Patient acceptability of home monitoring for neovascular age-related macular degeneration reactivation: a qualitative study

Sean O'Connor*, Charlene Treanor, Elizabeth Ward, Robin A Wickens, Abby J O'Connell, Lucy A Culliford, Chris A Rogers, Eleanor A Gidman, Tunde Peto, Paul Knox, Benjamin Burton, Andrew Lotery, Sobha Sivaprasad, Barnaby C Reeves, Ruth E. Hogg, Michael Donnelly

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Neovascular age-related macular degeneration (nAMD) is a chronic, progressive condi-tion and the commonest cause of visual disability in older adults. This study formed part of a diag-nostic test accuracy study to quantify the ability of three index home monitoring (HM) tests (one paper-based and two digital tests) to identify reactivation in nAMD. The aim of this qualitative research was to investigate patients’ or participants’ views about acceptability and explore adher-ence to weekly HM. Semi-structured interviews were held with 78/297 participants (26%), with close family members (n=11) and with healthcare professionals involved in training participants in HM procedures (n=9) (n=98 in total). A directed thematic analytical approach was applied to the data using a deductive and inductive coding framework informed by theories of technology acceptance. Five themes emerged related to: 1. The role of HM; 2. Suitability of procedures and instruments; 3. Experience of HM; 4. Feasibility of HM in usual practice; and 5. Impediments to patient acceptability of HM. Various factors influenced acceptability including a patient’s understanding about the pur-pose of monitoring. While initial training and ongoing support were regarded as essential for over-coming unfamiliarity with use of digital technology, patients viewed HM as relatively straightfor-ward and non-burdensome. There is a need for further research about how use of performance feedback, level of support and nature of tailoring might facilitate further the implementation of routinely conducted HM. Home monitoring was acceptable to patients and they recognised its po-tential to reduce clinic visits during non-active treatment phases. Findings have implications for implementation of digital HM in the care of older people with nAMD and other long-term condi-tions.
Original languageEnglish
Article number13714
JournalInternational Journal of Environmental Research and Public Health
Volume19
Issue number20
DOIs
Publication statusPublished - 21 Oct 2022

Bibliographical note

Funding Information:
This project was funded by the National Institute for Health Research, Health Technology Assessment (HTA) Programme (ref 15/97/02). The views and opinions are the authors’ and do not necessarily reflect the HTA programme, NIHR, NHS or the Department of Health and Social Care.

Funding Information:
The study is sponsored by The Queen’s University of Belfast, UK. This study was designed and delivered in collaboration with the Clinical Trials and Evaluation Unit (CTEU), a UKCRC registered clinical trials unit which, as part of the Bristol Trials Centre, is in receipt of National Institute for Health Research CTU support funding. The authors would like to acknowledge the Patient and Public Involvement group (PPI), the Macular Society and the Royal National Institute of Blind People for feedback on the study and the patient documents and the SSC for their oversight of the study.

Publisher Copyright:
© 2022 by the authors.

Structured keywords

  • BTC (Bristol Trials Centre)

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