Designing Patient Empowerment Systems: Tackling Low Adherence in Weight Management

Chronic diseases are the main drivers of rising healthcare costs in Europe. Over the last 30 years, the number of people with obesity has doubled. Reducing overweight and obesity is critical in tackling chronic diseases as they are the primary risk factors for many chronic diseases. However, adherence to lifestyle interventions is low. Patient empowerment is strongly associated with improving adher-ence. Despite the potential of digital health to support the empowerment process, there is a lack of de-sign knowledge for such systems that span multiple iterations of patient self-management and consul-tations. Such knowledge is essential as chronic diseases are iterative in nature and require continuous care. This study reports on a research-through-design project that aimed to improve adherence to treatment with the Digital Companion. The Digital Companion is an integrated system that facilitates the empowerment process by activating patients to participate in patient-centered consultations. We evaluate the Digital Companion in a naturalistic and formative evaluation. Analyzing the behavior of 27 patients when using the Digital Companion allowed us to formulate four socio-technical design principles that propose the design of patient empowerment systems to improve adherence in weight management.