Abstract
Evidence-based guidelines recommend that patient knowledge should be considered an essential component in oral anticoagulation treatment (OAT) to improve adherence and subsequent clinical outcomes. Therefore, a mobile health (mHealth) technology-based educational intervention using smartphone features could be a promising approach for patients receiving OAT. However, mobile applications (mApps) developed in this context are rare, and there is still a lack of research examining the perceived usability of these apps from end-users' perspectives and the feasibility of implementing them in daily clinical practice for chronic OAT end-users. In this study, we developed a novel mApp educational tool about OAT (warfarin) and evaluated the perceived usability of this app among Saudi adult patients. In addition, the impact of the app intervention on anticoagulation control parameters was examined. The Coagulation and Anticoagulant Therapy and Awareness (CATA) mApp was developed by a collaborative effort from a multidisciplinary team using the Android system. The mApp content was processed using an intuitive user-friendly interface containing simple Arabic text. The app was uploaded to the mobile phones of patients who were randomly selected from two medical centers in Riyadh, Saudi Arabia. Usability evaluation was conducted after 6 months post-mApp intervention, using a comprehensive questionnaire that addressed five main dimensions of participants' perceived usability of the mApp: attractiveness, ease of use, satisfaction, operability, and presentation quality. Thirty-seven participants (M-age = 45 years) completed the usage survey. The mean overall usability score (76.8%) demonstrates that most participants were satisfied with the CATA mApp and found it useful. Of the five user experience domains examined, patients expressed the highest agreement score for the presentation quality domain (79.5%), reflecting the attractiveness of the visual appearance and logic of information demonstration of the app. Additional themes were identified by some users in the free-text questions, indicating that further unique features such as longer audiovisual demonstrations and direct web browser facility should be added to ensure sustained engagement with the app in their daily routines. Regarding international normalized ratio (INR) control parameters, no significant changes were observed. Further feedback from practitioners is warranted to gain constructive insights into the facilitators and barriers for mApp implementation in routine care. Additionally, the current data revealed that there are concerns about increasing INR control via the incorporation of a computing tool that empowers patient data entry and doctor sharing of patient records. These features are projected to ultimately bridge the gap between patient adherence and clinical outcomes.