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Escobar-Agreda S, Silva-Valencia J, Soto-Becerra P, Reategui-Rivera CM, De la Cruz-Torralva K, Chahuara-Rojas M, Hernandez-Iriarte B, Espinoza-Herrera DH, Delgado CA, Matassini S, Vargas-Herrera J, Rojas-Mezarina L. Patient Engagement With and Perceptions of the COVIDA Project, a Volunteer-Led Telemonitoring and Teleorientation Service for COVID-19 Community Management: Mixed Methods Study. JMIR Form Res 2024; 8:e51237. [PMID: 39269741 PMCID: PMC11437321 DOI: 10.2196/51237] [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: 07/26/2023] [Revised: 02/05/2024] [Accepted: 04/04/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND During the pandemic in Peru, the COVIDA (Collaboration Network of Volunteer Brigade Members for the Investigation, Detection, and Primary Management of Community Cases Affected by COVID-19) project proposed an innovative way to provide telemonitoring and teleorientation to COVID-19 patients, led by health care student volunteers. However, it has not been described how this interaction is perceived from the patient's perspective and which factors increase their engagement with this service. OBJECTIVE The aim of this study is to describe the perceptions of patients about COVIDA and identify factors associated with their engagement with this service. METHODS A mixed methods study was conducted to evaluate perceptions of patients that participated in the COVIDA project. This telehealth intervention organized by the National University of San Marcos was implemented in Peru from August to December 2020. The service involved daily phone calls by volunteer students to monitor registered COVID-19 patients until the completion of the 14th day of the illness or if a warning sign was identified. The volunteers also provided teleorientation to address the patients' needs and concerns. Quantitative analysis was performed to describe the characteristics of the patients and to assess the factors related to their engagement with the service, which was defined by the percentage of participants who completed the follow-up according to their individual schedule. Qualitative analysis through semistructured interviews evaluated the patients' perceptions of the service regarding the aspects of communication, interaction, and technology. RESULTS Of the 770 patients enrolled in COVIDA, 422 (55.7%) were female; the median age was 39 (IQR 28-52) years. During the monitoring, 380 patients (49.4%) developed symptoms, and 471 (61.2%) showed warning signs of COVID-19. The overall median for engagement was 93% (IQR 35.7%-100%). Among those patients who did not develop warning signs, engagement was associated with the presence of symptoms (OR 3.04, 95% CI 2.22-4.17), a positive COVID-19 test at the start of follow-up (OR 1.97, 95% CI 1.48-2.61), and the presence of comorbidities (OR 1.83, 95% CI 1.29-2.59). Patients reported that the volunteers provided clear and valuable information and emotional support. Communication via phone calls took place smoothly and without interruptions. CONCLUSIONS COVIDA represents a well-accepted and well-perceived alternative model for student volunteers to provide telemonitoring, teleorientation, and emotional support to patients with COVID-19 in the context of overwhelmed demand for health care services. The deployment of this kind of intervention should be prioritized among patients with symptoms and comorbidities, as they show more engagement with these services.
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Affiliation(s)
- Stefan Escobar-Agreda
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Javier Silva-Valencia
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - C Mahony Reategui-Rivera
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, United States
| | | | - Max Chahuara-Rojas
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Bruno Hernandez-Iriarte
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | - Silvana Matassini
- Department of Anthropology, University of Southern California, Los Angeles, CA, United States
| | - Javier Vargas-Herrera
- Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Leonardo Rojas-Mezarina
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
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Pohl P, Klerfors K, Kjörk EK. Evaluation of a Digital Previsit Tool for Identifying Stroke-Related Health Problems Before a Follow-Up Visit (Part 1): Survey Study. JMIR Hum Factors 2024; 11:e55852. [PMID: 39226546 PMCID: PMC11408892 DOI: 10.2196/55852] [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: 01/08/2024] [Revised: 03/28/2024] [Accepted: 08/04/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Stroke may lead to various disabilities, and a structured follow-up visit is strongly recommended within a few months after an event. To facilitate this visit, the digital previsit tool "Strokehealth" was developed for patients to fill out in advance. The concept Strokehälsa (or Strokehealth) was initially developed in-house as a Windows application, later incorporated in 1177.se. OBJECTIVE The study's primary objective was to use a patient satisfaction survey to evaluate the digital previsit tool Strokehealth when used before a follow-up visit, with a focus on feasibility and relevance from the perspective of people with stroke. Our secondary objective was to explore the extent to which the previsit tool identified stroke-related health problems. METHODS Between November 2020 and June 2021, a web-based survey was sent to patients who were scheduled for a follow-up visit after discharge from a stroke unit and had recently filled in the previsit tool. The survey covered demographic characteristics, internet habits, and satisfaction rated using 5 response options. Descriptive statistics were used to present data from both the previsit tool and the survey. We also compared the characteristics of those who completed the previsit tool and those who did not, using nonparametric statistics. Free-text responses were thematically analyzed. RESULTS All patients filling out the previsit tool (80/171; age: median 67, range 32-91 years) were community-dwelling. Most had experienced a mild stroke and reported a median of 2 stroke-related health problems (range 0-8), and they were significantly younger than nonresponders (P<.001). The survey evaluating the previsit tool was completed by 73% (58/80; 39 men). The majority (48/58, 83%) reported using the internet daily. Most respondents (56/58, 97%) were either satisfied (n=15) or very satisfied (n=41) with how well the previsit tool captured their health problems. The highest level of dissatisfaction was related to the response options in Strokehealth (n=5). Based on the free-text answers to the survey, we developed 4 themes. First, Strokehealth was perceived to provide a structure that ensured that issues would be emphasized and considered. Second, user-friendliness and accessibility were viewed as acceptable, although respondents suggested improvements. Third, participants raised awareness about being approached digitally for communication and highlighted the importance of how to be approached. Fourth, their experiences with Strokehealth were influenced by their perceptions of the explanatory texts, the response options, and the possibility of elaborating on their answers in free text. CONCLUSIONS People with stroke considered the freely available previsit tool Strokehealth feasible for preparing in advance for a follow-up visit. Despite high satisfaction with how well the tool captured their health problems, participants indicated that additional free-text responses and revised information could enhance usability. Improvements need to be considered in parallel with qualitative data to ensure that the tool meets patient needs. TRIAL REGISTRATION Researchweb 275135; https://www.researchweb.org/is/vgr/project/275135.
