title: Engineering for reliability in at-home chronic disease management.
abstract: Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people's daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants' experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems.
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Logan
authors.initials: L
authors.lastname: Kendall
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Eschler
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: Paula
authors.initials: P
authors.lastname: Lozano
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McClure
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vizer
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: James D
authors.initials: JD
authors.lastname: Ralston
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Wanda
authors.initials: W
authors.lastname: Pratt
mesh_terms: D001249:Asthma / Q000628:therapy*; D002648:Child; D002908:Chronic Disease / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009035:Mothers; D017010:Reminder Systems; D012648:Self Care