Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China

Improved stroke care has resulted in a significant 84% increase in global stroke survivors over the past two decades. As society ages, more research is needed for older stroke survivors. The COVID-19 pandemic has spurred the development of mobile health (mHealth). However, the data on the efficacy o...

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Main Author: Wenjing, Cao
Format: Thesis
Language:English
Published: 2024
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Online Access:http://eprints.usm.my/61005/1/CAO%20WENJING-FINAL%20THESIS%20P-SKD005321%28R%29-E.pdf
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spelling my-usm-ep.610052024-08-21T03:37:26Z Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China 2024-06 Wenjing, Cao R Medicine RA440-440.87 Study and teaching. Research RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Improved stroke care has resulted in a significant 84% increase in global stroke survivors over the past two decades. As society ages, more research is needed for older stroke survivors. The COVID-19 pandemic has spurred the development of mobile health (mHealth). However, the data on the efficacy of the mHealth innovations in stroke is limited. This study aims to develop and evaluate the effectiveness of a mobile application for older adult stroke survivors on medication adherence, medicine beliefs, health literacy on stroke, and blood pressure (BP) in Chenzhou, China. The study was divided into three phases: identifying medication non-adherence and its factors (Phase 1), developing a mobile application (Phase 2), and evaluating its usability and effectiveness for older aadult stroke survivors (Phase 3). Phase 1 was a cross-sectional study that involved 402 older adult stroke survivors from three tertiary hospitals in China. In Phase 2, a mobile application intervention module (e-MAIMOASS) was developed and validated. In phase 3, 82 older adult stroke survivors were randomly allocated to either the e-MAIMOASS group (n=41) or the control group (n=41). All subjects had to report medication adherence and BP at baseline, 1-month, and 3-month follow-ups. Medicine beliefs and health literacy were assessed at baseline and three months post-intervention. In Phase 1, 61.4% of participants exhibited medication non-adherence. Compared to individuals with primary education or less, those with a junior school education level had their odds of medication non-adherence decrease by 0.450 times, while those with a senior secondary or junior college education level experienced a decrease of 0.440 times. The higher the number of prescription medications an individual takes per day, the greater the likelihood of medication non-adherence (OR = 1.315). A significant association was found between medication non-adherence and health literacy (β = -0.059), BMQ Specific-Necessity score (β = -0.130), and BMQ Specific-Concerns score (OR=1.127). In Phase 2, a validated e-MAIMOASS comprising five core components received positive feedback and user satisfaction from Alpha and Beta testing. In Phase 3, older adult stroke survivors with the intervention exhibited enhanced medication adherence (p<0.001), significantly lower systolic BP (SBP) (p=0.009), improved health literacy (p=0.024), and better BMQ necessity scores (p=0.002) compared to the control group. The usability score for e-MAIMOASS was recorded with an average of 70.36 ± 7.05, surpassing the System Usability Scale (SUS) threshold of 68. In conclusion, the e-MAIMOASS effectively improved older adult stroke survivors' medication adherence, medicine beliefs, health literacy on stroke, and BP. However, more studies need to be conducted to improve the outcomes of this promising intervention. 2024-06 Thesis http://eprints.usm.my/61005/ http://eprints.usm.my/61005/1/CAO%20WENJING-FINAL%20THESIS%20P-SKD005321%28R%29-E.pdf application/pdf en public phd doctoral Universiti Sains Malaysia Pusat Pengajian Sains Kesihatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic R Medicine
R Medicine
R Medicine
spellingShingle R Medicine
R Medicine
R Medicine
Wenjing, Cao
Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
description Improved stroke care has resulted in a significant 84% increase in global stroke survivors over the past two decades. As society ages, more research is needed for older stroke survivors. The COVID-19 pandemic has spurred the development of mobile health (mHealth). However, the data on the efficacy of the mHealth innovations in stroke is limited. This study aims to develop and evaluate the effectiveness of a mobile application for older adult stroke survivors on medication adherence, medicine beliefs, health literacy on stroke, and blood pressure (BP) in Chenzhou, China. The study was divided into three phases: identifying medication non-adherence and its factors (Phase 1), developing a mobile application (Phase 2), and evaluating its usability and effectiveness for older aadult stroke survivors (Phase 3). Phase 1 was a cross-sectional study that involved 402 older adult stroke survivors from three tertiary hospitals in China. In Phase 2, a mobile application intervention module (e-MAIMOASS) was developed and validated. In phase 3, 82 older adult stroke survivors were randomly allocated to either the e-MAIMOASS group (n=41) or the control group (n=41). All subjects had to report medication adherence and BP at baseline, 1-month, and 3-month follow-ups. Medicine beliefs and health literacy were assessed at baseline and three months post-intervention. In Phase 1, 61.4% of participants exhibited medication non-adherence. Compared to individuals with primary education or less, those with a junior school education level had their odds of medication non-adherence decrease by 0.450 times, while those with a senior secondary or junior college education level experienced a decrease of 0.440 times. The higher the number of prescription medications an individual takes per day, the greater the likelihood of medication non-adherence (OR = 1.315). A significant association was found between medication non-adherence and health literacy (β = -0.059), BMQ Specific-Necessity score (β = -0.130), and BMQ Specific-Concerns score (OR=1.127). In Phase 2, a validated e-MAIMOASS comprising five core components received positive feedback and user satisfaction from Alpha and Beta testing. In Phase 3, older adult stroke survivors with the intervention exhibited enhanced medication adherence (p<0.001), significantly lower systolic BP (SBP) (p=0.009), improved health literacy (p=0.024), and better BMQ necessity scores (p=0.002) compared to the control group. The usability score for e-MAIMOASS was recorded with an average of 70.36 ± 7.05, surpassing the System Usability Scale (SUS) threshold of 68. In conclusion, the e-MAIMOASS effectively improved older adult stroke survivors' medication adherence, medicine beliefs, health literacy on stroke, and BP. However, more studies need to be conducted to improve the outcomes of this promising intervention.
format Thesis
qualification_name Doctor of Philosophy (PhD.)
qualification_level Doctorate
author Wenjing, Cao
author_facet Wenjing, Cao
author_sort Wenjing, Cao
title Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
title_short Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
title_full Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
title_fullStr Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
title_full_unstemmed Development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in China
title_sort development and evaluation of the effectiveness of a mobile application module on medication adherence, medicine beliefs, health literacy and blood pressure for older adult stroke survivors in china
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Kesihatan
publishDate 2024
url http://eprints.usm.my/61005/1/CAO%20WENJING-FINAL%20THESIS%20P-SKD005321%28R%29-E.pdf
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