1
|
Zil-E-Ali A, Tsagkaris C. Wearable technology to leverage home-Based cardiac rehabilitation: A step forward in cardiovascular disease management. Int J Health Plann Manage 2024; 39:602-604. [PMID: 37966981 DOI: 10.1002/hpm.3740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Affiliation(s)
- Ahsan Zil-E-Ali
- Penn State Heart and Vascular Institute, Hershey, Pennsylvania, USA
| | - Christos Tsagkaris
- Aristotle University of Thessaloniki, Faculty of Medicine, Thessaloniki, Greece
- European Student Think Tank, Public Health and Policy Working Group, Amsterdam, Netherlands
| |
Collapse
|
2
|
Venkatesh KP, Brito G, Kamel Boulos MN. Health Digital Twins in Life Science and Health Care Innovation. Annu Rev Pharmacol Toxicol 2024; 64:159-170. [PMID: 37562495 DOI: 10.1146/annurev-pharmtox-022123-022046] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Health digital twins (HDTs) are virtual representations of real individuals that can be used to simulate human physiology, disease, and drug effects. HDTs can be used to improve drug discovery and development by providing a data-driven approach to inform target selection, drug delivery, and design of clinical trials. HDTs also offer new applications into precision therapies and clinical decision making. The deployment of HDTs at scale could bring a precision approach to public health monitoring and intervention. Next steps include challenges such as addressing socioeconomic barriers and ensuring the representativeness of the technology based on the training and validation data sets. Governance and regulation of HDT technology are still in the early stages.
Collapse
|
3
|
Elkefi S. Supporting patients' workload through wearable devices and mobile health applications, a systematic literature review. ERGONOMICS 2023:1-17. [PMID: 37830977 DOI: 10.1080/00140139.2023.2270780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
Patients face a challenging workload in their course of care. In this study, we investigate the impact of using mobile health technologies in supporting this workload and identify the system challenges of its application through a systematic review of the literature published in the last two decades following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines PRISMA guidelines. Twenty-two studies that satisfied the inclusion criteria were included. The review revealed various mobile health and wearable devices used to support mental demand, physical demand, frustration, and performance. Better outcomes were related to mobile health use in healthcare for patients in different settings. There were no applications of health that supported the temporal demand of patients. Some populations, such as cancer patients, need more than only physical demand. Mhealth devices are important in supporting the patients' workload in their daily activities and clinical settings.Practitioner summary: This review study shows the importance of mHealth and wearables in supporting patients' workload (physical, mental, emotional) but not the temporal load.
Collapse
Affiliation(s)
- Safa Elkefi
- Nursing School, Columbia University, New York, NY, USA
- HPHACTORS Lab, NYC, USA
| |
Collapse
|
4
|
Nair US, Kue J, Athilingam P, Rodríguez CS, Menon U. Application of the ConNECT Framework to achieve digital health equity. Nurs Outlook 2023; 71:101991. [PMID: 37302261 DOI: 10.1016/j.outlook.2023.101991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND The emphasis on digital technology and informatics in health care (digital health) has introduced innovative ways to deliver health care and engage populations in health research. However, inadequate attention to the development and implementation of digital health interventions can exacerbate health disparities. PURPOSE We applied the transdisciplinary ConNECT Framework principles within the context of digital health, with an aim to describe strategies to achieve digital health equity. METHODS We described the five ConNECT principles of (a) integrating context, (b) fostering a norm of inclusion, (c) ensuring equitable diffusion of innovations, (d) harnessing communication technology, and (e) prioritizing specialized training within the framework of achieving digital health equity. FINDINGS AND DISCUSSION We describe proactive, actionable strategies for the systematic application of the ConNECT Framework principles to address digital health equity. Recommendations to reduce the digital health divide in nursing research and practice are also described.
Collapse
Affiliation(s)
- Uma S Nair
- College of Nursing, University of South Florida, Tampa, FL.
| | - Jennifer Kue
- College of Nursing, University of South Florida, Tampa, FL
| | | | | | - Usha Menon
- College of Nursing, University of South Florida, Tampa, FL
| |
Collapse
|
5
|
Betcheva L, Kim JY, Erhun F, Oraiopoulos N, Getz K. Applying Systems Thinking to Inform Decentralized Clinical Trial Planning and Deployment. Ther Innov Regul Sci 2023:10.1007/s43441-023-00540-2. [PMID: 37389795 PMCID: PMC10400692 DOI: 10.1007/s43441-023-00540-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023]
Abstract
Recently, there has been a growing interest in understanding how decentralized clinical trial (DCT) solutions can mitigate existing challenges in clinical development, particularly participant burden and access, and the collection, management, and quality of clinical data. This paper examines DCT deployments, emphasizing how they are integrated and how they may impact clinical trial oversight, management, and execution. We propose a conceptual framework that employs systems thinking to evaluate the impact on key stakeholders through a reiterative assessment of pain points. We conclude that decentralized solutions should be customized to meet patient needs and preferences and the unique requirements of each clinical trial. We discuss how DCT elements introduce new demands and pressures within the existing system and reflect on enablers that can overcome DCT implementation challenges. As stakeholders look for ways to make clinical research more relevant and accessible to a larger and more diverse patient population, further robust and granular research is needed to quantify the impact of DCTs empirically.
