A participatory process to design an app to improve adherence to anti-osteoporotic therapies: A development and usability study

Abstract

Objective: The aim of the study was to develop an app to improve patients' adherence to therapy for osteoporosis and to test its usability.

Methods: In Phase I, the app functions needed to improve medication adherence were identified through a focus group with six patients with osteoporosis and a joint interview with two bone specialists. The app prototype was then developed (Phase II) and refined after its feasibility testing (Phase III) for 13-25 days by eight patients. Finally, the app underwent usability testing (Phase IV) for 6 months by nine other patients. The mHealth App Usability Questionnaire (MAUQ) was used to collect the assessment of the app by the 17 patients.

Results: The final version of the app provided information on osteoporosis, allowed patients to contact the bone specialist for an additional consultation, and generated a reminder for taking medications accompanied by feedback on adherence. The assessment of the app was positive but evaluations differed between the feasibility and usability testing, with the former displaying a significantly (p ≤ .05) better assessment across all MAUQ items.

Conclusions: In this study, we tested an app for improving adherence to medical therapies in patients with osteoporosis. The usability testing revealed a lower "patient-centered" performance of the app as compared to that observed during the feasibility phase. Future developments of the study include increasing the testing cohort and adding a technical support during the usability testing.

Keywords: App; adherence; anti-osteoporotic therapies; mHealth; participatory design.

Figure 1.

Phases of the study divided into the development and usability testing of the app.

Figure 2.

Selected screenshots of the developed app: (a) “contact” section, to request an extra consultation with the bone specialist; (b) “FAQs” section; (c) “adherence” section part 1, to set date, time and frequency of reminders, and (d) “adherence” section part 2, where patients declared if they had taken the drug.

Figure 3.

Average values of the answers to the MAUQ questionnaire in the feasibility testing (pink continuous line) and in the usability testing groups (blue dotted line). Ideal results corresponding to 5 are indicated with a violet dotted line.