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Reinders P, Augustin M, Kirsten N, Fleyder A, Otten M. Digital health interventions in dermatology-Mapping technology and study parameters of systematically identified publications. J Eur Acad Dermatol Venereol 2023; 37:2440-2449. [PMID: 37528462 DOI: 10.1111/jdv.19392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023]
Abstract
Digital health interventions (DHI) potentially improve the efficiency and effectiveness of dermatological care. Currently, an overview clustering and characterizing the evidence on DHIs is missing. This systematic mapping of the literature aims to analyse published research on DHIs in dermatology to identify trends and gaps in research. For this purpose, a systematic search of the MEDLINE database was conducted in August 2022 to identify original publications on DHIs in dermatology. Data on country, targeted audience, DHI category, indication, outcome parameter and study design were extracted. Out of 12,009 records identified in MEDLINE, 403 studies were included in the final analysis. Studies on DHIs mainly performed in western countries, headed by the United States (n = 133), Germany (n = 32) and Spain (n = 23). Of all identified DHIs, 261 targeted healthcare providers (HCP), 66 clients (e.g. patients, caregivers, healthy individuals) and 67 both clients and HCPs. A majority of DHIs focussed on establishing a diagnosis (n = 254). Every other study analysed store-and-forward teledermatology (n = 187), followed by artificial intelligence applications for image analysis (n = 65). The most often analysed DHI category for clients was a support of health behaviour change (n = 31). Monitoring of clients was targeted by 77 studies. Skin cancer (n = 148), wounds (n = 29) and psoriasis (n = 29) were the most targeted indications by DHIs. Most studies analysed diagnostic performance (n = 166), fewer studies analysed acceptance (n = 92) and effectiveness (n = 98). Usability (n = 32) and efficiency (n = 36) were investigated only to a small extent. Studies on DHIs in dermatology have focused on teledermatology and AI applications, with an emphasis on skin cancer diagnosis. Apart from that, a range of DHIs for different user groups, purposes and indications were identified, demonstrating the broad potential for DHIs in dermatology. Further research with a wider set of outcome parameters is needed to fully understand the potential of DHIs and ensure their sustainable implementation into dermatological care.
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Affiliation(s)
- Patrick Reinders
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anastasia Fleyder
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marina Otten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Lach E, Szewczenko A, Chuchnowska I, Bursiewicz N, Benek I, Widzisz-Pronobis S, Bal D, Elsner K, Sanigórska M, Sutor M, Włodarz J. The Problem of Monitoring the Psycho-Physical Condition of Seniors during Proposed Activities in Urban Space. SENSORS (BASEL, SWITZERLAND) 2023; 23:1602. [PMID: 36772642 PMCID: PMC9920559 DOI: 10.3390/s23031602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The world's population is rapidly ageing, which places a heavy burden on traditional healthcare systems with increased economic and social costs. Technology can assist in the implementation of strategies that enable active and independent ageing by promoting and motivating health-related behaviours, monitoring, and collecting data on daily life for assessment and for aiding in independent living. ICT (Information and Communication Technology) tools can help prevent cognitive and physical decline and social isolation, and enable elderly people to live independently. In this paper, we introduced a comprehensive tool for guiding seniors along the designed urban health paths employing urban architecture as an impulse to perform physical and cognitive exercises. The behaviour of seniors is monitored during their activities using wearable sensors and mobile application. We distinguished three types of data recipients (seniors, path/exercise designers, and the public), for whom we proposed methods of analysing the obtained data and examples of their use. In this work, a wide range of diverse information was examined from which short- and long-term patterns can be drawn. We have also shown that by fusing sensory data and data from mobile applications, we can give context to sensory data, thanks to which we can formulate more insightful assessments of seniors' behaviour.
