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A Digital Patient–Provider Communication Intervention to Support Shared Decision Making in Chronic Health Care, InvolveMe: Feasibility Pilot Study (Preprint)


 BACKGROUND
 Living with a chronic health condition is demanding and comes with symptoms that may negatively affect health related quality of life (HRQoL). Management of chronic conditions often requires communication and interaction with health care providers (HCP), and good communication can improve symptom management as well as HRQoL. However, experiences of poor communication and interaction between patients and HCPs are common. Digital patient-provider communication interventions carry the potential to facilitate shared decision making (SDM) through improved communication and interaction. The InvolveMe intervention was therefore designed to provide patients with the opportunity to communicate symptoms and informational needs, and to prioritize preferences for care prior to outpatient visits at the hospital, as well as to interact with HCPs through secure messages in-between outpatient visits.
 
 
 OBJECTIVE
 This study aimed to assess feasibility of the InvolveMe intervention (ie, use of a digital assessment prior to hospital visits and use of secure messages in-between visits) by investigating system acceptability and demand (ie, system use), explore potential impact on patient reported outcome measures, and use study findings to tailor the intervention and study routines to prepare for future implementation in a clinical trial.
 
 
 METHODS
 The study was designed as a pre-post feasibility study. Patients from one outpatient clinic were invited to use the InvolveMe intervention for 3 months. Feasibility was tested by exploring: (1) acceptability; data collected from non-participants and participants during recruitment, and the System Usability Scale (SUS), (2) demand; exploration of system use through extraction of system log data, (3) limited efficacy testing; exploration of potential effects from the Short-Form Health Survey (RAND 36), the Hospital Anxiety and Depression Scale and the Health Literacy Questionnaire, and (4) implementation preparation; using collected data to tailor the intervention and study routines.
 
 
 RESULTS
 Participants (N=23) were median 54 (range 26-78) years old and primarily male (61%, 14/23). All participants completed outcome measures at baseline, and 19 completed outcome measures at 3 months. Average SUS score was 72.2, indicating good system usability. Eight participants completed assessments from home prior to hospital visit. The assessments entailed various bodily symptoms and needs for information. Participants sent 17 secure messages related to patient administrative matters, symptoms and challenges. Preliminary outcome measure findings at 3 months were mixed. Results contributed to ideas for tailoring of the InvolveMe intervention as well as tailoring of study routines.
 
 
 CONCLUSIONS
 Findings allowed establishing feasibility for the InvolveMe intervention and informed intervention tailoring in preparation of a future clinical trial. Given that participants used the secure assessment and messages to communicate about bodily symptoms, needs for information and challenges experienced, use of InvolveMe may have the potential to facilitate SDM through enhancing accessibility, information exchange and strengthen patient-HCP relationship for patients living with chronic health conditions.
 
 
 CLINICALTRIAL
 ClinicalTrials.gov NCT NCT04218721
