A digital self-care intervention for Ugandan patients with heart failure and their clinicians: User-centred design and usability study

Hearn J., Wali S., Birungi P., Cafazzo J. A., Ssinabulya I., Akiteng A. R., ...More

Digital Health, vol.8, 2022 (Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 8
  • Publication Date: 2022
  • Doi Number: 10.1177/20552076221129064
  • Journal Name: Digital Health
  • Journal Indexes: Scopus
  • Keywords: Cardiovascular disease, digital health, general, education, lifestyle, cardiology, medicine, remote patient monitoring, personalized medicine
  • TED University Affiliated: No


© The Author(s) 2022.Background: The prevalence of heart failure (HF) is increasing in Uganda. Ugandan patients with HF report receiving limited information about their illness and associated self-care behaviours. Interventions targeted at improving HF self-care have been shown to improve patient quality of life and reduce hospitalizations in high-income countries. However, such interventions remain underutilized in resource-limited settings like Uganda. This study aimed to develop a digital health intervention that enables improved self-care amongst HF patients in Uganda. Methods: We implemented a user-centred design (UCD) process to develop a self-care intervention entitled Medly Uganda. The ideation phase comprised a scoping review and preliminary data collection amongst HF patients and clinicians in Uganda. An iterative design process was then used to advance an initial prototype into a functional digital health intervention. The evaluation phase involved usability testing of the intervention amongst Ugandan patients with HF and their clinicians. Results: Medly Uganda is a digital health intervention that allows patients to report daily HF symptoms, receive tailored treatment advice and connect with a clinician when showing signs of decompensation. The system harnesses Unstructured Supplementary Service Data (USSD) technology that is already widely used in Uganda for mobile phone-based financial transactions. Usability testing showed Medly Uganda to be both acceptable and feasible amongst clinicians, patients and caregivers. Conclusions: Medly Uganda is a functional digital health intervention with demonstrated acceptability and feasibility in enabling Ugandan HF patients to better care for themselves. We are hopeful that the system will improve self-care efficacy amongst HF patients in Uganda.