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A Review of Internet of Things Technologies for Ambient Assisted Living Environments. FUTURE INTERNET 2019. [DOI: 10.3390/fi11120259] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The internet of things (IoT) aims to extend the internet to real-world objects, connecting smart and sensing devices into a global network infrastructure by connecting physical and virtual objects. The IoT has the potential to increase the quality of life of inhabitants and users of intelligent ambient assisted living (AAL) environments. The paper overviews and discusses the IoT technologies and their foreseen impacts and challenges for the AAL domain. The results of this review are summarized as the IoT based gerontechnology acceptance model for the assisted living domain. The model focuses on the acceptance of new technologies by older people and underscores the need for the adoption of the IoT for the AAL domain.
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Monteiro L, Maricoto T, Solha I, Ribeiro-Vaz I, Martins C, Monteiro-Soares M. Reducing Potentially Inappropriate Prescriptions for Older Patients Using Computerized Decision Support Tools: Systematic Review. J Med Internet Res 2019; 21:e15385. [PMID: 31724956 PMCID: PMC6883366 DOI: 10.2196/15385] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 11/28/2022] Open
Abstract
Background Older adults are more vulnerable to polypharmacy and prescriptions of potentially inappropriate medications. There are several ways to address polypharmacy to prevent its occurrence. We focused on computerized decision support tools. Objective The available literature was reviewed to understand whether computerized decision support tools reduce potentially inappropriate prescriptions or potentially inappropriate medications in older adult patients and affect health outcomes. Methods Our systematic review was conducted by searching the literature in the MEDLINE, CENTRAL, EMBASE, and Web of Science databases for interventional studies published through February 2018 to assess the impact of computerized decision support tools on potentially inappropriate medications and potentially inappropriate prescriptions in people aged 65 years and older. Results A total of 3756 articles were identified, and 16 were included. More than half (n=10) of the studies were randomized controlled trials, one was a crossover study, and five were pre-post intervention studies. A total of 266,562 participants were included; of those, 233,144 participants were included and assessed in randomized controlled trials. Intervention designs had several different features. Computerized decision support tools consistently reduced the number of potentially inappropriate prescriptions started and mean number of potentially inappropriate prescriptions per patient. Computerized decision support tools also increased potentially inappropriate prescriptions discontinuation and drug appropriateness. However, in several studies, statistical significance was not achieved. A meta-analysis was not possible due to the significant heterogeneity among the systems used and the definitions of outcomes. Conclusions Computerized decision support tools may reduce potentially inappropriate prescriptions and potentially inappropriate medications. More randomized controlled trials assessing the impact of computerized decision support tools that could be used both in primary and secondary health care are needed to evaluate the use of medication targets defined by the Beers or STOPP (Screening Tool of Older People’s Prescriptions) criteria, adverse drug reactions, quality of life measurements, patient satisfaction, and professional satisfaction with a reasonable follow-up, which could clarify the clinical usefulness of these tools. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42017067021; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017067021
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Affiliation(s)
- Luís Monteiro
- Esgueira+ Family Health Unit, Aveiro Healthcare Centre, Aveiro, Portugal.,Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Tiago Maricoto
- Aveiro-Aradas Family Health Unit, Aveiro Healthcare Centre, Aveiro, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Isabel Solha
- Terras de Souza Family Health Unit, Paredes, Portugal
| | - Inês Ribeiro-Vaz
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Porto Pharmacovigilance Centre, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carlos Martins
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Matilde Monteiro-Soares
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
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Andrikopoulou E, Scott P, Herrera H, Good A. What are the important design features of personal health records to improve medication adherence for patients with long-term conditions? A systematic literature review. BMJ Open 2019; 9:e028628. [PMID: 31558449 PMCID: PMC6773318 DOI: 10.1136/bmjopen-2018-028628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This systematic literature review aims to identify important design features of the electronic personal health record (PHR) that may improve medication adherence in the adult population with long-term conditions. DATA SOURCES PubMed (including MEDLINE), CINAHL, Science Direct (including EMBASE), BioMed Central, ACM digital, Emerald Insight, Google Scholar and Research Gate. METHODS Studies that were published between 1 January 2002 and 31 May 2018 in English were included if the participants were adults, with at least one long-term condition, were able to self-administer their medication and were treated in primary care settings. The quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the risk of bias was appraised using the Cochrane risk of bias tool. RESULTS From a total of 27 studies that matched the inclusion criteria, 12 were excluded due to low quality of evidence, 10 were rated moderate and 5 were rated high quality. All the included studies had low sample size and limited follow-up duration. Thirteen of the included studies found that the use of a PHR has increased medication adherence. The identified design features are reminders, education, personalisation and tailoring, feedback and alerts, gamification, medication management, medical appointment management, diary and self-monitoring, health condition management, set goals, patient's blog and tethered. It was impossible to draw conclusions as to which feature is important to what group of patients and why. The most frequently identified conditions were HIV and diabetes. This review did not identify any papers with negative results. It was not possible to numerically aggregate the PHR effect due to high heterogeneity of the medication adherence measurement, study type, participants and PHRs used. CONCLUSION Although we found recurrent evidence that PHRs can improve medication adherence, there is little evidence to date to indicate which design features facilitate this process. PROSPERO REGISTRATION NUMBER CRD42017060542.
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Affiliation(s)
- Elisavet Andrikopoulou
- School of Computing, Faculty of Technology, University of Portsmouth, Portsmouth, UK
- School of Computing, Buckingham Building, Lion Terrace, Portsmouth, UK
| | - Philip Scott
- School of Computing, Faculty of Technology, University of Portsmouth, Portsmouth, UK
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, Faculty of Science, University of Portsmouth, Portsmouth, UK
| | - Alice Good
- School of Computing, Faculty of Technology, University of Portsmouth, Portsmouth, UK
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54
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Grace-Farfaglia P. Social Cognitive Theories and Electronic Health Design: Scoping Review. JMIR Hum Factors 2019; 6:e11544. [PMID: 31325290 PMCID: PMC6676794 DOI: 10.2196/11544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/24/2018] [Accepted: 03/31/2019] [Indexed: 12/30/2022] Open
Abstract
Background There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. Objective This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. Methods The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. Results Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%). Conclusions This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.
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Huang Z, Lum E, Jimenez G, Semwal M, Sloot P, Car J. Medication management support in diabetes: a systematic assessment of diabetes self-management apps. BMC Med 2019; 17:127. [PMID: 31311573 PMCID: PMC6636047 DOI: 10.1186/s12916-019-1362-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/10/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Smartphone apps are becoming increasingly popular for supporting diabetes self-management. A key aspect of diabetes self-management is appropriate medication-taking. This study aims to systematically assess and characterise the medication management features in diabetes self-management apps and their congruence with best-practice evidence-based criteria. METHODS The Google Play and Apple app stores were searched in June 2018 using diabetes-related terms in the English language. Apps with both medication and blood glucose management features were downloaded and evaluated against assessment criteria derived from international medication management and diabetes guidelines. RESULTS Our search yielded 3369 Android and 1799 iOS potentially relevant apps; of which, 143 apps (81 Android, 62 iOS) met inclusion criteria and were downloaded and assessed. Over half 58.0% (83/143) of the apps had a medication reminder feature; 16.8% (24/143) had a feature to review medication adherence; 39.9% (57/143) allowed entry of medication-taking instructions; 5.6% (8/143) provided information about medication; and 4.2% (6/143) displayed motivational messages to encourage medication-taking. Only two apps prompted users on the use of complementary medicine. Issues such as limited medication logging capacity, faulty reminder features, unclear medication adherence assessment, and visually distracting excessive advertising were observed during app assessments. CONCLUSIONS A large proportion of diabetes self-management apps lacked features for enhancing medication adherence and safety. More emphasis should be given to the design of medication management features in diabetes apps to improve their alignment to evidence-based best practice.
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Affiliation(s)
- Zhilian Huang
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Level 18, 11 Mandalay Road, Singapore, 308232, Singapore. .,NTU Institute for Health Technologies (HealthTech NTU), Interdisciplinary Disciplinary School, Nanyang Technological University, Singapore, Singapore.
| | - Elaine Lum
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Level 18, 11 Mandalay Road, Singapore, 308232, Singapore.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Geronimo Jimenez
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Level 18, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Monika Semwal
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Level 18, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Peter Sloot
- Institute for Advanced Study, University of Amsterdam, Amsterdam, The Netherlands.,ITMO University, Saint Petersburg, Russia.,Complexity Institute, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Level 18, 11 Mandalay Road, Singapore, 308232, Singapore
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56
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Pérez-Jover V, Sala-González M, Guilabert M, Mira JJ. Mobile Apps for Increasing Treatment Adherence: Systematic Review. J Med Internet Res 2019; 21:e12505. [PMID: 31215517 PMCID: PMC6604503 DOI: 10.2196/12505] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/28/2019] [Accepted: 05/11/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND It is estimated that 20% to 50% of patients do not take their medication correctly, and this leads to increased morbidity and inefficacy of therapeutic approaches. Fostering treatment adherence is a priority objective for all health systems. The growth of mobile apps to facilitate therapeutic adherence has significantly increased in recent years. However, the effectiveness of the apps for this purpose has not been evaluated. OBJECTIVE This study aimed to analyze whether mobile apps are perceived as useful for managing medication at home and if they actually contribute to increasing treatment adherence in patients. METHODS We carried out a systematic review of research published using Scopus, Cochrane Library, ProQuest, and MEDLINE databases and analyzed the information about their contribution to increasing therapeutic adherence and the perceived usefulness of mobile apps. This review examined studies published between 2000 and 2017. RESULTS Overall, 11 studies fulfilled the inclusion criteria. The sample sizes of these studies varied between 16 and 99 participants. In addition, 7 studies confirmed that the mobile app increased treatment adherence. In 5 of them, the before and after adherence measures suggested significant statistical improvements, when comparing self-reported adherence and missed dose with a percentage increase ranging between 7% and 40%. The users found mobile apps easy to use and useful for managing their medication. The patients were mostly satisfied with their use, with an average score of 8.1 out of 10. CONCLUSIONS The use of mobile apps helps increase treatment adherence, and they are an appropriate method for managing medication at home.
