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Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study.
Acharya, Chathur; Sehrawat, Tejasav S; McGuire, Deborah B; Shaw, Jawaid; Fagan, Andrew; McGeorge, Sara; Olofson, Amy; White, Melanie B; Gavis, Edith; Kamath, Patrick S; Bergstrom, Lori; Bajaj, Jasmohan Singh.
Afiliação
  • Acharya C; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.
  • Sehrawat TS; McGuire VA Medical Center, Richmond, VA, United States.
  • McGuire DB; Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States.
  • Shaw J; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.
  • Fagan A; McGuire VA Medical Center, Richmond, VA, United States.
  • McGeorge S; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.
  • Olofson A; McGuire VA Medical Center, Richmond, VA, United States.
  • White MB; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.
  • Gavis E; McGuire VA Medical Center, Richmond, VA, United States.
  • Kamath PS; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.
  • Bergstrom L; McGuire VA Medical Center, Richmond, VA, United States.
  • Bajaj JS; Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States.
J Med Internet Res ; 23(4): e24639, 2021 04 09.
Article em En | MEDLINE | ID: mdl-33744844
ABSTRACT

BACKGROUND:

Health information technology (IT) interventions to decrease readmissions for cirrhosis may be limited by patient-associated factors.

OBJECTIVE:

The aim of this study was to determine perspectives regarding adoption versus refusal of health IT interventions among patient-caregiver dyads.

METHODS:

Inpatients with cirrhosis and their caregivers were approached to participate in a randomized health IT intervention trial requiring daily contact with research teams via the Patient Buddy app. This app focuses on ascites, medications, and hepatic encephalopathy over 30 days. Regression analyses for characteristics associated with acceptance were performed. For those who declined, a semistructured interview was performed with themes focused on caregivers, protocol, transport/logistics, technology demands, and privacy.

RESULTS:

A total of 349 patient-caregiver dyads were approached (191 from Virginia Commonwealth University, 56 from Richmond Veterans Affairs Medical Center, and 102 from Mayo Clinic), 87 of which (25%) agreed to participate. On regression, dyads agreeing included a male patient (odds ratio [OR] 2.08, P=.01), gastrointestinal bleeding (OR 2.3, P=.006), or hepatic encephalopathy admission (OR 2.0, P=.01), whereas opioid use (OR 0.46, P=.03) and alcohol-related etiology (OR 0.54, P=.02) were associated with refusal. Race, study site, and other admission reasons did not contribute to refusing participation. Among the 262 dyads who declined randomization, caregiver reluctance (43%), perceived burden (31%), technology-related issues (14%), transportation/logistics (10%), and others (4%), but not privacy, were highlighted as major concerns.

CONCLUSIONS:

Patients with cirrhosis admitted with hepatic encephalopathy and gastrointestinal bleeding without opioid use or alcohol-related etiologies were more likely to participate in a health IT intervention focused on preventing readmissions. Caregiver and study burden but not privacy were major reasons to decline participation. Reducing perceived patient-caregiver burden and improving communication may improve participation. TRIAL REGISTRATION ClinicalTrials.gov NCT03564626; https//www.clinicaltrials.gov/ct2/show/NCT03564626.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidadores / Pacientes Internados Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidadores / Pacientes Internados Idioma: En Ano de publicação: 2021 Tipo de documento: Article