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Affiliation(s)
- Ewa Lach
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Anna Szewczenko
- Faculty of Architecture, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Iwona Chuchnowska
- Faculty of Biomedical Engineering, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Natalia Bursiewicz
- Institute of History and Archival Studies, Pedagogical University of KEN in Cracow, 30-084 Krakow, Poland
| | - Iwona Benek
- Faculty of Architecture, Silesian University of Technology, 44-100 Gliwice, Poland
| | | | - Daria Bal
- Faculty of Architecture, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Klaudia Elsner
- Faculty of Architecture, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Marta Sanigórska
- Faculty of Architecture, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Mateusz Sutor
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Jakub Włodarz
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
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Fedkov D, Berghofen A, Weiss C, Peine C, Lang F, Knitza J, Kuhn S, Krämer BK, Leipe J. Efficacy and safety of a mobile app intervention in patients with inflammatory arthritis: a prospective pilot study. Rheumatol Int 2022; 42:2177-2190. [PMID: 36112186 PMCID: PMC9483251 DOI: 10.1007/s00296-022-05175-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
AbstractEULAR highlighted the essential role of digital health in increasing self-management and improving clinical outcomes in patients with arthritis. The objective of this study was to evaluate the efficacy and safety of the digital health application (DHA) in patients with inflammatory arthritis. We assessed demographic parameters, treatment regimen, disease activity, and other patient-reported outcomes at baseline and after 4 weeks of DHA use added to standard care treatment. Of 17 patients, who completed the study, 7 (41.2%) patients were male, ranging from 19 to 63 (40.5 ± 12.2) years. No significant change in antirheumatic treatment was observed during the study. Statistically significant improvements (p < 0.05) were noted for health-related quality of life (increase in Physical Component Summary of Short Form-36 (SF-36) by 23.6%) and disease activity (decrease of Clinical Disease Activity Index and Simple Disease Activity Index by 38.4% and 39.9%, respectively). Clinically significant improvement was demonstrated for SF-36 Total Score (+ 14.4%), disease activity (Rheumatoid Arthritis Disease Activity Index− 5 to 15.9%), and depression (Patient Health Questionnaire− 9 to 13.5%). None of the efficacy parameters showed negative trends. No adverse events were reported throughout the study. The usability level was high i.e., the mean mHealth Application Usability Questionnaire Score of 5.96 (max.: 7.0) demonstrated a high level of application usability. This suggests that using a personalized disease management program based on DHA significantly improves several measures of patient-reported outcomes and disease activity in patients with inflammatory arthritis in a timely manner. These findings highlight the potential of complementary digital therapy in patients with inflammatory arthritis.
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Affiliation(s)
- Dmytro Fedkov
- Department of Internal Medicine #3, Bogomolets National Medical University, Kiev, Ukraine
| | - Andrea Berghofen
- Medical Clinic, Medical Faculty Mannheim of the University Heidelberg, Mannheim, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer, Mannheim, Germany
| | | | | | - Johannes Knitza
- Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg, Erlangen, Germany
- Deutsches Zentrum Für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Université Grenoble Alpes, AGEIS, Grenoble, France
| | - Sebastian Kuhn
- Department of Digital Medicine, Bielefeld University—Medical Faculty OWL, Bielefeld, Germany
- Department of Orthopaedic and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard K. Krämer
- Department of Medicine (Nephrology, Rheumatology, Pneumology), University Hospital Mannheim, University of Heidelberg, HypertensiologyMannheim, Endocrinology Germany
| | - Jan Leipe
- Medical Clinic, Medical Faculty Mannheim of the University Heidelberg, Mannheim, Germany
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Abstract
Patient Generated Health Data (PGHD) is defined as data generated by and from patients.1 The use of PGHD has rapidly increased with the widespread availability of smart phone mobile health applications (mHealth apps) and wearable devices. Currently, the vast majority of PGHD is generated via the use of mHealth apps and wearables like "Fitbit" or medical devices such as a continuous glucose monitoring device. There are many benefits of PGHD including increased monitoring of children's chronic health conditions outside clinical care to supplement ambulatory clinic visits, improved health outcomes, increased patient awareness and engagement and improved patient-provider communication. When leveraged properly, PGHD can be a powerful tool in delivering safe, effective, patient centered, efficient and equitable care as outlined by the Institute of Medicine (IOM).2 The challenges that limit collection, use and acceptance of PGHD include limited access to the internet, inability to incorporate PGHD into clinical workflows, data privacy and security concerns and apprehension about accuracy and safety of mHealth apps. These issues can lead to a lack of use or compliance with devices or apps associated with PGHD. To ensure optimal health benefits, agreement to leverage PGHD should be a joint decision between the clinician and the patient/caregiver. Future steps to ensure safety and clinical relevance of PGHD include involving regulatory authorities, device manufacturers and professional bodies to develop standards for mHealth apps and wearables to promote uncomplicated PGHD integration into workflows, easy and secure sharing of PGHD. Wearable technology, medical devices and smart phone apps become more advanced and widespread among the population, there will be an increasing potential for PGHD to facilitate personalized, efficient, and collaborative care resulting in improved health outcomes for children and adolescent and young adult. More research and innovation is needed to facilitate this transition.
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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: 13] [Impact Index Per Article: 4.3] [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.
