"This is the peer reviewed version of the following article: [Ferguson, C. and Jackson, D. (2017), ‘Selecting, appraising, recommending and using mobile applications (apps) in nursing’. J Clin Nurs. Accepted Author Manuscript.], which has been published in final form at [doi:10.1111/jocn.13834] This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
Accepted Article in the Yet, whatpast. informeddecision your todownload or recommend topatients? apps health-related about patients to recommendations made have even possibly and apps, mobile ‘Medscape’ the as such apps popular including ranging wide and now prolific are category ‘Health’ the in applications Mobile b). 2017a, (Statista Market Android the as known iPhones and iPods, and morethan 2.6 million apps were available in the Google Play store, formerly more2017 than 2.2million appswere available download to variousto devices iOS such iPads,as reviewing the weather all easily accomplished for most,via their mobile device. At the beginning of or adiary maintaining transport, onpublic atrip planning banking, as such Everydaytasks tasks. tech-based solutionsmanypreviouslyto administrative, otherwise ortime-consuming repetitive waiting room. Mobile devices have infiltrated most screen,whether it bewalking thestreet,on travelling x inch 6 3 bysmall a immersed fully and over hunched often are people look, we Wherever life. daily that?” for app an there “Is you asked recently memberfamilya mayhave acolleague or their likely patient, than It’s that more declared. none statement: interest of Conflicts Editorial: February 2017 Journal of Clinical Nursing This by is protectedarticle reserved. Allrights copyright. doi: 10.1111/jocn.13834 lead to differences between this version and the throughbeen the copyediting, pagination typesetting, which process, may and proofreading hasThis article been accepted publicationfor andundergone peerfull but review not has PhD RN Ferguson Caleb Dr nursing’ in (apps) applications mobile using and recommending appraising, ‘Selecting, :Editorial type Article PROF. DEBRA JACKSON (Orcid ID :0000-0001-5252-5325) DR. FERGUSON CALEB (Orcid : ID 0000-0002-2417-2216) Email [email protected]; 3545 +6129514 T @debraejackson Twitter: @calebferg; 4. 3. 2. 1. Foundation Trusts Foundation & Al Midwifery for Nursing, Institute Oxford School of Nursing, Oxford Brookes University, UK University, Brookes Oxford Nursing, of School Faculty Health,of University of Technology Sydney, Australia Centre for Cardiovascular & Un Care, Chronic & Cardiovascular Centre for and BUPA’s ‘FoodSwitch’ 1,2 Mobile technology is inescapable. It is pervasive in almost every aspect of every of aspect almost in pervasive It is inescapable. is technology Mobile & Professor Debra Jackson RN PhD RN Jackson Debra Professor & App. It’s likely you already make use of a few nursing-related nursing-related few a of use make youalready likely It’s App. Version of Record. Please Version as this cite of Record. article lied Health Research, Oxford Health NHS Health Oxford Research, Health lied iversity of Technology Sydney, Australia aspects of our lives and offer quick, adaptive adaptive quick, andoffer lives ofour aspects on the bus, at the coffee shop or in the clinic coffeein shopor the bus, the at on the 2,3,4
‘Nursing Drug Handbook’ Drug ‘Nursing , ‘Lark’ , Accepted Article This by is protectedarticle reserved. Allrights copyright. approach. systematic similar a using apps health-related practice guidelines.However,littleis guidance there clinicians for onappraisehow to quality the of clinical and reviews systematic studies, qualitative studies, cohort trials, controlled randomised typesdifferent of evidence. tools These arehelp (Shea Programme2017),(CASP): Making(Brouwers the senseof evidence AGREE ev of makesense us help to clinicians to available 2017). (MEDPAGETODAY professionals health other by evaluated been usually have which of apps rankand quality review to the available website useful be utilised in critically assessing health-related few areakeyThere critical factors appraisalthe in disease. chronic or wellbeing health, their advice of and recommendations seeking caregivers mobile applications. Yet, the proliferation in the availability has seen an increase in patients and practice, little guidance exists for nurses in the of nursing component essential an becoming fast apps health-related With or effect. purpose little serve that those and app agood between distinguish to difficult can be it caregivers, and patients functionality (IMS Insitute for Healthcare Informatics 2013). With so many apps available for nurses, nointeractive largely with information, and content health provide to used are ofapps majority However, the andcommunicate. oralert remind guide, display, record, inform, to instruct, used isThere huge variability in purpose, the function quality and of health related apps. They can be (Dean healthcare of perspectives caring and personalisation the from detracting apps, some of design interface dehumanising or may perceive what to impersonal be they as averse andpatients clinicians both Further, practice. clinical routine to augmentation slow the to contribute andproviders patients by ofskills a lack and healthcare of environment risk complex and human busy, The healthcare. in apps of integration and personal motivation Clinical (Elsevier Solutions However2015). manystill barriers exist to the modification behaviour with assist to apps from loop feedback