Development of Patient-Centric Digital Engagement Methods to Address Low Adoption and Adherence to Digital Health Tools: A Novel Conceptual Framework

OBJECTIVES: Digital health tools (DHTs) connect patients to care providers, researchers, and other stakeholders, with the potential to impact delivery and outcomes of care. However, misalignment between stakeholders, stemming from conflicting priorities and inadequate awareness of diverse patient needs has lead to low adoption and adherence to patient-DHTs (P-DHTs). Individual studies evaluating P-DHT use are often not generalizable as they focus on a single DHT or disease-area. This abstract introduces a framework to guide the development of evidence-based digital engagement methods associated with adoption and adherence to P-DHTs.

METHODS: We conducted a targeted review to explore current methods associated with adoption and adherence to P-DHTs and a benchmark analysis of currently available P-DHTs, including patient reviews. P-DHTs were included if they met the following criteria: used outside the point of care, allowed bidirectional communication with patients, and supported patients through routine care or research. We used thematic analysis to identify Moderating variables explaining why and how patients use P-DHTs and Mediating variables influencing the strength of adoption and adherence to P-DHTs. Additionally, we identified Control variables affecting why and how patients use P-DHTs and Confounding variables influencing patient interactions with P-DHTs.

RESULTS: Moderating variables include co-designing P-DHTs with patients and the patient-perceived value-to-burden ratio of P-DHT use. Mediating variables entail recruitment and retention efforts to promote patient-perceived benefits of P-DHTs and ongoing use. Control variables encompass demographics and condition status, which influence patients’ motivations for using P-DHTs. Confounding variables include resource constraints and stakeholder misalignments that influence the quality and functionality of P-DHTs.

CONCLUSIONS: This framework combines insights from a targeted literature review and benchmark analysis to identify moderating, mediating, controlling, and confounding variables influencing adoption and adherence to P-DHTs. Relationships between these variables should be considered when developing P-DHTs to assess their respective impact on patient adoption and adherence.