Mapping the Cardiometabolic Patient Experience and Self-Care Behaviors to Inform Design, Implementation, and Persistent Use of Digital Health Care Solutions: Mixed Methods Study

• Published in: JMIR formative research Vol. 8; p. e43683
• Main Authors: Liska, Jan, Mical, Marie, Maillard, Christophe, Dessapt, Cécile, Bendig, Europa, Mai, Daniel, Piette, John D, De Geest, Sabina, Fontaine, Guillaume
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 01.01.2024
• Subjects: Acute coronary syndromes; Caregivers; Chronic illnesses; Cognition & reasoning; Community support; COVID-19; Diabetes; Grounded theory; Health behavior; Human subjects; Intervention; Metabolic disorders; Pandemics; Patient compliance; Patients; Phenomenology; Qualitative research; Rehabilitation; United States > US; Germany; Taiwan; treatment; coronary; adherence; implementation; tool; digital health; type 2 diabetes; design; digital tool; behavior; patient engagement; interview; support; self-care; care
• ISSN: 2561-326X; 2561-326X
• DOI: 10.2196/43683

Cardiometabolic conditions including acute coronary syndrome (ACS) and type 2 diabetes (T2D) require comprehensive care and patient engagement in self-care behaviors, and the drivers of those behaviors at the individual and health system level are still poorly understood. We aim to gain insights into self-care behaviors of individuals with cardiometabolic conditions. A convenience sample of 98 adult patients with ACS and T2D was recruited in the United States, Germany, and Taiwan to participate in a mixed methods study using ethnographic methods. All participants completed 7-day web-based diaries tracking their level of engagement, and 48 completed 90-minute web-based semistructured interviews between February 4, 2021, and March 27, 2021, focusing on themes including moments of engagement. Qualitative analysis identified factors influencing self-care practices and a Patient Mind States Model prototype. Patient reports indicate that many patients feel social pressure to adhere to treatment. Patients' experience can be understood within 5 categories defined in terms of their degree of engagement and adherence ("ignoring," "struggling," "juggling," "controlling," and "reframing"). For people living with ACS and T2D, the self-care journey is defined by patterns of patient experiences, which can identify areas that tailored digital health care interventions may play a meaningful role.