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Affiliation(s)
| | | | - Mercedes Guilabert
- Departamento Psicología de la Salud, Universidad Miguel Hernández, Elche, Spain
| | - José Joaquín Mira
- Departamento Psicología de la Salud, Universidad Miguel Hernández, Elche, Spain
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57
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Affiliation(s)
- José Joaquín Mira
- a Health Psychology Department , Universidad Miguel Hernández , Sant Joan , Spain.,b Alicante-Sant Joan Health District , Alicante , Spain.,c Prometeo173 Research Group , FISABIO , Sant Joan , Spain
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Small AC, Thorogood SL, Shah O, Healy KA. Emerging Mobile Platforms to Aid in Stone Management. Urol Clin North Am 2019; 46:287-301. [PMID: 30961861 DOI: 10.1016/j.ucl.2018.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Nephrolithiasis is an increasingly common condition worldwide and mobile technology is revolutionizing how patients with kidney stone are being diagnosed and managed. Emerging platforms include software applications to increase adherence to stone prevention, mobile compatible hardware, online social media communities, and telemedicine. Applications and hardware specifically relevant to increasing hydration, diet modification, medication adherence, and rapid diagnosis (ie, mobile ultrasound and endoscopy) have the greatest potential to reduce stone recurrence and expedite treatment. Social media and online communities have also been rapidly adopted by patients and providers to promote education and support.
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Affiliation(s)
- Alexander C Small
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Samantha L Thorogood
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Ojas Shah
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Kelly A Healy
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA.
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Yang Q, Van Stee SK. The Comparative Effectiveness of Mobile Phone Interventions in Improving Health Outcomes: Meta-Analytic Review. JMIR Mhealth Uhealth 2019; 7:e11244. [PMID: 30942695 PMCID: PMC6468337 DOI: 10.2196/11244] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/01/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022] Open
Abstract
Background As mobile technology continues expanding, researchers have been using mobile phones to conduct health interventions (mobile health—mHealth—interventions). The multiple features of mobile phones offer great opportunities to disseminate large-scale, cost-efficient, and tailored messages to participants. However, the interventions to date have shown mixed results, with a large variance of effect sizes (Cohen d=−0.62 to 1.65). Objective The study aimed to generate cumulative knowledge that informs mHealth intervention research. The aims were twofold: (1) to calculate an overall effect magnitude for mHealth interventions compared with alternative interventions or conditions, and (2) to analyze potential moderators of mHealth interventions’ comparative efficacy. Methods Comprehensive searches of the Communication & Mass Media Complete, PsycINFO, Web of Knowledge, Academic Search Premier, PubMed and MEDLINE databases were conducted to identify potentially eligible studies in peer-reviewed journals, conference proceedings, and dissertations and theses. Search queries were formulated using a combination of search terms: “intervention” (Title or Abstract) AND “health” (Title or Abstract) AND “*phone*” OR “black-berr*” (OR mHealth OR “application*” OR app* OR mobile OR cellular OR “short messag*” OR palm* OR iPhone* OR MP3* OR MP4* OR iPod*) (Title or Abstract). Cohen d was computed as the basic unit of analysis, and the variance-weighted analysis was implemented to compute the overall effect size under a random-effects model. Analysis of variance–like and meta-regression models were conducted to analyze categorical and continuous moderators, respectively. Results The search resulted in 3424 potential studies, the abstracts (and full text, as necessary) of which were reviewed for relevance. Studies were screened in multiple stages using explicit inclusion and exclusion criteria, and citations were evaluated for inclusion of qualified studies. A total of 64 studies were included in the current meta-analysis. Results showed that mHealth interventions are relatively more effective than comparison interventions or conditions, with a small but significant overall weighted effect size (Cohen d=0.31). In addition, the effects of interventions are moderated by theoretical paradigm, 3 engagement types (ie, changing personal environment, reinforcement tracking, social presentation), mobile use type, intervention channel, and length of follow-up. Conclusions To the best of our knowledge, this is the most comprehensive meta-analysis to date that examined the overall effectiveness of mHealth interventions across health topics and is the first study that statistically tested moderators. Our findings not only shed light on intervention design using mobile phones, but also provide new directions for research in health communication and promotion using new media. Future research scholarship is needed to examine the effectiveness of mHealth interventions across various health issues, especially those that have not yet been investigated (eg, substance use, sexual health), engaging participants using social features on mobile phones, and designing tailored mHealth interventions for diverse subpopulations to maximize effects.
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Affiliation(s)
- Qinghua Yang
- Department of Communication Studies, Bob Schieffer College of Communication, Texas Christian University, Fort Worth, TX, United States
| | - Stephanie K Van Stee
- Department of Communication and Media, University of Missouri-St. Louis, St. Louis, MO, United States
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Shim KY, Seo S, Lee SJ, Lee CE. Eye Drop Chart for Improvement of Topical Eye Drops Administration and Adherence. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.2.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Sam Seo
- Cheil Eye Hospital, Daegu, Korea
| | - Soo Jin Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Chong Eun Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
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Del Pino-Sedeño T, Peñate W, de Las Cuevas C, Valcarcel-Nazco C, Fumero A, Serrano-Pérez PG, Acosta Artiles FJ, Ramos García V, León Salas B, Bejarano-Quisoboni D, Trujillo-Martín MM. Effectiveness and cost-effectiveness of a multicomponent intervention to improve medication adherence in people with depressive disorders - MAPDep: a study protocol for a cluster randomized controlled trial. Patient Prefer Adherence 2019; 13:309-319. [PMID: 30863020 PMCID: PMC6391125 DOI: 10.2147/ppa.s172963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Depression is a widespread mental disorder which can be treated effectively. However, low adherence to antidepressants is very common. The study of medication adherence in depression (MAPDep study) assesses the effectiveness and cost-effectiveness of a multicomponent strategy to enhance adherence toward medications in patients with depression. INTERVENTION The intervention is a multicomponent one consisting of an educational program for psychiatrists and/or a collaborative care program for patients and relatives, plus a reminder system that works through the use of an already available high-quality medication reminder application. STUDY DESIGN MAPDep study is an open, multicenter, four-arm cluster randomized controlled trial. The clusters are mental health units where psychiatrists are invited to participate. The clusters are randomly allocated to one of the three interventions or to usual care (control arm). Patients (18-65 years of age) diagnosed with depressive disorder, those taking antidepressant medication for an existing diagnosis of depression, and mobile phone users are selected. In group 1, only patients and relatives receive intervention; in group 2, only psychiatrists receive intervention; and in group 3, patients/relatives and psychiatrists receive intervention. The primary outcome is adherence to the antidepressant drug. The calculated sample size is 400 patients. To examine changes across time, generalized linear mixed model with repeated measures will be used. A cost-effectiveness analysis will be conducted. The effectiveness measure is quality-adjusted life years. Deterministic sensitivity analyses are planned. CONCLUSION MAPDep study aims to assess a multicomponent strategy to improve adherence toward medications in patients with depression, based not only on clinical effectiveness but also on cost-effectiveness. This methodology will enhance the transferability of the expected results beyond mental health services (patients and psychiatrists) to health care policy decision making. CLINICAL TRIAL IDENTIFIER NCT03668457.
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Affiliation(s)
- Tasmania Del Pino-Sedeño
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | - Wenceslao Peñate
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Carlos de Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain,
| | - Cristina Valcarcel-Nazco
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
- Canary Islands Foundation of Health Research (FUNCANIS), San Cristóbal de La Laguna, Canary Islands, Spain
| | - Ascensión Fumero
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Pedro Guillermo Serrano-Pérez
- Department of Psychiatry, Hospital Universitari Vall d' Hebron, Catalonia, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Francisco Javier Acosta Artiles
- Service of Mental Health, General Health Care Programs Direction, Canary Health Service, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Vanesa Ramos García
- Canary Islands Foundation of Health Research (FUNCANIS), San Cristóbal de La Laguna, Canary Islands, Spain
| | - Beatriz León Salas
- Canary Islands Foundation of Health Research (FUNCANIS), San Cristóbal de La Laguna, Canary Islands, Spain
| | | | - María M Trujillo-Martín
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
- Canary Islands Foundation of Health Research (FUNCANIS), San Cristóbal de La Laguna, Canary Islands, Spain
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Ramprasad C, Tamariz L, Garcia-Barcena J, Nemeth Z, Palacio A. The Use of Tablet Technology by Older Adults in Health Care Settings-Is It Effective and Satisfying? A Systematic Review and Meta Analysis. Clin Gerontol 2019; 42:17-26. [PMID: 28665775 DOI: 10.1080/07317115.2017.1322162] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This systematic review/meta-analysis examines the potential for older people to accept and use tablet technology in clinical settings by assessing satisfaction and effectiveness. METHODS A comprehensive literature search was conducted of PubMed, SCOPUS, and CINAHL through March 2017. Inclusion criteria included studies with any clinical use of a tablet technology with a median patient age above 65 years. RESULTS We included a total of 12 studies (4 randomized controlled trials, 4 cross-sectional studies, and 4 pre/post studies). Interventions included the use of tablet technology for medication self-management, post-surgery education, memory retention, cognitive rehabilitation, and exercise promotion. The use of tablet technology by older people in clinical settings was associated with high satisfaction with a pooled prevalence of satisfaction of 78%; 95% CI 27-100. We did not find evidence for effectiveness in improving clinical or behavioral outcomes. CONCLUSIONS Older people can use and are satisfied with table technology in clinical settings. More studies are needed to evaluate the effectiveness of tablet technology at promoting health outcomes. CLINICAL IMPLICATIONS Clinicians should be encouraged to utilize tablet technology in the care of older patients.