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Affiliation(s)
- Petra Pohl
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karoline Klerfors
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emma K Kjörk
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
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Hummel K, Newburger JW, Antonelli RC. The Role of Specialists in Care Integration: A Primary Responsibility. J Pediatr 2024:114276. [PMID: 39216621 DOI: 10.1016/j.jpeds.2024.114276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/30/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Kevin Hummel
- Divisions of Pediatric Critical Care and Cardiology, Department of Pediatrics, University of Utah; Intermountain Health Primary Children's Hospital.
| | - Jane W Newburger
- Department of Cardiology, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School
| | - Richard C Antonelli
- Division of General Pediatrics, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School
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Lawrence K, Levine DL. The Digital Determinants of Health: A Guide for Competency Development in Digital Care Delivery for Health Professions Trainees. JMIR MEDICAL EDUCATION 2024; 10:e54173. [PMID: 39207389 PMCID: PMC11376139 DOI: 10.2196/54173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/01/2024] [Accepted: 06/27/2024] [Indexed: 09/04/2024]
Abstract
Unlabelled Health care delivery is undergoing an accelerated period of digital transformation, spurred in part by the COVID-19 pandemic and the use of "virtual-first" care delivery models such as telemedicine. Medical education has responded to this shift with calls for improved digital health training, but there is as yet no universal understanding of the needed competencies, domains, and best practices for teaching these skills. In this paper, we argue that a "digital determinants of health" (DDoH) framework for understanding the intersections of health outcomes, technology, and training is critical to the development of comprehensive digital health competencies in medical education. Much like current social determinants of health models, the DDoH framework can be integrated into undergraduate, graduate, and professional education to guide training interventions as well as competency development and evaluation. We provide possible approaches to integrating this framework into training programs and explore priorities for future research in digitally-competent medical education.
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Affiliation(s)
- Katharine Lawrence
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th Street 6th Floor, New York, NY, 10016, United States, 1 6465012684
| | - Defne L Levine
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th Street 6th Floor, New York, NY, 10016, United States, 1 6465012684
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Yoon R, Wong JPH, Chung-Lee L, Akbarian A, Abdulai AF, Hou R, Ho M, Zinaic R, Anoushka A. Scoping review protocol: what is the state of evidence for the use of communication apps with immigrant seniors in long-term care and community settings? BMJ Open 2024; 14:e089939. [PMID: 39174072 PMCID: PMC11340699 DOI: 10.1136/bmjopen-2024-089939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION First language care is critical for older immigrant adults with limited English proficiency, especially in long-term care settings where most residents require staff assistance and experience complex chronic conditions, resulting in multiple communication interactions where language poses a barrier. Although there are a myriad of cultural-language translation apps and devices available, there is a gap in both research and practice on the acceptability and feasibility of these digital resources within the context of long-term care and community settings for older immigrant adults, from a cultural relevance and digital health equity perspective. Our paper outlines a scoping review protocol to examine the state of the literature on the extent to which cultural-language translation apps are used in long-term care settings and community-based elder care. We will also examine the extent to which such apps bridge or further gaps in equitable, accessible and acceptable care for older immigrant adults with limited English language proficiency. METHODS AND ANALYSIS This scoping review protocol will employ an adapted five-stage framework outlined by Arksey and O'Malley guided by enhancements recommended by Levac et al and Colquhoun et al. Using the Joanna Briggs Institute's population, concept and context framework, we defined the scope of the scoping review by identifying the target population, concepts for investigation and the context within which the research is situated. We will conduct a search of the literature from 2005 to 2024 using five bibliographic databases from health sciences (Healthstar OVID, MEDLINE OVID and Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO), engineering (Engineering Village Elsevier) and a cross-disciplinary database (Web of Science Clarivate). The research team will adopt a critical, equity-focused approach for the scoping review by integrating Richardson et al's framework for Digital Health Equity into our analysis of the findings. This will ensure that health and social equity perspectives are integrated within our methodology and analytical lens. Our analysis will specifically examine selected studies for their engagement with health equity and their ability to address issues such as ageism, ableism and the digital divide within geriatric care. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review as it involves secondary analysis of published works and no primary data collection involving human subjects. Findings of the review will be shared with community partners and disseminated through publications, conferences and peer-reviewed publications.
