient advocates recount delayed diagnoses, treatment failures and call for patient‑centered trials

Patient advocates and survivors described multi‑year diagnostic delays, difficult therapies and the importance of integrating patient perspectives into trial design and clinician education.

dlvr.it

Assessment of Technology Usage and Literacy From a Patient Tech Testing Panel in an Adult Primary Care Practice: Cross-Sectional Study

Tech testing panels (TTPs) can assess the #usability of patient-facing health technology and provide critical feedback; TTPs should draw upon diverse patient populations by language preference and with a range of technology usage and literacy to ensure that digital health interventions are equitably designed.

dlvr.it

Emerging Adults’ Experiences of Digital Measurement-Based Care in Routine Mental Health Care: Qualitative Study and Conceptual Synthesis

Background: Emerging adults (aged 18‐29 years) experience a high burden of mental health (MH) concerns during a developmental period marked by increasing autonomy and vulnerability to symptom onset. Many emerging adults face challenges in accessing and sustaining engagement with developmentally appropriate care. Digital measurement-based care (dMBC), which involves the routine use of patient-reported outcome measures (PROMs), has been introduced as an approach to support emerging adult engagement and improve responsiveness of care through ongoing monitoring and informed clinical decision-making. However, its integration into routine care remains variable, and there is limited understanding of how emerging adults experience and engage with dMBC in practice. Objective: This study aimed to examine how emerging adults experience dMBC within routine MH care and identify factors relevant to its use and integration in clinical practice. Methods: Using a descriptive qualitative design, semistructured interviews were conducted with 23 purposively sampled emerging adults who were either actively receiving care or had recently been discharged from 1 of 2 outpatient MH clinics in southern Alberta, Canada. dMBC was delivered through a web-based platform that enabled emerging adults to complete PROMs and view their results, which were also available to clinicians to inform care. All participants completed PROMs at baseline, with subsequent completion varying across participants and over the course of care. Interview data were analyzed using thematic analysis. Results: Four interconnected themes were identified and synthesized into a higher-level conceptual representation of emerging adults’ experiences with dMBC: technology, tracking, translation, and therapeutic guidance. Technology captured participants’ varied experiences with accessing and using the digital platform, including its #usability and accessibility. Tracking reflected how monitoring PROM results over time supported reflection on changes in MH. Translation described how PROM data were interpreted and incorporated into therapeutic discussions, while therapeutic guidance reflected the role of clinician involvement in supporting the use of dMBC in care. Across the themes, participants described variation in the relevance and burden of measurement and in how consistently dMBC was integrated into clinical care. Conclusions: Emerging adults’ experiences of dMBC were shaped by both their interactions with digital measurement and the integration of PROMs into routine MH care. The findings highlight the importance of considering dMBC within the broader therapeutic context in which measurement occurs, rather than as a stand-alone digital activity. The conceptual synthesis provides a way of organizing these experiences and can inform future research and implementation efforts focused on the use of dMBC in emerging adult MH services.

dlvr.it

Prompted Text-Based Vital Sign Recording Versus Unprompted Electronic Medical Record Entries in Patients With Advanced Heart Failure: Observational Study

Background: Long-term remote patient monitoring of weight, pulse, and blood pressure has been shown to significantly reduce mortality and hospitalization rates among patients with heart failure. Despite its proven effectiveness, maintaining patient engagement in remote monitoring programs remains challenging. Objective: This study aimed to evaluate the impact of 2-way text-based communication on prompting patients to record key vital signs and to compare it with unprompted patient reporting through electronic medical records in terms of engagement and clinical outcomes. Methods: We analyzed data from patients participating in the University of Michigan Advanced Heart Failure Program who reported daily weight, blood pressure, and pulse using either the MiChart Patient Outreach Texting Application (MPOTA) or patient enrolled flowsheets (PEFs). The study’s primary metric was the consistency of patient-reported vital signs, with secondary descriptive metrics including variations in hospitalization and emergency room visits pre-enrollment and postenrollment in the programs. Results: A total of 890 patients were included, with 301 enrolled in the MPOTA group and 589 in the PEF group. The engagement rate for the PEF group had a median of 2.29% (IQR 0%‐23.93%). In contrast, the MPOTA group showed a significantly higher median engagement rate of 66.67% (IQR 30.67%‐88.24%). There were no significant differences in hospitalization or emergency room visit rates across engagement categories (none, low, medium, and high) or between programs. Mean hospitalizations declined by 21% in the MPOTA group (from mean 0.53, SD 0.90 to mean 0.42, SD 0.88; =.06) and 18% in the PEF group (from mean 0.50, SD 0.86 to mean 0.41, SD 0.80; =.03) after the initiation of each program. This reduction was small and statistically significant only for the PEF group. Mean emergency room visits did not significantly change in either group. Regression analyses showed no significant association between engagement level and hospitalization or emergency room utilization, although medium engagement was associated with a nonsignificant trend toward fewer events. Despite improved engagement with MPOTA, this did not translate into significant reductions in hospitalizations or emergency room visits. All analyses of clinical outcomes were exploratory and underpowered, and no significant associations were found between engagement level and utilization. Conclusions: Although MPOTA was associated with substantially higher patient engagement levels compared to unprompted patient reporting, neither demonstrated significant differences in hospitalization or emergency room visits across engagement levels or between programs. Small reductions in hospitalizations were observed, but these were significant only in PEF, not in MPOTA. Observed changes in utilization were exploratory, small in magnitude, and underpowered to detect clinically meaningful effects. These findings suggest that mobile text-based communication may be a useful tool for improving engagement in remote monitoring programs for patients with advanced heart failure; however, further research is needed to assess its impact on clinical outcomes.