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. 2024 Jan 12:8:e43683.
doi: 10.2196/43683.

Mapping the Cardiometabolic Patient Experience and Self-Care Behaviors to Inform Design, Implementation, and Persistent Use of Digital Health Care Solutions: Mixed Methods Study

Jan Liska  1 , Marie Mical  1 , Christophe Maillard  1 , Cécile Dessapt  1 , Europa Bendig  2 , Daniel Mai  2 , John D Piette  3 , Sabina De Geest  4   5 , Guillaume Fontaine  6   7   8   9
Affiliations

Mapping the Cardiometabolic Patient Experience and Self-Care Behaviors to Inform Design, Implementation, and Persistent Use of Digital Health Care Solutions: Mixed Methods Study

Jan Liska et al. JMIR Form Res. .

Abstract

Background: Cardiometabolic conditions including acute coronary syndrome (ACS) and type 2 diabetes (T2D) require comprehensive care and patient engagement in self-care behaviors, and the drivers of those behaviors at the individual and health system level are still poorly understood.

Objective: We aim to gain insights into self-care behaviors of individuals with cardiometabolic conditions.

Methods: A convenience sample of 98 adult patients with ACS and T2D was recruited in the United States, Germany, and Taiwan to participate in a mixed methods study using ethnographic methods. All participants completed 7-day web-based diaries tracking their level of engagement, and 48 completed 90-minute web-based semistructured interviews between February 4, 2021, and March 27, 2021, focusing on themes including moments of engagement. Qualitative analysis identified factors influencing self-care practices and a Patient Mind States Model prototype.

Results: Patient reports indicate that many patients feel social pressure to adhere to treatment. Patients' experience can be understood within 5 categories defined in terms of their degree of engagement and adherence ("ignoring," "struggling," "juggling," "controlling," and "reframing").

Conclusions: For people living with ACS and T2D, the self-care journey is defined by patterns of patient experiences, which can identify areas that tailored digital health care interventions may play a meaningful role.

Keywords: adherence; behavior; care; coronary; design; digital health; digital tool; implementation; interview; patient engagement; self-care; support; tool; treatment; type 2 diabetes.

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Conflict of interest statement

Conflicts of Interest: SDG received consultancy fees from Novartis and Sanofi. CD, CM, JL, and MM are Sanofi employees and may hold shares or stock options in the company. The other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Patient modes of engagement and experience domains. HCP: health care professional.
Figure 2
Figure 2
The ongoing process of gaining self-care expertise.
Figure 3
Figure 3
The Patient Mind States Model (PMM)—this model contains patient mind states regarding disease self-care identified in patients with chronic cardiometabolic disease.
See this image and copyright information in PMC

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