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Affiliation(s)
- Rosanra Yoon
- Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
| | | | - Leinic Chung-Lee
- Daphne Cockwell School of Nursing, Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
| | - Abdolreza Akbarian
- Daphne Cockwell School of Nursing, Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
| | | | - Rui Hou
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Mabel Ho
- Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
| | - Rade Zinaic
- Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
| | - Anoushka Anoushka
- Toronto Metropolitan University Faculty of Community Services, Toronto, Ontario, Canada
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Sapienza S, Tsurkalenko O, Giraitis M, Mejia AC, Zelimkhanov G, Schwaninger I, Klucken J. Assessing the clinical utility of inertial sensors for home monitoring in Parkinson's disease: a comprehensive review. NPJ Parkinsons Dis 2024; 10:161. [PMID: 39164257 PMCID: PMC11335938 DOI: 10.1038/s41531-024-00755-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 07/24/2024] [Indexed: 08/22/2024] Open
Abstract
This review screened 296 articles on wearable sensors for home monitoring of people with Parkinson's Disease within the PubMed Database, from January 2017 to May 2023. A three-level maturity framework was applied for classifying the aims of 59 studies included: demonstrating technical efficacy, diagnostic sensitivity, or clinical utility. As secondary analysis, user experience (usability and patient adherence) was evaluated. The evidences provided by the studies were categorized and stratified according to the level of maturity. Our results indicate that approximately 75% of articles investigated diagnostic sensitivity, i.e. correlation of sensor-data with clinical parameters. Evidence of clinical utility, defined as improvement on health outcomes or clinical decisions after the use of the wearables, was found only in nine papers. A third of the articles included reported evidence of user experience. Future research should focus more on clinical utility, to facilitate the translation of research results within the management of Parkinson's Disease.
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Affiliation(s)
- Stefano Sapienza
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Olena Tsurkalenko
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Centre Hospitalier de Luxembourg (CHL), Rollengergronn-belair-nord, Luxembourg
| | - Marijus Giraitis
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Centre Hospitalier de Luxembourg (CHL), Rollengergronn-belair-nord, Luxembourg
| | - Alan Castro Mejia
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Gelani Zelimkhanov
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Centre Hospitalier de Luxembourg (CHL), Rollengergronn-belair-nord, Luxembourg
| | - Isabel Schwaninger
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Jochen Klucken
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg.
- Centre Hospitalier de Luxembourg (CHL), Rollengergronn-belair-nord, Luxembourg.
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Ibrahim AM, Abdel-Aziz HR, Mohamed HAH, Zaghamir DEF, Wahba NMI, Hassan GA, Shaban M, El-Nablaway M, Aldughmi ON, Aboelola TH. Balancing confidentiality and care coordination: challenges in patient privacy. BMC Nurs 2024; 23:564. [PMID: 39148055 PMCID: PMC11328515 DOI: 10.1186/s12912-024-02231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND In the digital age, maintaining patient confidentiality while ensuring effective care coordination poses significant challenges for healthcare providers, particularly nurses. AIM To investigate the challenges and strategies associated with balancing patient confidentiality and effective care coordination in the digital age. METHODS A cross-sectional study was conducted in a general hospital in Egypt to collect data from 150 nurses across various departments with at least six months of experience in patient care. Data were collected using six tools: Demographic Form, HIPAA Compliance Checklist, Privacy Impact Assessment (PIA) Tool, Data Sharing Agreement (DSA) Framework, EHR Privacy and Security Assessment Tool, and NIST Cybersecurity Framework. Validity and Reliability were ensured through pilot testing and factor analysis. RESULTS Participants were primarily aged 31-40 years (45%), with 75% female and 60% staff nurses. High compliance was observed in the HIPAA Compliance Checklist, especially in Administrative Safeguards (3.8 ± 0.5), indicating strong management and training processes, with an overall score of 85 ± 10. The PIA Tool showed robust privacy management, with Project Descriptions scoring 4.5 ± 0.3 and a total score of 30 ± 3. The DSA Framework had a mean total score of 20 ± 2, with Data Protection Measures scoring highest at 4.0 ± 0.4. The EHR assessments revealed high scores in Access Controls (4.4 ± 0.3) and Data Integrity Measures (4.3 ± 0.3), with an overall score of 22 ± 1.5. The NIST Cybersecurity Framework had a total score of 18 ± 2, with the highest scores in Protect (3.8) and lower in Detect (3.6). Strong positive correlations were found between HIPAA Compliance and EHR Privacy (r = 0.70, p < 0.05) and NIST Cybersecurity (r = 0.55, p < 0.05), reflecting effective data protection practices. CONCLUSION The study suggests that continuous improvement in privacy practices among healthcare providers, through ongoing training and comprehensive privacy frameworks, is vital for enhancing patient confidentiality and supporting effective care coordination.