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Affiliation(s)
- Chethan Ramprasad
- a University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Leonardo Tamariz
- a University of Miami Miller School of Medicine , Miami , Florida , USA
| | | | - Zsuzsanna Nemeth
- a University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Ana Palacio
- a University of Miami Miller School of Medicine , Miami , Florida , USA
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63
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Chib A, Lin SH. Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps. JOURNAL OF HEALTH COMMUNICATION 2018; 23:909-955. [PMID: 30449261 DOI: 10.1080/10810730.2018.1544676] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There are now few hundred thousand healthcare apps, yet there is a gap in our understanding of the theoretical mechanisms for which, and how, technological features translate into improved healthcare outcomes. In particular, the technological convergence, within mobile health (mHealth) apps, of the processes of mass and interpersonal communication, and human-computer interaction requires greater parsing in the literature. This paper analyzed 85 empirical studies on mHealth apps using the Input-Mechanism-Output model. We found in the literature that, firstly, there is a greater emphasis on technological inputs (87%) of accessibility, usability, usage, and data quality, than health outputs (52%) such as system process efficiencies and individual level behavioral or health outcomes. Secondly, there is little evidence of explanatory mechanisms (19%) of how the effects of mHealth apps are achieved. While we believe that successful apps would require research that incorporates technological inputs, theoretical mechanisms and health outputs, such studies are a rarity (n = 3). There is a minor increase in rigor with randomized control trials (n = 5), and a preponderance of discussion around social influence (n = 8) and gamification (n = 7), albeit in a scattered manner. We discuss the implications of the trend towards socialization and gamification findings in terms of future research, particularly in terms of study design guided by theoretical mechanisms.
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Affiliation(s)
- Arul Chib
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Sapphire H Lin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
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64
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Burnett-Zeigler IE, Waldron EM, Hong S, Yang A, Wisner KL, Ciolino JD. Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health. Complement Ther Clin Pract 2018; 33:93-99. [PMID: 30396633 DOI: 10.1016/j.ctcp.2018.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/31/2018] [Accepted: 09/07/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE We evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. MATERIALS AND METHODS Adult women (N = 19) who previously participated in a mindfulness intervention wore an activity monitor for eight-weeks. The activity monitor notified them when they were stressed (based on standard deviation pulse pressure). Heart rate and pulse pressure were continuously collected via the activity monitor. Mindfulness, stress, depression and trauma symptoms were collected via self-report surveys. RESULTS There were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks. Pulse pressure and standard deviation of pulse pressure increased over time. Those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed. CONCLUSION Those who are more mindful are less likely to have physiological signs of stress.
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Affiliation(s)
- Inger E Burnett-Zeigler
- Northwestern University, Asher Center for the Study and Treatment of Depressive Disorders, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 676 N. Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA.
| | - Elizabeth M Waldron
- Northwestern University, Asher Center for the Study and Treatment of Depressive Disorders, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 676 N. Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Sunghyun Hong
- Northwestern University, Asher Center for the Study and Treatment of Depressive Disorders, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 676 N. Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Amy Yang
- Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Katherine L Wisner
- Northwestern University, Asher Center for the Study and Treatment of Depressive Disorders, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 676 N. Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Jody D Ciolino
- Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
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Thurnheer SE, Gravestock I, Pichierri G, Steurer J, Burgstaller JM. Benefits of Mobile Apps in Pain Management: Systematic Review. JMIR Mhealth Uhealth 2018; 6:e11231. [PMID: 30348633 PMCID: PMC6231845 DOI: 10.2196/11231] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 12/16/2022] Open
Abstract
Background Pain is a common condition with a significant physical, psychosocial, and economic impact. Due to enormous progress in mobile device technology as well as the increase in smartphone ownership in the general population, mobile apps can be used to monitor patients with pain and support them in pain management. Objective The aim of this review was to assess the efficacy of smartphone or computer tablet apps in the management of patients with pain. Methods In December 2017, a literature search was performed in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane, and PsycINFO. In addition, a bibliography search was conducted. We included studies with at least 20 participants per arm that evaluated the effects of apps on smartphones or computer tablets on improvement in pain. Results A total of 15 studies with 1962 patients met the inclusion criteria. Of these, 4 studies examined the effect of mobile apps on pain management in an in-clinic setting and 11 in an out-clinic setting. The majority of the original studies reported beneficial effects of the use of a pain app. Severity of pain decreased in most studies where patients were using an app compared with patients not using an app. Other outcomes, such as worst pain or quality of life showed improvements in patients using an app. Due to heterogeneity between the original studies—patient characteristics, app content, and study setting—a synthesis of the results by statistical methods was not performed. Conclusions Apps for pain management may be beneficial for patients, particularly in an out-clinic setting. Studies have shown that pain apps are workable and well liked by patients and health care professionals. There is no doubt that in the near future, mobile technologies will develop further. Medicine could profit from this development as indicated by our results, but there is a need for more scientific inputs. It is desirable to know which elements of apps or additional devices and tools may improve usability and help patients in pain management.
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Affiliation(s)
- Simon E Thurnheer
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
| | - Isaac Gravestock
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
| | - Giuseppe Pichierri
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
| | - Johann Steurer
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
| | - Jakob M Burgstaller
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
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Perceptions of older people in Ireland and Australia about the use of technology to address falls prevention. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractFalls are common events with serious consequences for older people. With an ageing population and increasing health-care costs, information and communication technologies (ICT) will have a potential role in future health-care delivery. However, research on technology acceptance in health care for older people is limited and its application to falls prevention is unknown. The aims of this study were to explore and describe the perceptions of community-dwelling Australian and Irish older people about their current use of technology, and the potential use of technology for falls prevention. Qualitative data were collected from three focus groups conducted in and around Limerick in Ireland, and three in the Sydney area, Australia. A total of 35 older people participated. Data were analysed using thematic analysis. Four themes emerged from the data: (a) perceptions of vulnerability to falls, (b) preferences for exercise interventions, (c) participation in and ownership of technology, and (d) perceptions about applications of technology for falls prevention. As the use of technology is an instrumental activity of daily living, health professionals need to assess the capacity of older people to adopt these technologies, and provide falls prevention interventions to accommodate the technology skills of older people. Some participants were reluctant to embrace technology and barriers to the effective use of technology to assist in preventing falls may conflict with future health service trends.
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Hsieh WT, Su YC, Han HL, Huang MY. A Novel mHealth Approach for a Patient-Centered Medication and Health Management System in Taiwan: Pilot Study. JMIR Mhealth Uhealth 2018; 6:e154. [PMID: 29970356 PMCID: PMC6053609 DOI: 10.2196/mhealth.9987] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/12/2018] [Accepted: 06/18/2018] [Indexed: 12/05/2022] Open
Abstract
Background Mobile health (mHealth) apps have recently demonstrated the potential to engage and empower people to improve their own health. Although the availability of health-related apps is increasing, their adoption rate in Taiwan is exceptionally low mainly due to the preponderance of Western culture-based app designs that are challenging for non-English-speaking individuals. To our knowledge, no mHealth app is available in Taiwan that is culturally tailored for Chinese-speaking users and that applies a patient-centered approach to self-manage medication and health. Objective The purpose of this study was to design and deploy a culturally tailored mHealth system that could be easily integrated into current clinical practice and to evaluate how this mHealth system could support the continuity of patient care in Taiwan. Methods An mHealth information system and a mobile app were designed. To promote the best patient experience, a Quick Response (QR) code system was developed to enable efficient registration of personal medication information through the mobile app. The app also supported notifications for drug utilization, refills, and symptom checks. Patients were encouraged to record medication use, symptoms, and self-assessments in the app during their treatment period. Evaluation of the novel mHealth system was conducted from August 1, 2016 to December 31, 2016 at MacKay Memorial Hospital, Taipei, Taiwan. Population data and app usage statistics were analyzed. Results During the 5-month implementation period, a total of 25,909 users downloaded the app with an overall 7-day retention rate of 15.4% (SD 3.9). Young male adults (range 25-44 years) were the predominant user population. Patients’ feedback on app usability and design, QR code system as drug input method, medication reminders, and linking family or friends into care networks was generally positive. Physicians showed great interest in utilizing patient-generated data in their care process, and the positive medication adherence rate was the most highly valued component of this system. Conclusions This pilot study demonstrated the value of a novel mHealth approach for individualized medication and health management in Taiwan. The mHealth system shows the potential to optimize personalized care into existing clinical services and may help hospitals and health authorities perform continuous quality improvement and policy development.
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Affiliation(s)
- Wen-Ting Hsieh
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yung-Cheng Su
- Department of Emergency, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hsin-Lien Han
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Yuan Huang
- Biomedical Research and Innovation Incubation Center, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Department of Emergency, MacKay Memorial Hospital, Taipei, Taiwan
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Wanderley GMP, Vandenbergh É, Abel MH, Barthès JPA, Hainselin M, Mouras H, Lenglet A, Tir M, Heurley L. CONSIGNELA: A multidisciplinary patient-centered project to improve drug prescription comprehension and execution in elderly people and parkinsonian patients. TELEMATICS AND INFORMATICS 2018. [DOI: 10.1016/j.tele.2017.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Lu C, Hu Y, Xie J, Fu Q, Leigh I, Governor S, Wang G. The Use of Mobile Health Applications to Improve Patient Experience: Cross-Sectional Study in Chinese Public Hospitals. JMIR Mhealth Uhealth 2018; 6:e126. [PMID: 29792290 PMCID: PMC5990855 DOI: 10.2196/mhealth.9145] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 01/18/2018] [Accepted: 04/10/2018] [Indexed: 12/18/2022] Open
Abstract
Background The proliferation of mobile health apps has greatly changed the way society accesses the health care industry. However, despite the widespread use of mobile health apps by patients in China, there has been little research that evaluates the effect of mobile health apps on patient experience during hospital visits. Objective The purpose of our study was to examine whether the use of mobile health apps improves patient experience and to find out the difference in patient experience between users and nonusers and the characteristics associated with the users of these apps. Methods We used the Chinese Outpatient Experience Questionnaire to survey patient experience. A sample of 300 outpatients was randomly selected from 3 comprehensive public hospitals (3 tertiary hospitals) in Hubei province, China. Each hospital randomly selected 50 respondents from mobile health app users and 50 from nonusers. A chi-square test was employed to compare the different categorical characteristics between mobile health app users and nonusers. A t test was used to test the significance in continuous variables between user scores and nonuser scores. Multiple linear regression was conducted to determine whether the use of mobile health apps during hospital visits was associated with patient experience. Results The users and nonusers differed in age (χ22=12.2, P=.002), education (χ23=9.3, P=.03), living place (χ21=7.7, P=.006), and the need for specialists (χ24=11.0, P=.03). Compared with nonusers, mobile health app users in China were younger, better educated, living in urban areas, and had higher demands for specialists. In addition, mobile health app users gave significantly higher scores than nonusers in total patient experience scores (t298=3.919, P<.001), the 18 items and the 5 dimensions of physician-patient communication (t298=2.93, P=.004), health information (t298=3.556, P<.001), medical service fees (t298=3.991, P<.001), short-term outcome (t298=4.533, P<.001), and general satisfaction (t298=4.304, P<.001). Multiple linear regression results showed that the use of mobile health apps during hospital visits influenced patient experience (t289=3.143, P=.002). After controlling for other factors, it was shown that the use of mobile health apps increased the outpatient experience scores by 17.7%. Additional results from the study found that the self-rated health status (t289=3.746, P<.001) and monthly income of patients (t289=2.416, P=.02) influenced the patient experience as well. Conclusions The use of mobile health apps could improve patient experience, especially with regard to accessing health information, making physician-patient communication more convenient, ensuring transparency in medical charge, and ameliorating short-term outcomes. All of these may contribute to positive health outcomes. Therefore, we should encourage the adoption of mobile health apps in health care settings so as to improve patient experience.
