Barriers to and Facilitators of Engagement With Remote Measurement Technology for Managing Health: Systematic Review and Content Analysis of Findings.
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BACKGROUND Remote measurement technology refers to the use of mobile health technology to track and measure change in health status in real time as part of a person s everyday life With accurate measurement remote measurement technology offers the opportunity to augment health care by providing personalized precise and preemptive interventions that support insight into patterns of health related behavior and self management However for successful implementation users need to be engaged in its use OBJECTIVE Our objective was to systematically review the literature to update and extend the understanding of the key barriers to and facilitators of engagement with and use of remote measurement technology to guide the development of future remote measurement technology resources METHODS We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines involving original studies dating back to the last systematic review published in 2014 We included studies if they met the following entry criteria population people using remote measurement technology approaches to aid management of health intervention remote measurement technology system comparison group no comparison group specified outcomes qualitative or quantitative evaluation of the barriers to and facilitators of engagement with this system and study design randomized controlled trials feasibility studies and observational studies We searched 5 databases MEDLINE IEEE Xplore EMBASE Web of Science and the Cochrane Library for articles published from January 2014 to May 2017 Articles were independently screened by 2 researchers We extracted study characteristics and conducted a content analysis to define emerging themes to synthesize findings Formal quality assessments were performed to address risk of bias RESULTS A total of 33 studies met inclusion criteria employing quantitative qualitative or mixed methods designs Studies were conducted in 10 countries included male and female participants with ages ranging from 8 to 95 years and included both active and passive remote monitoring systems for a diverse range of physical and mental health conditions However they were relatively short and had small sample sizes and reporting of usage statistics was inconsistent Acceptability of remote measurement technology according to the average percentage of time used 64 86 5 and dropout rates 0 44 was variable The barriers and facilitators from the content analysis related to health status perceived utility and value motivation convenience and accessibility and usability CONCLUSIONS The results of this review highlight gaps in the design of studies trialing remote measurement technology including the use of quantitative assessment of usage and acceptability Several processes that could facilitate engagement with this technology have been identified and may drive the development of more person focused remote measurement technology However these factors need further testing through carefully designed experimental studies TRIAL REGISTRATION International Prospective Register of Systematic Reviews PROSPERO CRD42017060644 https www crd york ac uk PROSPERO display record php RecordID 60644 Archived by WebCite at http www webcitation org 70K4mThTr