MGHD 2023

Background Smartphone applications in healthcare are becoming popular and widespread across the globe. Most of these applications screen, diagnose, and monitor health outcomes. The recent development of the OptiBP application in measuring blood pressure is a ground-breaking technology that uses smartphones already in the pockets of 3 out of 4 people across the globe (https://www.itu.int/itud/ reports/statistics/2022/11/24/ff22-mobile-phone-ownership/). The application uses photoplethysmography (PPG) to analyse pulse oximetry and report blood pressure via the fingertip (Schoettker et al., 2020). This study aimed to determine the feasibility of the OptiBP application for self-monitoring blood pressure among adults living with hypertension in Rwanda. This study employed the System Usability Scale (SUS), and the Unified Theory for Acceptance and Use of Technology (UTAUT), to determine the usability and acceptance of OptiBP in Rwanda. Methods This cross-sectional study was conducted between May 12th and June 4th, 2023. The study focused on individuals with hypertension. Participants were purposively selected from two public health facilities, namely Nyarugenge District Hospital and Nyacyonga Health Centre, located in Kigali City Province, Rwanda. The participants were provided with training on how to use the OptiBP application. They were then instructed to measure their blood pressure at least twice daily for seven consecutive days while using the application in their homes. At the end of the seven days, a structured questionnaire was administered to assess the feasibility and acceptance of the OptiBP application and analysis were performed quantitively. The questionnaire included sections covering baseline information, the System Usability Scale, the Unified Theory for Use and Acceptance of Technology. Results We enrolled 49 study participants to be involved in this study, however, 46.9% (n=23) were dropped due to incompatibility of their smartphones with the OptiBP application after attempt to calibrate their smartphones failed. The study found that 46.1% (n=12) of the participants considered the OptiBP application usable, with a SUS score of ≥68 which is the ideal SUS score for a usable application. Only length of smartphone use was found to have a significant association with SUS scores (p-value = 0.048), indicating that more prolonged smartphone use was associated with higher SUS scores and ease of use. Overall, participants expressed positive perceptions regarding the possibilities and outcomes of the OptiBP application such as ease of use, ability to use the application without help and willingness to pay a monthly subscription fee. The Net Promoter Scale (NPS) analysis, which indicates the participants' willingness to recommend the OptiBP application, shows no associations between sex, age, education, and length of smartphone use. The compliance rates for blood pressure (BP) measurements show that 46.2% of participants were compliant, while 53.8% were non-compliant. Being busy emerged as the primary factor among the various reasons cited for non-compliance. Conclusion Several challenges related to smartphone compatibility, compliance, usability, and user concerns need to be addressed for the broader implementation of the OptiBP application for self-monitoring. The findings provide valuable insights for further optimizing the OptiBP application.