Collapse
Affiliation(s)
- Lidia Betcheva
- Judge Business School, University of Cambridge, Cambridge, CB2 1AG, UK.
| | - Jennifer Y Kim
- Tufts Center for the Study of Drug Development, Tufts University, Boston, MA, 02111, USA
| | - Feryal Erhun
- Judge Business School, University of Cambridge, Cambridge, CB2 1AG, UK
| | | | - Kenneth Getz
- Tufts Center for the Study of Drug Development, Tufts University, Boston, MA, 02111, USA
| |
Collapse
|
6
|
Yao Y, Li Z, He Y, Zhang Y, Guo Z, Lei Y, Zhao Q, Li D, Zhang Z, Zhang Y, Liao X. Factors affecting wearable ECG device adoption by general practitioners for atrial fibrillation screening: cross-sectional study. Front Public Health 2023; 11:1128127. [PMID: 37213597 PMCID: PMC10196261 DOI: 10.3389/fpubh.2023.1128127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Atrial fibrillation (AF) is a challenging cardiovascular disease worldwide. Wearable electrocardiograph devices (WEDs) have great potential to improve the detection rate of AF in primary care. However, the factors that influence general practitioners' (GPs) perception and acceptance of WEDs are not well understood. To identify factors that influence the intention of GPs to utilize WEDs in a clinical setting to screen patients for AF. Method The research hypotheses and questionnaire items were designed and developed based on the unified theory of acceptance and technology (UTAUT) framework. We used stratified sampling and obtained the data through an online survey. Structural equation modeling was used to analyze the collected data.Results: A total of 1,004 valid questionnaires from GPs across Sichuan province in China were collected. Three factors increased GPs' intention to utilize WEDs to screen patients for AF, including performance expectancy (β = 0.121, p = 0.004), social influence (β = 0.356, p < 0.001), and price perception (β = 0.587, p < 0.001). Perception risk (β = -0.059, p < 0.001) decreased usage intention, while effort expectancy (β = -0.079, p = 0.155) and facilitating conditions (β = -0.014, p = 0.868) did not affect usage intention. Gender (β = -0.022, p = 0.179), age (β = 0.006, p = 0.699), education level (β = -0.22, p = 0.184) and training (β = 0.007, p = 0.69) were not significantly correlated with usage intention, and these four factors had no moderating effect on the path coefficients. Discussion GPs' intention to utilize WEDs is affected by performance expectancy, price perception, perception risk and social influence. Researcher should improve the usability and perception of WEDs for screening and carry out studies to provide high-quality evidence for the security and efficacy of wearable devices.
Collapse
Affiliation(s)
- Yi Yao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Li
- Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi He
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- Chengdu Seventh People Hospital, Chengdu, China
| | - Yalin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxia Guo
- Business School, Sichuan University, Chengdu, China
| | - Yi Lei
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zhao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Dongze Li
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Zhang
- Chengdu Shuangliu District Xihanggang Community Hospital, Chengdu, China
| | - Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Yonggang Zhang,
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaoyang Liao,
| |
Collapse
|
7
|
Patil V, Singhal DK, Naik N, Hameed BMZ, Shah MJ, Ibrahim S, Smriti K, Chatterjee G, Kale A, Sharma A, Paul R, Chłosta P, Somani BK. Factors Affecting the Usage of Wearable Device Technology for Healthcare among Indian Adults: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11237019. [PMID: 36498594 PMCID: PMC9740494 DOI: 10.3390/jcm11237019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Wearable device technology has recently been involved in the healthcare industry substantially. India is the world's third largest market for wearable devices and is projected to expand at a compound annual growth rate of ~26.33%. However, there is a paucity of literature analyzing the factors determining the acceptance of wearable healthcare device technology among low-middle-income countries. METHODS This cross-sectional, web-based survey aims to analyze the perceptions affecting the adoption and usage of wearable devices among the Indian population aged 16 years and above. RESULTS A total of 495 responses were obtained. In all, 50.3% were aged between 25-50 years and 51.3% belonged to the lower-income group. While 62.2% of the participants reported using wearable devices for managing their health, 29.3% were using them daily. technology and task fitness (TTF) showed a significant positive correlation with connectivity (r = 0.716), health care (r = 0.780), communication (r = 0.637), infotainment (r = 0.598), perceived usefulness (PU) (r = 0.792), and perceived ease of use (PEOU) (r = 0.800). Behavioral intention (BI) to use wearable devices positively correlated with PEOU (r = 0.644) and PU (r = 0.711). All factors affecting the use of wearable devices studied had higher mean scores among participants who were already using wearable devices. Male respondents had significantly higher mean scores for BI (p = 0.034) and PEOU (p = 0.009). Respondents older than 25 years of age had higher mean scores for BI (p = 0.027) and Infotainment (p = 0.032). CONCLUSIONS This study found a significant correlation with the adoption and acceptance of wearable devices for healthcare management in the Indian context.
