Florian Prümer

Florian Prümer

Master's Thesis

Motivational UI: Enhancing Adherence and Engagement of Heart Failure Patients within a Digital Health Application

Madeleine Flaucher (M.Sc.), Katharina Jäger (M.Sc.), Dr.-Ing. Heike Leutheuser, Prof. Dr. Björn Eskofier, Dr. Sebastian Eckl, Jana Rolny (ProCarement GmbH)

05 / 2022 – 11 / 2022


In 2019, heart failure was the most frequent single diagnosis for in-patient stays in German hospitals [1]. As part of the therapy, heart failure patients need to continuously monitor their medication intake and their vital parameters such as blood pressure, oxygen saturation, weight and pulse [2]. This enables early countermeasures in the event of a deterioration of the health condition or adjustment of the medication. One way of assisting patients with this process is through the use of smartphone-based health applications. These applications support patients by enabling them to self-monitor relevant health data, and track their medication intake. Moreover, they offer the possibility to provide psychological support to patients and to increase health literacy through educational content [3].

Generally, mobile health solutions have a beneficial impact on chronic disease management. In the context of heart failure treatment, mobile applications indicate a high potential to effectively support patients during their therapy. [4, 5]. One important factor for the adoption of and engagement with mobile health applications is motivation. Motivated users are more likely to use and sustain their app usage [6]. Several studies already identified a set of potential factors increasing the motivation and therefore the engagement and adherence of users [7–9]. However, little research has been conducted on the actual implementation of these factors and their impact on already existing digital health applications.

Therefore, the aim of this research is to collect motivational factors for the use of smartphonebased health applications and integrate them in a user interface concept for an already existing digital health application for heart failure patients. This concept is then to be implemented as a prototype and evaluated.

This thesis is conducted in cooperation with ProCarement GmbH, which has developed the ProHerz app to support heart failure patients during their therapy. The app enables the user to monitor relevant health data, track medication intake, manage medical documentation and be in personal contact with medical professionals.

[1] Dietrich Andersen, Thomas Voigtländer, and Martin Vestweber. Deutscher Herzbericht 2020. Deutsche Herzstiftung e.V. (Frankfurt), June 2021.
[2] Theresa A McDonagh, Marco Metra, Marianna Adamo, Roy S Gardner, Andreas Baumbach, Michael Böhm, Haran Burri, Javed Butler, Jelena Čelutkien˙e, Ovidiu Chioncel, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European heart journal, 42(36):3599–3726, 2021.
[3] Maan Isabella Cajita, Kelly T Gleason, and Hae-Ra Han. A systematic review of mhealthbased heart failure interventions. The Journal of cardiovascular nursing, 31(3):E10, 2016.
[4] Spyros Kitsiou, Haleh Vatani, Guy Paré, Ben S Gerber, Susan W Buchholz, Mayank M Kansal, Jonathan Leigh, and Ruth M Masterson Creber. Effectiveness of mobile health technology interventions for patients with heart failure: systematic review and meta-analysis. Canadian Journal of Cardiology, 37(8):1248–1259, 2021.
[5] Milena Soriano Marcolino, João Antonio Queiroz Oliveira, Marcelo D’Agostino, Antonio Luiz Ribeiro, Maria Beatriz Moreira Alkmim, and David Novillo-Ortiz. The impact of mhealth interventions: systematic review of systematic reviews. JMIR mHealth and uHealth, 6(1):e8873, 2018.
[6] Abdulsalam Salihu Mustafa, Nor’ashikin Ali, Jaspaljeet Singh Dhillon, Gamal Alkawsi, Yahia Baashar, et al. User Engagement and Abandonment of mHealth: A Cross-Sectional Survey. In Healthcare, volume 10, page 221. Multidisciplinary Digital Publishing Institute, 2022.
[7] Maan Isabella Cajita, Nancy A Hodgson, Katherine Wai Lam, Sera Yoo, and Hae-Ra Han. Facilitators of and barriers to mhealth adoption in older adults with heart failure. Computers, informatics, nursing: CIN, 36(8):376, 2018.
[8] Stephanie A Morey, Laura H Barg-Walkow, and Wendy A Rogers. Managing heart failure on the go: Usability issues with mhealth apps for older adults. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting, volume 61, pages 1–5. SAGE Publications Sage CA: Los Angeles, CA, 2017.
[9] Leanna Sarah Woods, Jed Duff, Erin Roehrer, Kim Walker, and Elizabeth Cummings. Patients’ experiences of using a consumer mhealth app for self-management of heart failure: mixed-methods study. JMIR Human Factors, 6(2):e13009, 2019.