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Waligóra J, Bujnowska-Fedak MM. Online Health Technologies and Mobile Devices: Attitudes, Needs, and Future. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1153:19-29. [PMID: 30725364 DOI: 10.1007/5584_2019_335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Advances in mobile technology constitute a promising and evolving trend that enables better access to health care especially for the elderly, disabled, and chronically ill. It overcomes geographical, temporal, and organizational barriers at low and affordable costs. The aim of the study was to evaluate the needs and expectations of Polish citizens and their attitudes toward mobile health (mHealth) services using mobile phones and communication devices in medical care and also to evaluate the sociodemographic factors affecting such behavioral processes. A total of 1000 adults were selected from the Polish population by random sampling. The assessment was made with the use of computer-assisted telephone interview (CATI). Approximately 78% of the study participants were proficient mobile phone users with a predominance of young people. Forty-seven percent of them expressed the desire to obtain information about their health via their mobile phone if they had the opportunity to do so. Important factors associated with the aforementioned statement included younger age, being still in education, or unemployed. Among the mHealth supporters, the vast majority of people (84%) would like to receive SMS (short message service) reminders for appointments and prescribed medicines. Other favorable mHealth activities were e-registration (77.9%), viewing test results online (80.6%), or receiving basic medical recommendations (75.7%). Only 30% of the respondents had a positive attitude toward teleconsultation, while 17.8% of them were willing to pay for this option. Further research on emerging new and beneficial mHealth solutions needs to be conducted.
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Affiliation(s)
- Joanna Waligóra
- Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland
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Andrès E, Talha S, Zulfiqar AA, Hajjam M, Ervé S, Hajjam J, Gény B, Hajjam El Hassani A. Current Research and New Perspectives of Telemedicine in Chronic Heart Failure: Narrative Review and Points of Interest for the Clinician. J Clin Med 2018; 7:jcm7120544. [PMID: 30551588 PMCID: PMC6306809 DOI: 10.3390/jcm7120544] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/25/2022] Open
Abstract
Background: This is a narrative review of both the literature and Internet pertaining to telemedicine projects within the field of heart failure, with special attention placed on remote monitoring of second-generation projects and trials, particularly in France. Results: Since the beginning of the 2000’s, several telemedicine projects and trials focused on chronic heart failure have been developed. The first telemedicine projects (e.g., TEN-HMS, BEAT-HF, Tele-HF, and TIM-HF) primarily investigated telemonitoring or for the older ones, telephone follow-up. Numerous second-generation telemedicine projects have emerged in Europe over the last ten years or are still under development for computer science heart failure, especially in Europe, such as SCAD, OSICAT, E-care, PRADO-INCADO, and TIM-HF2. The E-care telemonitoring project fits within the telemedicine 2.0 framework, based on connected objects, new information and communication technologies (ICT) and Web 2.0 technologies. E-care is the first telemedicine project including artificial intelligence (AI). TIM-HF2 is the first positive prospective randomized study with regards to EBM with positive significant clinical benefit, in terms of unplanned cardiovascular hospital admissions and all-cause deaths. The potential contribution of second-generation telemedicine projects in terms of mortality, morbidity, and number of hospitalizations avoided is currently under study. Their impact in terms of health economics is likewise being investigated, taking into account that the economic and social benefits brought up by telemedicine solutions were previously validated by the original telemedicine projects.
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Affiliation(s)
- Emmanuel Andrès
- Service de Médecine Interne, Diabète et Maladies Métaboliques de la Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, 1 porte de l'Hôpital, 67091 Strasbourg Cedex, France.
- Equipe de recherche EA 3072 "Mitochondrie, Stress oxydant et Protection musculaire", Faculté de Médecine de Strasbourg, Université de Strasbourg (Unistra), 4 rue Kirschleger, 67091 Strasbourg, France.
| | - Samy Talha
- Equipe de recherche EA 3072 "Mitochondrie, Stress oxydant et Protection musculaire", Faculté de Médecine de Strasbourg, Université de Strasbourg (Unistra), 4 rue Kirschleger, 67091 Strasbourg, France.
- Service de Physiologie et d'Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg, 1 porte de l'Hôpital, 67091 Strasbourg CEDEX, France.
| | - Abrar-Ahmad Zulfiqar
- Service de Médecine Interne, Gériatrie et Thérapeutique, CHU de Rouen, 76000 Rouen, France.
| | | | - Sylvie Ervé
- Centre d'expertise des Technologies de l'Information et de la Communication pour l'autonomie (CENTICH) et Mutualité Française Anjou-Mayenne (MFAM), 49000 Angers, France.
| | - Jawad Hajjam
- Centre d'expertise des Technologies de l'Information et de la Communication pour l'autonomie (CENTICH) et Mutualité Française Anjou-Mayenne (MFAM), 49000 Angers, France.
| | - Bernard Gény
- Equipe de recherche EA 3072 "Mitochondrie, Stress oxydant et Protection musculaire", Faculté de Médecine de Strasbourg, Université de Strasbourg (Unistra), 4 rue Kirschleger, 67091 Strasbourg, France.
