Evaluating the implementation of a patient engagement mHealth application in clinical infection prevention

TL;DR

A study evaluated a smartphone app to engage patients in preventing urinary tract infections, finding it acceptable but facing adoption challenges due to training and workflow issues.

Contribution

The study provides insights into barriers and facilitators for implementing a patient engagement mHealth app in infection prevention.

Findings

The Participatient app was perceived as acceptable by patients and had high ratings for patient engagement and quality of care.

Healthcare professionals identified barriers like incomplete training and unclear communication, which hindered app adoption.

Despite a positive attitude toward patient engagement, the app's adoption remained low due to workflow misfit and communication issues.

Abstract

Successful implementation of patient engagement (PE) and mHealth could reduce inappropriate catheter use and Catheter-associated urinary tract infections (CAUTIs). Insight into patient acceptance, impact on PE and quality of care, potential barriers and facilitators to the implementation of an mHealth intervention could improve the impact of both current and future infection prevention programs.

Implementation of the smartphone app “Participatient” was evaluated in four Dutch hospitals. Patient questionnaires assessed the acceptability of the app and its impact. Healthcare professionals (HCPs) were interviewed to evaluate the implementation process.

Acceptability constructs were evaluated positively. PE and quality of care were rated high before and after implementation. All 22 HCPs perceived barriers, eg incomplete training for HCPs and unclear communication on roles; and lack of promotion by ward professionals. The principal facilitator was the HCPs’ positive attitude toward PE.

App users perceived the Participatient app as acceptable, which fulfills a precondition for implementation. The implementation strategy evaluated in the present study was designed to fulfill all the conditions considered crucial for implementation. Nevertheless, the level of adoption remained low, and HCPs still imputed their failure to promote the use of the app to insufficiencies in training and communication and to a misfit between the app and their existing workflow. These findings underscore the need to verify whether there may be additional, less evident barriers to the adoption of mHealth tools that support PE in general, and more specifically, to the adoption of Participatient to engage patients in preventing CAUTIs.

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