data; health personalised analytics; and data big information; health for personalised want the patient; informed ofthe recognition co low their development; app of ease health); of culture a growing devices; ofmobile ubiquity and the smartphones of ownership increasing the include These appadoption. health mobile to (Biesd people younger among highest is for apps digital services in the withfuture usage expected to increase across age groups.all However demand The McKinsey Digital Patient Survey (2014) highlighted over that 75% of all patients expectuse to et al. et 2009)are highly usefultools that are available forthecritical appraisal of research and etal. 2016, 2016, O'Connor st; patient empowerment and the movement towards movement and the towards empowerment patient st; apps. iMedical Apps (www.imedicalapps.com) is a orf & orf 2014). Niedermann There areseveral drivers idence and research. CASP (Critical Appraisal Skills of health-related websitesof and can health-related guidelines that selection and critical appraisal of the quality of quality ofthe appraisal critical and selection instantaneous access to information (including ‘the best app’ to support self-management of self-management support to app’ best ‘the ful to guide appraisal of evidence such as To date, excellent tools and instruments are and instruments tools excellent To date, etal. 2016). et al. et 2010) and AMSTAR AMSTAR and 2010) Accepted Article This by is protectedarticle reserved. Allrights copyright. OVERALL ASSESSMENT Patient-centeredness 6: CRITERIA rank and review Usability, 5: CRITERIA credibility and 4:Endorsement CRITERIA evidence and Content 3: CRITERIA CRITERIA 2: App development and production CRITERIA 1: Purpose, description and audience criteria evaluation app mobile related Health app. health-related a of appraisal quality systematic a guide to apply, Drawing on existing criticalappraisal instruments, we suggest the following criteria nurses for to 8. 7. 3. 6. 12. 11. 10. 5. 2. 17. 16. 15. 14. 13. 9. 4. 1. • • 23. 22. 21. 20. 19. 18.
Is the web address credible credible address web the Is Is this credible a or well-known health outlet? Were experts and/or consumers involved in the development of the app? app? the of development the in involved consumers and/or experts Were described? Is the target population patientclinic (e.g. or Who is the app written, developed or produced by? by? produced or developed written, app the is Who store? app the in described specifically app by the covered topic health the Is recommendations? recommendations? users to seekmo Are links availableto there described? clearly recommendations If app makes the recommendations methods the the tothe are user, formulating for Does the app detail how evidencewas selected evidence-based? reviewed or peer content theapp Isof the Does the app describe how it was developed or produced? described? well app health the of objective purpose/ overall the Is independently or in partnership with their caregiver? caregiver? their with partnership in or independently this use they Could them? for suitable app this –is literacy health and and digital Consider patient’s health status,wellbeing and independence,cognitive and physical ability a cost attached? is there or free, Is theapp Does the app rank wellby users in the app store? Has the app received generally positive or negative reviews and comments byusers? easy touse? intuitive and Generally, theapp is updated? or revised everbeen content Has the developed? first it was when app, the is old How acknowledgements or conflicts of interest disclosed? funding any Arethere funded? was development app the how on details Are there body? peak credible and relevant any by certified or endorsed app the Is Has the app been externally reviewed by experts? Would you recommend this app for use? (YES/ NO) Rate the overall quality 10wi app ofthe – (1 app? Is there patient for need follow tomonitor up evaluate healthand outcomes to the related (if downloaded from awebsite)? re information evidence toand re information related the th 1 being very poor and 10 being outstanding) outstanding) being 10 and verypoor being 1 th ian target group or, speciality specifically area) or appraised to be included in the app? app? the in included be to or appraised
Accepted Article This by is protectedarticle reserved. Allrights copyright. We provide followingthe considerations for nur Practical considerations to health apps (O'Connor improvementof digital literacy skillsalongside improvedfunding models ensure equity to of access bodies toassist increase to en bypeak endorsement and accreditation seek may Developers of apps). advertising as (such them of areknowledgeable public general the ofapps, that so awareness the include; raising These apps. addres help to of recommendations a number make (2016) al et O’Connor interventions. health digital uptake to ability anindividuals’ impact that factors byO’Co developed (DIEGO) Model recommendanapp, may to care. be Engagement In it deciding draw to useful on the Digital Health point of at a patient use with may This initiating include app. the for using support app, provide and interventionmust nurses help patients make to senseofthe app, assist in the quality appraise the ahealthcare for anapp use to deciding In intervention. app the to adherence andsustain use import is it however, beconsidered; must app the or fa impede would that factors and address identify Once an app has been selected for suitability and appraised for quality, itis important that clinicians al. 2010) et (Brouwers Instrument AGREE-II the from adapted been have Some criteria Acknowledgement: • • • • • • • •