- Service de Physiologie et d'Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg, 1 porte de l'Hôpital, 67091 Strasbourg CEDEX, France.
| | - Amir Hajjam El Hassani
- Equipe de recherche EA 4662 "Nanomédecine, Imagerie, Thérapeutiques", Université de Technologie de Belfort-Montbéliard (UTBM), 25200 Belfort-Montbéliard, France.
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Abstract
Telemedicine in chronic diseases like heart failure is rapidly evolving and has two important goals: improving and individualising care as well as reducing costs. In this paper, we provide a critical and an updated review of the current evidence by discussing the most important trials, meta-analyses and systematic reviews. So far, evidence for the CardioMEMS device is most convincing. Other trials regarding invasive and non-invasive telemonitoring and telephone support show divergent results, but several meta-analyses and systematic reviews uniformly reported a beneficial effect. Voice-over systems and ECG monitoring had neutral results. Lack of direct comparison between different modalities makes it impossible to determine the most effective method. Dutch studies showed predominantly non-significant results, mainly due to underpowered studies or because of a high standard of usual care. There are no conclusive results on cost-effectiveness of telemedicine because of the above shortcomings. The adherence of elderly patients was good in the trials, being essential for the compliance of telemedicine in the entire heart failure population. In the future perspective, telemedicine should be better standardised and evolve to be more than an addition to standard care to improve care and reduce costs.
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Pekmezaris R, Tortez L, Williams M, Patel V, Makaryus A, Zeltser R, Sinvani L, Wolf-Klein G, Lester J, Sison C, Lesser M, Kozikowski A. Home Telemonitoring In Heart Failure: A Systematic Review And Meta-Analysis. Health Aff (Millwood) 2018; 37:1983-1989. [DOI: 10.1377/hlthaff.2018.05087] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Renee Pekmezaris
- Renee Pekmezaris is vice president of the Division of Health Services Research and a professor in the Departments of Medicine and Population Health, Northwell Health, in Manhasset, New York
| | - Leanne Tortez
- Leanne Tortez is a research assistant in the Department of Medicine, Northwell Health, in Manhasset
| | - Myia Williams
- Myia Williams is a research assistant in the Department of Medicine, Northwell Health, in Manhasset
| | - Vidhi Patel
- Vidhi Patel is a research assistant in the Department of Medicine, Northwell Health, in Manhasset
| | - Amgad Makaryus
- Amgad Makaryus is chair of the Department of Cardiology, Nassau University Medical Center, in East Meadow, New York, and a cardiologist in the Department of Cardiology, Northwell Health, in Manhasset
| | - Roman Zeltser
- Roman Zeltser is a cardiologist in the Department of Cardiology, Nassau University Medical Center, and a cardiologist in the Department of Cardiology, Northwell Health, in Manhasset
| | - Liron Sinvani
- Liron Sinvani is a physician in the Department of Medicine, Northwell Health, in Great Neck, New York
| | - Gisele Wolf-Klein
- Gisele Wolf-Klein is a physician in the Department of Medicine, Division of Geriatrics and Palliative Care, Northwell Health, in New Hyde Park, New York
| | - Janice Lester
- Janice Lester is a health sciences librarian in the Clinical Medical Library, Northwell Health, in New Hyde Park
| | - Cristina Sison
- Cristina Sison is assistant director in the Department of Biostatistics, Feinstein Institute for Medical Research, in Manhasset
| | - Martin Lesser
- Martin Lesser is assistant vice president in the Department of Biostatistics, Feinstein Institute for Medical Research
| | - Andrzej Kozikowski
- Andrzej Kozikowski is a senior analyst in the Division of Health Services Research and an assistant professor in the Department of Medicine, Northwell Health, in Manhasset
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Hansen L, Burks M, Kingman M, Stewart T. Volume Management in Pulmonary Arterial Hypertension Patients: An Expert Pulmonary Hypertension Clinician Perspective. Pulm Ther 2018; 4:13-27. [PMID: 32026242 PMCID: PMC6966996 DOI: 10.1007/s41030-018-0052-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Indexed: 12/17/2022] Open
Abstract
Fluid volume management in patients with pulmonary arterial hypertension (PAH) is essential in preventing right ventricular failure. Volume overload may be caused by disease progression, indiscretion of dietary sodium and fluid intake, or medication side effects, and is a frequent complication in patients with PAH. Healthcare professionals (HCPs) who care for patients with PAH have a key role in monitoring, preventing, and managing volume overload. Volume management techniques in patients with PAH include managing diuretic use and electrolyte imbalances, and monitoring fluid retention that can occur from the use of endothelin receptor antagonists or calcium channel blockers. Healthcare providers can create volume management protocols as well as patient educational materials. Patients should be educated to self-monitor their daily weights, incorporate dietary restrictions, and recognize symptoms associated with volume overload. Tools to help HCPs with volume management in patients with PAH are provided in this article.Funding Actelion Pharmaceuticals US, Inc.
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Affiliation(s)
| | | | - Martha Kingman
- University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - Traci Stewart
- Heart and Vascular Center, University of Iowa, Iowa, USA
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