Collapse
Affiliation(s)
- Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Deepak Kumar Singhal
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
- Correspondence: (D.K.S.); (N.N.); Tel.: +91-8310874339 (N.N.)
| | - Nithesh Naik
- Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
- iTRUE (International Training and Research in Uro-Oncology and Endourology) Group, Manipal 576104, Karnataka, India
- Curiouz TechLab Private Limited, BIRAC-BioNEST, Government of Karnataka Bioincubator, Manipal 576104, Karnataka, India
- Correspondence: (D.K.S.); (N.N.); Tel.: +91-8310874339 (N.N.)
| | - B. M. Zeeshan Hameed
- iTRUE (International Training and Research in Uro-Oncology and Endourology) Group, Manipal 576104, Karnataka, India
- Curiouz TechLab Private Limited, BIRAC-BioNEST, Government of Karnataka Bioincubator, Manipal 576104, Karnataka, India
- Department of Urology, Father Muller Medical College, Mangalore 575001, Karnataka, India
| | - Milap J. Shah
- iTRUE (International Training and Research in Uro-Oncology and Endourology) Group, Manipal 576104, Karnataka, India
- Robotics and Urooncology, Max Hospital and Max Institute of Cancer Care, New Delhi 110024, India
| | - Sufyan Ibrahim
- iTRUE (International Training and Research in Uro-Oncology and Endourology) Group, Manipal 576104, Karnataka, India
- Department of Neurosurgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Gaurav Chatterjee
- Department of Electrical and Electronics Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Ameya Kale
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Anshika Sharma
- Department of Psychology, Amity University, Noida 201313, Uttar Pradesh, India
| | - Rahul Paul
- iTRUE (International Training and Research in Uro-Oncology and Endourology) Group, Manipal 576104, Karnataka, India
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
- Center for Biologics Evaluation and Research (CBER), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Piotr Chłosta
- Department of Urology, Jagiellonian University in Krakow, 31-007 Kraków, Poland
| | - Bhaskar K. Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| |
Collapse
|
8
|
Kang HS, Exworthy M. Wearing the Future—Wearables to Empower Users to Take Greater Responsibility for Their Health and Care: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e35684. [PMID: 35830222 PMCID: PMC9330198 DOI: 10.2196/35684] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background Wearables refer to devices that are worn by individuals. In the health care field, wearables may assist with individual monitoring and diagnosis. In fact, the potential for wearable technology to assist with health care has received recognition from health systems around the world, including a place in the strategic Long Term Plan shared by the National Health Service in England. However, wearables are not limited to specialist medical devices used by patients. Leading technology companies, including Apple, have been exploring the capabilities of wearable health technology for health-conscious consumers. Despite advancements in wearable health technology, research is yet to be conducted on wearables and empowerment. Objective This study aimed to identify, summarize, and synthesize knowledge on how wearable health technology can empower individuals to take greater responsibility for their health and care. Methods This study was a scoping review with thematic analysis and narrative synthesis. Relevant guidance, such as the Arksey and O’Malley framework, was followed. In addition to searching gray literature, we searched MEDLINE, EMBASE, PsycINFO, HMIC, and Cochrane Library. Studies were included based on the following selection criteria: publication in English, publication in Europe or the United States, focus on wearables, relevance to the research, and the availability of the full text. Results After identifying 1585 unique records and excluding papers based on the selection criteria, 20 studies were included in the review. On analysis of these 20 studies, 3 main themes emerged: the potential barriers to using wearables, the role of providers and the benefits to providers from promoting the use of wearables, and how wearables can drive behavior change. Conclusions Considerable literature findings suggest that wearables can empower individuals by assisting with diagnosis, behavior change, and self-monitoring. However, greater adoption of wearables and engagement with wearable devices depend on various factors, including promotion and support from providers to encourage uptake; increased short-term investment to upskill staff, especially in the area of data analysis; and overcoming the barriers to use, particularly by improving device accuracy. Acting on these suggestions will require investment and constructive input from key stakeholders, namely users, health care professionals, and designers of the technology. As advancements in technology to make wearables viable health care devices have only come about recently, further studies will be important for measuring the effectiveness of wearables in empowering individuals. The investigation of user outcomes through large-scale studies would also be beneficial. Nevertheless, a significant challenge will be in the publication of research to keep pace with rapid developments related to wearable health technology.
Collapse
Affiliation(s)
- Harjeevan Singh Kang
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Health Services Management Centre, University of Birmingham, Birmingham, United Kingdom
| | - Mark Exworthy
- Health Services Management Centre, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
9
|
Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers. Nutrients 2022; 14:nu14142801. [PMID: 35889758 PMCID: PMC9318739 DOI: 10.3390/nu14142801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 02/05/2023] Open
Abstract
This study explored how South African food labels could be improved, to enhance customer evaluation of the overall healthiness of packaged food. Focus was given to the comparison of front-of-pack (FOP) nutrition labels as a quick assessment tool. The exploratory sequential mixed-methods design used qualitative interviews (n = 49) to gain insight into labeling challenges and select FOP nutrition labels for consumer testing. Consumers (n = 1261) randomly assessed two out of six possible FOP nutrition labels relative to a ‘no-label’ control in one of 12 online surveys, applied to a fictitious cereal product. A mixed-model analysis of variance was used to compare the differences in health ratings for the different FOP nutrition labels. The interviews revealed three themes for label improvement, that are presented over three time horizons. In terms of helping consumers identify less healthy products, the effect sizes were most prominent for health warnings (p < 0.01) and low health star ratings (p < 0.01). The findings of this research not only clarify whether FOP nutrition labeling formats used in other regions such as Europe, South America and Australia could be useful in the South African context, but they can assist policymakers and decision-makers in selecting an effective FOP label.
