Design and evaluation of a mobile application for monitoring patients with Alzheimer's disease: A day center case study (original) (raw)

2019, International Journal of Medical Informatics

Background and objective: This paper presents Alzheed, a mobile application for monitoring patients with Alzheimer's disease at day centers as well as a set of design recommendations for the development of healthcare mobile applications. The Alzheed project was conducted at Day Center "Dorita de Ojeda" that is focused on the care of patients with Alzheimer's disease. Materials and methods: A software design methodology based on participatory design was employed for the design of Alzheed. This methodology is both iterative and incremental and consists of two main iterative stages: evaluation of low-fidelity prototypes and evaluation of high-fidelity prototypes. Low-fidelity prototypes were evaluated by 11 day center's healthcare professionals (involved in the design of Alzheed), whereas high-fidelity prototypes were evaluated using a questionnaire based on the technology acceptance model (TAM) by the same healthcare professionals plus 30 senior psychology undergraduate students uninvolved in the design of Alzheed. Results: Healthcare professional participants perceived Alzheed as extremely likely to be useful and extremely likely to be usable, whereas senior psychology undergraduate students perceived Alzheed as quite likely to be useful and quite likely to be usable. Particularly, the median and mode of the TAM questionnaire were 7 (extremely likely) for healthcare professionals and 6 (quite likely) for psychology students (for both constructs: perceived usefulness and perceived ease of use). One-sample Wilcoxon signed-rank tests were performed to confirm the significance of the median for each construct. Conclusions: From the experience of designing Alzheed, it can be concluded that co-designing with healthcare professionals leads to (i) fostering group endorsement, which prevents resistance to change and (ii) helps to meet the needs of both healthcare professionals and patients, guaranteeing the usefulness of the application. In addition, evaluation of mobile healthcare applications by users involved and uninvolved in the application's design process helps to improve the ease of use of the application. Particularly, the number of people with Alzheimer's is projected to double every 20 years [2,3]. This becomes a global issue because, among other aspects, there will be an even higher need for senior care, and in particular, for specialized care for patients with Alzheimer's disease [3]. Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive deterioration of vital brain functions [5]. According to the Alzheimer's Association [6], patients with AD pass through several stages including early stage, middle stage, and late stage. In the early stage, patients may be independent and may have memory lapses, lose objects, and/or have difficulties in planning. In the middle stage, patients may be confused about time and space, may have bladder control problems, may show mood swings, and may forget