Development and formative usability evaluation of a user-centered mobile application for COPD self-management.

Abstract

BackgroundChronic Obstructive Pulmonary Disease (COPD) is a globally burdensome chronic disease characterized by persistent respiratory symptoms and progressive airflow limitation, which severely impairs patients' quality of life and prognosis. Effective self-management is crucial for COPD management, as targeted self-management interventions have been shown to improve disease outcomes. Digital health technologies (DHTs) offer an innovative approach to address the challenges of traditional self-management and provide sustainable support for patients' long-term disease management. However, existing digital interventions for COPD commonly face several major challenges, including low user engagement, poor long-term adherence, and high participant withdrawal rates, highlighting an urgent need for optimized digital solutions.ObjectiveThis study aimed to develop a user-centered mobile application tailored to meet self-management needs of patients with COPD under the guidance of the Centre for eHealth and Wellbeing Research (CeHRes) Roadmap and persuasive system design (PSD) principles, as well as to evaluate its usability performance.MethodsThe development of the COPD Digital Health Self-Management System (COPD DHSS) was guided by the CeHRes Roadmap.The process commenced with a comprehensive literature review, semi-structured interviews involving fifteen COPD patients and five healthcare providers, and expert panel discussions (n=7) to identify challenges in COPD self-management and define the key values for the DHTs into self-management protocols. Based on these key values, the research team identified PSD features. These PSD features were integrated with COPD self-management evidence synthesis and were utilized to inform the design of the COPD DHSS prototype. A mixed-methods evaluation was employed: Sixteen COPD patients were recruited to test the COPD DHSS. After one month of system deployment, the System Usability Scale (SUS) was administered to evaluate usability metrics. Participants subsequently engaged in focus group discussions to provide feedback on user experience.ResultsA User-Centered Mobile Application for COPD was successfully developed through a structured process. The system integrated patient self-reported data with evidence-based best practices for COPD self-management, generating personalized recommendations to enhance patients' self-management capabilities and improve disease prognosis and quality of life. Usability testing was conducted with 16 COPD patients, whose average age was 71.5 (±6.9) years. Of these participants, 14 (87.5%) maintained twice-weekly app usage throughout the evaluation period. The median SUS score was 76.25(66.88, 83.13),indicating an acceptable level of usability. User feedback consistently indicated that the COPD DHSS demonstrated favorable usability characteristics.ConclusionsIntegrating the CeHRes Roadmap with PSD principles, this study successfully developed a usable, user-centered mobile application tailored to the self-management needs of older patients with COPD. It also demonstrates how a structured, theory-driven approach can translate patient and stakeholder insights into a practical digital tool that is both acceptable and usable for this target population. It can serve as a paradigm for applying mobile health technology in chronic disease self-management.