Home Medical Monitoring Made Difficult?
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The researchers concluded that based on previous studies, their task for the six people, reported problems from users of the devices, and difficulties they have noticed, people clearly have problems when using these devices, and there are many ways that a mistake could be made. "If they are unable to use meters properly, patients are unable to adjust treatment of their diabetes," they write.
"The instructions for the meters are not done from the users' point of view," Rogers says. "We need to do usability studies on how the instructions are written."
She recommends that developers improve the design of the monitors so that they provide prompts for directing the sequence of steps necessary for taking samples for blood sugar, and presenting both video and written instructions in simple language.
But some diabetes healthcare professionals say that current monitors don't present problems to users, unless they are mentally or physically disabled. Some glucose meters are even designed for the blind; they will talk to you.
"You can take someone who is basically illiterate and show them, and they can do it," says Marilyn Alford, MSN, RN, CS. "Even most 6- and 7-year-olds can use it themselves with their parents' guidance."
The monitors are uncomplicated, just requiring the patient to stick his finger in a hole in the machine and push a button, says Alford, a regional recruiting coordinator for a diabetes type 1 clinical trial at University of Texas Southwestern Medical Center at Dallas.
Mabyn Hager, RN, CDE, a diabetes educator at Baylor Medical Center in Irving, Texas, agrees that monitors currently available are "very easy to use."
"Most have memory with time and date, and they can be downloaded to a computer so the patient can get a printout with pie charts or graphs that they can take to their doctor," Hager says. Many are available in different languages.
One complaint cited by some users in the study was that it takes too long for the monitor to give a result, but Hager says getting a blood drop and running the glucose measurement only takes 30 seconds. A new machine is coming next week that only takes five seconds.
And James Bond-like monitors are hitting the stores, Hager says. One is a watch that measures blood sugar through the skin using an electrical current.
The machines also show -- in sequence -- prompts either by picture or words that ensure that a patient will do the steps in the correct order, Alford says.
Hager and Alford also say that most of the meters are self-calibrating. Rogers and her team had cited this as one stumbling block for many people in using the devices.
Nonetheless, Rogers says the purpose of their study was to illustrate the types of health-endangering problems people encounter with self-use medical devices in general. They want to encourage developers to make changes that will make the gadgets safer.