Collapse
|
10
|
Smart Home Technology Solutions for Cardiovascular Diseases: A Systematic Review. APPLIED SYSTEM INNOVATION 2022. [DOI: 10.3390/asi5030051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cardiovascular diseases (CVD) are the leading cause of mortality globally. Despite improvement in therapies, people with CVD lack support for monitoring and managing their condition at home and out of hospital settings. Smart Home Technologies have potential to monitor health status and support people with CVD in their homes. We explored the Smart Home Technologies available for CVD monitoring and management in people with CVD and acceptance of the available technologies to end-users. We systematically searched four databases, namely Medline, Web of Science, Embase, and IEEE, from 1990 to 2020 (search date 18 March 2020). “Smart-Home” was defined as a system using integrated sensor technologies. We included studies using sensors, such as wearable and non-wearable devices, to capture vital signs relevant to CVD at home settings and to transfer the data using communication systems, including the gateway. We categorised the articles for parameters monitored, communication systems and data sharing, end-user applications, regulations, and user acceptance. The initial search yielded 2462 articles, and the elimination of duplicates resulted in 1760 articles. Of the 36 articles eligible for full-text screening, we selected five Smart Home Technology studies for CVD management with sensor devices connected to a gateway and having a web-based user interface. We observed that the participants of all the studies were people with heart failure. A total of three main categories—Smart Home Technology for CVD management, user acceptance, and the role of regulatory agencies—were developed and discussed. There is an imperative need to monitor CVD patients’ vital parameters regularly. However, limited Smart Home Technology is available to address CVD patients’ needs and monitor health risks. Our review suggests the need to develop and test Smart Home Technology for people with CVD. Our findings provide insights and guidelines into critical issues, including Smart Home Technology for CVD management, user acceptance, and regulatory agency’s role to be followed when designing, developing, and deploying Smart Home Technology for CVD.
Collapse
|
11
|
Abstract
Wearable technologies are making a significant impact on people’s way of living thanks to the advancements in mobile communication, internet of things (IoT), big data and artificial intelligence. Conventional wearable technologies present many challenges for the continuous monitoring of human health conditions due to their lack of flexibility and bulkiness in size. Recent development in e-textiles and the smart integration of miniature electronic devices into textiles have led to the emergence of smart clothing systems for remote health monitoring. A novel comprehensive framework of smart clothing systems for health monitoring is proposed in this paper. This framework provides design specifications, suitable sensors and textile materials for smart clothing (e.g., leggings) development. In addition, the proposed framework identifies techniques for empowering the seamless integration of sensors into textiles and suggests a development strategy for health diagnosis and prognosis through data collection, data processing and decision making. The conceptual technical specification of smart clothing is also formulated and presented. The detailed development of this framework is presented in this paper with selected examples. The key challenges in popularizing smart clothing and opportunities of future development in diverse application areas such as healthcare, sports and athletics and fashion are discussed.