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Affiliation(s)
- Chuntao Lu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinhuan Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinzhu Xie
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Fu
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Missouri, MO, United States
| | - Isabella Leigh
- Department of Communication, Morrissey College of Arts and Sciences, Boston College, Chestnut Hill, MA, United States
| | - Samuel Governor
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Missouri, MO, United States
| | - Guanping Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Horne F, Burns P, Traynor V, Gillespie R, Mullan J, Baker A, Harrison L, Win KT. Managing medications for individuals living with a dementia: Evaluating a web-based information resource for informal carers. Int J Older People Nurs 2018; 13:e12198. [DOI: 10.1111/opn.12198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Frances Horne
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| | - Pippa Burns
- School of Medicine; University of Wollongong; Wollongong NSW Australia
- Centre for Health Research Illawarra Shoalhaven Population; Australian Health Services Research Institute; University of Wollongong; Wollongong NSW Australia
| | - Victoria Traynor
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| | - Robyn Gillespie
- School of Health and Society; University of Wollongong; Wollongong NSW Australia
| | - Judy Mullan
- School of Medicine; University of Wollongong; Wollongong NSW Australia
- Centre for Health Research Illawarra Shoalhaven Population; Australian Health Services Research Institute; University of Wollongong; Wollongong NSW Australia
| | - Amanda Baker
- School of Education; University of Wollongong; Wollongong NSW Australia
| | - Lindsey Harrison
- School of Health and Society; University of Wollongong; Wollongong NSW Australia
| | - Khin Than Win
- School of Computing and Information Technology; University of Wollongong; Wollongong NSW Australia
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Black DA, O'Loughlin K, Wilson LA. Climate change and the health of older people in Australia: A scoping review on the role of mobile applications (apps) in ameliorating impact. Australas J Ageing 2018; 37:99-106. [DOI: 10.1111/ajag.12522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Deborah A Black
- Faculty of Health Sciences; University of Sydney; Sydney New South Wales Australia
| | - Kate O'Loughlin
- Faculty of Health Sciences; University of Sydney; Sydney New South Wales Australia
| | - Leigh A Wilson
- School of Science and Health; Western Sydney University; Sydney New South Wales Australia
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Ali EE, Teo AKS, Goh SXL, Chew L, Yap KYL. MedAd-AppQ: A quality assessment tool for medication adherence apps on iOS and android platforms. Res Social Adm Pharm 2018; 14:1125-1133. [PMID: 29402755 DOI: 10.1016/j.sapharm.2018.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND With the recent proliferation of smartphone medication adherence applications (apps), it is increasingly more difficult for patients and clinicians to identify the most useful app. OBJECTIVE To develop a quality assessment tool for medication adherence apps, and evaluate the quality of such apps from the major app stores. METHODS In this study, a Medication Adherence App Quality assessment tool (MedAd-AppQ) was developed and two evaluators independently assessed apps that fulfilled the following criteria: availability in English, had at least a medication reminder feature, non-specific to certain disease conditions (generic apps), free of technical malfunctions and availability on both the iPhone Operating System (iOS) and Android platforms. Descriptive statistics, Mann-Whitney U test, Pearson product moment correlation and Spearman rank-order correlation were used for statistical analysis. RESULTS MedAd-AppQ was designed to have 24 items (total 43 points) categorized under three sections: content reliability (11 points), feature usefulness (29 points) and feature convenience (3 points). The three sections of MedAd-AppQ were found to have inter-rater correlation coefficients of 0.801 (p-value < .001) or higher. Based on analysis of 52 apps (27 iOS and 25 Android), quality scores ranged between 7/43 (16.3%) and 28/43 (65.1%). There was no significant difference between the quality scores of the Android and iOS versions. None of the apps had features for self-management of side effects. Only two apps in each platform provided disease-related and/or medication information. CONCLUSIONS MedAd-AppQ can be used to reliably assess the quality of adherence apps. Clinicians can use the tool in selecting apps for use by patients. Developers of adherence apps should consider features that provide therapy-related information and help patients in medications and side-effects management.
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Affiliation(s)
- Eskinder Eshetu Ali
- Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore.
| | - Amanda Kai Sin Teo
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Republic of Singapore.
| | - Sherlyn Xue Lin Goh
- Department of Economics, Faculty of Arts and Social Sciences, National University of Singapore, Republic of Singapore.
| | - Lita Chew
- Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore; Department of Pharmacy, National Cancer Centre Singapore, Republic of Singapore.
| | - Kevin Yi-Lwern Yap
- National Pharmacy Programme Management Office, Office of Director of Medical Services, Ministry of Health, Republic of Singapore.
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Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020310. [PMID: 29439425 PMCID: PMC5858379 DOI: 10.3390/ijerph15020310] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/31/2018] [Accepted: 02/08/2018] [Indexed: 01/03/2023]
Abstract
The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to healthcare systems. This study reviews the published literature on the inappropriate use of medicines in order to articulate recommendations on how to reduce it in chronic patients, particularly in those who are elderly, polymedicated, or multipathological. A systematic review of articles published from January 2000 to October 2015 was performed using MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus databases. We selected 80 studies in order to analyse the content that addressed the question under consideration. Our literature review found that half of patients know what their prescribed treatment is; that most of elderly people take five or more medications a day; that in elderly, polymedicated people, the probability of a medication error occurring is higher; that new tools have been recently developed to reduce errors; that elderly patients can understand written information but the presentation and format is an important factor; and that a high percentage of patients have remaining doubts after their visit. Thus, strategies based on the evidence should be applied in order to reduce medication errors.
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Kotecha D, Chua WWL, Fabritz L, Hendriks J, Casadei B, Schotten U, Vardas P, Heidbuchel H, Dean V, Kirchhof P. European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers. Europace 2018; 20:225-233. [PMID: 29040548 PMCID: PMC5834097 DOI: 10.1093/europace/eux299] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/02/2017] [Indexed: 01/02/2023] Open
Abstract
We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes.
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Affiliation(s)
- Dipak Kotecha
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Corresponding author. Tel: +44 121 371 8122; fax: +44 121 371 4175. E-mail address:
| | - Winnie W L Chua
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
| | - Larissa Fabritz
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Department of Cardiovascular Medicine, University Hospital Muenster, Germany
| | - Jeroen Hendriks
- Centre for Heart Rhythm Disorders, University of Adelaide, Australia
- Department of Medical and Health Sciences, University of Linköping, Sweden
| | - Barbara Casadei
- Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Ulrich Schotten
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+ and Maastricht Centre for Systems Biology, Maastricht, The Netherlands
| | - Panos Vardas
- Cardiology Department, University Hospital of Heraklion, Crete, Greece
| | - Hein Heidbuchel
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Veronica Dean
- European Society of Cardiology, Sophia-Antipolis, France
| | - Paulus Kirchhof
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Department of Cardiovascular Medicine, University Hospital Muenster, Germany
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Brar Prayaga R, Jeong EW, Feger E, Noble HK, Kmiec M, Prayaga RS. Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study. JMIR Mhealth Uhealth 2018; 6:e30. [PMID: 29382623 PMCID: PMC5811648 DOI: 10.2196/mhealth.8930] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/20/2017] [Accepted: 01/08/2018] [Indexed: 11/21/2022] Open
Abstract
Background Nonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan. Objective The aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases. Methods We used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017. Results The text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (P<.001). Conclusions The results showed a strong benefit of using this text messaging solution to improve medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement. Program outcomes and insights can be used to enhance the design of future text-based solutions to improve health outcomes and promote adherence and long-term behavior change.