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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
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Nikiphorou E, Santos EJF, Marques A, Böhm P, Bijlsma JW, Daien CI, Esbensen BA, Ferreira RJO, Fragoulis GE, Holmes P, McBain H, Metsios GS, Moe RH, Stamm TA, de Thurah A, Zabalan C, Carmona L, Bosworth A. 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. Ann Rheum Dis 2021; 80:1278-1285. [PMID: 33962964 PMCID: PMC8458093 DOI: 10.1136/annrheumdis-2021-220249] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/26/2022]
Abstract
Background An important but often insufficient aspect of care in people with inflammatory arthritis (IA) is empowering patients to acquire a good understanding of their disease and building their ability to deal effectively with the practical, physical and psychological impacts of it. Self-management skills can be helpful in this regard. Objectives To develop recommendations for the implementation of self-management strategies in IA. Methods A multidisciplinary taskforce of 18 members from 11 European countries was convened. A systematic review and other supportive information (survey of healthcare professionals (HCPs) and patient organisations) were used to formulate the recommendations. Results Three overarching principles and nine recommendations were formulated. These focused on empowering patients to become active partners of the team and to take a more proactive role. The importance of patient education and key self-management interventions such as problem solving, goal setting and cognitive behavioural therapy were highlighted. Role of patient organisations and HCPs in promoting and signposting patients to available resources has been highlighted through the promotion of physical activity, lifestyle advice, support with mental health aspects and ability to remain at work. Digital healthcare is essential in supporting and optimising self-management and the HCPs need to be aware of available resources to signpost patients. Conclusion These recommendations support the inclusion of self-management advice and resources in the routine management of people with IA and aim to empower and support patients and encourage a more holistic, patient-centred approach to care which could result in improved patient experience of care and outcomes.
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Affiliation(s)
- Elena Nikiphorou
- Rheumatology Department, King's College Hospital, London, UK .,Centre for Rheumatic Diseases, King's College London, London, UK
| | - Eduardo José Ferreira Santos
- Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Health Sciences Research Unit Nursing, Higher School of Nursing of Coimbra, Coimbra, Portugal
| | - Andrea Marques
- Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Health Sciences Research Unit Nursing, Higher School of Nursing of Coimbra, Coimbra, Portugal
| | - Peter Böhm
- German League against Rheumatism, Bonn, Germany
| | - Johannes Wj Bijlsma
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Claire Immediato Daien
- Lapeyronie Hospital, CHU Montpellier, and Inserm U1046, CNRS UMR 9214, Montpellier University, Montpellier, France
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ricardo J O Ferreira
- Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Health Sciences Research Unit Nursing, Higher School of Nursing of Coimbra, Coimbra, Portugal
| | - George E Fragoulis
- First Department of Internal Medicine, Propaedeutic Clinic, Athens, Greece
| | - Pat Holmes
- National Rheumatoid Arthritis Society, Maidenhead, UK
| | - Hayley McBain
- School of Health Sciences, City, University of London, London, UK
| | - George S Metsios
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall, UK.,Department of Nutrition and Dietetics, University of Thessaly, Trikala, Thessaly, Greece
| | - Rikke Helene Moe
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Departent of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Ailsa Bosworth
- National Rheumatoid Arthritis Society, Littlewick Green, UK
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O’Grady M, O’Dwyer T, Connolly J, Condell J, Esquivel KM, O’Shea FD, Gardiner P, Wilson F. Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Reliability Study in Axial Spondyloarthritis. Diagnostics (Basel) 2021; 11:diagnostics11030490. [PMID: 33801982 PMCID: PMC8001996 DOI: 10.3390/diagnostics11030490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 01/13/2023] Open
Abstract
The objectives of this study were to evaluate the reliability of wearable inertial motion unit (IMU) sensors in measuring spinal range of motion under supervised and unsupervised conditions in both laboratory and ambulatory settings. A secondary aim of the study was to evaluate the reliability of composite IMU metrology scores (IMU-ASMI (Amb)). Forty people with axSpA participated in this clinical measurement study. Participant spinal mobility was assessed by conventional metrology (Bath Ankylosing Spondylitis Metrology Index, linear version—BASMILin) and by a wireless IMU sensor-based system which measured lumbar flexion-extension, lateral flexion and rotation. Each sensor-based movement test was converted to a normalized index and used to calculate IMU-ASMI (Amb) scores. Test-retest reliability was evaluated using intra-class correlation coefficients (ICC). There was good to excellent agreement for all spinal range of movements (ICC > 0.85) and IMU-ASMI (Amb) scores (ICC > 0.87) across all conditions. Correlations between IMU-ASMI (Amb) scores and conventional metrology were strong (Pearson correlation ≥ 0.85). An IMU sensor-based system is a reliable way of measuring spinal lumbar mobility in axSpA under supervised and unsupervised conditions. While not a replacement for established clinical measures, composite IMU-ASMI (Amb) scores may be reliably used as a proxy measure of spinal mobility.
