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Lessard D, Engler K, Ma Y, Rodriguez Cruz A, Vicente S, Kronfli N, Barkati S, Brouillette MJ, Cox J, Kildea J, Hijal T, Pomey MP, Bartlett SJ, Asselah J, Lebouché B. Remote Follow-up of Self-isolating Patients With COVID-19 Using a Patient Portal: Protocol for a Mixed Methods Pilot Study (Opal-COVID Study). JMIR Res Protoc 2022; 11:e35760. [PMID: 35820054 PMCID: PMC9390833 DOI: 10.2196/35760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background People with COVID-19 are instructed to self-isolate at home. During self-isolation, they may experience anxiety and insufficient care. Patient portals can allow patients to self-monitor and remotely share their health status with health care professionals, but little data are available on their feasibility. Objective This paper presents the protocol of the Opal-COVID Study. Its objectives are to assess the implementation of the Opal patient portal for distance monitoring of self-isolating patients with COVID-19, identify influences on the intervention’s implementation, and describe service and patient outcomes of this intervention. Methods This mixed methods pilot study aims to recruit 50 patient participants with COVID-19 tested at the McGill University Health Centre (Montreal, Canada) for 14 days of follow-up. With access to an existing patient portal through a smartphone app, patients will complete a daily self-assessment of symptoms, vital signs, and mental health monitored by a nurse, and receive teleconsultations as needed. Study questionnaires will be administered to collect data on sociodemographic characteristics, medical background, implementation outcomes (acceptability, usability, and respondent burden), and patient satisfaction. Coordinator logbook entries will inform on feasibility outcomes, namely, on recruitment, retention, and fidelity, as well as on the frequency and nature of contacts with health care professionals. The statistical analyses for objectives 1 (implementation outcomes), 3 (service outcomes), and 4 (patient outcomes) will evaluate the effects of time and sociodemographic characteristics on the outcomes. For objectives 1 (implementation outcomes) and 4 (patient outcomes), the statistical analyses will also examine the attainment of predefined success thresholds. As for the qualitative analyses, for objective 2 (influences on implementation), semistructured qualitative interviews will be conducted with 4 groups of stakeholders (ie, patient participants, health care professionals, technology developers, and study administrators) and submitted for content analysis, guided by the Consolidated Framework for Implementation Research to help identify barriers to and facilitators of implementation. For objective 3 (service outcomes), reasons for contacting health care professionals through Opal will also be submitted for content analysis. Results Between December 2020 and March 2021, a total of 51 patient participants were recruited. Qualitative interviews were conducted with 39 stakeholders from April to September 2021. Delays were experienced owing to measures taken at the McGill University Health Centre to address COVID-19. The quantitative and qualitative analyses began in May 2022. As of June 2022, a total of 2 manuscripts (on the implementation and the patient outcomes) were being prepared, and 3 conference presentations had been given on the study’s methods. Conclusions This protocol is designed to generate multidisciplinary knowledge on the implementation of a patient portal–based COVID-19 care intervention and will lead to a comprehensive understanding of feasibility, stakeholder experience, and influences on implementation that may prove useful for scaling up similar interventions. Trial Registration ClinicalTrials.gov NCT04978233; https://clinicaltrials.gov/ct2/show/NCT04978233 International Registered Report Identifier (IRRID) DERR1-10.2196/35760
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Affiliation(s)
- David Lessard
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Kim Engler
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments,
| | - Yuanchao Ma
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, QC, Canada
| | - Adriana Rodriguez Cruz
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Serge Vicente
- See Acknowledgments, .,Department of Mathematics and Statistics, Université de Montréal, Montreal, QC, Canada
| | | | - Nadine Kronfli
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Marie-Josée Brouillette
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Psychiatry Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Joseph Cox
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Tarek Hijal
- Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Susan J Bartlett
- Department of Medicine, Divisions of Experimental Medicine, Clinical Epidemiology, Respiratory Medicine, and Rheumatology, McGill University, Montreal, QC, Canada
| | - Jamil Asselah
- Department of Medicine, Division of Medical Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Bertrand Lebouché
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Chu D, Lessard D, Laymouna MA, Engler K, Schuster T, Ma Y, Kronfli N, Routy JP, Hijal T, Lacombe K, Sheehan N, Rougier H, Lebouché B. Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives. J Pers Med 2022; 12:jpm12020314. [PMID: 35207803 PMCID: PMC8880024 DOI: 10.3390/jpm12020314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Like other chronic viral illnesses, HIV infection necessitates consistent self-management and adherence to care and treatment, which in turn relies on optimal collaboration between patients and healthcare professionals (HCPs), including physicians, nurses, pharmacists, and clinical care coordinators. By providing people living with HIV (PLHIV) with access to their personal health information, educational material, and a communication channel with HCPs, a tailored patient portal could support their engagement in care. Our team intends to implement a patient portal in HIV-specialized clinics in Canada and France. We sought to understand the perceived risks and benefits among PLHIV and HCPs of patient portal use in HIV clinical care. Methods: This qualitative study recruited PLHIV and HIV-specialized HCPs, through maximum variation sampling and purposeful sampling, respectively. Semi-structured focus group discussions (FGDs) were held separately with PLHIV and HCPs between August 2019 and January 2020. FGDs were recorded, transcribed, coded using NVivo 12 software, and analyzed using content analysis. Results: A total of twenty-eight PLHIV participated in four FGDs, and thirty-one HCPs participated in six FGDs. PLHIV included eighteen men, nine women, and one person identifying as other; while, HCPs included ten men, twenty women, and one person identifying as other. A multi-disciplinary team of HCPs were included, involving physicians, nurses, pharmacists, social workers, and clinical coordinators. Participants identified five potential risks: (1) breach of confidentiality, (2) stress or uncertainty, (3) contribution to the digital divide, (4) dehumanization of care, and (5) increase in HCPs’ workload. They also highlighted four main benefits of using a patient portal: (1) improvement in HIV self-management, (2) facilitation of patient visits, (3) responsiveness to patient preferences, and (4) fulfillment of current or evolving patient needs. Conclusion: PLHIV and HCPs identified both risks and benefits of using a patient portal in HIV care. By engaging stakeholders and understanding their perspectives, the configuration of a patient portal can be optimized for end-users and concerns may be mitigated during its implementation.
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Affiliation(s)
- Dominic Chu
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Moustafa A. Laymouna
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
| | - Kim Engler
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
| | - Yuanchao Ma
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, QC H3C 3A7, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Jean-Pierre Routy
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Tarek Hijal
- Division of Radiation Oncology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Karine Lacombe
- Faculté de Médecine, Sorbonne Université, Inserm IPLESP, Hôpital St Antoine, APHP, 75012 Paris, France;
| | - Nancy Sheehan
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Faculté de Pharmacie, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Hayette Rougier
- IMEA, Institut de Médecine et d’Épidémiologie Appliquée, F75018 Paris, France;
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Correspondence: ; Tel.: +1-514-843-2090
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