BACKGROUND: Technology is becoming increasingly integrated into healthcare, including the rapid development of mobile health (mHealth) applications (apps) for various medical conditions such as urinary incontinence and pelvic organ prolapse (POP). As patients turn to these sources more frequently, closer evaluation of the apps becomes more important. OBJECTIVES: To (1) evaluate free applications designed for POP and urinary incontinence using the Xcertia guidelines for medical app quality, (2) analyze user sentiment of the apps, and (3) evaluate app information for quality, understandability, and actionability with the DISCERN and the Patient Education Materials Assessment Tool (PEMAT) tools. METHODS: Mobile medical apps were identified on the Apple App Store or Google Play Store with keywords "pelvic organ prolapse," "incontinence," or "bladder." Exclusion criteria included 1) not free, 2) not updated in past year, 3) required a product for use, 4) not in English. Apps were evaluated using the Xcertia Guidelines. Categories included Operability, Privacy, Security, Content, and Usability. Ratings and sentiment of reviews were assessed, and associations analyzed with one-sided Fisher's exact test. Apps with an informational component were evaluated for quality, usability and actionability using DISCERN and PEMAT criteria. RESULTS: Overall, a total of 73 apps were found and 28 were included. There was an average number of ratings of 2341 and an average score of 3.39 for all the apps included. The average number of reviews was 216.2, with the majority of reviews having positive sentiment. A high number of ratings was associated with a high rating score (p < 0.05) and a high number of reviews was associated with a high percentage of positive reviews (p < 0.05). Based on Xcertia Guidelines, all apps met the guidelines for privacy, security, and usability. Regarding content, 67.9 % of apps incorporated an informational component, but only 17.9 % delineated sources. The average DISCERN score for information quality indicated good quality information (>3). The average PEMAT scores for Understandability and Actionability were 90.6 % and 86.6 %, respectively, which are good scores (≥75 %). CONCLUSIONS: Most free apps were functional and well received by users, however quality of app content varied. Only some apps had an informational component, and even fewer had sources listed. Providers recommending health apps should consider those that meet Xcertia guidelines, have reliable information, and have good understandability and actionability.
Mobile Applications , Pelvic Organ Prolapse/therapy , Telemedicine/instrumentation , Urinary Incontinence/therapy , Exercise Therapy/instrumentation , Exercise Therapy/methods , Health Records, Personal , Humans , Pelvic Floor/physiopathology , Pelvic Organ Prolapse/diagnosis , Pelvic Organ Prolapse/physiopathology , Smartphone , Telemedicine/methods , Urinary Incontinence/diagnosis , Urinary Incontinence/physiopathology
INTRODUCTION: Limited patient understanding due to challenges in physician-patient communication and inadequate patient education materials (PEMs) can result in poor outcomes after pelvic organ prolapse (POP) repair. Our objective was to identify how patients learned about POP and review their perception of available educational tools. METHODS: Patients with a history of POP were recruited using ResearchMatch and invited to participate in a virtual semi-structured interview where they were shown a website, brochure, and video pertaining to POP. Information regarding patient preference for PEMs was obtained. The interviews were transcribed, coded, and qualitative data analysis was performed using grounded theory methodology. RESULTS: Qualitative analysis of interviews of 13 participants averaging 58 years old yielded several preliminary themes including: insufficient information to guide treatment decisions, preference for multimodal, dynamic, and comprehensive materials, and lack of support leading to avoidance of care, misinformation, and self-advocacy mechanisms. Emerging concepts included: lack of complete information regarding POP treatment resulted in misinformation, stress and desperation, distrust of healthcare providers leading to feelings of isolation, desire of support groups, and loss of follow up, and a desire for well-organized, detailed, multimodal, and destigmatizing materials as a guide to their disease process, prevention and risk factors, its natural progression, and treatment decisions. Participants developed self-reliant strategies for making treatment decisions, including the use of online resources, advice from friends, and independent search for more specialized physicians. CONCLUSIONS: Women with POP reported a lack of information and support which resulted in the generation of self-coping mechanisms. This led to significant anxiety surrounding their diagnosis and treatment and poor satisfaction. Developing a reproducible methodology to create evidence-based PEMs will significantly decrease patient misinformation, apprehension, and use of inaccurate sources of information.
Frustration , Pelvic Organ Prolapse , Adaptation, Psychological , Female , Humans , Middle Aged , Pelvic Organ Prolapse/therapy , Physician-Patient Relations
INTRODUCTION: The purpose of this study was to identify preoperative factors associated with worse PROMIS Pain Interference (PI) two years following knee surgery. METHODS: Participants completed surveys preoperatively and two years postoperatively. Data collected included demographics, medical history, and multiple patient-reported outcomes measures, including PROMIS PI. RESULTS: After controlling for confounders, lower income, smoking, worse PROMIS Anxiety, worse Numeric Pain Score body pain, and worse Marx Activity Rating Scale were independent predictors for worse PROMIS PI two years after surgery. CONCLUSION: Worse PROMIS PI two years after elective knee surgery is associated with multiple socio-demographic patient identifiers.