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Affiliation(s)
- Megan O’Grady
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
- Correspondence:
| | - Tom O’Dwyer
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
- Independent Researcher, D08 W9RT Dublin, Ireland
| | - James Connolly
- Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Joan Condell
- Magee Campus, Intelligent Systems Research Centre, Faculty of Computing, Engineering and the Built Environment, Ulster University, Derry/Londonderry BT48 7JL, UK; (J.C.); (K.M.E.)
| | - Karla Muñoz Esquivel
- Magee Campus, Intelligent Systems Research Centre, Faculty of Computing, Engineering and the Built Environment, Ulster University, Derry/Londonderry BT48 7JL, UK; (J.C.); (K.M.E.)
| | - Finbar D. O’Shea
- Rheumatology Department, St James’s Hospital, D08 NHY1 Dublin, Ireland;
| | - Philip Gardiner
- Western Health and Social Care Trust, Londonderry BT47 6SB, UK;
| | - Fiona Wilson
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
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Lopo C, Razak A, Maidin A, Rivai F, Mallongi A, Sesa E. Technology impact on healthcare quality of the hospital: A literature review. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Paiva JOV, Andrade RMC, de Oliveira PAM, Duarte P, Santos IS, Evangelista ALDP, Theophilo RL, de Andrade LOM, Barreto ICDHC. Mobile applications for elderly healthcare: A systematic mapping. PLoS One 2020; 15:e0236091. [PMID: 32730266 PMCID: PMC7392241 DOI: 10.1371/journal.pone.0236091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/26/2020] [Indexed: 12/31/2022] Open
Abstract
Context The increase in the population aging has brought more significant concern about how proper care will be provided to the elderly in the future. Thus, the development of technological solutions for the health domain has gained more prominence. Joining this scenario to the growing use of mobile devices for daily activities, several mobile applications focused on the elderly healthcare have been developed with healthcare and software engineer professionals involved. However, there is no survey to help both professionals to take decisions on the target of application, elderly profile, empirical validation techniques, among others. Thus, the following question arises: how have mobile applications for elderly healthcare been addressed in the literature in the past years? Objective To identify the state of the art in the literature concerned with the development of mobile applications for elderly healthcare, considering healthcare and software Engineering viewpoints. Method We performed a systematic mapping conducted by health and software engineering researchers to provide an interdisciplinary investigation of the papers that address mobile applications for elderly healthcare, summarizing the data collected under the following classification: target of application, older adult profile, spatial-temporal distribution, techniques for empirical validation and type of software engineering research. Results We found a total of 2533 papers and, after applying our eligibility criteria, we got 149. We observed aspects related to the digital health initiative type, using the classification proposed by the World Health Organization (WHO), the elderly profile prioritized by the application, the spatial-temporal distribution of the studies, the empirical validation type, and the research contribution of each analyzed paper to the software engineering area. Conclusions Regarding the WHO classification, we noticed that two categories were more frequently found, Clients and Data Services, and that none of the mobile apps were classified in the Health System Manager category. The data extraction result also reveals that most of the applications found in the literature focused on the independent elderly. Moreover, we observed that most of the studies were proposals of solutions for elderly health and the validation process of these solutions generally consisted of controlled experiments and usability evaluations. At last, the research focused on mobile applications for elderly healthcare has been performed mostly by developed countries.
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Affiliation(s)
- Joseane O. V. Paiva
- Group of Computer Networks, Software Engineering and Systems (GREat), Federal University of Ceará (UFC), Fortaleza, Brazil
- * E-mail:
| | - Rossana M. C. Andrade
- Group of Computer Networks, Software Engineering and Systems (GREat), Federal University of Ceará (UFC), Fortaleza, Brazil
| | - Pedro Almir M. de Oliveira
- Group of Computer Networks, Software Engineering and Systems (GREat), Federal University of Ceará (UFC), Fortaleza, Brazil
| | - Paulo Duarte
- Group of Computer Networks, Software Engineering and Systems (GREat), Federal University of Ceará (UFC), Fortaleza, Brazil
| | - Ismayle S. Santos
- Group of Computer Networks, Software Engineering and Systems (GREat), Federal University of Ceará (UFC), Fortaleza, Brazil
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Salgado T, Tavares J, Oliveira T. Drivers of Mobile Health Acceptance and Use From the Patient Perspective: Survey Study and Quantitative Model Development. JMIR Mhealth Uhealth 2020; 8:e17588. [PMID: 32673249 PMCID: PMC7380904 DOI: 10.2196/17588] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) has potential to play a significant role in realizing a reversal of the current paradigm in health care toward a more patient-centric and more collaborative system to improve the outcomes obtained along with the quality and sustainability of health care systems. Objective The aim of this study was to explore and understand individual mHealth acceptance drivers between two groups of users: those with chronic health conditions and those without. Methods The extended unified theory of acceptance and usage of technology (UTAUT2) was enhanced with a new health-related framework: behavior intention to recommend and new mediation effects. We applied partial least squares (PLS) causal modeling to test the research model. Results We obtained 322 valid responses through an online questionnaire. The drivers of behavior intention with statistical significance were performance expectancy (β=.29, P<.001), habit (β=.39, P<.001), and personal empowerment (β=.18, P=.01). The precursors of use behavior were habit (β= .47, P<.001) and personal empowerment (β=.17, P=.01). Behavior intention to recommend was significantly influenced by behavior intention (β=.58, P<.001) and personal empowerment (β=.26, P<.001). The model explained 66% of the total variance in behavior intention, 54% of the variance in use behavior, and 70% of the variance in behavior intention to recommend. Conclusions Our study demonstrates a significant role of personal empowerment, as a second-order construct, in the mHealth acceptance context. The presence of a chronic health condition predicates an impact on acceptance of this technology.