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Affiliation(s)
- Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia.
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said City, Port Said, 42526, Egypt.
| | - Hassanat Ramadan Abdel-Aziz
- College of Nursing, Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia
- Gerontological Nursing Department, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Heba Ali Hamed Mohamed
- Community Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura City, Dakahlia, Egypt
| | - Donia Elsaid Fathi Zaghamir
- College of Nursing, Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia
- Pediatric Nursing Department, Faculty of Nursing, Port Said University, Port Said City, 42526, Egypt
| | - Nadia Mohamed Ibrahim Wahba
- College of Nursing, Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia
- Psychiatric Nursing and Mental Health Department, Faculty of Nursing, Port Said University, Port Said, 42526, Egypt
| | - Ghada A Hassan
- Pediatric Nursing Department, Faculty of Nursing, Menoufia University, Shibin el Kom, Egypt
| | - Mostafa Shaban
- Community Health Nursing Department, College of Nursing, Jouf University, Sakaka, Al Jouf, 72388, Saudi Arabia
| | - Mohammad El-Nablaway
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, P.O.Box 71666, 11597, Riyadh, Saudi Arabia
| | - Ohoud Naif Aldughmi
- Department of Medical and Surgical Nursing, Northern Border University, Arar, Saudi Arabia
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Sharma A, Deshmukh P, Jain S, Gaurkar SS, Sharma A. Factors Contributing to Postoperative Radiotherapy Delays in Head and Neck Cancer: A Comprehensive Review. Cureus 2024; 16:e67240. [PMID: 39301336 PMCID: PMC11412262 DOI: 10.7759/cureus.67240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 08/19/2024] [Indexed: 09/22/2024] Open
Abstract
Head and neck cancer encompasses a diverse group of malignancies that pose significant challenges in their management due to their heterogeneity in clinical behavior and treatment response. Postoperative radiotherapy (PORT) is a critical component in the treatment regimen for head and neck cancer, aimed at reducing local recurrence and improving overall survival (OS). However, delays in the initiation of PORT can significantly compromise patient outcomes. This comprehensive review explores the factors contributing to such delays, categorizing them into patient-related, treatment-related, and systemic factors. Patient-related factors include health status, comorbidities, socioeconomic barriers, and psychological issues. Treatment-related factors involve surgical complications, complexities in treatment planning, and coordination challenges between surgical and radiation oncology teams. Systemic and institutional factors encompass hospital resources, staffing levels, administrative and insurance issues, and geographic barriers. The review also examined the impact of these delays on patient outcomes, highlighting the increased risk of recurrence and reduced survival rates. Strategies to mitigate delays are discussed, including improved preoperative and postoperative planning, enhanced multidisciplinary coordination, patient education, and systemic policy changes. Additionally, case studies and real-world examples of successful interventions are presented. Future directions for research and policy recommendations are also outlined, emphasizing the need for continued efforts to ensure timely PORT for head and neck cancer patients. This review aims to provide a comprehensive analysis that can inform clinical practice and policy, ultimately improving the standard of care and patient outcomes in head and neck cancer treatment.
