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Attitudes towards digital health tools for outpatient cirrhosis management in patients with decompensated cirrhosis
  1. Patricia Pringle Bloom1,
  2. Madeline Marx1,
  3. Thomas J Wang2,
  4. Bradley Green1,
  5. Jasmine Ha1,
  6. Camden Bay3,
  7. Raymond T Chung1,
  8. James M Richter1
  1. 1Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Patricia Pringle Bloom, Gastroenterology, Massachusetts General Hospital, Boston, MA 02114, USA; ppbloom{at}partners.org

Abstract

Background Technology represents a promising tool to improve healthcare delivery for patients with cirrhosis. We sought to assess utilisation of technology and preferred features of a digital health management tool, in patients with an early readmission for decompensated cirrhosis.

Methods We conducted a cross-sectional study of patients readmitted within 90 days for decompensated cirrhosis. A semistructured interview obtained quantitative and qualitative data through open-ended questions.

Results Of the 50 participants, mean age was 57.6 years and mean (range) model for end stage liver disease was 22.7 (10–46). Thirty-eight (76%) patients own a Smartphone and 62% have regular access to a computer with internet. Thirty-nine (78%) patients would consider using a Smartphone application to manage their cirrhosis. Forty-six (92%) patients report having a principal caregiver, of which 80% own a Smartphone. Patients were interested in a Smartphone application that could communicate with their physician (85%), send medication notifications to the patient (65%) and caregiver (64%), transmit diagnostic results and appointment reminders (82%), educate about liver disease (79%), regularly transmit weight data to the doctor (85% with ascites) and play a game to detect cognitive decline (67% with encephalopathy). Common themes from qualitative data include a desire to learn about liver disease and communicate with providers via digital tools.

Conclusion Among patients with cirrhosis with an early readmission for decompensation, most have Smartphones and would be willing to use a Smartphone to manage their disease. Future digital health management tools should be tailored to the use patterns and preferences of the patients with cirrhosis and their caregivers.

  • healthcare innovation
  • qualitative research
  • telemedicine
  • healthcare delivery
  • technology

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Footnotes

  • Twitter @BloomPringle

  • Contributors PPB was responsible for the planning, conduct and reporting of the study. PPB is also the guarantor of the study. MM, TJW and BG were responsible for the conduct and reporting of the study. CB was responsible for data analysis. JH and RTC were responsible for the reporting of the study. JMR was responsible for planning, conduct and reporting of the study.

  • Funding This project was supported by a Partners Healthcare Center of Expertise in Quality and Safety grant and by a Massachusetts General Hospital Department of Medicine Innovation Program Spark Grant, awarded to PPB. PPB is supported by the following grant: NIH T32 DK007191-43. RTC was supported by the following grant: NIH K24 DK078772.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.