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Affiliation(s)
- Tânia Salgado
- NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Jorge Tavares
- NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Tiago Oliveira
- NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
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11
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How Do Smart Device Apps for Diabetes Self-Management Correspond with Theoretical Indicators of Empowerment? An Analysis of App Features. Int J Technol Assess Health Care 2019; 35:150-159. [PMID: 31017563 DOI: 10.1017/s0266462319000163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Smart device apps for diabetes have the potential to support patients in their daily disease management. However, uncertainty exists regarding their suitability for empowering patients to improve self-management behaviors. This paper addresses a general research gap regarding theoretically based examinations of empowerment in diabetes research, by examining how diabetes app features correspond with conceptual indicators of empowerment. METHODS We examined features of 121 apps for diabetes self-management available in Singapore, with the second highest proportion of diabetes among developed nations, for psychological empowerment (feeling of empowerment) and for behavioral empowerment (social support). RESULTS Diabetes apps studied offered a narrow range of features, with limited feature-sets corresponding to indicators of empowerment. Customization as a strategy to improve perceived relevance of diabetes self-management as an indicator of psychological empowerment was especially limited. Moreover, there was a lack of features supporting patients' communication with healthcare professionals and within their private social networks. CONCLUSIONS Mobile apps for diabetes self-management failed to provide relevant features for empowering patients. Specific practical recommendations target improved adoption, sustained usage, and effectiveness of diabetes self-management apps.
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Bol N, Høie NM, Nguyen MH, Smit ES. Customization in mobile health apps: explaining effects on physical activity intentions by the need for autonomy. Digit Health 2019; 5:2055207619888074. [PMID: 31807312 PMCID: PMC6880050 DOI: 10.1177/2055207619888074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/22/2019] [Indexed: 11/30/2022] Open
Abstract
Given the widespread adoption and technical possibilities of mobile technology,
mobile health apps could be potentially effective tools to intervene in people’s
daily routines and stimulate physical activity. Self-determination theory and
the motivational technology model both suggest that mobile technology can
promote health behaviour change by allowing users to customize their online
experience when using mobile health apps. However, we know very little about why
and for whom customization is most effective. Using a between-subjects
experimental design, we tested the effects of customization in mobile health
apps among a convenience sample (N = 203). We assessed the
effects of customization on perceived active control over mobile health apps,
autonomous motivation to use mobile health apps, and intention to engage in
physical activity, and tested the moderating role of need for autonomy.
Structural equation modelling showed that customization in mobile health apps
does not increase perceived active control, autonomous motivation, or the
intention to engage in physical activity. However, an interaction effect between
customization and need for autonomy showed that customization in mobile health
apps leads to higher intentions to engage in physical activity for those with a
greater need for autonomy, but not for those with a lesser need for autonomy.
The implications for theory and practice are discussed.
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Affiliation(s)
- Nadine Bol
- Department of Communication and Cognition, Tilburg University,
the Netherlands
- Amsterdam School of Communication Research (ASCoR), University
of Amsterdam, the Netherlands
- Nadine Bol, Department of Communication and
Cognition, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, the
Netherlands.
| | - Nina Margareta Høie
- Amsterdam School of Communication Research (ASCoR), University
of Amsterdam, the Netherlands
| | - Minh Hao Nguyen
- Amsterdam School of Communication Research (ASCoR), University
of Amsterdam, the Netherlands
- Department of Communication and Media Research (IKMZ),
University of Zurich, Switzerland
| | - Eline Suzanne Smit
- Amsterdam School of Communication Research (ASCoR), University
of Amsterdam, the Netherlands
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Najm A, Nikiphorou E, Kostine M, Richez C, Pauling JD, Finckh A, Ritschl V, Prior Y, Balážová P, Stones S, Szekanecz Z, Iagnocco A, Ramiro S, Sivera F, Dougados M, Carmona L, Burmester G, Wiek D, Gossec L, Berenbaum F. EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases. RMD Open 2019; 5:e001014. [PMID: 31565245 PMCID: PMC6744072 DOI: 10.1136/rmdopen-2019-001014] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/24/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022] Open
Abstract
Background Mobile health applications (apps) are available to enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health. However, guidance on the development and evaluation of such apps is lacking. Objectives The objective of this EULAR task force was to establish points to consider (PtC) for the development, evaluation and implementation of apps for self-management of RMDs. Methods A systematic literature review of app content and development strategies was conducted, followed by patient focus group and an online survey. Based on this information and along with task force expert opinion, PtC were formulated in a face-to-face meeting by a multidisciplinary task force panel of experts, including two patient research partners. The level of agreement among the panel in regard to each PtC was established by anonymous online voting. Results Three overarching principles and 10 PtC were formulated. Three PtC are related to patient safety, considered as a critical issue by the panel. Three are related to relevance of the content and functionalities. The requirement for transparency around app development and funding sources, along with involvement of relevant health professionals, were also raised. Ease of app access across ages and abilities was highlighted, in addition to considering the cost benefit of apps from the outset. The level of agreement was from 8.8 to 9.9 out of 10. Conclusion These EULAR PtC provide guidance on important aspects that should be considered for the development, evaluation and implementation of existing and new apps.
