OBJECTIVES: Voice assistant technology can provide real-time, hands-free access to therapy information and administration instructions to support patients in managing health conditions. Key objectives of this study (NCT06150534) were to generate insights into the patient/caregiver experience with initiating home-based subcutaneous immunoglobulin (SCIG) and to evaluate the usability of, and satisfaction with, a newly developed interactive voice assistant support application.
DESIGN AND METHOD: This US-based qualitative, non-interventional study aimed to include up to 13 patients (aged ≥ 18 years initiating self-administered SCIG for primary immunodeficiency disease [PID] within 4–6 months before or 30 days after enrolment), 13 caregivers, and 10 healthcare professionals (HCPs) experienced in the treatment of PID. Before receiving access to the voice assistant (Alexa Skill via Amazon Echo Show device), semi-structured interviews were conducted with patients/caregivers to identify key themes related to experiences with home-based SCIG. After an application-use period, (patients/caregivers, 2–3 months; HCPs, 1–2 weeks), debriefing interviews captured insights into user experience and satisfaction during SCIG initiation and identified areas for application improvement.
RESULTS: Between 11 January 2024 and 25 February 2025, four patients, one caregiver and eight HCPs (five nurses, three physicians) completed the study. All patients/caregivers reported receiving training for self-infusion of SCIG before the study. Mean (standard deviation) age of enrolled patients was 50.0 (17.0) years and three (75%) were women. Patients reported that the voice assistant provides useful reminders (e.g. hand-washing, loading medication completely) and overall reassurance about self-infusions. Patients preferred hands-free video instructions (via the voice assistant) to printed instructions when preparing and/or administering SCIG. HCPs appreciated the potential for the Alexa Skill to improve patient experience and reduce HCP burden. HCPs recommended incorporating additional video and image content, and broadening the range of phrases that can be used to perform each command. Patients/caregivers also suggested improvements to the application, including expansive and reliable verbal commands, additional instructions for navigating the Alexa Skill, more video and image content, specific guidance on various aspects of the infusion process, and versions tailored to user-level experience, demonstrating a high-degree of engagement with the platform. Most participants who completed the study would recommend the application.
CONCLUSION: Interactive digital technologies may facilitate the transition to and compliance with self-administration of SCIG at home following training from an HCP. Video and images may be key attributes for such technologies.
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