Stroke Manager App - Individual and Mobile Support for Stroke Patients and Their Caregivers



Roland A Görlitz* Roland A Görlitz*, Research Center for Information Technology (FZI), Karlsruhe, Germany
Robert Hagedorn, Research Center for Information Technology (FZI), Karlsruhe, Germany


Track: Research
Presentation Topic: Mobile & Tablet Health Applications
Presentation Type: Rapid-Fire Presentation
Submission Type: Single Presentation

Building: Mermaid
Room: Room 4 - Queenshithe
Date: 2013-09-23 04:00 PM – 06:00 PM
Last modified: 2013-09-25
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Abstract


Word limit: 500 words

Stroke Manager App - Individual and Mobile Support for Stroke Patients and Their Caregivers

Background:
Today, there is a smartphone app for almost everything. Apps for mHealth seem to be a promising approach to address individual needs of patients and caregivers that are affected by a chronic medical condition. Nevertheless, they are still scarce and their benefits have not been studied thoroughly. Especially for stroke patients with their complex, long-term post-acute care, a holistic supportive approach seems promising.

Objective:
We present an mHealth app - the Stroke Manager App (SMA) - that supports stroke patients and their caregivers. It is based on an mHealth concept that combines individual information with mobile IT and serious games to support stroke patients.

Methods:
First, we developed an mHealth concept for stroke patients and their care-giving relatives based on expert interviews, literature analysis and medical guidelines.
Second, the conceived functions have been evaluated by an online survey with 81 German stroke patients and caregivers acquired in online stroke forums.
Third, an SMA prototype was created accordingly using an evolutionary prototyping approach including constant workshops with stroke patients and subsequent refinements. A field study with 5 stroke patients was conducted for two weeks. Afterwards, the patients were then interviewed and app log files were analyzed.

Results:
The mHealth concept that has been deduced from expert interviews and literature, such as medical guidelines, consists of three parts: general information for stroke patients and their caregivers; rehabilitation support; and adherence support. Information should be provided for stroke patients and their caregivers. In cooperation with clinicians we created a set of general information about the stroke itself, the different treatment phases, effective secondary prevention, and tips on how to cope with the repercussions of the stroke. Rehabilitation is provided by taking a mobile serious games approach allowing stroke patients to exercise their cognitive and motor skills. Adherence is supported through a calendar with history and reporting functions. It allows patients to track and evaluate their appointments, therapy sessions, medication, and home exercises. Recording the adherence also creates data about therapy adherence that is currently not available when evaluating effects of post-clinical therapies.
In the survey, the average age of the 81 participants was 45+/-11 (the 41 patients were 47+/-10 and the 40 caregivers were 44+/-11). The caregivers were almost all female (90%). 74% of the respondents stated that there is one major caregiver and all of the participating caregivers have at least a mobile phone. The majority (58%) of the respondents possess a smartphone (Android: 44%, iPhone: 40%, unknown: 16%) and another 20% plan to buy one in the next 12 months. All the conceived functions have been rated as important (information: 75%, calendar: 68%, games:51%). No other, missing functionality has been suggested by the respondents even though they were explicitly asked for.
The field test performed by 5 participants and confirmed the initial impression from the online survey. Concluding from the interviews and log files the three functions are important and the participants use them frequently. However, because of usability issues, the calendar was not used as intended.

Conclusion:
We observed that our novel mhealth concept addresses stroke patient’s needs and the prototypically implemented SMA provides the functionality to address the stroke patients’ information deficits and supports adherence as well as home-based rehabilitation. In a next step, usability issues will be tackled and a long-term randomized controlled trial started to assess the SMA’s effectiveness.




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