Exploring the smartwatch as a tool for medical adherence

61 Pages·2015·4.36 MB·English

by  Akash Shrivastava

Uppsala University
Masters Thesis
Exploring the smartwatch as a tool for
medical adherence
Author: Supervisor:
Akash Shrivastava Dr. Jonas Sj¨ostro¨m
A thesis submitted in fulfilment of the requirements
for the degree of Master of Science
in the
Department of Informatics and Media
June 2015
Declaration of Authorship
I, Akash Shrivastava, declare that this thesis titled, ’Exploring the smartwatch as
a tool for medical adherence’ and the work presented in it are my own. I confirm
that:
This work was done wholly or mainly while in candidature for a masters
(cid:4)
degree at this University.
Where any part of this thesis has previously been submitted for a degree or
(cid:4)
any other qualification at this University or any other institution, this has
been clearly stated.
Where I have consulted the published work of others, this is always clearly
(cid:4)
attributed.
Where I have quoted from the work of others, the source is always given.
(cid:4)
With the exception of such quotations, this thesis is entirely my own work.
I have acknowledged all main sources of help.
(cid:4)
Signed: Akash Shrivastava
Date: 28th May 2015
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Abstract
Department of Informatics and Media
Master of Science
Exploring the smartwatch as a tool for medical adherence
by Akash Shrivastava
Keywords: Adherence, Compliance, Smart watch, Wearable technology
Adherence to medication is generally described as a huge problem in the health
care system. The term adherence is generally preferred by many health care
providers as the word ’compliance’ describes a patient who is passively taking
medication as advised/ordered by the doctor. This thesis goes in depth in iden-
tifying the problems faced to achieve maximum adherence to medication and the
important factors contributing to it. The objective is to come up with an alter-
native approach to help improve medical adherence using a smart watch based
application that reminds patients to consume their medicines in a timely fashion.
It addresses precisely which medication to take and in what quantity. This form
of reporting and alerting is believed to achieve higher levels of adherence based on
grounded theory. Shedding light on the methodologies used while clearly identifies
the assumptions and limitations such a system can have....
Acknowledgements
The completion of this thesis would not have been possible without the help and
support of the people whom I would like to thank.
I am thankful to Dr. Jonas Sjo¨str¨om for his valuable opinion on this project as he
guide me through the various challenges of the project.
Dr. Lars Osterberg who was kind enough to spare his valuable time and point me
to the right direction during the initial stages of this thesis. His work has inspired
me a great deal.
I thank Dr. ˚Asa and Dr. Johan H¨aggstro¨m who helped me gain valuable insights
into the healthcare system. As doctors they were more than I could wish for to
help me understand their subject.
My girlfriend Amanda who has been there for me during my highs and lows, being
as amazing as a human being can be.
Lastly and most importantly my brother Kush, who taught me important things
that really matter in life. I could not have gotten through this without his con-
tinued support, encouragement and also my parents, for their everlasting love and
support.
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Contents
Declaration of Authorship i
Abstract ii
Acknowledgements iii
Contents iv
List of Figures vi
List of Tables vii
Abbreviations viii
1 Introduction 1
1.1 Identifying the problem . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 The Internet Of Things . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2.1 Smart Watches and IoT . . . . . . . . . . . . . . . . . . . . 5
1.2.2 Android Wear, a Platform . . . . . . . . . . . . . . . . . . . 6
1.3 Aim Of The Study . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.4 Research Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2 Knowledge Base 10
2.1 Measure of Adherence . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.2 Patient personas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.2.1 Age as a factor . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.2.2 Dosage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.3 Measures to Improve Adherence . . . . . . . . . . . . . . . . . . . . 16
2.4 Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.4.1 Severe Chronic Illness . . . . . . . . . . . . . . . . . . . . . 18
2.4.2 Psychiatric Illness . . . . . . . . . . . . . . . . . . . . . . . . 19
2.4.3 Social factors . . . . . . . . . . . . . . . . . . . . . . . . . . 20
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Contents v
3 Methodology 21
3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.2 Research Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.3 Reflections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3.3.1 Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3.4 Development Methodology . . . . . . . . . . . . . . . . . . . . . . . 27
4 Implementation and Design 28
4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
4.2 Software Architecture . . . . . . . . . . . . . . . . . . . . . . . . . . 29
4.3 Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
4.3.1 The Application . . . . . . . . . . . . . . . . . . . . . . . . . 30
4.4 Wearable solution requirements . . . . . . . . . . . . . . . . . . . . 31
4.5 Design principals for adherence . . . . . . . . . . . . . . . . . . . . 32
4.5.1 Heuristics for a Smart Watch . . . . . . . . . . . . . . . . . 33
4.5.2 Prototypes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
4.6 UML . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
4.6.1 Activity Diagram . . . . . . . . . . . . . . . . . . . . . . . . 36
4.7 Screenshots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
5 Conclusion and the future 39
5.1 Answering the research questions . . . . . . . . . . . . . . . . . . . 39
5.2 Future development . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
5.2.1 Adaptability . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
5.3 Design contributions to research and practice . . . . . . . . . . . . . 41
5.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
A Studies on reminder systems 43
B Interview questions 45
C Backlog 46
Bibliography 48
List of Figures
1.1 Internet of things . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.2 Number of developers in millions working on IoT . . . . . . . . . . 4
1.3 Internet Of Things Trends . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 Wearable Technology Market Spread . . . . . . . . . . . . . . . . . 7
2.1 Patient, provider and health care system dynamics . . . . . . . . . 16
2.2 Variance in Adherence [1] . . . . . . . . . . . . . . . . . . . . . . . 19
3.1 Research Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.1 Wear to Application Architecture . . . . . . . . . . . . . . . . . . . 29
4.2 Phone application prototype . . . . . . . . . . . . . . . . . . . . . . 31
4.3 Android Wear prototypes . . . . . . . . . . . . . . . . . . . . . . . . 35
4.4 Activity Diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
4.5 List view of all medications . . . . . . . . . . . . . . . . . . . . . . 38
4.6 Edit screen for the medications . . . . . . . . . . . . . . . . . . . . 38
4.7 Date picker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
4.8 Deleting an entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
C.1 Midway snapshot of the backlog . . . . . . . . . . . . . . . . . . . . 47
vi
List of Tables
A.1 Previous studies made on reminder systems and their responce on
adherence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
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Abbreviations
IoT Internet Of Things
API Application Programming Interface
HIV Human Immunodeficiency Virus
NSAID Nonsteriodal Anti- Inflammatory Drugs
SMS Short Message Service
ADR Action Design Research
IDE Integrated Development Environment
UI User Interface
UX User Experience
BIE Building Intervention Evaluation
APK Android Application Package
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I dedicate my thesis to my father who inspired me to
reach new heights, who enabled me to be where I am
today, without him it wouldn’t have been possible. His
story is what inspired me to have this subject as my
thesis.
I miss him dearly.
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