Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Apr 9;23(4):e24639.
doi: 10.2196/24639.

Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study

Chathur Acharya  1   2 , Tejasav S Sehrawat  3 , Deborah B McGuire  1   2 , Jawaid Shaw  1   2 , Andrew Fagan  1   2 , Sara McGeorge  1   2 , Amy Olofson  3 , Melanie B White  1   2 , Edith Gavis  1   2 , Patrick S Kamath  3 , Lori Bergstrom  3 , Jasmohan Singh Bajaj  1   2
Affiliations
Multicenter Study

Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study

Chathur Acharya et al. J Med Internet Res. .

Abstract

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.

Keywords: PatientBuddy; acceptance; ascites; cirrhosis; encephalopathy; hepatic; hepatic encephalopathy; outcomes; readmissions.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None of the authors have a conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Kanwal F, Tansel A, Kramer JR, Feng H, Asch SM, El-Serag HB. Trends in 30-day and 1-year mortality among patients hospitalized with cirrhosis from 2004 to 2013. Am J Gastroenterol. 2017 Aug;112(8):1287–1297. doi: 10.1038/ajg.2017.175. - DOI - PubMed
    1. Tapper EB, Volk M. Strategies to reduce 30-day readmissions in patients with cirrhosis. Curr Gastroenterol Rep. 2017 Jan;19(1):1. doi: 10.1007/s11894-017-0543-3. - DOI - PubMed
    1. Volk ML, Tocco RS, Bazick J, Rakoski MO, Lok AS. Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol. 2012 Mar;107(2):247–252. doi: 10.1038/ajg.2011.314. http://europepmc.org/abstract/MED/21931378 - DOI - PMC - PubMed
    1. Tapper EB, Finkelstein D, Mittleman MA, Piatkowski G, Chang M, Lai M. A quality improvement initiative reduces 30-day rate of readmission for patients with cirrhosis. Clin Gastroenterol Hepatol. 2016 May;14(5):753–759. doi: 10.1016/j.cgh.2015.08.041. http://europepmc.org/abstract/MED/26407750 - DOI - PMC - PubMed
    1. Ganapathy D, Acharya C, Lachar J, Patidar K, Sterling RK, White MB, Ignudo C, Bommidi S, DeSoto J, Thacker LR, Matherly S, Shaw J, Siddiqui MS, Puri P, Sanyal AJ, Luketic V, Lee H, Stravitz RT, Bajaj JS. The Patient Buddy app can potentially prevent hepatic encephalopathy-related readmissions. Liver Int. 2017 Dec;37(12):1843–1851. doi: 10.1111/liv.13494. - DOI - PubMed

Publication types

Associated data