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Affiliation(s)
- Aurélie Najm
- Rheumatology Department, University Hospital Centre Nantes, Nantes, France
- INSERM UMR 1238, Universite de Nantes Ecole Doctorale Biologie-Sante, Nantes, France
| | - Elena Nikiphorou
- Department of Inflammation Biology, King's College London Academic, London, UK
| | - Marie Kostine
- Rheumatology Department, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France
| | - Christophe Richez
- Rheumatology Department, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France
| | - John D Pauling
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital Bath NHS Trust, Bath, UK
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Axel Finckh
- Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
| | - Valentin Ritschl
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Wien, Austria
- Division of Occupational Therapy, University of Applied Sciences, FH Campus Wien, Wien, Austria
| | - Yeliz Prior
- Centre for Health Sciences Research, University of Salford, Salford, UK
- Mid Cheshire NHS Foundation Trust Hospitals, Crewe, UK
| | - Petra Balážová
- EULAR Young PARE, Zurich, Switzerland
- Slovak League Against Rheumatism, Piestany, Slovakia
| | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, UK
| | - Zoltan Szekanecz
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Università degli Studi di Torino, Torino, Italy
| | - Sofia Ramiro
- Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Francisca Sivera
- Rheumatology, Hospital General Universitario de Elda, Elda, Spain
| | - Maxime Dougados
- Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France
| | | | - Gerd Burmester
- Rheumatology, Charité - University Medicine Berlin, Berlin, Germany
| | | | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM UMR S1136, Sorbonne Universite, Paris, France
- APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Francis Berenbaum
- Rheumatology Department, AP-HP, Hopital Saint-Antoine, Paris, France
- INSERM CRSA, Sorbonne Université, Paris, France
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Ali H, Li H. Evaluating a smartwatch notification system in a simulated nursing home. Int J Older People Nurs 2019; 14:e12241. [PMID: 31099184 DOI: 10.1111/opn.12241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/05/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
AIMS This paper evaluates a high-fidelity prototype of a smartwatch-based communication system for nursing homes. The system could improve communication between residents and caregivers, thus reducing staff response time and improving residents' safety. BACKGROUND Across the country, nursing homes are often cited as having serious quality and safety issues. Deficiencies in the communication systems that connect residents with caregivers significantly impact the quality of care. Most nursing homes still use traditional call light systems, that give visual and auditory cues to caregivers, who may or may not be in proximity to the system. This study evaluates a smartwatch communication system developed to quickly relay a resident's requests for assistance to staff anywhere in the nursing home. METHOD Certified Nursing Assistants (CNAs) employed by nursing homes were recruited to perform routine tasks using both a traditional system and a smart system. Response time to call lights, staff performance and outcomes were measured through direct and recorded observations and through the surveys of participants. RESULTS The smartwatch system reduced staff response time to call lights from bedrooms by 40%, from bathrooms by 58% and from bed exit alarms by 29%. The smartwatch system also reduced perceived workload by about 50% and was highly accepted by the CNAs. CONCLUSION A smartwatch-based notification system may increase staff performance and decrease workload, thus leading to greater staff and patient satisfaction, which could ultimately lead to better quality of care and patient safety. RELEVANCE TO CLINICAL PRACTICE This study provides empirical evidence for the usefulness of smartwatches in facilitating the notification and communication processes in healthcare settings and is also among the first to actually examine a smartwatch system in a healthcare setting.