Collapse
|
12
|
Patel V, Moosa S, Sundaram S, Langer L, MacMillan TE, Cavalcanti R, Cram P, Gunaratne K, Bayley M, Wu R. Perceptions of patients and nurses regarding the use of wearables in inpatient settings: a mixed methods study. Inform Health Soc Care 2022; 47:444-452. [DOI: 10.1080/17538157.2022.2042304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Vikas Patel
- Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sabreena Moosa
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Sanjana Sundaram
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Laura Langer
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Thomas E. MacMillan
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Division of General Internal Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, ON, Canada
| | - Rodrigo Cavalcanti
- Division of General Internal Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, ON, Canada
| | - Peter Cram
- Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Keith Gunaratne
- Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Robert Wu
- Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
13
|
Bokharaei Nia M, Afshar Kazemi M, Valmohammadi C, Abbaspour G. Wearable IoT intelligent recommender framework for a smarter healthcare approach. LIBRARY HI TECH 2021. [DOI: 10.1108/lht-04-2021-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe increase in the number of healthcare wearable (Internet of Things) IoT options is making it difficult for individuals, healthcare experts and physicians to find the right smart device that best matches their requirements or treatments. The purpose of this research is to propose a framework for a recommender system to advise on the best device for the patient using machine learning algorithms and social media sentiment analysis. This approach will provide great value for patients, doctors, medical centers, and hospitals to enable them to provide the best advice and guidance in allocating the device for that particular time in the treatment process.Design/methodology/approachThis data-driven approach comprises multiple stages that lead to classifying the diseases that a patient is currently facing or is at risk of facing by using and comparing the results of various machine learning algorithms. Hereupon, the proposed recommender framework aggregates the specifications of wearable IoT devices along with the image of the wearable product, which is the extracted user perception shared on social media after applying sentiment analysis. Lastly, a proposed computation with the use of a genetic algorithm was used to compute all the collected data and to recommend the wearable IoT device recommendation for a patient.FindingsThe proposed conceptual framework illustrates how health record data, diseases, wearable devices, social media sentiment analysis and machine learning algorithms are interrelated to recommend the relevant wearable IoT devices for each patient. With the consultation of 15 physicians, each a specialist in their area, the proof-of-concept implementation result shows an accuracy rate of up to 95% using 17 settings of machine learning algorithms over multiple disease-detection stages. Social media sentiment analysis was computed at 76% accuracy. To reach the final optimized result for each patient, the proposed formula using a Genetic Algorithm has been tested and its results presented.Research limitations/implicationsThe research data were limited to recommendations for the best wearable devices for five types of patient diseases. The authors could not compare the results of this research with other studies because of the novelty of the proposed framework and, as such, the lack of available relevant research.Practical implicationsThe emerging trend of wearable IoT devices is having a significant impact on the lifestyle of people. The interest in healthcare and well-being is a major driver of this growth. This framework can help in accelerating the transformation of smart hospitals and can assist doctors in finding and suggesting the right wearable IoT for their patients smartly and efficiently during treatment for various diseases. Furthermore, wearable device manufacturers can also use the outcome of the proposed platform to develop personalized wearable devices for patients in the future.Originality/valueIn this study, by considering patient health, disease-detection algorithm, wearable and IoT social media sentiment analysis, and healthcare wearable device dataset, we were able to propose and test a framework for the intelligent recommendation of wearable and IoT devices helping healthcare professionals and patients find wearable devices with a better understanding of their demands and experiences.
Collapse
|
14
|
Lee R, James C, Edwards S, Skinner G, Young JL, Snodgrass SJ. Evidence for the Effectiveness of Feedback from Wearable Inertial Sensors during Work-Related Activities: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:6377. [PMID: 34640695 PMCID: PMC8512480 DOI: 10.3390/s21196377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/03/2023]
Abstract
Background: Wearable inertial sensor technology (WIST) systems provide feedback, aiming to modify aberrant postures and movements. The literature on the effects of feedback from WIST during work or work-related activities has not been previously summarised. This review examines the effectiveness of feedback on upper body kinematics during work or work-related activities, along with the wearability and a quantification of the kinematics of the related device. Methods: The Cinahl, Cochrane, Embase, Medline, Scopus, Sportdiscus and Google Scholar databases were searched, including reports from January 2005 to July 2021. The included studies were summarised descriptively and the evidence was assessed. Results: Fourteen included studies demonstrated a 'limited' level of evidence supporting posture and/or movement behaviour improvements using WIST feedback, with no improvements in pain. One study assessed wearability and another two investigated comfort. Studies used tri-axial accelerometers or IMU integration (n = 5 studies). Visual and/or vibrotactile feedback was mostly used. Most studies had a risk of bias, lacked detail for methodological reproducibility and displayed inconsistent reporting of sensor technology, with validation provided only in one study. Thus, we have proposed a minimum 'Technology and Design Checklist' for reporting. Conclusions: Our findings suggest that WIST may improve posture, though not pain; however, the quality of the studies limits the strength of this conclusion. Wearability evaluations are needed for the translation of WIST outcomes. Minimum reporting standards for WIST should be followed to ensure methodological reproducibility.
