Early-Stage Feasibility of a Mobile Health Intervention (Copilot) to Enhance Exacerbation-Related Self-Management in Patients With Chronic Obstructive Pulmonary Disease: Multimethods Approach.
BACKGROUND
There is an emergence of mobile health (mHealth) interventions to support self-management in patients with chronic obstructive pulmonary disease (COPD). Recently, an evidence-driven mHealth intervention has been developed to support patients with COPD in exacerbation-related self-management: the Copilot app. Health care providers (HCPs) are important stakeholders as they are the ones who have to provide the app to patients, personalize the app, and review the app. It is, therefore, important to investigate at an early stage whether the app is feasible in the daily practice of the HCPs.


OBJECTIVE
The aim of this study is to evaluate the perceived feasibility of the Copilot app in the daily practice of HCPs.


METHODS
A multimethods design was used to investigate how HCPs experience working with the app and how they perceive the feasibility of the app in their daily practice. The feasibility areas described by Bowen et al were used for guidance. HCPs were observed while performing tasks in the app and asked to think aloud. The System Usability Scale was used to investigate the usability of the app, and semistructured interviews were conducted to explore the feasibility of the app. The study was conducted in primary, secondary, and tertiary care settings in the Netherlands from February 2019 to September 2019.


RESULTS
In total, 14 HCPs participated in this study-8 nurses, 5 physicians, and 1 physician assistant. The HCPs found the app acceptable to use. The expected key benefits of the app were an increased insight into patient symptoms, more structured patient conversations, and more tailored self-management support. The app especially fits within the available time and workflow of nurses. The use of the app will be influenced by the autonomy of the professional, the focus of the organization on eHealth, costs associated with the app, and compatibility with the current systems used. Most HCPs expressed that there are conditions that must be met to be able to use the app. The app can be integrated into the existing care paths of primary, secondary, and tertiary health care settings. Individual organizational factors must be taken into account when integrating the app into daily practice.


CONCLUSIONS
This early-stage feasibility study shows that the Copilot app is feasible to use in the daily practice of HCPs and can be integrated into primary, secondary, and tertiary health care settings in the Netherlands. The app was considered to best fit the role of the nurses. The app will be less feasible for those organizations in which many conditions need to be met to use the app. This study provides a new approach to evaluate the perceived feasibility of mHealth interventions at an early stage and provides valuable insights for further feasibility testing.
['Korpershoek|Yvonne Jg|YJ|https://orcid.org/0000-0002-2383-9090', 'Holtrop|Tjitske|T|https://orcid.org/0000-0002-6677-3888', 'Vervoort|Sigrid Cjm|SC|https://orcid.org/0000-0003-3578-3685', 'Schoonhoven|Lisette|L|https://orcid.org/0000-0002-7129-3766', 'Schuurmans|Marieke J|MJ|https://orcid.org/0000-0001-6679-2141', 'Trappenburg|Jaap Ca|JC|https://orcid.org/0000-0003-0489-7401']
mobile health self-management mHealth COPD exacerbation mobile app self-care