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Alzamanan MZ, Lim KS, Ismail MA, Ghani NA. Development of an epilepsy self-management mobile health app framework: Content validity study results. PLoS One 2024; 19:e0302844. [PMID: 38848353 PMCID: PMC11161114 DOI: 10.1371/journal.pone.0302844] [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: 12/17/2023] [Accepted: 04/14/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) applications (apps) show promise in supporting epilepsy self-management (eSM). To delve deeper into this potential, we conducted a systematic review of epilepsy mHealth apps available on both iOS and Android platforms, examining articles related to eSM. This review allowed us to identify important domains related to eSM. Furthermore, based on the findings, we developed an epilepsy mHealth app framework that aims to improve self-management for the local population. This study aims to assess the practicality and usability of the proposed mHealth app framework designed to improve eSM. We will conduct an expert panel review to evaluate the effectiveness and feasibility of the framework. MATERIAL AND METHODS Content validity was assessed by an expert panel comprising epileptologists and pharmacists. The validation process involved scoring the items within each domain of the framework to evaluate their practicality and usability (quantitative component). In addition, a panel discussion was conducted to further explore and discuss the qualitative aspects of the items. RESULTS A total of 4 domains with 15 items were highly rated for their practicality and usefulness in eSM. CONCLUSIONS The locally validated framework will be useful for developing eSM mobile apps. Seizure Tracking, Medication Adherence, Treatment Management, and Healthcare Communication emerged as the most crucial domains for enhancing eSM.
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Affiliation(s)
| | - Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maizatul Akmar Ismail
- Department of Information Systems, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Norjihan Abdul Ghani
- Department of Information Systems, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
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Ernawati I, Yasin NM, Setyopranoto I, Ikawati Z. Effect of Mobile Health Applications on Improving Self-Management Knowledge and Seizure Control in Epilepsy Patients: A Scoping Review. Healthc Inform Res 2024; 30:127-139. [PMID: 38755103 PMCID: PMC11098771 DOI: 10.4258/hir.2024.30.2.127] [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: 12/16/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES Mobile health app-based interventions are increasingly being developed to support chronic disease management, particularly for epilepsy patients. These interventions focus on managing stress, monitoring drug side effects, providing education, and promoting adherence to medication regimens. Therefore, this scoping review aims to assess how mobile health applications improve epilepsy patients' knowledge and seizure control, and to identify the features of these apps that are frequently used and have proven to be beneficial. METHODS This scoping review was conducted using scientific databases such as ScienceDirect, PubMed, and Google Scholar, adhering to the Joanna Briggs Institute guidelines. The review framework consisted of five steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. The literature search included all original articles published in English from 2013 to 2023. RESULTS Among six articles that discussed mobile applications for epilepsy patients, all featured similar functionalities, including education on epilepsy management and seizure monitoring. Four of the articles highlighted behavioral interventions, such as reminder systems, designed to improve medication adherence. The remaining two articles focused on a side-effect reporting system that enabled doctors or health workers to evaluate and regularly monitor adverse effects. CONCLUSIONS This scoping review reveals that mobile health applications employing a combination of educational and behavioral interventions for epilepsy patients significantly improve knowledge about patient self-management and medication adherence. These interventions can prevent seizures, increase awareness, enable better activity planning, improve safety, and reduce the frequency of seizures and side effects of antiepileptic drugs.
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Affiliation(s)
- Iin Ernawati
- Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta,
Indonesia
- Akademi Farmasi Surabaya, Surabaya,
Indonesia
| | - Nanang Munif Yasin
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta,
Indonesia
| | - Ismail Setyopranoto
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta,
Indonesia
| | - Zullies Ikawati
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta,
Indonesia
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Lazaro MJ, Alvaran A, Yun MH, Kim S. Mobile Health Application for Seizure Management: A Human-Systems Integration Approach. HUMAN FACTORS 2024; 66:744-769. [PMID: 35337190 DOI: 10.1177/00187208221074427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The study aims to develop a mHealth application for seizure management based on the human system integration (HSI) approach. BACKGROUND Unmet healthcare needs among people with epilepsy continue to exist despite the advancement in healthcare technology. Current seizure management methods are found to be ineffective. Therefore, a more efficient strategy such as mHealth technology is necessary to aid seizure management. METHOD The needs identification phase involved identifying the user requirements by interviewing 10 stakeholders and conducting thematic analysis and needs interpretation technique. In the solution identification phase, the system requirements were derived using various human-centered design and systems engineering approaches and were evaluated through quality function deployment to determine design targets. For the design and evaluation phase, the design targets were reflected in the app through the iterative prototyping process, and the interface and functional design were evaluated by seven human factors and ergonomics experts and four stakeholders, respectively. RESULTS Three primary needs and ten user requirements were derived from the needs identification phase. Ten out of fifteen system requirements were selected as design targets to be included in the final prototype. Results of the evaluation showed that the interface design of the proposed app showed superior usability compared to a competitor app and that the app functions were beneficial for the stakeholders. CONCLUSION The mHealth app designed through the HSI framework showed good potential in addressing the main issues in seizure management. APPLICATION The mHealth app design methodology based on the HSI approach can be applied to the design of small-scale systems in various domains.