Collapse
Affiliation(s)
- Roger Lee
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle 2308, Australia
| | - Carole James
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Resources Health and Safety, The University of Newcastle, Newcastle 2308, Australia
| | - Suzi Edwards
- School of Health Sciences, The University of Sydney, Sydney 2006, Australia;
| | - Geoff Skinner
- School of Information and Physical Sciences, The University of Newcastle, Newcastle 2308, Australia;
| | - Jodi L. Young
- Department of Physical Therapy, Bellin College, Green Bay, WI 54311, USA;
| | - Suzanne J. Snodgrass
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle 2308, Australia
| |
Collapse
|
15
|
Volpato L, Del Río Carral M, Senn N, Santiago Delefosse M. General Practitioners' Perceptions of the Use of Wearable Electronic Health Monitoring Devices: Qualitative Analysis of Risks and Benefits. JMIR Mhealth Uhealth 2021; 9:e23896. [PMID: 34383684 PMCID: PMC8386401 DOI: 10.2196/23896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/15/2021] [Accepted: 05/17/2021] [Indexed: 01/13/2023] Open
Abstract
Background The rapid diffusion of wearable electronic health monitoring devices (wearable devices or wearables) among lay populations shows that self-tracking and self-monitoring are pervasively expanding, while influencing health-related practices. General practitioners are confronted with this phenomenon, since they often are the expert-voice that patients will seek. Objective This article aims to explore general practitioners’ perceptions of the role of wearable devices in family medicine and of their benefits, risks, and challenges associated with their use. It also explores their perceptions of the future development of these devices. Methods Data were collected during a medical conference among 19 Swiss general practitioners through mind maps. Maps were first sketched at the conference and their content was later compared with notes and reports written during the conference, which allowed for further integration of information. This tool represents an innovative methodology in qualitative research that allows for time-efficient data collection and data analysis. Results Data analysis highlighted that wearable devices were described as user-friendly, adaptable devices that could enable performance monitoring and support medical research. Benefits included support for patients’ empowerment and education, behavior change facilitation, better awareness of personal medical history and body functioning, efficient information transmission, and connection with the patient’s medical network; however, general practitioners were concerned by a lack of scientific validation, lack of clarity over data protection, and the risk of stakeholder-associated financial interests. Other perceived risks included the promotion of an overly medicalized health culture and the risk of supporting patients’ self-diagnosis and self-medication. General practitioners also feared increased pressure on their workload and a compromised doctor–patient relationship. Finally, they raised important questions that can guide wearables’ future design and development, highlighting a need for general practitioners and medical professionals to be involved in the process. Conclusions Wearables play an increasingly central role in daily health-related practices, and general practitioners expressed a desire to become more involved in the development of such technologies. Described as useful information providers, wearables were generally positively perceived and did not seem to pose a threat to the doctor–patient relationship. However, general practitioners expressed their concern that wearables may fuel a self-monitoring logic, to the detriment of patients’ autonomy and overall well-being. While wearables can contribute to health promotion, it is crucial to clarify the logic underpinning the design of such devices. Through the analysis of group discussions, this study contributes to the existing literature by presenting general practitioners’ perceptions of wearable devices. This paper provides insight on general practitioners’ perception to be considered in the context of product development and marketing.
Collapse
Affiliation(s)
- Lucia Volpato
- Research Centre for Psychology of Health, Aging and Sport Examination, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - María Del Río Carral
- Research Centre for Psychology of Health, Aging and Sport Examination, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Marie Santiago Delefosse
- Research Centre for Psychology of Health, Aging and Sport Examination, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
16
|
Ganti V, Carek AM, Jung H, Srivatsa AV, Cherry D, Johnson LN, Inan OT. Enabling Wearable Pulse Transit Time-Based Blood Pressure Estimation for Medically Underserved Areas and Health Equity: Comprehensive Evaluation Study. JMIR Mhealth Uhealth 2021; 9:e27466. [PMID: 34338646 PMCID: PMC8369375 DOI: 10.2196/27466] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 05/10/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Noninvasive and cuffless approaches to monitor blood pressure (BP), in light of their convenience and accuracy, have paved the way toward remote screening and management of hypertension. However, existing noninvasive methodologies, which operate on mechanical, electrical, and optical sensing modalities, have not been thoroughly evaluated in demographically and racially diverse populations. Thus, the potential accuracy of these technologies in populations where they could have the greatest impact has not been sufficiently addressed. This presents challenges in clinical translation due to concerns about perpetuating existing health disparities. OBJECTIVE In this paper, we aim to present findings on the feasibility of a cuffless, wrist-worn, pulse transit time (PTT)-based device for monitoring BP in a diverse population. METHODS We recruited a diverse population through a collaborative effort with a nonprofit organization working with medically underserved areas in Georgia. We used our custom, multimodal, wrist-worn device to measure the PTT through seismocardiography, as the proximal timing reference, and photoplethysmography, as the distal timing reference. In addition, we created a novel data-driven beat-selection algorithm to reduce noise and improve the robustness of the method. We compared the wearable PTT measurements with those from a finger-cuff continuous BP device over the course of several perturbations used to modulate BP. RESULTS Our PTT-based wrist-worn device accurately monitored diastolic blood pressure (DBP) and mean arterial pressure (MAP) in a diverse population (N=44 participants) with a mean absolute difference of 2.90 mm Hg and 3.39 mm Hg for DBP and MAP, respectively, after calibration. Meanwhile, the mean absolute difference of our systolic BP estimation was 5.36 mm Hg, a grade B classification based on the Institute for Electronics and Electrical Engineers standard. We have further demonstrated the ability of our device to capture the commonly observed demographic differences in underlying arterial stiffness. CONCLUSIONS Accurate DBP and MAP estimation, along with grade B systolic BP estimation, using a convenient wearable device can empower users and facilitate remote BP monitoring in medically underserved areas, thus providing widespread hypertension screening and management for health equity.