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Affiliation(s)
- Abhijeet Sharma
- Otorhinolaryngology and Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasad Deshmukh
- Otorhinolaryngology and Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shraddha Jain
- Otorhinolaryngology and Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sagar S Gaurkar
- Otorhinolaryngology and Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ayushi Sharma
- Dental Sciences, People's College of Dental Science and Research Centre, Bhopal, IND
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Hong JSW, Ostinelli EG, Kamvar R, Smith KA, Walsh AEL, Kabir T, Tomlinson A, Cipriani A. An online evidence-based dictionary of common adverse events of antidepressants: a new tool to empower patients and clinicians in their shared decision-making process. BMC Psychiatry 2024; 24:532. [PMID: 39049079 PMCID: PMC11270875 DOI: 10.1186/s12888-024-05950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Adverse events (AEs) are commonly reported in clinical studies using the Medical Dictionary for Regulatory Activities (MedDRA), an international standard for drug safety monitoring. However, the technical language of MedDRA makes it challenging for patients and clinicians to share understanding and therefore to make shared decisions about medical interventions. In this project, people with lived experience of depression and antidepressant treatment worked with clinicians and researchers to co-design an online dictionary of AEs associated with antidepressants, taking into account its ease of use and applicability to real-world settings. METHODS Through a pre-defined literature search, we identified MedDRA-coded AEs from randomised controlled trials of antidepressants used in the treatment of depression. In collaboration with the McPin Foundation, four co-design workshops with a lived experience advisory panel (LEAP) and one independent focus group (FG) were conducted to produce user-friendly translations of AE terms. Guiding principles for translation were co-designed with McPin/LEAP members and defined before the finalisation of Clinical Codes (CCs, or non-technical terms to represent specific AE concepts). FG results were thematically analysed using the Framework Method. RESULTS Starting from 522 trials identified by the search, 736 MedDRA-coded AE terms were translated into 187 CCs, which balanced key factors identified as important to the LEAP and FG (namely, breadth, specificity, generalisability, patient-understandability and acceptability). Work with the LEAP showed that a user-friendly language of AEs should aim to mitigate stigma, acknowledge the multiple levels of comprehension in 'lay' language and balance the need for semantic accuracy with user-friendliness. Guided by these principles, an online dictionary of AEs was co-designed and made freely available ( https://thesymptomglossary.com ). The digital tool was perceived by the LEAP and FG as a resource which could feasibly improve antidepressant treatment by facilitating the accurate, meaningful expression of preferences about potential harms through a shared decision-making process. CONCLUSIONS This dictionary was developed in English around AEs from antidepressants in depression but it can be adapted to different languages and cultural contexts, and can also become a model for other interventions and disorders (i.e., antipsychotics in schizophrenia). Co-designed digital resources may improve the patient experience by helping to deliver personalised information on potential benefits and harms in an evidence-based, preference-sensitive way.
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Affiliation(s)
- James S W Hong
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK.
| | - Edoardo G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | | | - Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | | | - Thomas Kabir
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Anneka Tomlinson
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
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Lazarou I, Krooupa AM, Nikolopoulos S, Apostolidis L, Sarris N, Papadopoulos S, Kompatsiaris I. Cancer Patients' Perspectives and Requirements of Digital Health Technologies: A Scoping Literature Review. Cancers (Basel) 2024; 16:2293. [PMID: 39001356 PMCID: PMC11240750 DOI: 10.3390/cancers16132293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024] Open
Abstract
Digital health technologies have the potential to alleviate the increasing cancer burden. Incorporating patients' perspectives on digital health tools has been identified as a critical determinant for their successful uptake in cancer care. The main objective of this scoping review was to provide an overview of the existing evidence on cancer patients' perspectives and requirements for patient-facing digital health technologies. Three databases (CINAHL, MEDLINE, Science Direct) were searched and 128 studies were identified as eligible for inclusion. Web-based software/platforms, mobile or smartphone devices/applications, and remote sensing/wearable technologies employed for the delivery of interventions and patient monitoring were the most frequently employed technologies in cancer care. The abilities of digital tools to enable care management, user-friendliness, and facilitate patient-clinician interactions were the technological requirements predominantly considered as important by cancer patients. The findings from this review provide evidence that could inform future research on technology-associated parameters influencing cancer patients' decisions regarding the uptake and adoption of patient-facing digital health technologies.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Anna-Maria Krooupa
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Lazaros Apostolidis
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Nikos Sarris
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Symeon Papadopoulos
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
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Kilfoy A, Chu C, Krisnagopal A, Mcatee E, Baek S, Zworth M, Hwang K, Park H, Jibb L. Nurse-led remote digital support for adults with chronic conditions: A systematic synthesis without meta-analysis. J Clin Nurs 2024. [PMID: 38894583 DOI: 10.1111/jocn.17226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024]
Abstract
AIM The systematic review aims to synthesize the literature examining the effectiveness of nurse-led remote digital support on health outcomes in adults with chronic conditions. BACKGROUND Adults with chronic diseases have increased rates of mortality and morbidity and use health care resources at a higher intensity than those without chronic conditions-placing strain on the patient, their caregivers and health systems. Nurse-led digital health disease self-management interventions have potential to improve outcomes for patients with chronic conditions by facilitating care in environments other that the hospital setting. DESIGN AND METHODS We searched PubMed/MEDLINE, Embase, PsycINFO and Cochrane Central databases from inception to 7 December 2022. We included randomized controlled trials assessing the impact of nurse-led remote digital support interventions compared to usual care on health-related outcomes in adults with chronic illness. The Cochrane risk-of-bias tool was used to assess bias in studies. Outcomes were organized into four categories: self-management, clinical outcomes, health care resource use and satisfaction with care. Results are presented narratively based on statistical significance. RESULTS Forty-four papers pertaining to 40 unique studies were included. Interventions most targeted diabetes (n = 11) and cardiovascular disease (n = 8). Websites (n = 10) and mobile applications (n = 10) were the most used digital modalities. Nurses supported patients either in response to incoming patient health data (n = 14), virtual appointment (n = 8), virtual health education (n = 5) or through a combination of these approaches (n = 13). Positive impacts of nurse-led digital chronic disease support were identified in each outcome category. Mobile applications were the most effective digital modality. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE Results show that nurse-led remote digital support interventions significantly improve self-management capacity, clinical health outcomes, health care resource use and satisfaction with care. Such interventions have potential to support overall health for adults with chronic conditions in their home environments.