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Affiliation(s)
- May Jorella Lazaro
- Interdisciplinary Program in Cognitive Science, Seoul National University, South Korea
| | | | - Myung Hwan Yun
- Department of Industrial Engineering & Institute for Industrial System Innovation, Seoul National University, Seoul, Korea
| | - Sungho Kim
- Department of Systems Engineering, Republic of Korea Air Force Academy, South Korea
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Panjasriprakarn P, Treesuthacheep P, Surawattanawong T, Limotai C. Development and validation of the Thai version of the Adult Epilepsy Self-Management Scale (Thai-ESMS). Epilepsy Behav 2023; 141:109155. [PMID: 36871318 DOI: 10.1016/j.yebeh.2023.109155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Self-management is an important strategy for helping people with epilepsy (PWE) control their seizures and improve their quality of life. To date, there are scarce standard measurement tools for assessing self-management practices. This study aimed to develop and validate a Thai version of the Epilepsy Self-Management Scale (Thai-ESMS) for Thai people with epilepsy. METHODS The translation of the Thai-ESMS was created using the adaptation of Brislin's translation model. Content validity of the developed Thai-ESMS was independently assessed by 6 neurology experts and reported as item content validity index (I-CVI) and scale-CVI (S-CVI). We consecutively invited epilepsy patients at our outpatient epilepsy clinic to participate in the study from November to December 2021. Participants were asked to complete our 38-item Thai-ESMS. Based on the participant's responses, construct validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha coefficient was employed to evaluate internal consistency reliability. RESULTS Overall, our 38-item Thai ESMS scale showed high content validity (S-CVI = 0.89), assessed by neurology experts. Responses from 216 patients were then used for the assessment of construct validity and internal consistency. The results showed good construct validity of 5 domains (5 factors with Eigenvalue > 1 upon EFA and good fitness index upon CFA) meaning that the developed scale is an adequate measure of the concept it was designed to evaluate and had good internal consistency (Cronbach's alpha 0.819), which both values were comparable to the original English version. However, some items or domains had poorer validity and reliability than the overall scale. CONCLUSIONS We developed a robust 38-item Thai ESMS with high validity and good reliability to be used to help assess the magnitude of self-management skills in Thai PWE. However, more work on this measure is needed before distribution to a wider population.
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Affiliation(s)
- Poonnakarn Panjasriprakarn
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Peerasit Treesuthacheep
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Chulalongkorn Comprehensive Epilepsy Center of Excellence (CCEC), King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Totsapol Surawattanawong
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Chulalongkorn Comprehensive Epilepsy Center of Excellence (CCEC), King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Chusak Limotai
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Chulalongkorn Comprehensive Epilepsy Center of Excellence (CCEC), King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
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Kharaman-nia F, Rezaei H, Roustaei N, Etemadfar P, Hosseini N. Comparing the effects of self- care education by lecture and smartphone application on self-efficacy of patients with thalassemia. BMC Med Inform Decis Mak 2023; 23:21. [PMID: 36717912 PMCID: PMC9885911 DOI: 10.1186/s12911-023-02097-4] [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: 07/01/2022] [Accepted: 01/02/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Patients with the thalassemia have a basic requirement for self-efficacy regarding their treatment procedure. The present study aimed to compare the effect of self-care education via a smartphone application and lectures on the self-efficacy of patients with thalassemia. METHODS In the present quasi-experimental study, 99 patients with thalassemia at Shahid Beheshti Hospital in Yasuj, Iran, in 2019 who were eligible to enter the study, were selected. The block randomization was done with the block sizes of 3, 6, and 9, and participants were randomly assigned to 3 groups: smartphone application (A), lecture intervention (B), and control (c). Smartphone application and lecture interventions were performed for intervention groups A and B, respectively, during 8 weeks. Scherer's self-efficacy measure was used to collect the data at baseline and eight weeks after the intervention. Data were analyzed by SPSS-version 25 software using Paired t-test, Wilcoxon and Kruskal-Wallis tests. RESULTS Ninety-nine patients with thalassemia with a mean (SD) age of 25 (6) and 58 females (58.59%) participated in the present study. The results indicated a significant difference in self-efficacy among 3 groups after intervention (P = 0.001). However, self-care education with smartphone application revealed a significant increase in the mean (SD) of self-efficacy of the patients with thalassemia 68.36(8.45) compared to the lecture method 62.55 (7.3) (P = 0.003) and control 62.09 (6.7) (P = 0.001). There were no significant differences among the self-efficacy scores of the patients in lecture intervention and control groups. CONCLUSIONS The results revealed that smartphone application was a suitable educational software to promote self-efficacy in patients with thalassemia. It is recommended to use smartphone application methods to improve the self-efficacy levels of patients with thalassemia.