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Affiliation(s)
| | - Erwin W Jeong
- Medicare Medication Therapy Management, Kaiser Permanente Southern California, Downey, CA, United States
| | - Erin Feger
- mPulse Mobile, Inc, Encino, CA, United States
| | - Harmony K Noble
- Regional Pharmacy Clinical Operations, Kaiser Permanente Southern California, Downey, CA, United States
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Park DY, Goering EM, Head KJ, Bartlett Ellis RJ. Implications for Training on Smartphone Medication Reminder App Use by Adults With Chronic Conditions: Pilot Study Applying the Technology Acceptance Model. JMIR Form Res 2017; 1:e5. [PMID: 30684397 PMCID: PMC6334682 DOI: 10.2196/formative.8027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/25/2017] [Accepted: 09/23/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The majority of middle-aged to older patients with chronic conditions report forgetting to take medications as prescribed. The promotion of patients' smartphone medication reminder app (SMRA) use shows promise as a feasible and cost-effective way to support their medication adherence. Providing training on SMRA use, guided by the technology acceptance model (TAM), could be a promising intervention to promote patients' app use. OBJECTIVE The aim of this pilot study was to (1) assess the feasibility of an SMRA training session designed to increase patients' intention to use the app through targeting perceived usefulness of app, perceived ease of app use, and positive subjective norm regarding app use and (2) understand the ways to improve the design and implementation of the training session in a hospital setting. METHODS A two-group design was employed. A total of 11 patients older than 40 years (median=58, SD=9.55) and taking 3 or more prescribed medications took part in the study on one of two different dates as participants in either the training group (n=5) or nontraining group (n=6). The training group received an approximately 2-hour intervention training session designed to target TAM variables regarding one popular SMRA, the Medisafe app. The nontraining group received an approximately 2-hour control training session where the participants individually explored Medisafe app features. Each training session was concluded with a one-time survey and a one-time focus group. RESULTS Mann-Whitney U tests revealed that the level of perceived ease of use (P=.13) and the level of intention to use an SMRA (P=.33) were higher in the training group (median=7.00, median=6.67, respectively) than in the nontraining group (median=6.25, median=5.83). However, the level of perceived usefulness (U=4.50, Z=-1.99, P=.05) and the level of positive subjective norm (P=.25) were lower in the training group (median=6.50, median=4.29) than in the nontraining group (median=6.92, median=4.50). Focus groups revealed the following participants' perceptions of SMRA use in the real-world setting that the intervention training session would need to emphasize in targeting perceived usefulness and positive subjective norm: (1) the participants would find an SMRA to be useful if they thought the app could help address specific struggles in medication adherence in their lives and (2) the participants think that their family members (or health care providers) might view positively the participants' SMRA use in primary care settings (or during routine medical checkups). CONCLUSIONS Intervention training session, guided by TAM, appeared feasible in targeting patients' perceived ease of use and, thereby, increasing intention to use an SMRA. Emphasizing the real-world utility of SMRA, the training session could better target patients' perceived usefulness and positive subjective norm that are also important in increasing their intention to use the app.
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Affiliation(s)
- Daniel Y Park
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Elizabeth M Goering
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Rebecca J Bartlett Ellis
- Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Ankem K, Cho S, Simpson D. Nurses' perceptions and problems in the usability of a medication safety app. Inform Health Soc Care 2017; 44:48-69. [PMID: 29035624 DOI: 10.1080/17538157.2017.1364249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. OBJECTIVES The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. METHODS Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. RESULTS While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. CONCLUSION To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.
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Affiliation(s)
- Kalyani Ankem
- a Assistant Professor, Health Informatics , Northern Kentucky University , Highland Heights , KY , USA
| | - Sookyung Cho
- b Assistant Professor, Media Informatics , Northern Kentucky University , Highland Heights , KY , USA
| | - Diana Simpson
- c Baptist Health Lexington, Lexington, KY, USA; Master of Health Informatics Student , Northern Kentucky University , Highland Heights , KY , USA
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Rathbone AL, Prescott J. The Use of Mobile Apps and SMS Messaging as Physical and Mental Health Interventions: Systematic Review. J Med Internet Res 2017; 19:e295. [PMID: 28838887 PMCID: PMC5590007 DOI: 10.2196/jmir.7740] [Citation(s) in RCA: 240] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/05/2017] [Accepted: 05/25/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The initial introduction of the World Wide Web in 1990 brought around the biggest change in information acquisition. Due to the abundance of devices and ease of access they subsequently allow, the utility of mobile health (mHealth) has never been more endemic. A substantial amount of interactive and psychoeducational apps are readily available to download concerning a wide range of health issues. mHealth has the potential to reduce waiting times for appointments; eradicate the need to meet in person with a clinician, successively diminishing the workload of mental health professionals; be more cost effective to practices; and encourage self-care tactics. Previous research has given valid evidence with empirical studies proving the effectiveness of physical and mental health interventions using mobile apps. Alongside apps, there is evidence to show that receiving short message service (SMS) messages, which entail psychoeducation, medication reminders, and links to useful informative Web pages can also be advantageous to a patient's mental and physical well-being. Available mHealth apps and SMS services and their ever improving quality necessitates a systematic review in the area in reference to reduction of symptomology, adherence to intervention, and usability. OBJECTIVE The aim of this review was to study the efficacy, usability, and feasibility of mobile apps and SMS messages as mHealth interventions for self-guided care. METHODS A systematic literature search was carried out in JMIR, PubMed, PsychINFO, PsychARTICLES, Google Scholar, MEDLINE, and SAGE. The search spanned from January 2008 to January 2017. The primary outcome measures consisted of weight management, (pregnancy) smoking cessation, medication adherence, depression, anxiety and stress. Where possible, adherence, feasibility, and usability outcomes of the apps or SMS services were evaluated. Between-group and within-group effect sizes (Cohen d) for the mHealth intervention method group were determined. RESULTS A total of 27 studies, inclusive of 4658 participants were reviewed. The papers included randomized controlled trials (RCTs) (n=19), within-group studies (n=7), and 1 within-group study with qualitative aspect. Studies show improvement in physical health and significant reductions of anxiety, stress, and depression. Within-group and between-group effect sizes ranged from 0.05-3.37 (immediately posttest), 0.05-3.25 (1-month follow-up), 0.08-3.08 (2-month follow-up), 0.00-3.10 (3-month follow-up), and 0.02-0.27 (6-month follow-up). Usability and feasibility of mHealth interventions, where reported, also gave promising, significant results. CONCLUSIONS The review shows the promising and emerging efficacy of using mobile apps and SMS text messaging as mHealth interventions.
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Affiliation(s)
- Amy Leigh Rathbone
- School of Education and Psychology, University of Bolton, Bolton, United Kingdom
| | - Julie Prescott
- School of Education and Psychology, University of Bolton, Bolton, United Kingdom
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Pandey A, Krumme AA, Patel T, Choudhry NK. The Impact of Text Messaging on Medication Adherence and Exercise Among Postmyocardial Infarction Patients: Randomized Controlled Pilot Trial. JMIR Mhealth Uhealth 2017; 5:e110. [PMID: 28778843 PMCID: PMC5561384 DOI: 10.2196/mhealth.7144] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/11/2017] [Accepted: 06/05/2017] [Indexed: 11/20/2022] Open
Abstract
Background Adherence to evidence-based therapies such as medications and exercise remains poor among patients after a myocardial infarction (MI). Text message reminders have been shown to improve rates of adherence to medication and exercise, but the existing studies have been of short duration. Objective Two single-center randomized controlled pilot trials were conducted to evaluate the impact of text message reminders over 12 months on adherence to cardiac medications and exercise among patients receiving cardiac rehabilitation after hospitalization for MI. Methods In the medication adherence trial, 34 patients were randomized to receive usual care alone or usual care plus daily text message reminders delivered at the time of day at which medications were to be taken. In the exercise adherence trial, 50 patients were randomized to receive usual care alone or usual care plus 4 daily text messages reminding them to exercise as directed. Results The text message reminders led to a mean 14.2 percentage point improvement in self-reported medication adherence over usual care (P<.001, 95% CI 7-21). In the exercise trial, text message reminders resulted in an additional 4.2 days (P=.001, 95% CI 1.9-6.4) and 4.0 hours (P<.001, 95% CI 2.4-5.6) of exercise per month over usual care and a nonsignificant increase of 1.2 metabolic equivalents (METS; P=.06) in exercise capacity as assessed by a BRUCE protocol at 12 months. Conclusions Text message reminders significantly increased adherence to medication and exercise among post-MI patients receiving care in a structured cardiac rehabilitation program. This technology represents a simple and scalable method to ensure consistent use of evidence-based cardiovascular therapies. Trial Registration Clinicaltrials.gov NCT02783287; https://clinicaltrials.gov/ct2/show/NCT02783287 (Archived by WebCite at http://www.webcitation.org/6sBnvNb05)
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Affiliation(s)
| | - Alexis A Krumme
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Center for Healthcare Delivery Sciences, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Niteesh K Choudhry
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Center for Healthcare Delivery Sciences, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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Baysari MT, Westbrook JI. Mobile Applications for Patient-centered Care Coordination: A Review of Human Factors Methods Applied to their Design, Development, and Evaluation. Yearb Med Inform 2017; 10:47-54. [PMID: 26293851 DOI: 10.15265/iy-2015-011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To examine if human factors methods were applied in the design, development, and evaluation of mobile applications developed to facilitate aspects of patient-centered care coordination. METHODS We searched MEDLINE and EMBASE (2013-2014) for studies describing the design or the evaluation of a mobile health application that aimed to support patients' active involvement in the coordination of their care. RESULTS 34 papers met the inclusion criteria. Applications ranged from tools that supported self-management of specific conditions (e.g. asthma) to tools that provided coaching or education. Twelve of the 15 papers describing the design or development of an app reported the use of a human factors approach. The most frequently used methods were interviews and surveys, which often included an exploration of participants' current use of information technology. Sixteen papers described the evaluation of a patient application in practice. All of them adopted a human factors approach, typically an examination of the use of app features and/or surveys or interviews which enquired about patients' views of the effects of using the app on their behaviors (e.g. medication adherence), knowledge, and relationships with healthcare providers. No study in our review assessed the impact of mobile applications on health outcomes. CONCLUSION The potential of mobile health applications to assist patients to more actively engage in the management of their care has resulted in a large number of applications being developed. Our review showed that human factors approaches are nearly always adopted to some extent in the design, development, and evaluation of mobile applications.
