Patients with Sickle Cell Disease Report Chatbot Health Coach Is Fun, Easy to Use, and Helpful

By Keightley Amen - Last Updated: December 2, 2021

A recent report in Frontiers in Digital Health offered results of an ongoing study exploring the usability and usefulness of chatbot technology to improve self-care and outcomes in patients with sickle cell disease (SCD).

The researchers, led by David-Zacharie Issom, PhD, of the Department of Radiology and Medical Informatics in the Faculty of Medicine at the University of Geneva in Switzerland, chose to develop the chatbot for use in SCD because this patient population often does not receive adequate preventive care for several reasons, including a shortage of well-trained providers.

They believed a chatbot could provide health coaching to educate and empower patients who may be largely managing their own care. They aimed to develop a chatbot that could enhance patients’ efforts at self-management and support health behavior changes to lessen the burden of disease.

“Recent studies have demonstrated that conversational agents (chatbots) could effectively support chronic patients’ self-management needs, improve self-efficacy, encourage behavior changes, and reduce disease severity,” the authors wrote.

The researchers developed a prototype of a fully automated health coaching chatbot app, called TREVOR. The technology delivers simple text-based messages and other media such as videos and podcasts to users. It also shares self-care practices that other patients have reported as effective, and it connects patients for peer-to-peer support.

The researchers recruited a sample of 33 patients to sample the technology and provide feedback. Inclusion criteria were those 16 years or older who were diagnosed with SCD, had a Facebook account in Europe, had a smartphone with Facebook Messenger pre-installed, and could understand French.

Two-thirds of the participants were female, and the median age was 38 years. Most (23, 70%) were students or actively employed. Most participants (64%) had the most severe phenotype of SCD, Hb SS, HbS?0.

The researchers then surveyed the participants about the usability and usefulness of the technology. They sought to understand patients’ satisfaction with the technology, as well as any recommendations that could be used to develop future chatbot apps. Participants provided feedback through the System Usability Scale and the Usefulness Scale for Patient Information Material questionnaire.

Most participants (94%) rated the chatbot as easy and fun to use, and 88% reported that it was useful support for patient empowerment. Furthermore, 82% said the technology improved their knowledge about self-management for SCD. Only two patients scored the app as below average.

“Quantitative results suggest that chatbots for health coaching can be easy and fun to use, while providing useful support for patient empowerment,” the authors concluded. “Participants expressed their enthusiasm using the system and emphasized on the usefulness of such system for disease-specific knowledge acquisition.”

Based on the participants’ feedback, the researchers said their chatbot and other similar health coaching technology developed in the future should:

  • Make it easy for users to input their information.
  • Consider the various levels of people’s health literacy.
  • Be advertised and available on as many messaging platforms as possible, and also be available through their own native apps, available for download in Google and Apple app stores.
  • Build or use a knowledge base the chatbot can access for evidence-based information.
  • Add capability for empathetic small-talk and psychosocial support.