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Volume 19
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10.3390/ijerph192013714
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Article

Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study

by
Seán R. O’Connor
1,*,
Charlene Treanor
2,*,
Elizabeth Ward
3,
Robin A. Wickens
3,4,
Abby O’Connell
5,
Lucy A. Culliford
3,
Chris A. Rogers
3,
Eleanor A. Gidman
3,
Tunde Peto
2,
Paul C. Knox
6,
Benjamin J. L. Burton
7,
Andrew J. Lotery
8,
Sobha Sivaprasad
9,
Barnaby C. Reeves
3,
Ruth E. Hogg
2,
Michael Donnelly
2 and
MONARCH Study Group
1
School of Psychology, Queen’s University of Belfast, Belfast BT7 1NN, UK
2
Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
3
Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
4
Southampton Clinical Trials Unit, University of Southampton, University Road, Southampton SO17 1BJ, UK
5
Exeter Clinical Trials Unit (EXECTU), University of Exeter, St. Lukes Campus, Exeter EX1 2LT, UK
6
Department of Eye and Vision Science, University of Liverpool, Liverpool L7 8TX, UK
7
James Paget University Hospitals NHS Foundation Trust, Norfolk NR31 6LA, UK
8
Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
9
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(20), 13714; https://doi.org/10.3390/ijerph192013714
Submission received: 30 August 2022 / Revised: 19 October 2022 / Accepted: 19 October 2022 / Published: 21 October 2022
(This article belongs to the Special Issue Applied Digital Health Approaches for the Management of Chronic Conditions)
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Abstract

Neovascular age-related macular degeneration (nAMD) is a chronic, progressive condition and the commonest cause of visual disability in older adults. This study formed part of a diagnostic test accuracy study to quantify the ability of three index home monitoring (HM) tests (one paper-based and two digital tests) to identify reactivation in nAMD. The aim of this qualitative research was to investigate patients’ or participants’ views about acceptability and explore adherence to weekly HM. Semi-structured interviews were held with 78/297 participants (26%), with close family members (n = 11) and with healthcare professionals involved in training participants in HM procedures (n = 9) (n = 98 in total). A directed thematic analytical approach was applied to the data using a deductive and inductive coding framework informed by theories of technology acceptance. Five themes emerged related to: 1. The role of HM; 2. Suitability of procedures and instruments; 3. Experience of HM; 4. Feasibility of HM in usual practice; and 5. Impediments to patient acceptability of HM. Various factors influenced acceptability including a patient’s understanding about the purpose of monitoring. While initial training and ongoing support were regarded as essential for overcoming unfamiliarity with use of digital technology, patients viewed HM as relatively straightforward and non-burdensome. There is a need for further research about how use of performance feedback, level of support and nature of tailoring might facilitate further the implementation of routinely conducted HM. Home monitoring was acceptable to patients and they recognised its potential to reduce clinic visits during non-active treatment phases. Findings have implications for implementation of digital HM in the care of older people with nAMD and other long-term conditions.
Keywords: patient perspective; technology acceptance; ophthalmic care; qualitative methods patient perspective; technology acceptance; ophthalmic care; qualitative methods

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MDPI and ACS Style

O’Connor, S.R.; Treanor, C.; Ward, E.; Wickens, R.A.; O’Connell, A.; Culliford, L.A.; Rogers, C.A.; Gidman, E.A.; Peto, T.; Knox, P.C.; et al. Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 13714. https://doi.org/10.3390/ijerph192013714

AMA Style

O’Connor SR, Treanor C, Ward E, Wickens RA, O’Connell A, Culliford LA, Rogers CA, Gidman EA, Peto T, Knox PC, et al. Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study. International Journal of Environmental Research and Public Health. 2022; 19(20):13714. https://doi.org/10.3390/ijerph192013714

Chicago/Turabian Style

O’Connor, Seán R., Charlene Treanor, Elizabeth Ward, Robin A. Wickens, Abby O’Connell, Lucy A. Culliford, Chris A. Rogers, Eleanor A. Gidman, Tunde Peto, Paul C. Knox, and et al. 2022. "Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study" International Journal of Environmental Research and Public Health 19, no. 20: 13714. https://doi.org/10.3390/ijerph192013714

APA Style

O’Connor, S. R., Treanor, C., Ward, E., Wickens, R. A., O’Connell, A., Culliford, L. A., Rogers, C. A., Gidman, E. A., Peto, T., Knox, P. C., Burton, B. J. L., Lotery, A. J., Sivaprasad, S., Reeves, B. C., Hogg, R. E., Donnelly, M., & MONARCH Study Group. (2022). Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study. International Journal of Environmental Research and Public Health, 19(20), 13714. https://doi.org/10.3390/ijerph192013714

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