TY  - JOUR
AU  - Acharya, Chathur
AU  - Sehrawat, Tejasav S
AU  - McGuire, Deborah B
AU  - Shaw, Jawaid
AU  - Fagan, Andrew
AU  - McGeorge, Sara
AU  - Olofson, Amy
AU  - White, Melanie B
AU  - Gavis, Edith
AU  - Kamath, Patrick S
AU  - Bergstrom, Lori
AU  - Bajaj, Jasmohan Singh
PY  - 2021
DA  - 2021/4/9
TI  - Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study
JO  - J Med Internet Res
SP  - e24639
VL  - 23
IS  - 4
KW  - hepatic encephalopathy
KW  - cirrhosis
KW  - outcomes
KW  - acceptance
KW  - PatientBuddy
KW  - ascites
KW  - readmissions
KW  - hepatic
KW  - encephalopathy
AB  - Background: Health information technology (IT) interventions to decrease readmissions for cirrhosis may be limited by patient-associated factors. Objective: The aim of this study was to determine perspectives regarding adoption versus refusal of health IT interventions among patient-caregiver dyads. Methods: Inpatients with cirrhosis and their caregivers were approached to participate in a randomized health IT intervention trial requiring daily contact with research teams via the Patient Buddy app. This app focuses on ascites, medications, and hepatic encephalopathy over 30 days. Regression analyses for characteristics associated with acceptance were performed. For those who declined, a semistructured interview was performed with themes focused on caregivers, protocol, transport/logistics, technology demands, and privacy. Results: A total of 349 patient-caregiver dyads were approached (191 from Virginia Commonwealth University, 56 from Richmond Veterans Affairs Medical Center, and 102 from Mayo Clinic), 87 of which (25%) agreed to participate. On regression, dyads agreeing included a male patient (odds ratio [OR] 2.08, P=.01), gastrointestinal bleeding (OR 2.3, P=.006), or hepatic encephalopathy admission (OR 2.0, P=.01), whereas opioid use (OR 0.46, P=.03) and alcohol-related etiology (OR 0.54, P=.02) were associated with refusal. Race, study site, and other admission reasons did not contribute to refusing participation. Among the 262 dyads who declined randomization, caregiver reluctance (43%), perceived burden (31%), technology-related issues (14%), transportation/logistics (10%), and others (4%), but not privacy, were highlighted as major concerns. Conclusions: Patients with cirrhosis admitted with hepatic encephalopathy and gastrointestinal bleeding without opioid use or alcohol-related etiologies were more likely to participate in a health IT intervention focused on preventing readmissions. Caregiver and study burden but not privacy were major reasons to decline participation. Reducing perceived patient-caregiver burden and improving communication may improve participation. Trial Registration: ClinicalTrials.gov NCT03564626; https://www.clinicaltrials.gov/ct2/show/NCT03564626 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/4/e24639
UR  - https://doi.org/10.2196/24639
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33744844
DO  - 10.2196/24639
ID  - info:doi/10.2196/24639
ER  -