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Affiliation(s)
- M T Baysari
- Dr. Melissa Baysari, Centre for Health Systems & Safety Research, Level 6, 75 Talavera Rd, Macquarie University, NSW 2109, Australia, E-mail:
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Kim BY, Lee J. Smart Devices for Older Adults Managing Chronic Disease: A Scoping Review. JMIR Mhealth Uhealth 2017; 5:e69. [PMID: 28536089 PMCID: PMC5461419 DOI: 10.2196/mhealth.7141] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/30/2017] [Accepted: 04/18/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The emergence of smartphones and tablets featuring vastly advancing functionalities (eg, sensors, computing power, interactivity) has transformed the way mHealth interventions support chronic disease management for older adults. Baby boomers have begun to widely adopt smart devices and have expressed their desire to incorporate technologies into their chronic care. Although smart devices are actively used in research, little is known about the extent, characteristics, and range of smart device-based interventions. OBJECTIVE We conducted a scoping review to (1) understand the nature, extent, and range of smart device-based research activities, (2) identify the limitations of the current research and knowledge gap, and (3) recommend future research directions. METHODS We used the Arksey and O'Malley framework to conduct a scoping review. We identified relevant studies from MEDLINE, Embase, CINAHL, and Web of Science databases using search terms related to mobile health, chronic disease, and older adults. Selected studies used smart devices, sampled older adults, and were published in 2010 or after. The exclusion criteria were sole reliance on text messaging (short message service, SMS) or interactive voice response, validation of an electronic version of a questionnaire, postoperative monitoring, and evaluation of usability. We reviewed references. We charted quantitative data and analyzed qualitative studies using thematic synthesis. To collate and summarize the data, we used the chronic care model. RESULTS A total of 51 articles met the eligibility criteria. Research activity increased steeply in 2014 (17/51, 33%) and preexperimental design predominated (16/50, 32%). Diabetes (16/46, 35%) and heart failure management (9/46, 20%) were most frequently studied. We identified diversity and heterogeneity in the collection of biometrics and patient-reported outcome measures within and between chronic diseases. Across studies, we found 8 self-management supporting strategies and 4 distinct communication channels for supporting the decision-making process. In particular, self-monitoring (38/40, 95%), automated feedback (15/40, 38%), and patient education (13/40, 38%) were commonly used as self-management support strategies. Of the 23 studies that implemented decision support strategies, clinical decision making was delegated to patients in 10 studies (43%). The impact on patient outcomes was consistent with studies that used cellular phones. Patients with heart failure and asthma reported improved quality of life. Qualitative analysis yielded 2 themes of facilitating technology adoption for older adults and 3 themes of barriers. CONCLUSIONS Limitations of current research included a lack of gerontological focus, dominance of preexperimental design, narrow research scope, inadequate support for participants, and insufficient evidence for clinical outcome. Recommendations for future research include generating evidence for smart device-based programs, using patient-generated data for advanced data mining techniques, validating patient decision support systems, and expanding mHealth practice through innovative technologies.
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Affiliation(s)
- Ben Yb Kim
- Health Data Science Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Joon Lee
- Health Data Science Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Dayer LE, Shilling R, Van Valkenburg M, Martin BC, Gubbins PO, Hadden K, Heldenbrand S. Assessing the Medication Adherence App Marketplace From the Health Professional and Consumer Vantage Points. JMIR Mhealth Uhealth 2017; 5:e45. [PMID: 28428169 PMCID: PMC5415657 DOI: 10.2196/mhealth.6582] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/07/2017] [Accepted: 03/02/2017] [Indexed: 01/10/2023] Open
Abstract
Background Nonadherence produces considerable health consequences and economic burden to patients and payers. One approach to improve medication nonadherence that has gained interest in recent years is the use of smartphone adherence apps. The development of smartphone adherence apps has increased rapidly since 2012; however, literature evaluating the clinical app and effectiveness of smartphone adherence apps to improve medication adherence is generally lacking. Objective The aims of this study were to (1) provide an updated evaluation and comparison of medication adherence apps in the marketplace by assessing the features, functionality, and health literacy (HL) of the highest-ranking adherence apps and (2) indirectly measure the validity of our rating methodology by determining the relationship between our app evaluations and Web-based consumer ratings. Methods Two independent reviewers assessed the features and functionality using a 4-domain rating tool of all adherence apps identified based on developer claims. The same reviewers downloaded and tested the 100 highest-ranking apps including an additional domain for assessment of HL. Pearson product correlations were estimated between the consumer ratings and our domain and total scores. Results A total of 824 adherence apps were identified; of these, 645 unique apps were evaluated after applying exclusion criteria. The median initial score based on descriptions was 14 (max of 68; range 0-60). As a result, 100 of the highest-scoring unique apps underwent user testing. The median overall user-tested score was 31.5 (max of 73; range 0-60). The majority of the user tested the adherence apps that underwent user testing reported a consumer rating score in their respective online marketplace. The mean consumer rating was 3.93 (SD 0.84). The total user-tested score was positively correlated with consumer ratings (r=.1969, P=.04). Conclusions More adherence apps are available in the Web-based marketplace, and the quality of these apps varies considerably. Consumer ratings are positively but weakly correlated with user-testing scores suggesting that our rating tool has some validity but that consumers and clinicians may assess adherence app quality differently.
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Affiliation(s)
- Lindsey E Dayer
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, United States
| | - Rebecca Shilling
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | - Bradley C Martin
- Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, United States
| | - Paul O Gubbins
- Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Springfield, MO, United States
| | - Kristie Hadden
- UAMS Regional Programs, Center for Health Literacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Seth Heldenbrand
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, United States
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Labovitz DL, Shafner L, Reyes Gil M, Virmani D, Hanina A. Using Artificial Intelligence to Reduce the Risk of Nonadherence in Patients on Anticoagulation Therapy. Stroke 2017; 48:1416-1419. [PMID: 28386037 DOI: 10.1161/strokeaha.116.016281] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/07/2017] [Accepted: 02/16/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding. METHODS A randomized, parallel-group, 12-week study was conducted in adults (n=28) with recently diagnosed ischemic stroke receiving any anticoagulation. Patients were randomized to daily monitoring by the artificial intelligence platform (intervention) or to no daily monitoring (control). The artificial intelligence application visually identified the patient, the medication, and the confirmed ingestion. Adherence was measured by pill counts and plasma sampling in both groups. RESULTS For all patients (n=28), mean (SD) age was 57 years (13.2 years) and 53.6% were women. Mean (SD) cumulative adherence based on the artificial intelligence platform was 90.5% (7.5%). Plasma drug concentration levels indicated that adherence was 100% (15 of 15) and 50% (6 of 12) in the intervention and control groups, respectively. CONCLUSIONS Patients, some with little experience using a smartphone, successfully used the technology and demonstrated a 50% improvement in adherence based on plasma drug concentration levels. For patients receiving direct oral anticoagulants, absolute improvement increased to 67%. Real-time monitoring has the potential to increase adherence and change behavior, particularly in patients on direct oral anticoagulant therapy. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02599259.
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Affiliation(s)
- Daniel L Labovitz
- From the Montefiore Medical Center, Bronx, New York (D.L.L., M.R.G., D.V.); and AiCure, New York, NY (L.S., A.H.)
| | - Laura Shafner
- From the Montefiore Medical Center, Bronx, New York (D.L.L., M.R.G., D.V.); and AiCure, New York, NY (L.S., A.H.).
| | - Morayma Reyes Gil
- From the Montefiore Medical Center, Bronx, New York (D.L.L., M.R.G., D.V.); and AiCure, New York, NY (L.S., A.H.)
| | - Deepti Virmani
- From the Montefiore Medical Center, Bronx, New York (D.L.L., M.R.G., D.V.); and AiCure, New York, NY (L.S., A.H.)
| | - Adam Hanina
- From the Montefiore Medical Center, Bronx, New York (D.L.L., M.R.G., D.V.); and AiCure, New York, NY (L.S., A.H.)
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Sarzynski E, Decker B, Thul A, Weismantel D, Melaragni R, Cholakis E, Tewari M, Beckholt K, Zaroukian M, Kennedy AC, Given C. Beta Testing a Novel Smartphone Application to Improve Medication Adherence. Telemed J E Health 2017; 23:339-348. [DOI: 10.1089/tmj.2016.0100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Erin Sarzynski
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
- Institute for Health Policy, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Brian Decker
- Electronic Medical Office Logistics, LLC, Royal Oak, Michigan
| | - Aaron Thul
- Electronic Medical Office Logistics, LLC, Royal Oak, Michigan
| | - David Weismantel
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
- Office of the University Physician, Michigan State University, East Lansing, Michigan
| | | | | | - Megha Tewari
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
- Sparrow Health System, Lansing, Michigan
| | - Kristy Beckholt
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
- Sparrow Health System, Lansing, Michigan
| | - Michael Zaroukian
- Sparrow Health System, Lansing, Michigan
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Angie C. Kennedy
- School of Social Work, Michigan State University, East Lansing, Michigan
| | - Charles Given
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan
- Institute for Health Policy, College of Human Medicine, Michigan State University, East Lansing, Michigan
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Dasgupta D, Johnson RA, Chaudhry B, Reeves KG, Willaert P, Chawla NV. Design and Evaluation of a Medication Adherence Application with Communication for Seniors in Independent Living Communities. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2017; 2016:480-489. [PMID: 28269843 PMCID: PMC5333254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Medication non-adherence is a pressing concern among seniors, leading to a lower quality of life and higher healthcare costs. While mobile applications provide a viable medium for medication management, their utility can be limited without tackling the specific needs of seniors and facilitating the active involvement of care providers. To address these limitations, we are developing a tablet-based application designed specifically for seniors to track their medications and a web portal for their care providers to track medication adherence. In collaboration with a local Aging in Place program, we conducted a three-month study with sixteen participants from an independent living facility. Our study found that the application helped participants to effectively track their medications and improved their sense of wellbeing. Our findings highlight the importance of catering to the needs of seniors and of involving care providers in this process, with specific recommendations for the development of future medication management applications.
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Teo CH, Ng CJ, White A. What Do Men Want from a Health Screening Mobile App? A Qualitative Study. PLoS One 2017; 12:e0169435. [PMID: 28060953 PMCID: PMC5217942 DOI: 10.1371/journal.pone.0169435] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/05/2016] [Indexed: 12/23/2022] Open
Abstract
There is a lack of mobile app which aims to improve health screening uptake developed for men. As part of the study to develop an effective mobile app to increase health screening uptake in men, we conducted a needs assessment to find out what do men want from a health screening mobile app. In-depth interviews and focus group discussions were conducted with 31 men from a banking institution in Kuala Lumpur. The participants were purposely sampled according to their job position, age, ethnicity and screening status. The recruitment was stopped once data saturation was achieved. The audio-recorded interviews were transcribed verbatim and analyzed using thematic approach. Three themes emerged from the analysis and they were: content, feature and dissemination. In terms of the content, men wanted the app to provide information regarding health screening and functions that can assess their health; which must be personalized to them and are trustable. The app must have user-friendly features in terms of information delivery, ease of use, attention allocation and social connectivity. For dissemination, men proposed that advertisements, recommendations by health professionals, providing incentive and integrating the app as into existing systems may help to increase the dissemination of the app. This study identified important factors that need to be considered when developing a mobile app to improve health screening uptake. Future studies on mobile app development should elicit users' preference and need in terms of its content, features and dissemination strategies to improve the acceptability and the chance of successful implementation.