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Affiliation(s)
- Alicia Kilfoy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charlene Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- KITE Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Archanaa Krisnagopal
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Enoch Mcatee
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sunny Baek
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Mallory Zworth
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyobin Hwang
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hyun Park
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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Frid S, Amat-Fernández C, Fuentes-Expósito MÁ, Muñoz-Mateu M, Valachis A, Sisó-Almirall A, Grau-Corral I. Mapping the Evidence on the Impact of mHealth Interventions on Patient-Reported Outcomes in Patients With Breast Cancer: A Systematic Review. JCO Clin Cancer Inform 2024; 8:e2400014. [PMID: 38710001 PMCID: PMC11161246 DOI: 10.1200/cci.24.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE To comprehensively synthesize the existing evidence concerning mHealth interventions for patients with breast cancer (BC). DESIGN On July 30, 2023, we searched PubMed, PsycINFO, and Google Scholar for articles using the following inclusion criteria: evaluation of mHealth interventions in patients with cancer, at least 30 participants with BC, randomized control trials or prospective pre-post studies, determinants of health (patient-reported outcomes [PROs] and quality of life [QoL]) as primary outcomes, interventions lasting at least 8 weeks, publication after January 2015. Publications were excluded if they evaluated telehealth or used web-based software for desktop devices only. The quality of the included studies was analyzed with the Cochrane Collaboration Risk of Bias Tool and the Methodological Index for Non-Randomized Studies. RESULTS We included 30 studies (20 focused on BC), encompassing 5,691 patients with cancer (median 113, IQR, 135.5). Among these, 3,606 had BC (median 99, IQR, 75). All studies contained multiple interventions, including physical activity, tailored information for self-management of the disease, and symptom tracker. Interventions showed better results on self-efficacy (3/3), QoL (10/14), and physical activity (5/7). Lifestyle programs (3/3), expert consulting (4/4), and tailored information (10/11) yielded the best results. Apps with interactive support had a higher rate of positive findings, while interventions targeted to survivors showed worse results. mHealth tools were not available to the public in most of the studies (17/30). CONCLUSION mHealth interventions yielded heterogeneous results on different outcomes. Identifying lack of evidence on clinical scenarios (eg, patients undergoing systemic therapy other than chemotherapy) could aid in refining strategic planning for forthcoming research endeavors within this field.
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Affiliation(s)
- Santiago Frid
- Clinical Informatics Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Clara Amat-Fernández
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | | | | | - Antonis Valachis
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Immaculada Grau-Corral
- Fundación iSYS, Barcelona, Spain
- mHealth and digital Health Observatory, Hospital Clínic de Barcelona, Barcelona, Spain
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Rakers M, van Hattem N, Simic I, Chavannes N, van Peet P, Bonten T, Vos R, van Os H. Tailoring remote patient management in cardiovascular risk management for healthcare professionals using panel management: a qualitative study. BMC PRIMARY CARE 2024; 25:122. [PMID: 38643103 PMCID: PMC11031879 DOI: 10.1186/s12875-024-02355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/28/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND While remote patient management (RPM) has the potential to assist in achieving treatment targets for cardiovascular risk factors in primary care, its effectiveness may vary among different patient subgroups. Panel management, which involves proactive care for specific patient risk groups, could offer a promising approach to tailor RPM to these groups. This study aims to (i) assess the perception of healthcare professionals and other stakeholders regarding the adoption and (ii) identify the barriers and facilitators for successfully implementing such a panel management approach. METHODS In total, nineteen semi-structured interviews and two focus groups were conducted in the Netherlands. Three authors reviewed the audited transcripts. The Consolidated Framework for Implementation Strategies (CFIR) domains were used for the thematic analysis. RESULTS A total of 24 participants (GPs, nurses, health insurers, project managers, and IT consultants) participated. Overall, a panel management approach to RPM in primary care was considered valuable by various stakeholders. Implementation barriers encompassed concerns about missing necessary risk factors for patient stratification, additional clinical and technical tasks for nurses, and reimbursement agreements. Facilitators included tailoring consultation frequency and early detection of at-risk patients, an implementation manager accountable for supervising project procedures and establishing agreements on assessing implementation metrics, and ambassador roles. CONCLUSION Panel management could enhance proactive care and accurately identify which patients could benefit most from RPM to mitigate CVD risk. For successful implementation, we recommend having clear agreements on technical support, financial infrastructure and the criteria for measuring evaluation outcomes.
