PMID- 37624633
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230912
IS  - 2561-326X (Electronic)
IS  - 2561-326X (Linking)
VI  - 7
DP  - 2023 Aug 25
TI  - Exploring Patient Needs and Designing Concepts for Digitally Supported Health 
      Solutions in Managing Type 2 Diabetes: Cocreation Study.
PG  - e49738
LID - 10.2196/49738 [doi]
LID - e49738
AB  - BACKGROUND: Self-management of the progressive disease type 2 diabetes mellitus 
      (T2DM) becomes part of the daily life of patients starting from the time of 
      diagnosis. However, despite the availability of technical innovations, the uptake 
      of digital solutions remains low. One reason that has been reported is that 
      digital solutions often focus purely on clinical factors that may not align with 
      the patient's perspective. OBJECTIVE: The aim of this study was to develop 
      digital solutions that address the needs of patients with T2DM, designed from the 
      user's perspective. The goal was to address the patients' expressed real-world 
      needs by having the users themselves choose the scope and format of the 
      solutions. METHODS: Using participatory methods, we conducted 3 cocreation 
      workshops in collaboration with the Danish Diabetes Association, with 20 persons 
      with T2DM and 11 stakeholders across workshops: user experience designers, 
      researchers, and diabetes experts including a diabetes nurse. The overall 
      structure of the 3 workshops was aligned with the 4 phases of the double diamond: 
      initially discovering and mapping out key experienced issues, followed by a 
      workshop on thematic mapping and definition of key concepts, and succeeded by an 
      exploration and development of 2 prototypes. Subsequently, high-fidelity 
      interactive prototypes were refined as part of the delivery phase, in which 7 
      formative usability tests were conducted. RESULTS: The workshops mapped 
      experiential topics over time from prediagnosis to the current state, resulting 
      in a detailed exploration and understanding of 6 themes related to and based on 
      the experiences of patients with T2DM: diabetes care, diabetes knowledge, glucose 
      monitoring, diet, physical activity, and social aspects of diabetes. Two 
      prototypes were developed by the participants to address some of their expressed 
      needs over time related to the 6 themes: an activity-based continuous glucose 
      monitoring app and a web-based guide to diabetes. Both prototypes emphasize 
      periods of structured self-measurements of blood glucose to support evolving 
      needs for self-exploration through distinct phases of learning, active use, and 
      supporting use. Periods of low or intermittent use may thus not reflect a failure 
      of design in a traditional sense but rather be a sign of evolving needs over 
      time. CONCLUSIONS: Our results indicate that the needs of patients with T2DM 
      differ between individuals and change over time. As a result, the suggested 
      digitally supported empowering health prototypes can be personalized to support 
      self-exploration, individual preference in long-term management, and changing 
      needs over time. Despite individuals experiencing different journeys with 
      diabetes, users perceive the self-measurement of blood glucose as a universally 
      useful tool to empower everyday decision-making.
CI  - (c)Dan Roland Persson, Katiarina Zhukouskaya, Anne-Marie Karin Wegener, Lene Kolle 
      Jorgensen, Jakob Eyvind Bardram, Per Baekgaard. Originally published in JMIR 
      Formative Research (https://formative.jmir.org), 25.08.2023.
FAU - Persson, Dan Roland
AU  - Persson DR
AUID- ORCID: 0000-0002-4258-6949
AD  - Department of Applied Mathematics and Computer Science, Technical University of 
      Denmark, Kgs. Lyngby, Denmark.
FAU - Zhukouskaya, Katiarina
AU  - Zhukouskaya K
AUID- ORCID: 0009-0005-9233-2698
AD  - Department of Applied Mathematics and Computer Science, Technical University of 
      Denmark, Kgs. Lyngby, Denmark.
FAU - Wegener, Anne-Marie Karin
AU  - Wegener AK
AUID- ORCID: 0000-0001-7586-5920
AD  - Danish Diabetes Association, Glostrup, Denmark.
FAU - Jorgensen, Lene Kolle
AU  - Jorgensen LK
AUID- ORCID: 0009-0006-7328-2303
AD  - Danish Diabetes Association, Glostrup, Denmark.
FAU - Bardram, Jakob Eyvind
AU  - Bardram JE
AUID- ORCID: 0000-0003-1390-8758
AD  - Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 
      Denmark.
FAU - Baekgaard, Per
AU  - Baekgaard P
AUID- ORCID: 0000-0002-6720-1128
AD  - Department of Applied Mathematics and Computer Science, Technical University of 
      Denmark, Kgs. Lyngby, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20230825
PL  - Canada
TA  - JMIR Form Res
JT  - JMIR formative research
JID - 101726394
PMC - PMC10492168
OTO - NOTNLM
OT  - T2DM
OT  - chronic illness
OT  - co-creation
OT  - cocreation
OT  - diabetes
OT  - eHealth
OT  - mHealth
OT  - mobile health
OT  - participatory design
OT  - personalized self-care
OT  - type 2 diabetes mellitus
COIS- Conflicts of Interest: None declared.
EDAT- 2023/08/25 12:42
MHDA- 2023/08/25 12:43
PMCR- 2023/08/25
CRDT- 2023/08/25 11:53
PHST- 2023/06/08 00:00 [received]
PHST- 2023/07/20 00:00 [accepted]
PHST- 2023/07/19 00:00 [revised]
PHST- 2023/08/25 12:43 [medline]
PHST- 2023/08/25 12:42 [pubmed]
PHST- 2023/08/25 11:53 [entrez]
PHST- 2023/08/25 00:00 [pmc-release]
AID - v7i1e49738 [pii]
AID - 10.2196/49738 [doi]
PST - epublish
SO  - JMIR Form Res. 2023 Aug 25;7:e49738. doi: 10.2196/49738.