A failed clinical trial meant to improve patients' self-management of chronic conditions provided insight into what factors are most important for mHealth adoption, according to a study published in JMIR Human Factors.
The researchers initially sought to evaluate the effectiveness of a commercial mHealth app in improving clinical outcomes for diabetes and hypertension patients. Patients would enter clinical data into the app, which also supported a messaging capability to connect patients and providers.
However, after four months of attempting to recruit patients at a Federally Qualified Health Center, the researchers suspended the trial due to low enrollment and inconsistent use of the app among those who were enrolled. The researchers proceeded to interview patients and staff involved with the trial to understand why it was unsuccessful.
The researchers determined there was not sufficient time during routine care for clinical staff to train the patients to use the app. For providers, the researchers also noted checking the participants' clinical data and messages were unreimbursed activities and that lack of integration with the EHR made the app "just one more thing to attend to."
"This brief trial underscores the pitfalls in the utilization of mHealth apps," the study authors concluded. "Effective use of mHealth tools requires a good fit between the app, the users' electronic health (eHealth) literacy, the treatment approach, staff time and reimbursement for services."
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