Can an app improve patients' knowledge of their medical condition and treatment options?

ISRCTN ISRCTN98629372
DOI https://doi.org/10.1186/ISRCTN98629372
Secondary identifying numbers N16.130
Submission date
30/04/2018
Registration date
13/05/2018
Last edited
02/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Modern healthcare focuses on shared decision making (SDM). SDM is the process in which both the doctor and the patient decide on the best treatment, taking into account medical factors as well as patients’ preferences. In order to be able to participate in the process of SDM, patients need to have knowledge about the subjects they are discussing with their doctor. Currently patients are mainly educated about their illness and the available treatment options during the consultation with the doctor. Unfortunately, this has proven to be an ineffective way to improve their knowledge.
Factors that make it difficult for the patient to absorb information from the doctor include age, level of education of the patient, lack of time available, complex language from the doctor and above all, too much information in too little time.
This study aimed to investigate whether providing patients with 'bite-size', categorised and interactive content through an app for smartphone or tablet could increase their knowledge about their illness and treatment options.

Who can participate?
Patients with knee osteoarthritis, who were referred to the hospital by their general practitioner.

What does the study involve?
In the week before the consultation, patients in the app group received information on a daily basis. The information was about 5 important topics that would be addressed in the consultation with the orthopedic (joint) surgeon: about the knee and osteoarthritis, conservative (non-invasive) treatment, surgical treatment, rehabilitation and expectations. Patients were actively offered the information through push notifications. Each topic was available in text, images and a short video. Each topic had quiz-like questions to, on a day-to-day basis, measure (and reflect) on patients’ knowledge about the topic.

What are the possible benefits and risks of participating?
There are no risks of participating. People in the app group might gain a better understanding of knee osteoarthritis and options for treatment.

Where is the study run from?
Several medical centres in the Netherlands

When is the study starting and how long is it expected to run for?
April 2017 to September 2017

Who is funding the study?
The maker of the app, Interactive Studios

Who is the main contact?
Thomas Timmers, thomas@interactivestudios.nl

Contact information

Mr Thomas Timmers
Public

Huisbergenweg 6
Rosmalen
5249JR
Netherlands

ORCiD logoORCID ID 0000-0002-2534-5799
Phone 0031 73 644 6069
Email thomas@interactivestudios.nl

Study information

Study designSurgeon-blinded randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet ISRCTN98629372_PIS_11May18.pdf
Scientific titleAssessing the efficacy of an educational smartphone or tablet app with subdivided and interactive content to increase patients’ medical knowledge: A randomized controlled trial
Study objectivesProviding patients with medical information in a subdivided, categorized, and interactive manner via an educational app for smartphone or tablet increases the knowledge about their illness and the treatment options
Ethics approval(s)Medical Ethical Board Maxima MC (Eindhoven, The Netherlands), 18/10/2016, N16.130
Health condition(s) or problem(s) studiedKnee osteoarthritis
InterventionA surgeon-blinded randomized controlled trial was conducted with 213 patients who were referred to one of the six Dutch hospitals by their general practitioner owing to knee complaints that were indicative of knee osteoarthritis (OA). The eligibility of patients was assessed during their first contact with the hospital to schedule their appointment with the orthopedic surgeon. One group of patients were randomly allocated to use an interactive app that, in addition to standard care, actively sends informative and pertinent content to patients about their illness on a daily basis by means of push notifications in the week prior to their consultation with the orthopedic surgeon. Patients received, on a daily base and by means of push notifications, information about one of the following topics: the knee and the origin of the complaints, conservative treatment, surgical treatment, risks, rehabilitation after discharge and expectations. Each day covered one topic. Video, images and text were used as modes of information. Quiz-like questions were asked after each video to provide direct feedback of patients' understanding of the information.
Patients in the control group did not receive the app. They had access to all the standard information (eg. website, brochure) that is normally offered to them in the period prior to the consultation.
After accepting participating in the study, patients were automatically online randomised. No blocks or clusters were used.
Intervention typeBehavioural
Primary outcome measurePatients' knowledge (perceived and actual) about their illness and the treatment options. Actual knowledge was measured 2 days prior to the consultation by a 12-item multiple choice questionnaire, with possible scores ranging from 0 to 36. Perceived knowledge was also measured 2 days before the consultation by a 5-item multiple choice questionnaire, with possible scores ranging from 0 to 25.
Secondary outcome measures1. Satisfaction with information and patient knowledge was measured 2 days before the consultation by using NRS scores ranging from 0 to 10
2. Certainty of the treatment chosen was measured 1 day after the consultation using an NRS 0 to 10 scale.
Overall study start date01/04/2017
Completion date01/09/2017

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants188
Key inclusion criteria1. Referred by GP to orthopedic surgeon for suspected knee osteoarthritis
2. Fluent in Dutch
3. Possess an email address and a smart phone or tablet
4. At least 10 days between scheduling the appointment and the hospital visit were required, to give patients in the app group the chance to experience the intervention
Key exclusion criteria1. Not Dutch-speaking
2. Not in possession of smartphone or tablet
Date of first enrolment01/04/2017
Date of final enrolment01/08/2017

Locations

Countries of recruitment

  • Netherlands

Study participating centres

VieCuri Medical Centre,
Venlo
5912BL
Netherlands
Kliniek ViaSana
Mill
5451AA
Netherlands
Jeroen Bosch Ziekenhuis
Den Bosch
5223GZ
Netherlands
Canisius-Wilhelmina Hospital
Nijmegen
6532SZ
Netherlands
Sint Anna Ziekenhuis
Geldrop
5664EH
Netherlands
Amphia Hospital
Breda
4818CK
Netherlands

Sponsor information

Interactive Studios
Industry

Huisbergenweg 6
5249 JR
5249JR
Netherlands

Phone 0031736446069
Email thomas@interactivestudios.nl

Funders

Funder type

Not defined

Interactive Studios

No information available

Results and Publications

Intention to publish date01/06/2018
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planThe data is available to the researchers from the participating hospitals upon request. They can request that data through the main investigator, Thomas Timmers. They can only access the data from their own patients. Data is provided in an encrypted Excel or SPSS file. In the files (and the complete data collection system) only data is available from patients that gave their informed consent.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 21/12/2018 Yes No
Participant information sheet 11/05/2018 02/04/2019 No Yes

Additional files

ISRCTN98629372_PIS_11May18.pdf
Uploaded 02/04/2019

Editorial Notes

02/04/2019: The participant information sheet has been uploaded.
03/01/2019: Publication reference added.