Usability and feasibility of ADappt: a digital toolkit to support communication on diagnosis and prognosis in memory clinics

BACKGROUND: ADappt is a digital toolkit for both memory clinic professionals and patients to support communication on diagnosis and prognosis in memory clinics. We aimed to evaluate ADappt's usability and feasibility in clinical practice.

METHODS: In this mixed-methods study, we first assessed usability via think-aloud sessions with ten memory clinic professionals from eight memory clinics, six patients, and one care partner. Think-aloud comments were deductively categorized into: content, navigation, and design. Second, we conducted a feasibility study in four memory clinics. Eight memory clinic professionals recruited 21 patients and 21 care partners. Professionals were instructed to integrate the ADappt-toolkit in their routine. Before their visit, patients received information about the ADappt-patient tools: two video-animations and a question prompt list (QPL). Participants completed questionnaires on usability, satisfaction, and feasibility either after the first consultation (n = 14 patients; n = 15 care partners), after the disclosure consultation (n = 4 patients; n = 5 care partners), or after both consultations (n = 3 patients; n = 1 care partner). Interviews with professionals were conducted and analyzed using thematic content analysis. Third, together with Alzheimer Europe, we co-organized a patient and public involvement (PPI) session with citizens, patients, and care partners to further improve the patient tools.

RESULTS: Professionals found ADappt relevant, easy-to-navigate, and visually appealing. Most think-aloud comments focused on content and navigation, especially regarding the risk calculation tool. Patients indicated the patient tools to be helpful in preparing for consultations. After use in practice, professionals reported acceptable usability (68 ± 14, scale 0-100) and satisfaction (71 ± 10, scale 0-100) with ADappt. Professionals most often used the tool that provides an overview of diagnostic tests with pros and cons (in 15/24(63%) consultations), which they also deemed most helpful (median(IQR): 4(3.75-4), scale 1-5). About half to two-thirds of patients and care partners reported to have received the patient tools (video-animations: n = 23/46(50%)); QPL: n = 30/46(65%)), of whom a majority used (video-animations: n = 16/23(70%)); QPL: n = 21/30(70%)) and would recommend them (video-animations: n = 15/16(94%); QPL: n = 20/21(95%)). The tools helped to express themselves more effectively. The PPI session highlighted the importance of widespread dissemination of the patient tools and through multiple channels.

CONCLUSIONS: Our study demonstrates the potential of digital tools to improve medical communication in memory clinics. Taking feedback into account, ADappt is further improved and steps towards implementation are being taken.