select and quality appraise apps. apps. appraise quality and select clinicians and caregivers patients, how understand better to required is research Greater purpose. for fit and credible both is app the if evaluate to taken be should When making healthcare decisions related toapps with patientscaregivers, and attention use. their evaluate and monitor tools other forwith As for self-management. role of recognitionthe greater is needfor There information. evidence-based date, to andup relevant contain patients with use or recommend select, they that apps the that ensure must Nurses apps. of content the appraise Patients may it helpfultofind learn how tosearchinternet and the how app store to and individualised care activities. permission to review dataor analytics thatcould be helpful toinform goals andplan If patient a advises that using are they a health-related app,be itmay useful obtain to irregular) routine (or regular their of part as apps any using are they if ascertain to patients with check Frequently support to bodies bypeak recommended are that apps of awareness general a developing include may This practice. clinical routine their into apps integrate and recommend to beable to necessary as upskill must Nurses et al. healthcare management. healthcare 2016). gagement. There is also a need is need alsogagement. There a nnor and colleagues (O'Connor colleagues and nnor
ses whoses are integrating apps into practice: patients in yourof area specialty. ant to consider other factors that will influence influence will that factors other consider to ant cilitate use. The overall suitability and quality of andquality suitability use.The overall cilitate self-management there is need toregularly is need there self-management s some challenges ofin theuptake healthcare
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Accepted Article Statista (2017b) Number of availa Statista (2017a) Number of available applications in the Google PlayDecember Strore from to 2009 Shea BJ, Hamel WellsGA,C, LM, Bouter Kristjan factors Understanding (2016): FS Mair J& Glanville S, Garcia CA, O'Donnell P, Hanlon S, O'Connor MEDPAGETODAY (2017)iMedicalApps. Available http://www.imedicalapps.com/ at: (accessed InsituteIMS Healthcarefor Patient Informatics (2013) Apps Healthcare: for Improved From Novelty Elsevier Clinical Solutions White (2015) Paper: Mobile Applications and Futurethe ofHealthcare. In touch? losing nurses for responsible technology Is Editorial: C(2016): Ferguson & J Lewis S, Dean Critical Appraisal SkillsProgramme Making (CASP): senseof the Critical evidence (2017) Appraisal This by is protectedarticle reserved. Allrights copyright. ID, Graham G, FerversB, Feder F, Cluzeau JS, Burgers GP, ME,Browman Brouwers Kho MC, future, digital Healthcare's (2014) F Niedermann & S Biesdorf References outcomes. support nurses in helping patients select, initiate healthinterventions. Overall, research, greater e recommendations and to make well situated are rout arenot present at apps Whilst improve health. to use app of and use evaluation initiation, in the patients support to better a newskillset develop must Nurses apps. of appraisal andquality selection the careful in caregiver and patients supporting in key role have a Nurses groups. age all across increasing is appuse mobile related Health Summary in-the-apple-app-store/ (accessed 17/01/2017 2017). store/. Available at: https://www.statista.com/statistics/263795/number-of-available-apps- https://www.statista.com/statistics/263795/ available-applications-in-the-google-play-store/ (accessed 17/01/2017 2017). December Available 2016. at: https://www.statista.com/statistics/266210/number-of- systematic reviews. of quality methodological the assess to tool measurement valid and reliable a is AMSTAR studies. qualitative of review systematic a interventions: health digital to recruitment and engagement public and patient affecting 17/01/2017 2017). to Mainstream, pp. 1-60. ElsevierSolutions Clinical Journal of Clinical Nursing http://www.casp-uk.net/casp-tools-checklists (accessed 17/01/2017 2017). Skills Programme (CASP):Making of thesense ev Association journal Association guideline development, reporting and evaluation in health care. Grimshaw J, Hanna SE,Littlejohns P,Makarski 2017). 17/01/2017 (accessed insights/healthcares-digital-future http://www.mckinsey.com/industries/healthcare-systems-and-services/our- insights/healthcares-digital-future. Available at: http://www.mckinsey.com/industries/healthcare-systems-and-services/our-
182 J Clin Epidemiol Clin J , E839-842. , pp.1-10. ble apps in the Apple App Stroke from 2008 July to January 2017, .
62 , 1013-1020. sson E,Grimshaw J, Henry DA M(2009): &Boers BMC Med Inform Inform Mak BMC Med Decis ducation, and evidence-based tools are required to required are tools evidence-based and ducation, and sustain the use of apps to improve health improve health to useof apps the andsustain target thesenon-pharmacological,target therapeutic inely prescribed by health professionals, nurses nurses professionals, byhealth prescribed inely number-of-available-apps-in-the-apple-app- J &Zitzelsberger L (2010): advancing II: AGREE idence -CASP Checklists.Available CASP. at: CMAJ : Canadian Medical Medical :Canadian CMAJ
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