Collapse
Affiliation(s)
- Venu Ganti
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Andrew M Carek
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Hewon Jung
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Adith V Srivatsa
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | | | | | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|
17
|
Aguila EJT, Cua IHY. Adapting digital technology to the gastroenterology and endoscopy practice in the pandemic era. ADVANCES IN DIGESTIVE MEDICINE 2021. [DOI: 10.1002/aid2.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Enrik John T. Aguila
- Institute of Digestive and Liver Diseases St. Luke's Medical Center Global City Taguig Philippines
| | - Ian Homer Y. Cua
- Institute of Digestive and Liver Diseases St. Luke's Medical Center Global City Taguig Philippines
| |
Collapse
|
18
|
Sencadas V, Tawk C, Searle T, Alici G. Low-Hysteresis and Ultrasensitive Microcellular Structures for Wearable Electronic Applications. ACS APPLIED MATERIALS & INTERFACES 2021; 13:1632-1643. [PMID: 33375786 DOI: 10.1021/acsami.0c20173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Wearable technologies offer the opportunity to record human physiological signals in real time, in a noninvasive way, and the data can be used to aid in the early detection of abnormal health conditions. Here, we demonstrate how the interconnected porosity can be used to increase the sensitivity and linearity of capacitive pressure sensors. The finite element analysis supports the experimental observation that the movement of air during the dynamic mechanical loading is responsible for the high sensitivity observed (0.18 ± 0.01 kPa-1) when compared with the solid poly(glycerol sebacate) sensor (0.0042 ± 0.0002 kPa-1). The porous sensors present strain insensitivity and remarkable linearity over the entire range of applied mechanical pressure (0-6 kPa), capable of detecting both static and dynamic mechanical stimuli (17 nm/s), and a response time of 50 ms, without evidence of fatigue or electrical hysteresis over 10,000 mechanical cycles. The outstanding features of the porous sensors can find a broad range of applications in real-time health monitoring, from demanding movements like walking/running, to small deformations resulting from breathing or heart beating. The ultrasensitive microcellular structures synthesized in this study can be applied to other types of sensing transductions to obtain tunable and function-specific sensors with high sensitivity.
Collapse
Affiliation(s)
- Vitor Sencadas
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
- ARC Center of Excellence for Electromaterials Science, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Charbel Tawk
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
- ARC Center of Excellence for Electromaterials Science, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Thomas Searle
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
- ARC Center of Excellence for Electromaterials Science, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Gursel Alici
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
- ARC Center of Excellence for Electromaterials Science, University of Wollongong, Wollongong, NSW 2522, Australia
| |
Collapse
|
19
|
Hurley N, Kehoe B, McCaffrey N, Redmond K, Cullen L, Moyna NM. Recommendations to improve physical activity prescription for the cystic fibrosis population: an Irish perspective. BMC Health Serv Res 2020; 20:1052. [PMID: 33213453 PMCID: PMC7678110 DOI: 10.1186/s12913-020-05910-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Physical activity (PA) is a well-established therapeutic modality for the maintenance and improvement of long-term health in cystic fibrosis (CF). Healthcare professionals (HCP) are considered credible and well-placed messengers for the delivery of PA advice. Limited research exists investigating the extent of PA prescription within CF care. This study aimed to identify Irish HCP i) knowledge and practice of, and ii) motivators and barriers to PA prescription, and iii) proposed strategies to optimize PA promotion and prescription in CF populations. METHODS HCP from six designated CF centres in Ireland and members of the national physiotherapy CF clinical interest group were invited to participate. Following an expression of interest, each HCP (n = 81) received an email containing the plain language statement and link to the online survey. 48 HCP (physiotherapists n = 24, other n = 24) completed the 30-item investigator-developed survey, which included multiple choice single answer, matrix style and open-ended questions. RESULTS Most HCP (81%) acknowledged that discussing PA with CF patients was part of their professional role. Almost all physiotherapists (95%) reported having sufficient knowledge regarding PA prescription, compared to 17% of other HCP. All physiotherapists reported discussing PA at every patient interaction, with 81% employing the current consensus guidelines, compared to 33 and 5% of other HCP, respectively. Among the most common barriers reported by HCP to recommending PA to their CF patients were; lack of motivation and compliance among patients to adhere to PA advice, limited availability of PA programmes to refer their patients to, limited time with patients during clinic visits and a lack of knowledge regarding PA prescription for CF care. Three-quarters of HCP reported a need to improve PA services for CF patients in Ireland. CONCLUSION As people with CF are living longer, it is imperative that HCP are expanding their scope of practice to include discussions around PA at every patient visit. Formal educational opportunities in the form of continuing professional development programmes are warranted for CF HCP to optimize long-term patient management and outcomes. There is also a need to develop patient-centered and evidence-based PA programmes underpinned by theories of behaviour change to enhance motivation and compliance among CF patients.
Collapse
Affiliation(s)
- Nicola Hurley
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.