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Affiliation(s)
| | - Huiyang Li
- State University of New York at Binghamton, Binghamton, New York
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15
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The Effects of Dietary Mobile Apps on Nutritional Outcomes in Adults with Chronic Diseases: A Systematic Review and Meta-Analysis. J Acad Nutr Diet 2019; 119:626-651. [DOI: 10.1016/j.jand.2018.11.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 11/12/2018] [Indexed: 01/19/2023]
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17
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Wu Y, Yao X, Vespasiani G, Nicolucci A, Dong Y, Kwong J, Li L, Sun X, Tian H, Li S. Mobile App-Based Interventions to Support Diabetes Self-Management: A Systematic Review of Randomized Controlled Trials to Identify Functions Associated with Glycemic Efficacy. JMIR Mhealth Uhealth 2017; 5:e35. [PMID: 28292740 PMCID: PMC5373677 DOI: 10.2196/mhealth.6522] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/20/2016] [Accepted: 02/25/2017] [Indexed: 02/05/2023] Open
Abstract
Background Mobile health apps for diabetes self-management have different functions. However, the efficacy and safety of each function are not well studied, and no classification is available for these functions. Objective The aims of this study were to (1) develop and validate a taxonomy of apps for diabetes self-management, (2) investigate the glycemic efficacy of mobile app-based interventions among adults with diabetes in a systematic review of randomized controlled trials (RCTs), and (3) explore the contribution of different function to the effectiveness of entire app-based interventions using the taxonomy. Methods We developed a 3-axis taxonomy with columns of clinical modules, rows of functional modules and cells of functions with risk assessments. This taxonomy was validated by reviewing and classifying commercially available diabetes apps. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Chinese Biomedical Literature Database, and ClinicalTrials.gov from January 2007 to May 2016. We included RCTs of adult outpatients with diabetes that compared using mobile app-based interventions with usual care alone. The mean differences (MDs) in hemoglobin A1c (HbA1c) concentrations and risk ratios of adverse events were pooled using a random-effects meta-analysis. After taxonomic classification, we performed exploratory subgroup analyses of the presence or absence of each module across the included app-based interventions. Results Across 12 included trials involving 974 participants, using app-based interventions was associated with a clinically significant reduction of HbA1c (MD 0.48%, 95% CI 0.19%-0.78%) without excess adverse events. Larger HbA1c reductions were noted among patients with type 2 diabetes than those with type 1 diabetes (MD 0.67%, 95% CI 0.30%-1.03% vs MD 0.37%, 95% CI –0.12%-0.86%). Having a complication prevention module in app-based interventions was associated with a greater HbA1c reduction (with complication prevention: MD 1.31%, 95% CI 0.66%-1.96% vs without: MD 0.38%, 95% CI 0.09%-0.67%; intersubgroup P=.01), as was having a structured display (with structured display: MD 0.69%, 95% CI 0.32%-1.06% vs without: MD 0.69%, 95% CI –0.18%-0.53%; intersubgroup P=.03). However, having a clinical decision-making function was not associated with a larger HbA1c reduction (with clinical decision making: MD 0.19%, 95% CI –0.24%-0.63% vs without: MD 0.61%, 95% CI 0.27%-0.95%; intersubgroup P=.14). Conclusions The use of mobile app-based interventions yields a clinically significant HbA1c reduction among adult outpatients with diabetes, especially among those with type 2 diabetes. Our study suggests that the clinical decision-making function needs further improvement and evaluation before being added to apps.
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Affiliation(s)
- Yuan Wu
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Xun Yao
- Department of Academic Affairs, West China School of Medicine, Sichuan University, Chengdu, China
| | - Giacomo Vespasiani
- Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto (AP), Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Yajie Dong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Joey Kwong
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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There’s No App for That: Assessing the Impact of mHealth on the Supervision, Motivation, Engagement, and Satisfaction of Community Health Workers in Sierra Leone. Ann Glob Health 2017; 82:936-949. [DOI: 10.1016/j.aogh.2016.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Cohen DJ, Keller SR, Hayes GR, Dorr DA, Ash JS, Sittig DF. Integrating Patient-Generated Health Data Into Clinical Care Settings or Clinical Decision-Making: Lessons Learned From Project HealthDesign. JMIR Hum Factors 2016; 3:e26. [PMID: 27760726 PMCID: PMC5093296 DOI: 10.2196/humanfactors.5919] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/02/2016] [Accepted: 09/10/2016] [Indexed: 02/07/2023] Open
Abstract
Background Patient-generated health data (PGHD) are health-related data created or recorded by patients to inform their self-care and understanding about their own health. PGHD is different from other patient-reported outcome data because the collection of data is patient-driven, not practice- or research-driven. Technical applications for assisting patients to collect PGHD supports self-management activities such as healthy eating and exercise and can be important for preventing and managing disease. Technological innovations (eg, activity trackers) are making it more common for people to collect PGHD, but little is known about how PGHD might be used in outpatient clinics. Objective The objective of our study was to examine the experiences of health care professionals who use PGHD in outpatient clinics. Methods We conducted an evaluation of Project HealthDesign Round 2 to synthesize findings from 5 studies funded to test tools designed to help patients collect PGHD and share these data with members of their health care team. We conducted semistructured interviews with 13 Project HealthDesign study team members and 12 health care professionals that participated in these studies. We used an immersion-crystallization approach to analyze data. Our findings provide important information related to health care professionals’ attitudes toward and experiences with using PGHD in a clinical setting. Results Health care professionals identified 3 main benefits of PGHD accessibility in clinical settings: (1) deeper insight into a patient’s condition; (2) more accurate patient information, particularly when of clinical relevance; and (3) insight into a patient’s health between clinic visits, enabling revision of care plans for improved health goal achievement, while avoiding unnecessary clinic visits. Study participants also identified 3 areas of consideration when implementing collection and use of PGHD data in clinics: (1) developing practice workflows and protocols related to PGHD collection and use; (2) data storage, accessibility at the point of care, and privacy concerns; and (3) ease of using PGHD data. Conclusions PGHD provides value to both patients and health care professionals. However, more research is needed to understand the benefit of using PGHD in clinical care and to identify the strategies and clinic workflow needs for optimizing these tools.