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Affiliation(s)
- Fahimeh Kharaman-nia
- grid.413020.40000 0004 0384 8939Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Habibolah Rezaei
- grid.413020.40000 0004 0384 8939Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Narges Roustaei
- grid.413020.40000 0004 0384 8939Department of Biostatistics and Epidemiology, School of Health and Nutrition Sciences, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Peyman Etemadfar
- grid.413020.40000 0004 0384 8939Department of Pediatrics, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Nazafarin Hosseini
- grid.413020.40000 0004 0384 8939Department of Nursing, School of Nursing, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, 759195436 Iran
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Esmaeili B, Vieluf S, Dworetzky BA, Reinsberger C. The Potential of Wearable Devices and Mobile Health Applications in the Evaluation and Treatment of Epilepsy. Neurol Clin 2022; 40:729-739. [DOI: 10.1016/j.ncl.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lavin B, Gray CL, Brodie M. Telemedicine and Epilepsy Care. Neurol Clin 2022; 40:717-727. [DOI: 10.1016/j.ncl.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
The development of mobile health for epilepsy has grown in the last years, bringing new applications (apps) to the market and improving already existing ones. In this systematic review, we analyse the scope of mobile apps for seizure detection and epilepsy self-management, with two research questions in mind: what are the characteristics of current solutions and do they meet users’ requirements? What should be considered when designing mobile health for epilepsy? We used PRISMA methodology to search within App Store and Google Play Store from February to April of 2021, reaching 55 potential apps. A more thorough analysis regarding particular features was performed on 26 of those apps. The content of these apps was evaluated in five categories, regarding if there was personalisable content; features related to medication management; what aspects of seizure log were present; what type of communication prevailed; and if there was any content related to seizure alarm or seizure action plans. Moreover, the 26 apps were evaluated through using MARS by six raters, including two neurologists. The analysis of MARS categories was performed for the top and bottom apps, to understand the core differences. Overall, the lowest MARS scores were related to engagement and information, which play a big part in long-term use, and previous studies raised the concern of assuring continuous use, especially in younger audiences. With that in mind, we identified conceptual improvement points, which were divided in three main topics: customisation, simplicity and healthcare connection. Moreover, we summarised some ideas to improve m-health apps catered around long-term adherence. We hope this work contributes to a better understanding of the current scope in mobile epilepsy management, endorsing healthcare professionals and developers to provide off-the-shelf solutions that engage patients and allows them to better manage their condition.
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Samanta D, Elumalai V, Hoyt ML, Modi AC, Sajatovic M. A qualitative study of epilepsy self-management barriers and facilitators in Black children and caregivers in Arkansas. Epilepsy Behav 2022; 126:108491. [PMID: 34929473 PMCID: PMC8764703 DOI: 10.1016/j.yebeh.2021.108491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To identify facilitators and barriers of epilepsy self-management practices among Black children and caregivers. METHODS Qualitative semi-structured in-depth interviews were conducted with 11 child-caregiver dyads (11 children with epilepsy and 11 caregivers). A deductive-inductive analysis was undertaken to describe the range of barriers and facilitators significant to participants. RESULTS The barriers and facilitators were classified into 3 management themes: epilepsy-specific knowledge and information, treatment, and lifestyle. Within these themes, several important subthemes were identified. Two subthemes related to knowledge barriers emerged: children and caregivers' limited understanding and retention of complex written and spoken information and variable training and confidence in seizure first-aid. In contrast, facilitators for introducing and encouraging access to epilepsy self-management concepts were participants' eagerness to learn about this topic and a keen interest in using educational materials enriched with visual aids on a phone platform as an adjunct to in-person education. The second theme revealed various practical barriers to optimum treatment adherence, including mistrust of the healthcare system. In comparison, caregivers' collaborative approach and innovative strategies were identified as facilitators for treatment adherence. Finally, the lifestyle management barriers included a lack of defined processes to adopt healthy behaviors and challenges with disclosing epilepsy. Facilitators of this theme were comprised of building a team around the child to foster wellbeing and making healthy habits a fun and joyful experience for children. DISCUSSION Qualitative evidence in this study highlights caregivers' mistrust in the healthcare system and the lack of community support. Culturally competent interventions may improve access to and quality and utilization of self-management programs in Black children and families while reducing disparities.
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Affiliation(s)
- Debopam Samanta
- Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Vimala Elumalai
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Megan Leigh Hoyt
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Avani C. Modi
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio,Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio
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