Introduction
Non-pharmacologic prevention measures reduce incident delirium by up to 30-40%% in inpatient and ED settings, but consistent application is often difficult. A mobile health application, titled iPREPARED (Improve Prevention and Recovery by Engaging Patients and FAmily-Caregivers to End Delirium) was co-developed with patients and their care partners to prepare them for delirium and empower them to use non-pharmacological prevention measures. This study assessed the feasibility, acceptability, and usability of iPREPARED in the emergency department (ED).
Methods
An IRB-approved prospective study enrolled a convenience sample of ED patients over age 60 and/or their care partners. Participants were provided a tablet with the iPREPARED application and were given time to review the contents and ask questions. Then, either the patient, care partner, or both completed a 20-item validated anonymous questionnaire including: 1) accessibility, 2) understandability, and 3) educational value. We used the validated Mobile health Apps Usability Questionnaire (MAUQ), with a 1 “strongly disagree” to 7 “strongly agree” Likert scale. Acceptability was measured by the satisfaction and perceived value of the app, and feasibility was measured by the practical implementation in the real-world setting.
Results
Slightly less than one half of the approached patients accepted to participate in the study. Questionnaires were completed by 40 participants (50% female). Questions addressing understandability, educational value, and ease of use had median ratings of 6 (IQR 5, 7) or 7 (6, 7). Individuals were less positive about iPREPARED improving access to healthcare services or managing health effectively (median 5 [4-7]) and noted a requirement for internet access. Reasons for declining participation included a language barrier (12%), feeling tired or not interested (17%), and feeling overwhelmed or uncomfortable (20%).
Conclusions
It is feasible to implement mobile health applications in real world settings including the ED. Patients and care partners perceived iPREPARED positively, particularly in terms of understandability and educational value.