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Affiliation(s)
- Deborah J Cohen
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, United States.
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Molina Recio G, García-Hernández L, Molina Luque R, Salas-Morera L. The role of interdisciplinary research team in the impact of health apps in health and computer science publications: a systematic review. Biomed Eng Online 2016; 15 Suppl 1:77. [PMID: 27454164 PMCID: PMC4959385 DOI: 10.1186/s12938-016-0185-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Several studies have estimated the potential economic and social impact of the mHealth development. Considering the latest study by Institute for Healthcare Informatics, more than 165.000 apps of health and medicine are offered including all the stores from different platforms. Thus, the global mHealth market was an estimated $10.5 billion in 2014 and is expected to grow 33.5 percent annually between 2015 and 2020s. In fact, apps of Health have become the third-fastest growing category, only after games and utilities. METHODS This study aims to identify, study and evaluate the role of interdisciplinary research teams in the development of articles and applications in the field of mHealth. It also aims to evaluate the impact that the development of mHealth has had on the health and computer science field, through the study of publications in specific databases for each area which have been published until nowadays. RESULTS Interdisciplinary nature is strongly connected to the scientific quality of the journal in which the work is published. This way, there are significant differences in those works that are made up by an interdisciplinary research team because of they achieve to publish in journals with higher quartiles. There are already studies that warn of methodological deficits in some studies in mHealth, low accuracy and no reproducibility. Studies of low precision and poor reproducibility, coupled with the low evidence, provide low degrees of recommendation of the interventions targeted and therefore low applicability. CONCLUSIONS From the evidence of this study, working in interdisciplinary groups from different areas greatly enhances the quality of research work as well as the quality of the publications derived from its results.
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Bulaj G, Ahern MM, Kuhn A, Judkins ZS, Bowen RC, Chen Y. Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases. CURRENT CLINICAL PHARMACOLOGY 2016; 11:128-45. [PMID: 27262323 PMCID: PMC5011401 DOI: 10.2174/1574884711666160603012237] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 02/08/2023]
Abstract
Merging pharmaceutical and digital (mobile health, mHealth) ingredients to create new therapies for chronic diseases offers unique opportunities for natural products such as omega-3 polyunsaturated fatty acids (n-3 PUFA), curcumin, resveratrol, theanine, or α-lipoic acid. These compounds, when combined with pharmaceutical drugs, show improved efficacy and safety in preclinical and clinical studies of epilepsy, neuropathic pain, osteoarthritis, depression, schizophrenia, diabetes and cancer. Their additional clinical benefits include reducing levels of TNFα and other inflammatory cytokines. We describe how pleiotropic natural products can be developed as bioactive incentives within the network pharmacology together with pharmaceutical drugs and self-care interventions. Since approximately 50% of chronically-ill patients do not take pharmaceutical drugs as prescribed, psychobehavioral incentives may appeal to patients at risk for medication non-adherence. For epilepsy, the incentive-based network therapy comprises anticonvulsant drugs, antiseizure natural products (n-3 PUFA, curcumin or/and resveratrol) coupled with disease-specific behavioral interventions delivered by mobile medical apps. The add-on combination of antiseizure natural products and mHealth supports patient empowerment and intrinsic motivation by having a choice in self-care behaviors. The incentivized therapies offer opportunities: (1) to improve clinical efficacy and safety of existing drugs, (2) to catalyze patient-centered, disease self-management and behavior-changing habits, also improving health-related quality-of-life after reaching remission, and (3) merging copyrighted mHealth software with natural products, thus establishing an intellectual property protection of medical treatments comprising the natural products existing in public domain and currently promoted as dietary supplements. Taken together, clinical research on synergies between existing drugs and pleiotropic natural products, and their integration with self-care, music and mHealth, expands precision/personalized medicine strategies for chronic diseases via pharmacological-behavioral combination therapies.
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Affiliation(s)
- Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, Skaggs Pharmacy Institute, University of Utah, 30 South 2000 East, Salt Lake City, Utah 84112, USA.
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