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Affiliation(s)
- Margot Rakers
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands.
| | - Nicoline van Hattem
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
| | - Iris Simic
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
| | - Petra van Peet
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
| | - Tobias Bonten
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
| | - Rimke Vos
- Health Campus the Hague, Leiden University Medical Center, The Hague, 2511 DP, The Netherlands
| | - Hendrikus van Os
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2333 ZA, The Netherlands
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Alvarez-Romero C, Polo-Molina A, Sánchez-Úbeda EF, Jimenez-De-Juan C, Cuadri-Benitez MP, Rivas-Gonzalez JA, Portela J, Palacios R, Rodriguez-Morcillo C, Muñoz A, Parra-Calderon CL, Nieto-Martin MD, Ollero-Baturone M, Hernández-Quiles C. Machine Learning-Based Prediction of Changes in the Clinical Condition of Patients With Complex Chronic Diseases: 2-Phase Pilot Prospective Single-Center Observational Study. JMIR Form Res 2024; 8:e52344. [PMID: 38640473 PMCID: PMC11069093 DOI: 10.2196/52344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Functional impairment is one of the most decisive prognostic factors in patients with complex chronic diseases. A more significant functional impairment indicates that the disease is progressing, which requires implementing diagnostic and therapeutic actions that stop the exacerbation of the disease. OBJECTIVE This study aimed to predict alterations in the clinical condition of patients with complex chronic diseases by predicting the Barthel Index (BI), to assess their clinical and functional status using an artificial intelligence model and data collected through an internet of things mobility device. METHODS A 2-phase pilot prospective single-center observational study was designed. During both phases, patients were recruited, and a wearable activity tracker was allocated to gather physical activity data. Patients were categorized into class A (BI≤20; total dependence), class B (2060; moderate or mild dependence, or independent). Data preprocessing and machine learning techniques were used to analyze mobility data. A decision tree was used to achieve a robust and interpretable model. To assess the quality of the predictions, several metrics including the mean absolute error, median absolute error, and root mean squared error were considered. Statistical analysis was performed using SPSS and Python for the machine learning modeling. RESULTS Overall, 90 patients with complex chronic diseases were included: 50 during phase 1 (class A: n=10; class B: n=20; and class C: n=20) and 40 during phase 2 (class B: n=20 and class C: n=20). Most patients (n=85, 94%) had a caregiver. The mean value of the BI was 58.31 (SD 24.5). Concerning mobility aids, 60% (n=52) of patients required no aids, whereas the others required walkers (n=18, 20%), wheelchairs (n=15, 17%), canes (n=4, 7%), and crutches (n=1, 1%). Regarding clinical complexity, 85% (n=76) met patient with polypathology criteria with a mean of 2.7 (SD 1.25) categories, 69% (n=61) met the frailty criteria, and 21% (n=19) met the patients with complex chronic diseases criteria. The most characteristic symptoms were dyspnea (n=73, 82%), chronic pain (n=63, 70%), asthenia (n=62, 68%), and anxiety (n=41, 46%). Polypharmacy was presented in 87% (n=78) of patients. The most important variables for predicting the BI were identified as the maximum step count during evening and morning periods and the absence of a mobility device. The model exhibited consistency in the median prediction error with a median absolute error close to 5 in the training, validation, and production-like test sets. The model accuracy for identifying the BI class was 91%, 88%, and 90% in the training, validation, and test sets, respectively. CONCLUSIONS Using commercially available mobility recording devices makes it possible to identify different mobility patterns and relate them to functional capacity in patients with polypathology according to the BI without using clinical parameters.
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Affiliation(s)
- Celia Alvarez-Romero
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of, Seville, Spain
| | - Alejandro Polo-Molina
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, Madrid, Spain
| | | | | | | | - Jose Antonio Rivas-Gonzalez
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of, Seville, Spain
| | - Jose Portela
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, Madrid, Spain
| | - Rafael Palacios
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, Madrid, Spain
| | - Carlos Rodriguez-Morcillo
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, Madrid, Spain
| | - Antonio Muñoz
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, Madrid, Spain
| | - Carlos Luis Parra-Calderon
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of, Seville, Spain
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Qoseem IO, Okesanya OJ, Olaleke NO, Ukoaka BM, Amisu BO, Ogaya JB, Lucero-Prisno III DE. Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa. Health Promot Perspect 2024; 14:3-8. [PMID: 38623352 PMCID: PMC11016138 DOI: 10.34172/hpp.42822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/19/2024] [Indexed: 04/17/2024] Open
Abstract
The healthcare industry is constantly evolving to bridge the inequality gap and provide precision care to its diverse population. One of these approaches is the integration of digital health tools into healthcare delivery. Significant milestones such as reduced maternal mortality, rising and rapidly proliferating health tech start-ups, and the use of drones and smart devices for remote health service delivery, among others, have been reported. However, limited access to family planning, migration of health professionals, climate change, gender inequity, increased urbanization, and poor integration of private health firms into healthcare delivery rubrics continue to impair the attainment of universal health coverage and health equity. Health policy development for an integrated health system without stigma, addressing inequalities of all forms, should be implemented. Telehealth promotion, increased access to infrastructure, international collaborations, and investment in health interventions should be continuously advocated to upscale the current health landscape and achieve health equity.