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Affiliation(s)
- Chin Hai Teo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Alan White
- Centre for Men’s Health, Leeds Beckett University, Leeds, United Kingdom
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Saghaeiannejad-Isfahani S, Ehteshami A, Savari E, Samimi A. Developing the Medication Reminder Mobile Application "Seeb". Acta Inform Med 2017; 25:108-111. [PMID: 28883675 PMCID: PMC5544449 DOI: 10.5455/aim.2017.25.108-111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction: Today, the structure of comprehensive health care emphasizes self-care more than therapy. Medication therapy is a strong instrument for therapy received through the health setting, especially in medication area. Error in medication administration has produced different problems and they cost billions of dollars every year. Regarding mobile phone extensions, we developed a local medication reminder mobile application called “Seeb” as a suitable solution for decreasing medication errors for Iranians. Methods: We conducted a mixed methods study in three Phases: 1) Comparative study of existing mobile applications; 2) developed its object-oriented model; 3) Developed the initial version of “Seeb” that was approved for production. Results: This application was designed for the appropriate medication administration including time and dosages through: recording patient and medication data; scheduling patients’ medication; and reporting medication administration on progress. Conclusion: “Seeb” has been designed in compliance with Iranian health information technologists and pharmacists requirements. It is expected to reduce medication error and improve patient adherence to medical prescriptions.
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Affiliation(s)
| | - Asghar Ehteshami
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ebtesam Savari
- Department of Health Information Technology and Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Samimi
- Department of Health Information Technology and Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhao J, Freeman B, Li M. Can Mobile Phone Apps Influence People's Health Behavior Change? An Evidence Review. J Med Internet Res 2016; 18:e287. [PMID: 27806926 PMCID: PMC5295827 DOI: 10.2196/jmir.5692] [Citation(s) in RCA: 326] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 07/07/2016] [Accepted: 10/12/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Globally, mobile phones have achieved wide reach at an unprecedented rate, and mobile phone apps have become increasingly prevalent among users. The number of health-related apps that were published on the two leading platforms (iOS and Android) reached more than 100,000 in 2014. However, there is a lack of synthesized evidence regarding the effectiveness of mobile phone apps in changing people's health-related behaviors. OBJECTIVE The aim was to examine the effectiveness of mobile phone apps in achieving health-related behavior change in a broader range of interventions and the quality of the reported studies. METHODS We conducted a comprehensive bibliographic search of articles on health behavior change using mobile phone apps in peer-reviewed journals published between January 1, 2010 and June 1, 2015. Databases searched included Medline, PreMedline, PsycINFO, Embase, Health Technology Assessment, Education Resource Information Center (ERIC), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published in the Journal of Medical Internet Research during that same period were hand-searched on the journal's website. Behavior change mechanisms were coded and analyzed. The quality of each included study was assessed by the Cochrane Risk of Bias Assessment Tool. RESULTS A total of 23 articles met the inclusion criteria, arranged under 11 themes according to their target behaviors. All studies were conducted in high-income countries. Of these, 17 studies reported statistically significant effects in the direction of targeted behavior change; 19 studies included in this analysis had a 65% or greater retention rate in the intervention group (range 60%-100%); 6 studies reported using behavior change theories with the theory of planned behavior being the most commonly used (in 3 studies). Self-monitoring was the most common behavior change technique applied (in 12 studies). The studies suggest that some features improve the effectiveness of apps, such as less time consumption, user-friendly design, real-time feedback, individualized elements, detailed information, and health professional involvement. All studies were assessed as having some risk of bias. CONCLUSIONS Our results provide a snapshot of the current evidence of effectiveness for a range of health-related apps. Large sample, high-quality, adequately powered, randomized controlled trials are required. In light of the bias evident in the included studies, better reporting of health-related app interventions is also required. The widespread adoption of mobile phones highlights a significant opportunity to impact health behaviors globally, particularly in low- and middle-income countries.
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Affiliation(s)
- Jing Zhao
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Becky Freeman
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Mu Li
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
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Ong SW, Jassal SV, Miller JA, Porter EC, Cafazzo JA, Seto E, Thorpe KE, Logan AG. Integrating a Smartphone-Based Self-Management System into Usual Care of Advanced CKD. Clin J Am Soc Nephrol 2016; 11:1054-1062. [PMID: 27173169 PMCID: PMC4891756 DOI: 10.2215/cjn.10681015] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/12/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Patient self-management has been shown to improve health outcomes. We developed a smartphone-based system to boost self-care by patients with CKD and integrated its use into usual CKD care. We determined its acceptability and examined changes in several clinical parameters. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We recruited patients with stage 4 or 5 CKD attending outpatient renal clinics who responded to a general information newsletter about this 6-month proof-of-principle study. The smartphone application targeted four behavioral elements: monitoring BP, medication management, symptom assessment, and tracking laboratory results. Prebuilt customizable algorithms provided real-time personalized patient feedback and alerts to providers when predefined treatment thresholds were crossed or critical changes occurred. Those who died or started RRT within the first 2 months were replaced. Only participants followed for 6 months after recruitment were included in assessing changes in clinical measures. RESULTS In total, 47 patients (26 men; mean age =59 years old; 33% were ≥65 years old) were enrolled; 60% had never used a smartphone. User adherence was high (>80% performed ≥80% of recommended assessments) and sustained. The mean reductions in home BP readings between baseline and exit were statistically significant (systolic BP, -3.4 mmHg; 95% confidence interval, -5.0 to -1.8 and diastolic BP, -2.1 mmHg; 95% confidence interval, -2.9 to -1.2); 27% with normal clinic BP readings had newly identified masked hypertension. One hundred twenty-seven medication discrepancies were identified; 59% were medication errors that required an intervention to prevent harm. In exit interviews, patients indicated feeling more confident and in control of their condition; clinicians perceived patients to be better informed and more engaged. CONCLUSIONS Integrating a smartphone-based self-management system into usual care of patients with advanced CKD proved feasible and acceptable, and it appeared to be clinically useful. The results provide a strong rationale for a randomized, controlled trial.
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Affiliation(s)
| | - Sarbjit V. Jassal
- Medicine
- Nephrology
- Institute of Health Policy, Management and Evaluation
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Judith A. Miller
- Medicine
- Nephrology
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Joseph A. Cafazzo
- Techna Institute, University Health Network, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute and Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation
- Institute of Biomaterials and Biomedical Engineering
| | - Emily Seto
- Centre for Global eHealth Innovation, and
- Techna Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation
| | - Kevin E. Thorpe
- Dalla Lana School of Public Health, University of Toronto, and
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Alexander G. Logan
- Medicine
- Nephrology
- Lunenfeld-Tanenbaum Research Institute and Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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90
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Figueiredo D, Teixeira L, Poveda V, Paúl C, Santos-Silva A, Costa E. Predictors of Difficulty in Medication Intake in Europe: a Cross-country Analysis Based on SHARE. Aging Dis 2016; 7:246-53. [PMID: 27330839 PMCID: PMC4898921 DOI: 10.14336/ad.2015.0925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 09/25/2015] [Indexed: 11/04/2022] Open
Abstract
The aim of this study is to evaluate the prevalence and the predictors of difficulty in medication intake across Europe, using a cross-sectional design. We used data from all participants in the wave 4 of the SHARE (Survey of Health, Ageing, and Retirement in Europe) database, which is a cross national European survey. The difficulty in take medication was evaluated using an item from the "Limitations with activities of daily living". Clinical and sociodemographic variables were evaluated as potential predictors. A total of 58 124 individual have been included in this work (mean age=64.9 ± 10.4 years; 43.3% male). The rate of difficulty in taking medication across the 16 European evaluated countries was 2.1%, presenting Spain the highest rate (5.7%) and Switzerland the lowest (0.6%). Increasing age, physical inactivity, physical limitations (mobility, arms function and fine motor limitations, and difficulties in picking up a small coin from a table), a poor sense of meaning in life, and losses in memory and concentration are independent and significant variables associated with difficulty in medication intake across Europe. Predictors of difficulties in medication intake are multicausal, including factors related to physical, cognitive and psychological conditions. Interventions aiming to optimize adherence to medication, particularly in elderly population, need to consider this diversity of determinants.
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Affiliation(s)
- Daniela Figueiredo
- University of Aveiro, School of Health Sciences, Aveiro, Portugal.
- Center for Health Technology and Services Research (CINTESIS.UA), Aveiro, Portugal.
| | - Laetitia Teixeira
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
| | - Veronica Poveda
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
- CINTESIS, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.
| | - Alice Santos-Silva
- UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal.
| | - Elísio Costa
- UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal.
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91
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Anglada-Martínez H, Martin-Conde M, Rovira-Illamola M, Sotoca-Momblona JM, Sequeira E, Aragunde V, Moreno MA, Catalan M, Codina-Jané C. Feasibility and Preliminary Outcomes of a Web and Smartphone–Based Medication Self-Management Platform for Chronically Ill Patients. J Med Syst 2016; 40:99. [DOI: 10.1007/s10916-016-0456-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 01/29/2016] [Indexed: 11/30/2022]
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Abstract
OBJECTIVES This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. DATA SOURCES Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. CONCLUSION Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. IMPLICATIONS FOR NURSING PRACTICE Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research.
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Affiliation(s)
- Stewart M. Bond
- William F. Connell School of Nursing, 378C Maloney Hall, 140 Commonwealth Ave, Chestnut Hill, MA 02467
| | - Ashley Leak Bryant
- School of Nursing, The University of North Carolina at Chapel Hill, 401 Carrington Hall, Chapel Hill, NC 27599,
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario, Canada M5T1P8,
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93
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Omaki E, Rizzutti N, Shields W, Zhu J, McDonald E, Stevens MW, Gielen A. A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change. Inj Prev 2016; 23:138-146. [PMID: 26787740 DOI: 10.1136/injuryprev-2015-041740] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/10/2015] [Accepted: 12/22/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps. METHODS Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990. RESULTS Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention. CONCLUSIONS There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours.
