A Digital Platform to Support HIV Case Management for Youth and Young Adults: Mixed Methods Feasibility Study.

Autor:	Fee C; University of San Francisco, San Francisco, CA, United States., Fuller J; Dimagi, Inc, Cambridge, MA, United States., Guss CE; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States.; Harvard Medical School, Boston, MA, United States., Woods ER; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States.; Harvard Medical School, Boston, MA, United States., Cooper ER; Boston University School of Medicine, Boston, MA, United States.; Division of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA, United States., Bhaumik U; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States., Graham D; Harvard Medical School, Boston, MA, United States.; Program for Patient Safety & Quality, Boston Children's Hospital, Boston, MA, United States., Burchett SK; Harvard Medical School, Boston, MA, United States.; Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, United States., Dumont O; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States., Martey EB; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States., Narvaez M; Division of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA, United States., Haberer JE; Harvard Medical School, Boston, MA, United States.; Massachusetts General Hospital, Boston, MA, United States., Swendeman D; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States., Mulvaney SA; School of Nursing, Vanderbilt University, Nashville, TN, United States., Kumar VS; Dimagi, Inc, Cambridge, MA, United States., Jackson JL; Dimagi, Inc, Cambridge, MA, United States., Ho YX; Dimagi, Inc, Cambridge, MA, United States.
Jazyk:	angličtina
Zdroj:	JMIR formative research [JMIR Form Res] 2022 Nov 21; Vol. 6 (11), pp. e39357. Date of Electronic Publication: 2022 Nov 21.
DOI:	10.2196/39357
Abstrakt:	Background: Advances in medical treatments in recent years have contributed to an overall decline in HIV-related opportunistic infections and deaths in youth; however, mortality and morbidity rates in perinatally and nonperinatally infected adolescents and young adults (AYA) living with HIV remain relatively high today. Objective: The goal of this project was to assess the use, utility, and cost-effectiveness of PlusCare, a digital app for HIV case management in AYA living with HIV. The app supports routine case management tasks, such as scheduling follow-up visits, sharing documents for review and signature, laboratory test results, and between-visit communications (eg, encouraging messages). Methods: We conducted a single-group mixed methods pre-post study with HIV case management programs in 2 large urban hospitals in the Boston metro area. Case management staff (case managers [CMs], N=20) and AYA living with HIV participants (N=45) took part in the study with access to PlusCare for up to 15 and 12 months, respectively. Results: The CMs and AYA living with HIV reported mean System Usability Scale scores of 51 (SD 7.9) and 63 (SD 10.6), respectively. Although marginally significant, total charges billed at 1 of the 2 sites compared with the 12 months before app use (including emergency, inpatient, and outpatient charges) decreased by 41% (P=.046). We also observed slight increases in AYA living with HIV self-reported self-efficacy in chronic disease management and quality of life (Health-Related Quality of Life-4) from baseline to the 12-month follow-up (P=.02 and P=.03, respectively) and increased self-efficacy from the 6- to 12-month follow-up (P=.02). There was no significant change in HIV viral suppression, appointment adherence, or medication adherence in this small-sample pilot study. Conclusions: Although perceived usability was low, qualitative feedback from CMs and use patterns suggested that direct messaging and timely, remote, and secure sharing of laboratory results and documents (including electronic signatures) between CMs and AYA living with HIV can be particularly useful and have potential value in supporting care coordination and promoting patient self-efficacy and quality of life. Trial Registration: ClinicalTrials.gov NCT03758066; https://clinicaltrials.gov/ct2/show/NCT03758066. (©Connie Fee, Julia Fuller, Carly E Guss, Elizabeth R Woods, Ellen R Cooper, Urmi Bhaumik, Dionne Graham, Sandra K Burchett, Olivia Dumont, Emily B Martey, Maria Narvaez, Jessica E Haberer, Dallas Swendeman, Shelagh A Mulvaney, Vikram S Kumar, Jonathan L Jackson, Y Xian Ho. Originally published in JMIR Formative Research (https://formative.jmir.org), 21.11.2022.)
Databáze:	MEDLINE
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