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Affiliation(s)
| | - Olalekan John Okesanya
- Department of Public Health and Maritime Transport, University of Thessaly, Volos, Greece
| | - Noah Olabode Olaleke
- Department of Medical Laboratory Science, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | | | | | | | - Don Eliseo Lucero-Prisno III
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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van Leersum CM, Konrad KE, Bults M, den Ouden ME. Living with my diabetes - introducing eHealth into daily practices of patients with type 2 diabetes mellitus. Digit Health 2024; 10:20552076241257052. [PMID: 39148810 PMCID: PMC11325462 DOI: 10.1177/20552076241257052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/07/2024] [Indexed: 08/17/2024] Open
Abstract
Objective Diabetes patients can draw on an increasing number of eHealth apps to support them in the self-management of their disease. While studies so far have focused on patients with type 1 diabetes, we explored how patients with type 2 diabetes mellitus (T2DM) integrate eHealth apps into their practices aimed at managing and coping with the disease, which aspects were considered particularly valuable and which challenges users encountered. Methods Semi-structured interviews and focus group sessions were conducted to explore how patients cope with T2DM in their daily lives and their attitude towards eHealth. In a further step, four eHealth apps were tested by patients and their expectations and experiences studied by way of qualitative interviews and focus groups. Results The analysis showed that the study participants valued in particular the possibility to use eHealth apps to sense and gain a better understanding of their own body, to learn about specific responses of their body to nutrition and physical activity, and to support changes in daily routines and lifestyle. Key challenges encountered related to difficulties in interpreting the data, matching the data to other bodily sensations, getting overly occupied with the disease and difficulties in integrating the apps into personal, family, and care practices. Conclusion Under certain conditions, eHealth can play an important role for patients in developing a nuanced, personal understanding of their body and coping with T2DM. A prerequisite is that eHealth needs to be fitted into the specific practices of users, and patients desire a strong role by their care professionals in providing support in interpretation of data.
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Affiliation(s)
- Catharina M van Leersum
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
- Faculty of Humanities, Open Universiteit Nederland, Heerlen, The Netherlands
| | - Kornelia E Konrad
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Marloes Bults
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, The Netherlands
| | - Marjolein Em den Ouden
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, The Netherlands
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Melhem SJ, Kayyali R. Multilayer framework for digital multicomponent platform design for colorectal survivors and carers: a qualitative study. Front Public Health 2023; 11:1272344. [PMID: 38115846 PMCID: PMC10728820 DOI: 10.3389/fpubh.2023.1272344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Background The advent of eHealth services offers the potential to support colorectal cancer (CRC) survivors and their informal caregivers (ICs), yet research into user needs and design requirements remains scant. This exploratory qualitative study addresses this knowledge gap by focusing on the development of a Digital Multicomponent Platform (DMP) designed to provide comprehensive support to these populations. Aims The objective of this research is to use qualitative methodologies to identify key user needs and design requirements for eHealth services. It seeks to propose and apply a multi-tiered framework for creating a DMP that encapsulates the needs of CRC survivors and their ICs. Methods Skype-based focus groups (FGs) were utilized to gather qualitative data from CRC survivors and ICs. This approach served to elicit crucial themes integral to the design of the DMP. A multi-tiered framework was subsequently developed to integrate user-centered design (UCD) principles and requirements with predetermined outcomes, eHealth services, and IT infrastructure. Results The first stage of the analysis identified five crucial themes: (1) the importance of healthcare system interaction via eHealth, (2) interaction between healthcare providers and peers, (3) lifestyle and wellness considerations, (4) platform content and user interface requirements, (5) caregiver support. The second stage analysis applied the multi-tiered framework, to determine the DMP that was conceptualized from these themes, underscores the significance of personalized content, caregiver involvement, and integration with electronic health records (EHRs). Conclusion The study offers novel insights into the design and development of digital supportive care interventions for CRC survivors and their caregivers. The results highlight the utility of user-centered design principles, the significance of personalized content and caregiver involvement, and the need for a unified health data platform that promotes communication among patients, healthcare providers, and peers. This multi-tiered framework could serve as a prototype for future eHealth service designs.
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Affiliation(s)
- Samar J. Melhem
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey, United Kingdom
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