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Affiliation(s)
- Elise Omaki
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
| | - Nicholas Rizzutti
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
| | - Wendy Shields
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
| | - Jeffrey Zhu
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
| | - Eileen McDonald
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
| | - Martha W Stevens
- Johns Hopkins School of Medicine, Division of Pediatric Emergency Medicine, Baltimore Maryland, USA
| | - Andrea Gielen
- Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland, USA
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94
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Davies MJ, Kotadia A, Mughal H, Hannan A, Alqarni H. The attitudes of pharmacists, students and the general public on mHealth applications for medication adherence. Pharm Pract (Granada) 2015; 13:644. [PMID: 26759619 PMCID: PMC4696122 DOI: 10.18549/pharmpract.2015.04.644] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/02/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND During recent years mobile technology has developed tremendously and has infiltrated the healthcare field. Mobile healthcare (mHealth) applications, or apps, may be used to support patient adherence to medication thus promoting optimal treatment outcomes and reducing medication wastage. OBJECTIVE This study shall consider the opinions of United Kingdom (UK) based pharmacists, pharmacy undergraduates and members of the general public towards the use of mHealth apps to promote adherence to prescribed medication regimens. METHODS On Liverpool John Moores University (LJMU) ethical approval, the 25 item questionnaire was distributed to UK registered pharmacists within inner city Liverpool and Manchester (n=500), pharmacy undergraduates studying at LJMU (n=420) and members of the general public within Liverpool City Centre (n=400). The questions were formatted as multiple choice, Likert scales or the open answer type. The data were analysed using simple frequencies, cross tabulations and non-parametric techniques in the SPSS v22 program. RESULTS The number of completed questionnaires from the pharmacist, student and general public cohorts were 245, 333 and 400; respectively. The data indicated that the general public rely heavily upon daily routine to take medication as prescribed (54.1%) with mHealth app use being extremely low (1.5%); a similar trend was noted for the pharmacist / student cohorts. The age of the individual is an important consideration, with the younger generation likely to engage with mHealth apps and the older generation less so. Here, education and training are important. Pharmacists (82.3%) would be happy to deliver training packages to the public who would in turn happily receive such training (84%). Key barriers precluding mHealth app use include data reliability, security and technical difficulties. CONCLUSION Adherence apps hold great promise to support the patient and their healthcare needs. In order to increase acceptance and uptake simple, user-friendly designs must be considered and constructed. In addition, such technology requires effective promotion and end user training in order to reach its full potential. Furthermore, the regulation of mobile adherence apps will be essential in order to overcome underlying patient concerns.
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Affiliation(s)
- Michael J Davies
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Alysha Kotadia
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Hassan Mughal
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Ashraf Hannan
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
| | - Hamdan Alqarni
- The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University . Liverpool ( United Kingdom ).
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95
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There's an App for That: A Guide for Healthcare Practitioners and Researchers on Smartphone Technology. Online J Public Health Inform 2015; 7:e218. [PMID: 26392848 PMCID: PMC4576443 DOI: 10.5210/ojphi.v7i2.5522] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Smartphone technology is nascent compared to other technologies; however, it has shown an unprecedented uptake amongst lay consumers and professionals. This article presents the history, components, and key features of smartphones, as well as their related concepts and how they work, and it also delineates the process of smartphone applications (apps) development and publishing in the app stores. It also describes and discusses smartphone technology utilisation for health consumers, healthcare professionals, and health researchers, as well as the regulations of health-related apps.
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96
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Mira JJ, Guilabert M, Carrillo I, Fernández C, Vicente MA, Orozco-Beltrán D, Gil-Guillen VF. Use of QR and EAN-13 codes by older patients taking multiple medications for a safer use of medication. Int J Med Inform 2015; 84:406-12. [DOI: 10.1016/j.ijmedinf.2015.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/26/2022]
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97
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McVeigh KA, Vakros G. The eye drop chart: a pilot study for improving administration of and compliance with topical treatments in glaucoma patients. Clin Ophthalmol 2015; 9:813-9. [PMID: 26005325 PMCID: PMC4427603 DOI: 10.2147/opth.s82909] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim In order to improve patient education, compliance, and administration of eye drops prescribed for patients suffering with glaucoma within a UK ophthalmology department, an eye drop chart (EDC) was designed, developed, and piloted with patients attending the glaucoma clinic over 1 month. Methods A cross-sectional prospective pilot study of 25 patients using an administration aid and a self-reported questionnaire. Chi-square tests were used to compare responses pre- and postintervention. Results Results demonstrated an impressive improvement in nine of eleven categories assessed regarding drop administration and compliance. Patients stating that they always wash their hands increased significantly from 64% (13 participants) to 92% (23 participants) (P=0.029), and those who always shake the bottle improved from 40% (10) to 84% (21) (P=0.001). Punctal occlusion techniques improved from 44% (11) to 72% (18) (P=0.015). Finally, patients who always discarded the bottle after 28 days of use rose from 68% to 92%, though the difference was not significant (P=0.09). Only the number of drops being administered to the eye and the length of time left between the application of drops remained relatively unchanged. Sixty-four percent reported finding EDC helpful or useful, 52% had positive responses when asked if they would continue using EDC, and 88% would recommend it to a friend. Conclusion Although there are limitations to the data as they are subjective, descriptive, and limited to sample size of 25, the results of this pilot study have shown promise. The EDC appears to be a cost-effective way at improving patients’ use of topical ocular medications.
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Affiliation(s)
| | - Georgios Vakros
- Department of Ophthalmology, Queen's Hospital, Romford, Essex, UK
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98
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Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs. Rheumatol Int 2015; 35:1675-85. [PMID: 25903352 DOI: 10.1007/s00296-015-3270-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
Patient-centered smartphone applications have potential to support rheumatoid arthritis (RA) self-management but remain almost unexplored in literature. Therefore, this study evaluated the usefulness of a smartphone application to support RA self-management, the willingness of RA patients to use and pay for it and the features the application should have. In this cross-sectional study, a questionnaire was developed to collect information on population, device ownership, usefulness and willingness to use and pay for a RA self-management application and application features. Descriptive statistics, Chi-square, Fisher's exact test, t test or Mann-Whitney's test and multivariate analysis were used. One hundred RA patients answered the questionnaire. Patients' mean age was 57 ± 11.9 years, most were females (91 %), with multiple drug regimens and a 40 % treatment non-compliance rate. Most patients believed that could have a more active role in self-management (94 %) and reported it would be useful to develop a RA self-management application (86 %). Patients willing to use an application (83 %) were younger, with a possible more active role in self-management, with access to a smartphone, and using short message service, electronic mail and Internet. Multivariate analysis confirmed these results, except the associations regarding access to a smartphone and use of electronic mail and Internet. Fifty-eight patients (82 %) were willing to pay for a RA self-management application and the most requested feature for it was information in a simple format. This study suggested the usefulness and patients' willingness to use and pay for a RA self-management application and provided insight on patients' needs.
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99
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Carrillo I, Guilabert M, Pérez-Jover V, Mira JJ. [Assessment of two applications of medication self-management in older patients. Qualitative study]. ACTA ACUST UNITED AC 2015; 30:142-9. [PMID: 25843349 DOI: 10.1016/j.cali.2015.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/20/2015] [Accepted: 02/24/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aging population and the growing use of technology are two realities of modern society. Developing tools to support medication self-management to polymedicated elderly may contribute to increase their safety. OBJECTIVE To know how patients polymedicated and older than 64 years manage dose their medication and assessment the utility of two medication self-management applications, specifically analyzing management systems, medication errors and positive and improvable aspects of each of the tools presented. PATIENTS AND METHODS Seven focal groups with 59 patients from associations and health departments were conducted. In such meetings, they received the applications and they were encouraged to use it. Then, a several group questions were asked them about their health status, how they managed their medication and their assessment about the applications. RESULTS Most participants reported to use memory strategies to take correctly their medication. They assessed positively the applications although some of them showed resistance to incorporate it in their daily routine. The simple interface and ease of use were the characteristics of the applications most appreciated by patients. CONCLUSIONS Is possible to foster among elderly patients the use of technological tools to support the proper administration of medications with purpose is to decrease errors and increase safety. When designing health applications is necessary to take into account the preferences of those who are targeted.
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Affiliation(s)
- I Carrillo
- Universidad Miguel Hernández, Elche, Alicante, España.
| | - M Guilabert
- Universidad Miguel Hernández, Elche, Alicante, España
| | - V Pérez-Jover
- Universidad Miguel Hernández, Elche, Alicante, España
| | - J J Mira
- Universidad Miguel Hernández, Elche, Alicante, España; Departamento de Salud Alicante-Sant Joan d'Alacant, Conselleria de Sanitat, Alicante, España; Red de Investigación en Servicios de Salud En Enfermedades Crónicas (REDISSEC), España
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100
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Mira JJ, Lorenzo S, Guilabert M, Navarro I, Pérez-Jover V. A systematic review of patient medication error on self-administering medication at home. Expert Opin Drug Saf 2015; 14:815-38. [PMID: 25774444 DOI: 10.1517/14740338.2015.1026326] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Medication errors have been analyzed as a health professionals' responsibility (due to mistakes in prescription, preparation or dispensing). However, sometimes, patients themselves (or their caregivers) make mistakes in the administration of the medication. The epidemiology of patient medication errors (PEs) has been scarcely reviewed in spite of its impact on people, on therapeutic effectiveness and on incremental cost for the health systems. AREAS COVERED This study reviews and describes the methodological approaches and results of published studies on the frequency, causes and consequences of medication errors committed by patients at home. A review of research articles published between 1990 and 2014 was carried out using MEDLINE, Web-of-Knowledge, Scopus, Tripdatabase and Index Medicus. EXPERT OPINION The frequency of PE was situated between 19 and 59%. The elderly and the preschooler population constituted a higher number of mistakes than others. The most common were: incorrect dosage, forgetting, mixing up medications, failing to recall indications and taking out-of-date or inappropriately stored drugs. The majority of these mistakes have no negative consequences. Health literacy, information and communication and complexity of use of dispensing devices were identified as causes of PEs. Apps and other new technologies offer several opportunities for improving drug safety.
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Affiliation(s)
- José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan d'Alacant , Alicante , Spain
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