| | - Bróna Kehoe
- Department of Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | | | - Karen Redmond
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Niall M Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| |
Collapse
|
20
|
Jennings M, Guilfoyle A, Green J, Cleary Y, Gowran RJ. Octopus Watch Fosters Family Resilience by Enhancing Occupational Engagement for Children with Spina Bifida and/or Hydrocephalus: Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228316. [PMID: 33182784 PMCID: PMC7697938 DOI: 10.3390/ijerph17228316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children with spina bifida and/or hydrocephalus (SB&/H) often experience difficulties with activities of daily living (ADLs) due to impaired executive functioning, increasing sedentary behaviours. The HeyJoy Octopus watch, a child-friendly icon-based smartwatch could be used as an enabler to promote purposeful ADLs (i.e., goal-orientated ADLs). OBJECTIVE to investigate the effectiveness of the Octopus watch in promoting purposeful ADLs for children living with SB&/H (<8 years). METHODS Mixed-methods engaging parents and children in four phases: (1) Administered demographic questionnaire, semi-structured interview, childhood executive functioning inventory (CHEXI) and the Canadian occupational performance measure (COPM); focus group one introducing the study, information pack using smartwatch and photovoice data collection methods. (2) Measured baseline movement for four days with smartwatch without using functions. (3) Measured activity for 16-days while using the smartwatch. (4) Re-administered assessments and conducted a second focus group based on photovoice narratives. RESULTS movement data recorded for four participants, three of four showed mean activity increase (36%). N-of-1 analyses found one participant showed clear improvement (p = 0.021, r2 = 0.28). Mean inhibition decreased by 16.4%, and mean change in COPM performance and satisfaction scores were 2.1 and 2.4, respectively. The photovoice narrative focus group supports findings evidenced with improved daily routines. CONCLUSIONS The Octopus watch is an innovative early intervention that can promote purposeful ADLs, fostering family resilience by enhancing occupational engagement. Further research is required.
Collapse
Affiliation(s)
- Mark Jennings
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - Aoife Guilfoyle
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - James Green
- School of Allied Health, Faculty of Education and Health Sciences, Physical Activity for Health (PAfH), Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Yvonne Cleary
- Technical Communication and Instructional Design, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Rosemary Joan Gowran
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology (HIST), University of Limerick, V94 T9PX Limerick, Ireland
- School of Health and Sports Science, University of the Sunshine Coast, Maroochydore DC QLD 4558, Australia
- Assisting Living and Learning (ALL), Institute Maynooth University, Maynooth, W23 VP22 Co. Kildare, Ireland
- Correspondence:
| |
Collapse
|
21
|
LeBaron V, Hayes J, Gordon K, Alam R, Homdee N, Martinez Y, Ogunjirin E, Thomas T, Jones R, Blackhall L, Lach J. Leveraging Smart Health Technology to Empower Patients and Family Caregivers in Managing Cancer Pain: Protocol for a Feasibility Study. JMIR Res Protoc 2019; 8:e16178. [PMID: 31815679 PMCID: PMC6928698 DOI: 10.2196/16178] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 12/11/2022] Open
Abstract
Background An estimated 60%-90% of patients with cancer experience moderate to severe pain. Poorly managed cancer pain negatively affects the quality of life for both patients and their family caregivers and can be a particularly challenging symptom to manage at home. Mobile and wireless technology (“Smart Health”) has significant potential to support patients with cancer and their family caregivers and empower them to safely and effectively manage cancer pain. Objective This study will deploy a package of sensing technologies, known as Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C), and evaluate its feasibility and acceptability among patients with cancer-family caregiver dyads. Our primary aims are to explore the ability of BESI-C to reliably measure and describe variables relevant to cancer pain in the home setting and to better understand the dyadic effect of pain between patients and family caregivers. A secondary objective is to explore how to best share collected data among key stakeholders (patients, caregivers, and health care providers). Methods This descriptive two-year pilot study will include dyads of patients with advanced cancer and their primary family caregivers recruited from an academic medical center outpatient palliative care clinic. Physiological (eg, heart rate, activity) and room-level environmental variables (ambient temperature, humidity, barometric pressure, light, and noise) will be continuously monitored and collected. Behavioral and experiential variables will be actively collected when the caregiver or patient interacts with the custom BESI-C app on their respective smart watch to mark and describe pain events and answer brief, daily ecological momentary assessment surveys. Preliminary analysis will explore the ability of the sensing modalities to infer and detect pain events. Feasibility will be assessed by logistic barriers related to in-home deployment, technical failures related to data capture and fidelity, smart watch wearability issues, and patient recruitment and attrition rates. Acceptability will be measured by dyad perceptions and receptivity to BESI-C through a brief, structured interview and surveys conducted at deployment completion. We will also review summaries of dyad data with participants and health care providers to seek their input regarding data display and content. Results Recruitment began in July 2019 and is in progress. We anticipate the preliminary results to be available by summer 2021. Conclusions BESI-C has significant potential to monitor and predict pain while concurrently enhancing communication, self-efficacy, safety, and quality of life for patients and family caregivers coping with serious illness such as cancer. This exploratory research offers a novel approach to deliver personalized symptom management strategies, improve patient and caregiver outcomes, and reduce disparities in access to pain management and palliative care services. International Registered Report Identifier (IRRID) DERR1-10.2196/16178
Collapse
Affiliation(s)
- Virginia LeBaron
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - James Hayes
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Kate Gordon
- Virginia Commonwealth University Health, Richmond, VA, United States
| | - Ridwan Alam
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Nutta Homdee
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Yudel Martinez
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Emmanuel Ogunjirin
- University of Virginia School of Engineering & Applied Science, Charlottesville, VA, United States
| | - Tanya Thomas
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Randy Jones
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Leslie Blackhall
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - John Lach
- The George Washington University School of Engineering & Applied Science, Washington, DC, United States
| |
Collapse
|