Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Meeting ReportHealthcare informatics

Supporting goal-oriented care using mobile technology: Findings from the mixed-methods trial of the ePRO tool

Carolyn Steele Gray, Jason Nie, Mayura Loganathan and Farah Tahsin
The Annals of Family Medicine April 2022, 20 (Supplement 1) 2763; DOI: https://doi.org/10.1370/afm.20.s1.2763
Carolyn Steele Gray
PhD, MA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jason Nie
MSc
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mayura Loganathan
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Farah Tahsin
MSc
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

Abstract

Context: Goal-oriented models of care are becoming more widely used as part of primary care delivery for older adults with multimorbidity and complex care needs. While these models hold promise, implementation remains challenging. Digital health solutions may improve adoption however, they require evaluation to determine feasibility and impact.

Objective: This study evaluates the implementation and effectiveness of the electronic Patient Reported Outcome (ePRO) mobile application and portal system, designed to enable goal-oriented care delivery in inter-professional primary care practices.

Study design: Multi-method pragmatic randomized control trial using a stepped-wedge design and ethnographic case studies over a 15-month period.

Setting: 6 comprehensive primary care practices across Ontario.

Population studied: Older adults with complex care needs; target sample 176 patients.

Intervention: Patient and provider participants used the ePRO tool in addition to usual care. The 6 practices randomized into either early (3-month control; 12-month intervention) or late (6-month control; 9-month intervention) groups.

Outcome measures: The Assessment of Quality of Life-4D collected at baseline and 3-month intervals. Ethnographic data (observations and interviews) collected at mid-point and end of the intervention. Outcome data were analyzed using linear models. Ethnographic data was analyzed using qualitative description and framework analysis methods, guided by Normalization Process Theory.

Results: The trial experienced recruitment challenges resulting in fewer sites (n=6) and participants (n=45) than expected. As such the impact of ePRO on quality of life could not be definitively assessed; analysis trends suggest decreased quality of life for patients over both the control and intervention periods. Ethnographic data reveals a complex implementation process, in which the meaningfulness (or coherence) of the technology to individuals lives, relationships and approach chronic disease management drove adoption and perceived value or irrelevance of ePRO.

Conclusions: Implementation challenges were broad and largely unexpected. The difficultly in aligning meaningfulness of a complex intervention across diverse user groups over time, suggests the intervention may not be sufficiently adaptable, or that more dynamic trial methods may be required. Including ethnographic data collection reveals critical underlying mechanisms driving digital health innovations.

  • © 2021 Annals of Family Medicine, Inc.
Previous
Back to top

In this issue

The Annals of Family Medicine: 20 (Supplement 1)
The Annals of Family Medicine: 20 (Supplement 1)
Vol. 20, Issue Supplement 1
1 Apr 2022
  • Table of Contents
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Supporting goal-oriented care using mobile technology: Findings from the mixed-methods trial of the ePRO tool
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
10 + 5 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Supporting goal-oriented care using mobile technology: Findings from the mixed-methods trial of the ePRO tool
Carolyn Steele Gray, Jason Nie, Mayura Loganathan, Farah Tahsin
The Annals of Family Medicine Apr 2022, 20 (Supplement 1) 2763; DOI: 10.1370/afm.20.s1.2763

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Supporting goal-oriented care using mobile technology: Findings from the mixed-methods trial of the ePRO tool
Carolyn Steele Gray, Jason Nie, Mayura Loganathan, Farah Tahsin
The Annals of Family Medicine Apr 2022, 20 (Supplement 1) 2763; DOI: 10.1370/afm.20.s1.2763
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • CPCSSN Data Quality: An Opportunity for Enhancing Canadian Primary Care Data
  • Evaluation of an Electronic Health Record Change Communication Program
  • Building Primary Care Recommender System for Electronic Consultation (eConsult) Service Users via Natural Language Processing
Show more Healthcare informatics

Similar Articles

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine