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Peñate GP, Parra NO, Morera JAD, Meñaca AM, Ramón ML, Menéndez SC, Marrero FL, de la Cal SG, Ghadban-Garrido C, Tolosana PR, Puentes JM, Aguayo RA, Mahdavi H, Jeanneret GB, Subías PE. Assessing the clinical benefit, safety, and patient-reported outcomes with the use of the PAHcare™ digital platform in pulmonary arterial hypertension: a pilot study. Front Public Health 2024; 12:1335072. [PMID: 38435295 PMCID: PMC10904626 DOI: 10.3389/fpubh.2024.1335072] [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: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Digital health interventions, particularly mobile health platforms, have shown promise in supporting patients with respiratory conditions, but their application in pulmonary arterial hypertension (PAH) remains limited. We aimed to assess the feasibility, acceptability, and potential clinical benefit of the novel PAHcare™ digital platform as a patient-centred intervention for PAH management through a prospective, single-arm, multicenter pilot study conducted on 53 patients diagnosed with PAH who used the platform for 6 months. Methods The primary objective was to assess the impact on Health-Related Quality of Life (HRQoL) through questionnaires. Secondary objectives included evaluating clinical outcomes, including disease progression, PAH signs and symptoms, the 6-min walking test, and the patient's symptom perception. Additionally, we assessed patient satisfaction and engagement with the PAHcare™ platform, interaction with health coaches, retention, costs and healthcare resource utilisation (HCRU), and safety through monitoring device incidents. Results Minimal changes in HRQoL and clinical outcomes were observed over 6 months. A noteworthy 92.4% of patients actively used the platform in the first month, maintaining high usage throughout the study. Patient satisfaction was substantial, with more than half of the patients expressing excellence in service quality, willingness to reuse the platform, and fulfilment of their needs. Health coach interaction was high, with 76% of patients initiating contact within the first week. User retention rates were 70%, with prevalent ongoing usage and interaction with healthcare professionals even after the study. In terms of HCRU and costs, the study showed no significant changes in PAH-related hospital admissions, clinical visits, or tests. Finally, the low number of device-related incidents indicated platform safety. Conclusion This pilot study provides compelling evidence supporting the feasibility and acceptability of the PAHcare™ digital platform to empower patients to manage their disease and significantly enhance their overall experience with PAH.
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Affiliation(s)
- Gregorio Pérez Peñate
- Unidad Multidisciplinar Vascular Pulmonar, Servicio de Neumología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Ochoa Parra
- Unidad Multidisciplinar de Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain
| | | | - Amaya Martínez Meñaca
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Marta López Ramón
- Servicios de Neumología y Cardiología, Unidad de Hipertensión Pulmonar, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Fernando León Marrero
- Unidad Multidisciplinar Vascular Pulmonar, Servicio de Neumología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Cristina Ghadban-Garrido
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | | | - Javier Martín Puentes
- Servicios de Neumología y Cardiología, Unidad de Hipertensión Pulmonar, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Hadis Mahdavi
- Digital Health & Technology, Ferrer, Barcelona, Spain
| | | | - Pilar Escribano Subías
- Unidad Multidisciplinar de Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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Pereira AM, Jácome C, Jacinto T, Amaral R, Pereira M, Sá-Sousa A, Couto M, Vieira-Marques P, Martinho D, Vieira A, Almeida A, Martins C, Marreiros G, Freitas A, Almeida R, Fonseca JA. Multidisciplinary Development and Initial Validation of a Clinical Knowledge Base on Chronic Respiratory Diseases for mHealth Decision Support Systems. J Med Internet Res 2023; 25:e45364. [PMID: 38090790 PMCID: PMC10753423 DOI: 10.2196/45364] [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: 12/27/2022] [Revised: 04/25/2023] [Accepted: 10/11/2023] [Indexed: 12/18/2023] Open
Abstract
Most mobile health (mHealth) decision support systems currently available for chronic obstructive respiratory diseases (CORDs) are not supported by clinical evidence or lack clinical validation. The development of the knowledge base that will feed the clinical decision support system is a crucial step that involves the collection and systematization of clinical knowledge from relevant scientific sources and its representation in a human-understandable and computer-interpretable way. This work describes the development and initial validation of a clinical knowledge base that can be integrated into mHealth decision support systems developed for patients with CORDs. A multidisciplinary team of health care professionals with clinical experience in respiratory diseases, together with data science and IT professionals, defined a new framework that can be used in other evidence-based systems. The knowledge base development began with a thorough review of the relevant scientific sources (eg, disease guidelines) to identify the recommendations to be implemented in the decision support system based on a consensus process. Recommendations were selected according to predefined inclusion criteria: (1) applicable to individuals with CORDs or to prevent CORDs, (2) directed toward patient self-management, (3) targeting adults, and (4) within the scope of the knowledge domains and subdomains defined. Then, the selected recommendations were prioritized according to (1) a harmonized level of evidence (reconciled from different sources); (2) the scope of the source document (international was preferred); (3) the entity that issued the source document; (4) the operability of the recommendation; and (5) health care professionals' perceptions of the relevance, potential impact, and reach of the recommendation. A total of 358 recommendations were selected. Next, the variables required to trigger those recommendations were defined (n=116) and operationalized into logical rules using Boolean logical operators (n=405). Finally, the knowledge base was implemented in an intelligent individualized coaching component and pretested with an asthma use case. Initial validation of the knowledge base was conducted internally using data from a population-based observational study of individuals with or without asthma or rhinitis. External validation of the appropriateness of the recommendations with the highest priority level was conducted independently by 4 physicians. In addition, a strategy for knowledge base updates, including an easy-to-use rules editor, was defined. Using this process, based on consensus and iterative improvement, we developed and conducted preliminary validation of a clinical knowledge base for CORDs that translates disease guidelines into personalized patient recommendations. The knowledge base can be used as part of mHealth decision support systems. This process could be replicated in other clinical areas.
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Affiliation(s)
- Ana Margarida Pereira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Allergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal
- PaCeIT - Patient Centered Innovation and Technologies, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Jácome
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Tiago Jacinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Allergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal
| | - Rita Amaral
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal
- Department of Women's and Children's Health, Pediatric Research, Uppsala University, Uppsala, Sweden
| | - Mariana Pereira
- Allergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal
- PaCeIT - Patient Centered Innovation and Technologies, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - Ana Sá-Sousa
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana Couto
- Allergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal
- Allergy Center, CUF Descobertas Hospital, Lisboa, Portugal
| | - Pedro Vieira-Marques
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Diogo Martinho
- Research Group on Intelligent Engineering and Computing for Advanced Innovation and Development, Institute of Engineering, Polytechnic of Porto, Porto, Portugal
| | - Ana Vieira
- Research Group on Intelligent Engineering and Computing for Advanced Innovation and Development, Institute of Engineering, Polytechnic of Porto, Porto, Portugal
| | - Ana Almeida
- Research Group on Intelligent Engineering and Computing for Advanced Innovation and Development, Institute of Engineering, Polytechnic of Porto, Porto, Portugal
| | - Constantino Martins
- Research Group on Intelligent Engineering and Computing for Advanced Innovation and Development, Institute of Engineering, Polytechnic of Porto, Porto, Portugal
| | - Goreti Marreiros
- Research Group on Intelligent Engineering and Computing for Advanced Innovation and Development, Institute of Engineering, Polytechnic of Porto, Porto, Portugal
| | - Alberto Freitas
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rute Almeida
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João A Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Allergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
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König L, Suhr R. The Effectiveness of Publicly Available Web-Based Interventions in Promoting Health App Use, Digital Health Literacy, and Media Literacy: Pre-Post Evaluation Study. J Med Internet Res 2023; 25:e46336. [PMID: 38048146 PMCID: PMC10728793 DOI: 10.2196/46336] [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: 02/07/2023] [Revised: 03/12/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND According to the World Health Organization, implementing mobile health (mHealth) technologies can increase access to quality health services worldwide. mHealth apps for smartphones, also known as health apps, are a central component of mHealth, and they are already used in diverse medical contexts. To benefit from health apps, potential users need specific skills that enable them to use such apps in a responsible and constructive manner. OBJECTIVE This study aimed to evaluate the effectiveness of the free and widely used web-based intervention, The APPocalypse?. Besides providing knowledge about health apps, the web-based intervention was designed to promote digital health and media literacy by teaching skills that enable users to distinguish between trustworthy and less trustworthy health apps. It was hypothesized that after completing the web-based intervention, participants' knowledge in the domain of health apps, their digital health literacy, and their media literacy would be higher than it was before completing the web-based intervention. METHODS The study was divided into 3 parts. During part 1, participants (n=365; 181 female, 181 male, and 3 diverse; mean age 17.74, SD 1.391 years) provided demographic information and answered the pre- and postmeasurements. The measurements included questionnaires about participants' knowledge in the domain of health apps, digital health literacy, and media literacy. During part 2, participants had 1 week to complete the web-based intervention. During part 3, participants answered the pre- and postmeasurements again. Furthermore, they answered educational quality and user experience questionnaires. Bayesian paired samples 2-tailed t tests were conducted to test the hypotheses. RESULTS Overall, the results support the hypotheses. After completing the web-based intervention, participants demonstrated more elaborate knowledge in the domain of health apps. Specifically, they displayed higher competencies in the domains of subjective (Bayes factor10 [BF10]=1.475×1079; effect size δ=-1.327) and objective health app knowledge (BF10=8.162×1080; effect size δ=-1.350). Furthermore, participants demonstrated higher digital health literacy. Specifically, they displayed higher competencies in the domains of information appraisal (BF10=3.413×1043; effect size δ=-0.870), information searching (BF10=3.324×1023; effect size δ=-0.604), evaluating reliability (BF10=3.081×1035; effect size δ=-0.766), and determining relevance (BF10=3.451×1024; effect size δ=-0.618). Regarding media literacy, the results were mixed. Participants displayed higher competencies in the domain of technology literacy beliefs (BF10=1.533×1021; effect size δ=-0.570). In the domain of technology control beliefs, their competencies did not seem to improve (BF10=0.109; effect size δ=-0.058). In comparison to relevant benchmarks, the web-based intervention offers exceptional educational quality and a superior user experience. CONCLUSIONS The free web-based intervention The APPocalypse? might promote the constructive use of health apps, digital health literacy, and media literacy. Therefore, it may contribute to achieving the health-related United Nations Sustainable Development Goals.
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Affiliation(s)
- Lars König
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Stiftung Gesundheitswissen, Berlin, Germany
| | - Ralf Suhr
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Stiftung Gesundheitswissen, Berlin, Germany
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Urdova V, Rogers L, Jesenak M, Seys SF. Real-life studies and registries of severe asthma: The advent of digital technology. Respir Med 2023; 220:107429. [PMID: 37926182 DOI: 10.1016/j.rmed.2023.107429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
Severe asthma is a chronic and heterogeneous disease that negatively affects the quality of life of our patients and health care utilization. Given the remaining burden of uncontrolled disease in many of these patients, better understanding of its epidemiology, disease mechanisms, effectiveness of novel therapies such as biologics are still highly needed. Asthma treatment guidelines are largely informed by randomized controlled trials (RCTs) and meta analyses of RCTs, however inclusion criteria of many efficacy RCTs of asthma treatments often exclude a high number of patients with asthma in the community. Data from real-life studies and registries of severe asthma can complement efficacy studies by not only providing evidence on how a treatment performs in everyday clinical practice, post marketing safety information, data to support subsequent clinical trial design, but also helping to delineate the natural history of a disease and supporting important translational research endeavors. In the current review, we summarise available national and international collaborative studies and registries, the variables studies and the novel data and insights they provide. The key source of information for most asthma registries are real-life data from patient's electronic health records. Advent of digital technology in collecting data and their analysis is obvious and we draw attention to generation of new knowledge from registries of severe asthma to improve current diagnostic and therapeutic guidelines and asthma control.
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Affiliation(s)
- V Urdova
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia; Institute of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia.
| | - L Rogers
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Jesenak
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia; Institute of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia
| | - S F Seys
- Research Unit, Galenus Health, Hasselt, Belgium
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Alsahli S, Hor SY, Lam M. Factors Influencing the Acceptance and Adoption of Mobile Health Apps by Physicians During the COVID-19 Pandemic: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e50419. [PMID: 37938873 PMCID: PMC10666016 DOI: 10.2196/50419] [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: 06/30/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented. OBJECTIVE The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic. METHODS A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines. CONCLUSIONS This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic. TRIAL REGISTRATION PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu.
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Affiliation(s)
- Sultan Alsahli
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Department of Health Information Technology and Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Su-Yin Hor
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Mary Lam
- Department of Health and Biomedical Sciences, STEM College, RMIT University, Melbourne, Australia
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Bischoff EWMA, Ariens N, Boer L, Vercoulen J, Akkermans RP, van den Bemt L, Schermer TR. Effects of Adherence to an mHealth Tool for Self-Management of COPD Exacerbations. Int J Chron Obstruct Pulmon Dis 2023; 18:2381-2389. [PMID: 37933244 PMCID: PMC10625742 DOI: 10.2147/copd.s431199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
Purpose Poor adherence to COPD mobile health (mHealth) has been reported, but its association with exacerbation-related outcomes is unknown. We explored the effects of mHealth adherence on exacerbation-free weeks and self-management behavior. We also explored differences in self-efficacy and stages of grief between adherent and non-adherent COPD patients. Patients and Methods We conducted secondary analyses using data from a recent randomized controlled trial (RCT) that compared the effects of mHealth (intervention) with a paper action plan (comparator) for COPD exacerbation self-management. We used data from the intervention group only to assess differences in exacerbation-free weeks (primary outcome) between patients who were adherent and non-adherent to the mHealth tool. We also assessed differences in the type and timing of self-management actions and scores on self-efficacy and stages of grief (secondary outcomes). We used generalized negative binomial regression analyses with correction for follow-up length to analyze exacerbation-free weeks and multilevel logistic regression analyses with correction for clustering for secondary outcomes. Results We included data of 38 patients of whom 13 (34.2%) (mean (SD) age 69.2 (11.2) years) were adherent and 25 (65.8%) (mean (SD) age 68.7 (7.8) years) were non-adherent. Adherent patients did not differ from non-adherent patients in exacerbation-free weeks (mean (SD) 31.5 (14.5) versus 33.5 (10.2); p=0.63). Although statistically not significant, adherent patients increased their bronchodilator use more often and more timely, contacted a healthcare professional and/or initiated prednisolone and/or antibiotics more often, and showed at baseline higher scores of self-efficacy and disease acceptance and lower scores of denial, resistance, and sorrow, compared with non-adherent patients. Conclusion Adherence to mHealth may be positively associated with COPD exacerbation self-management behavior, self-efficacy and disease acceptance, but its association with exacerbation-free weeks remains unclear. Our results should be interpreted with caution by this pilot study's explorative nature and small sample size.
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Affiliation(s)
- Erik W M A Bischoff
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nikki Ariens
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lonneke Boer
- Radboud Institute for Health Sciences, Department of Clinical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan Vercoulen
- Radboud Institute for Health Sciences, Department of Clinical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Reinier P Akkermans
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lisette van den Bemt
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tjard R Schermer
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- Science Support Office, Gelre Hospitals, Apeldoorn, the Netherlands
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Samadbeik M, Garavand A, Aslani N, Sajedimehr N, Fatehi F. Mobile health interventions for cancer patient education: A scoping review. Int J Med Inform 2023; 179:105214. [PMID: 37729837 DOI: 10.1016/j.ijmedinf.2023.105214] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Mobile health (mHealth) is using mobile devices and applications to deliver health information and services. mHealth has been increasingly applied in cancer care to support patients in various aspects of their disease journey. This scoping review aimed to explore the current evidence on the use of mHealth interventions for cancer patient education. METHODS This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. We searched four electronic databases (PubMed, Web of Science, CINAHL, and Cochrane) using a combination of keywords related to mHealth, cancer, and education. After finding articles at the initial search the screening has been done based on the inclusion and exclusion criteria. We included only original research articles and excluded all other types of publications, such as review papers, reports, editorials, letters to the editor, book reviews, short communications, conference proceedings, graduate dissertations, protocols, and commentaries. We extracted data on the characteristics and outcomes of the included studies using a standardized form. We conducted a narrative synthesis and inductive content analysis to summarize and categorize the evidence. RESULTS Out of 2131 records found in the initial search, 28 full-text articles reported on the use of mHealth educational interventions for cancer patients. The majority of the studies focused on breast cancer patients (n = 21, 75%). The most common type of mHealth intervention was exercise-based education delivered through various media such as text messages, videos, audio, images, and social networks. The main objectives of mHealth educational interventions were to enhance self-management skills, improve psychological well-being, and promote healthy lifestyle behaviors among cancer patients. The reported outcomes of mHealth interventions included reduced chemotherapy-related side effects, improved mental health, improved quality of life and lifestyle, and better pain management. CONCLUSION This scoping review showed that mHealth is a promising and feasible modality for delivering educational interventions to cancer patients. However, more rigorous and diverse studies are needed to evaluate the effectiveness and cost-effectiveness of mHealth interventions for different types of cancers, stages, and settings.
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Affiliation(s)
- Mahnaz Samadbeik
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Garavand
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Nasim Aslani
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Negin Sajedimehr
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farhad Fatehi
- School of Psychological Sciences, Monash University, Melbourne, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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Szylling A, Raciborski F, Wojas O, Furmańczyk K, Krzych‐Fałta E, Bousquet J, Samoliński B. Why the role of mHealth in allergy diagnosis and treatment adherence cannot be overlooked. Clin Transl Allergy 2023; 13:e12298. [PMID: 37876036 PMCID: PMC10580813 DOI: 10.1002/clt2.12298] [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: 05/23/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Allergic diseases-rhinitis and asthma-are the most common chronic conditions affecting adults. Traditional approaches to allergy diagnosis and treatment do not meet the health needs of all patients. Treatment adherence remains a challenge for physicians. The ubiquity of Internet access paired with limited in-person contact with medical personnel in the course of the COVID-19 pandemic demonstrated the potential of mHealth in communicating health information. BODY: The abundance of new applications dedicated to various medical specialties encourages reflection on the informed use of such tools. The paper takes a closer look at the potential of mHealth and presents conclusions of selected studies focusing on the use of good apps. The strength weakness opportunities threats analysis was used to illustrate the strengths of the mHealth strategy, as well as its advantages, limitations and areas in need of further development. CONCLUSION The strength of mHealth depends on the quality and quantity of the collected patient data, its reliable processing, as well as publication of outcomes and conclusions from analyses. Therefore, it is necessary to promote the use of validated applications among patients, physicians and medical staff.
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Affiliation(s)
- Anna Szylling
- Department of Allergy and Clinical ImmunologyUniversity Clinical Center of the Medical University of Warsaw Central Clinical HospitalWarszawaMazowieckiePoland
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
| | - Oksana Wojas
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
| | - Konrad Furmańczyk
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
- Institute of Information TechnologyWarsaw University of Life SciencesWarszawaPoland
| | | | - Jean Bousquet
- Institute of AllergologyCharite Universitatsmedizin BerlinBerlinGermany
- University of MontpellierMontpellierFrance
| | - Boleslaw Samoliński
- Department of Allergy and Clinical ImmunologyUniversity Clinical Center of the Medical University of Warsaw Central Clinical HospitalWarszawaMazowieckiePoland
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
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9
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Kouri A, Wong EKC, Sale JEM, Straus SE, Gupta S. Are older adults considered in asthma and chronic obstructive pulmonary disease mobile health research? A scoping review. Age Ageing 2023; 52:afad144. [PMID: 37742283 DOI: 10.1093/ageing/afad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) for asthma and chronic obstructive pulmonary disease (COPD) is rapidly growing and may help address the complex respiratory care needs of our ageing population. However, little is currently known about how airways mHealth is developed and used among older adults (≥65 years). OBJECTIVE To identify if and how older adults with asthma and COPD have been incorporated across the mHealth research cycle. METHODS We searched Ovid MEDLINE, EMBASE, CINAHL and the Cochrane Central Registry of Controlled Trials for studies pertaining to the development or evaluation of asthma and COPD mHealth for adults published after 2010. Study, participant and mHealth details, including any considerations of older age, were extracted, synthesised and charted. RESULTS A total of 334 studies of 191 mHealth tools were identified. Adults ≥65 years old were included in 33.3% of asthma mHealth studies and 85.3% of COPD studies. Discussions of older age focused on barriers to technology use. Methodologic and/or analytic considerations of older age were mostly absent throughout the research cycle. Among the 28 instances quantitative age-related analyses were detailed, 12 described positive mHealth use and satisfaction outcomes in older adults versus negative or equivocal outcomes. CONCLUSION We identified an overall lack of consideration for older age throughout the airways mHealth research cycle, even among COPD mHealth studies that predominantly included older adults. We also found a contrast between the perceptions of how older age might negatively influence mHealth use and available quantitative evaluations. Future airways mHealth research must better integrate the needs and concerns of older adults.
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Affiliation(s)
- Andrew Kouri
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
| | - Eric K C Wong
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Samir Gupta
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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10
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Kouri A, Gupta S, Straus SE, Sale JEM. Exploring the Perspectives and Experiences of Older Adults With Asthma and Chronic Obstructive Pulmonary Disease Toward Mobile Health: Qualitative Study. J Med Internet Res 2023; 25:e45955. [PMID: 37606961 PMCID: PMC10481221 DOI: 10.2196/45955] [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: 01/23/2023] [Revised: 05/23/2023] [Accepted: 06/29/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) in asthma and chronic obstructive pulmonary disease (COPD) is growing, and as the population ages, a greater number of older adults stand to benefit from mHealth-enhanced airway disease care. Though older adults are a heterogeneous population of health technology users, older age represents a potential barrier to health technology adoption, and there is currently a lack of knowledge on how older age influences mHealth use in asthma and COPD. OBJECTIVE In this qualitative study, we sought to explore the experiences and perspectives of adults who were aged 65 years and older with asthma and COPD toward mHealth use. METHODS Semistructured individual interviews were conducted with adults who were aged 65 years and older with asthma or COPD and owned a smartphone. Applying phenomenological methodology, we analyzed interview transcripts in order to develop themes and propose an essential experience of mHealth use among older adults with airway disease. We then summarized our qualitative findings and proposed strategies to leverage our results in order to guide future research and implementation efforts targeting older adults' use of airway mHealth. RESULTS Twenty participants (mean age 79.8, SD 4.4 years) were interviewed. Participants described a central tension between (1) the perception that mHealth could help maintain independence throughout aging and (2) an apprehension toward the ways in which mHealth could negatively affect established health care experiences. Several elements of these 2 themes are absent from previous research focusing on younger adults with asthma and COPD. The individual elements of these 2 themes informed potential strategies to optimize future older adults' use of asthma and COPD mHealth tools. CONCLUSIONS Focusing on the perspectives and experiences of older adults with asthma and COPD in their use of mHealth identified novel understandings of health technology use in this important demographic in need of greater care. These lessons were translated into potential strategies that will need to be objectively evaluated in future airway mHealth research, development, and implementation efforts.
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Affiliation(s)
| | - Samir Gupta
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Sharon E Straus
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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11
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Antó A, Sousa-Pinto B, Czarlewski W, Pfaar O, Bosnic-Anticevich S, Klimek L, Matricardi P, Tripodi S, Fonseca JA, Antó JM, Bousquet J. Automatic market research of mobile health apps for the self-management of allergic rhinitis. Clin Exp Allergy 2022; 52:1195-1207. [PMID: 35315164 DOI: 10.1111/cea.14135] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/02/2022] [Accepted: 03/01/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Only a small number of apps addressing allergic rhinitis (AR) patients have been evaluated. This makes their selection difficult. We aimed to introduce a new approach to market research for AR apps, based on the automatic screening of Apple App and Google Play stores. METHODS A JavaScript programme was devised for automatic app screening, and applied in a market assessment of AR self-management apps. We searched the Google Play and Apple App stores of three countries (USA, UK and Australia) with the following search terms: "hay fever", "hayfever", "asthma", "rhinitis", "allergic rhinitis". Apps were eligible if symptoms were evaluated. Results obtained with the automatic programme were compared to those of a blinded manual search. As an example, we used the search to assess apps that can be used to design a combined medication score for AR. RESULTS The automatic search programme identified 39 potentially eligible apps out of a total of 1593 retrieved apps. Each of the 39 apps was individually checked, with 20 being classified as relevant. The manual search identified 19 relevant apps (out of 6750 screened apps). Combining both methods, a total of 21 relevant apps were identified, pointing to a sensitivity of 95% and a specificity of 99% for the automatic method. Among these 21 apps, only two could be used for the combined symptom-medication score for AR. CONCLUSIONS The programmed algorithm presented herein is able to continuously retrieve all relevant AR apps in the Apple App and Google Play stores, with high sensitivity and specificity. This approach has the potential to unveil the gaps and unmet needs of the apps developed so far.
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Affiliation(s)
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | | | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Local Health District, Sydney, New South Wales, Australia
| | - Ludger Klimek
- AG Molecular Allergology and Digital Health, Department of Pediatric Pneumology, Immunology and Critical Care Medicine, Charité Universitätsmedizin - Berlin, Berlin, Germany
| | | | | | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal.,MEDIDA-Medicina, EDucação, I&D e Avaliação, Lda, Porto, Portugal
| | - Josep M Antó
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jean Bousquet
- Institute for Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.,University Hospital of Montpellier, Montpellier, France
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12
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Rezaee R, Asadi S, Yazdani A, Rezvani A, Kazeroon AM. Development, usability and quality evaluation of the resilient mobile application for women with breast cancer. Health Sci Rep 2022; 5:e708. [PMID: 35782301 PMCID: PMC9234476 DOI: 10.1002/hsr2.708] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Mental health problems as a consequence of cancer lower the quality of life of cancer patients. Despite increasing studies of breast cancer-focused mobile health applications (m-Health apps), there is less research on breast cancer patients' quality of life or well-being. The purpose of this study is to develop and evaluate the usability and quality of an educational m-Health app aimed at improving the resilience of breast cancer in women. Methods This study was conducted in four phases. It included extracting the requirements of the app through the nominal group technique. Based on these results, an m-Health app was developed and evaluated in terms of usability and quality by two scales, System Usability Scale and Mobile App Rating Scale questionnaires, respectively. Finally, the role of patients' age and educational backgrounds in the use of the app was assessed. The relationship between learnability and usability of the app was measured by the T-Test. Results The app was developed with three user interfaces. Its usability developed from the patient's point of view scored a remarkable score of 83.20 with a 95% confidence interval. This value was too indicative of high satisfaction with the usefulness and the possibility of recommending it to other cancer survivors. The results of the quality evaluation from an expert's point of view showed that this app had good functionality. Evaluation of the role of demographic information in the use of the app showed that it can be used for all age groups with different levels of education. The app did not differ significantly between learnability and usability. Conclusion The development of m-Health apps, based on usability principles that are suitable for all age groups with different levels of education, is welcomed by cancer patients.
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Affiliation(s)
- Rita Rezaee
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Sima Asadi
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Azita Yazdani
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Alireza Rezvani
- Department of Internal Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Arash Mani Kazeroon
- Department of Psychiatry, School of MedicineShiraz University of Medical SciencesShirazIran
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13
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Affinito L, Fontanella A, Montano N, Brucato A. How physicians can empower patients with digital tools. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01370-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
While there is broad consensus that the use of digital tools would significantly improve patient empowerment, to date, an improvement in health outcomes has been elusive.
Objective
The objective of this study was to assess how to improve the ability of physicians to empower patients with digital tools.
Methods
We conducted a web-based survey using SurveyMonkey over nearly 6 months. A questionnaire was sent with an email, explaining the aims of the survey and providing a link to complete the web-based questionnaire, to the heads of each of the 37 medical national societies adhering to the EFIM (European Federation of Internal Medicine), inviting them to disseminate the questionnaire among their members.
Results
Two hundred and eighteen responses were received. They suggest that the main success factors in increasing and improving patient empowerment with digital tools and realizing health goals are clinical evidence, followed by patient/physician involvement in the design, tools designed around the real needs of the patient, and reimbursement. Most of the respondents who have already prescribed digital tools for patient empowerment are just enough satisfied with the results achieved by their patients. Interestingly, 18% of the respondents had spent more than 30 min on the visit of patient to doctor. However, the majority devoted only 5–9 min to illustrating the suggested digital tools.
Conclusions
According to the respondents, clinical evidence, motivation, physician and patient’s involvement in design, and reimbursement, as well as organizations’ appropriate business models and support, are the main determinants of the diffusion and effective adoption of digital tools for successful patient empowerment in internal medicine.
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14
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Blackstock FC, Roberts NJ. Using Telemedicine to Provide Education for the Symptomatic Patient with Chronic Respiratory Disease. Life (Basel) 2021; 11:1317. [PMID: 34947848 PMCID: PMC8706811 DOI: 10.3390/life11121317] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022] Open
Abstract
Technology-enabled learning, using computers, smartphones, and tablets, to educate patients on their respiratory disease and management has grown over the last decade. This shift has been accelerated by the global COVID-19 pandemic and the need to socially distance for public health. Thirteen recently published papers examined experience, knowledge, skills and attitude acquisition, behaviour change, and impact on health outcomes of patient education using technology (websites and mobile device applications) for people with chronic respiratory disease. Technology-enabled patient education that includes relevant information, with activities that encourage the patient to interact with the digital platform, appears to lead to better patient experience and may increase learning and behaviour change with improved quality of life. Developing online relationships with healthcare providers, lower digital capabilities, and poor access to a computer/smartphone/tablet, appear to be barriers that need to be overcome for equity in access. Maintaining the principles of quality educational design, ensuring interactive experiences for patient involvement in the educational activities, patient co-design, healthcare professionals connecting with experts in the field of technology-enabled learning for development of education models, and ongoing research lead to the best patient outcomes in technology-enabled education for respiratory disease.
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Affiliation(s)
- Felicity C. Blackstock
- Physiotherapy, School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
- Physiotherapy, School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Nicola J. Roberts
- Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonia University, Glasgow G4 0BA, UK;
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15
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Claeys N, Teeling MT, Legrand P, Poppe M, Verschueren P, De Prins L, Cools L, Cypers L, Fokkens WJ, Hopkins C, Hellings PW. Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA. FRONTIERS IN ALLERGY 2021; 2:761388. [PMID: 35386961 PMCID: PMC8974789 DOI: 10.3389/falgy.2021.761388] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background: European patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have had only limited occasions to unite to have their voices heard, hence missing the opportunity to contribute to the improvement of CRSwNP care. Aims: To identify unmet needs in CRSwNP from the perspective of CRSwNP patients from the Patient Advisory Board (PAB) of the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA). Methodology: Semi-structured interviews were conducted individually with 15 European patients with CRSwNP and with a disease history of more than 2 years. Patients shared their burden of the disease and frustrations related to CRSwNP care, experiences with key pillars of current treatment options, shortcomings of the current care pathways and recommendations for improvement of care. A panel of 30 members of the Patient Advisory Board reviewed the interview report and provided further input during 2 virtual meetings. Results: CRSwNP patients indicated the need for greater awareness from society and physicians of the disease burden with impact on social function and well-being. Along with a loss of ability to smell and the continuous presence of secretions in the nose, most patients reported poor sleep quality and psychological impact as the most bothersome symptoms. Patients' frustrations relate primarily to the underestimation of the disease burden, the lack of coordination of care and the limited treatment options available to them. Treatment options with oral corticosteroids and/or sinus surgery both have positive and negative aspects, including the lack of long-lasting efficacy. Better coordination of care, more patient-centered care, greater public awareness, increases in research on the disease mechanisms and better therapeutic options would be warmly welcomed by CRSwNP patients. Conclusions: This statement of the EUFOREA Patient Advisory Board on CRSwNP provides novel insights on the underestimation of the burden of CRSwNP and shortcomings of current care. Multiple recommendations made by the patients can underpin action plans for implementation of better care for CRSwNP among all physicians treating patients with this disabling disease.
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16
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Hussain MS, Sharma P, Dhanjal DS, Khurana N, Vyas M, Sharma N, Mehta M, Tambuwala MM, Satija S, Sohal SS, Oliver BGG, Sharma HS. Nanotechnology based advanced therapeutic strategies for targeting interleukins in chronic respiratory diseases. Chem Biol Interact 2021; 348:109637. [PMID: 34506765 DOI: 10.1016/j.cbi.2021.109637] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/22/2021] [Accepted: 09/06/2021] [Indexed: 02/07/2023]
Abstract
Both communicable and non-communicable chronic respiratory conditions have accorded for suffering of millions of people of all ages and stated to be leading cause of death, morbidity, economic and social pressures, and disability-adjusted life-years (DALYs) worldwide. These illnesses impair patient's health and negatively impacts families and society, particularly in low and middle-income countries. Chronic respiratory diseases (CRDs) affect different organs of respiratory system, involving airways, parenchyma, and pulmonary vasculature. As the number of respiratory diseases are exponentially escalating but still the stakeholders are not paying attention towards its serious complications. Currently, the treatment being used primarily focusses only on alleviating symptoms of these illness rather delivering the therapeutic agent at target site for optimal care and/or prevention. Lately, extensive research is being conducted on airways and systemic inflammation, oxidative stress, airway, or parenchymal rehabilitation. From which macrophages, neutrophils, and T cells, as well as structural cells as fibroblasts, epithelial, endothelial, and smooth muscle cells have been found to be active participants that are involved in these chronic respiratory diseases. The pathogenesis of all these chronic respiratory diseases gets caused differently via mediators and proteins, including cytokines, chemokines, growth factors and oxidants. Presently, the target of prescription therapies is to reduce the inflammation of airways and relieve the airway contraction. In all studies, cytokines have been found to play an imperative role in fostering chronic airway inflammation and remodelling. Owing to the limitations of conventional treatments, the current review aims to summarize the current knowledge about the chronic respiratory disease and discuss further about the various conventional methods that can be used for treating this ailment. Additionally, it also highlights and discusses about the advanced drug delivery system that are being used for targeting the interleukins for the treatment of CRDs.
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Affiliation(s)
- Md Sadique Hussain
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Parvarish Sharma
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Daljeet Singh Dhanjal
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Navneet Khurana
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Manish Vyas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Neha Sharma
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Meenu Mehta
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Murtaza M Tambuwala
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, Londonderry, BT52 1SA, United Kingdom
| | - Saurabh Satija
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
| | - Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, 7248, Australia
| | - Brian G G Oliver
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, 2007, Australia; Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Hari S Sharma
- Department of Pathology and Clinical Bioinformatics, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
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17
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Naranjo-Rojas A, Perula-de-Torres LÁ, Cruz-Mosquera FE, Molina-Recio G. Mobile application for monitoring patients under home oxygen therapy: a protocol for a randomized controlled trial. BMC FAMILY PRACTICE 2021; 22:104. [PMID: 34039277 PMCID: PMC8157712 DOI: 10.1186/s12875-021-01450-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/04/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Mobile technologies have become capable of changing the paradigm of healthcare services. A clear example is that, nowadays, these technologies are an important instrument for data collection processes, epidemiologic surveillance, health promotion and disease prevention. Therefore, technological tools should be exploited to optimize the monitoring of patients with chronic diseases, including patients who require home oxygen therapy. PURPOSE The purpose of this study is to determine the efficacy of a mobile application in the clinical monitoring of patients under home oxygen therapy. METHODS This is a randomized controlled trial includes subjects of 18 years or older diagnosed with Chronic Obstructive Pulmonary Disease (COPD) who are under home oxygen therapy. Subjects will be divided into two arms: the intervention group will include patients who will be monitored with a mobile application, and the control group will include patients monitored by conventional follow-up methods (periodic visits of a respiratory therapist). The following outcome variables will be considered to measure the effect of the intervention: identification of dyspnea self-management, number of acute exacerbations associated with oxygen therapy, and the occurrence of oxygen supply underuse. DISCUSSION This study is expected to assess the efficacy of a mobile application in the follow up of patients under home oxygen therapy. It will also determine whether the monitoring of a six-month intervention by a team comprising a physician, a nurse and respiratory therapists can decrease acute exacerbations, determine the most appropriate oxygen dose, and identify the underuse of oxygen systems and supplies. TRIAL REGISTRATION The study has been registered at ClinicalTrials.gov ( NCT04820790 ; date of registration: March 29, 2021).
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Affiliation(s)
- Anisbed Naranjo-Rojas
- School of Medicine, GINEYSA - GISI. USC Research Groups, Universidad Santiago de Cali, Cali, Colombia.
| | - Luis Ángel Perula-de-Torres
- Multiprofessional teaching unit for Family and Community Care of the Córdoba and Guadalquivir District. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Hospital Universitario Reina Sofia, Universidad de Córdoba, Cordoba, Spain
| | | | - Guillermo Molina-Recio
- Nursing, Pharmacology and Physiotherapy Department, University of Cordoba. Lifestyles, Innovation and Health (GA-16). Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
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18
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Papadopoulos NG, Aggelides X, Stamataki S, Prokopakis E, Katotomichelakis M, Xepapadaki P. New concepts in pediatric rhinitis. Pediatr Allergy Immunol 2021; 32:635-646. [PMID: 33475171 DOI: 10.1111/pai.13454] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
Rhinitis-and especially allergic rhinitis (AR)-remains the most frequent hypersensitivity condition, affecting up to a quarter of the population and impacting the quality of life of individual patients and the health economy. Data, especially with respect to underlying pathophysiologic mechanisms, mainly derive from studies on adults and are subsequently extrapolated to the pediatric population. Therapeutic algorithms for children with rhinitis are long based on the same principles as in adults. We explore and describe novel aspects of rhinitis, ranging from mechanisms to disease classification, phenotypes, diagnostic and monitoring tools, and the use of treatments, with a focus on the traits of pediatric age groups.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.,Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK
| | - Xenophon Aggelides
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Stamataki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanuel Prokopakis
- Department of Otorhinolaryngology, University of Crete, School of Medicine, Heraklion, Greece
| | | | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
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19
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Vlastos I, Mullol J, Hox V, Doulaptsi M, Seys S, Hellings P, Prokopakis E. Multidisciplinary Care for Severe or Uncontrolled Chronic Upper Airway Diseases. Curr Allergy Asthma Rep 2021; 21:27. [PMID: 33791881 DOI: 10.1007/s11882-021-01004-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW A multidisciplinary approach is regarded as the best practice for many chronic diseases, such as cancer and asthma, with well-documented value. There is also evidence that it may be beneficial to patients with chronic rhinosinusitis (CRS) and/or allergic airway disease presenting to tertiary referral centres. We discuss here whether and how organizing this kind of healthcare transition into a more integrated care pathway would benefit severe chronic upper airways disease (SCUAD) management. RECENT FINDINGS Based on a recent related EUFOREA panel discussion, literature search, and review of the best overseas practices, an appropriate implementation strategy of multidisciplinary care and its potential results are presented. Organizational principles, hurdles, and challenges of the process, as well as envisaged solutions and results, are being reported. The efficiency of care and the quality control assessment are concepts that are currently gaining importance. At the same time, novel treatment options based on molecular and precision medicine advancements, such as biologics, are being increasingly prescribed. Appropriately organized multidisciplinary care teams can adapt to new demands, data, and discoveries to assure maximum benefit for both patients and healthcare professionals.
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Affiliation(s)
- Ioannis Vlastos
- Department of Otorhinolaryngology, University of Crete School of Medicine, Crete, Greece
- Department of Otorhinolaryngology, Aghia Sophia Children's Hospital, Athens, Greece
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona; Clinical and Experimental Respiratory Immunoallergy, IDIBAPS; and CIBERES, Barcelona, Catalonia, Spain
| | - Valerie Hox
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Maria Doulaptsi
- Department of Otorhinolaryngology, University of Crete School of Medicine, Crete, Greece
| | - Sven Seys
- Allergy & Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Peter Hellings
- Allergy & Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
- Clinical Division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Emmanuel Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Crete, Greece.
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20
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Kooij L, Vos PJE, Dijkstra A, van Harten WH. Effectiveness of a Mobile Health and Self-Management App for High-Risk Patients With Chronic Obstructive Pulmonary Disease in Daily Clinical Practice: Mixed Methods Evaluation Study. JMIR Mhealth Uhealth 2021; 9:e21977. [PMID: 33538699 PMCID: PMC7892284 DOI: 10.2196/21977] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/30/2020] [Accepted: 12/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mobile health and self-management interventions may positively affect behavioral change and reduce hospital admissions for patients with chronic obstructive pulmonary disease (COPD). However, not all patients qualify for these interventions, and systematic, comprehensive information on implementation- and compliance-related aspects of mobile self-management apps is lacking. Due to the tendency to target digital services to patients in stable phases of disease, it is especially relevant to focus on the use of these services in broad clinical practice for patients recently discharged from hospital. OBJECTIVE This study aims to evaluate the effects of a mobile health and self-management app in clinical practice for recently discharged patients with COPD on use of the app, self-management, expectations, and experiences (technology acceptance); patients' and nurses' satisfaction; and hospital readmissions. METHODS A prototype of the app was pilot tested with 6 patients with COPD. The COPD app consisted of an 8-week program including the Lung Attack Action Plan, education, medication overview, video consultation, and questionnaires (monitored by nurses). In the feasibility study, adult patients with physician-diagnosed COPD, access to a mobile device, and proficiency of the Dutch language were included from a large teaching hospital during hospital admission. Self-management (Partners in Health Scale), technology acceptance (Unified Theory Acceptance and Use of Technology model), and satisfaction were assessed using questionnaires at baseline, after 8 weeks, and 20 weeks. Use was assessed with log data, and readmission rates were extracted from the electronic medical record. RESULTS A total of 39 patients were included; 76.4% (133/174) of patients had to be excluded from participation, and 48.9% of those patients (65/133) were excluded because of lack of digital skills, access to a mobile device, or access to the internet. The COPD app was opened most often in the first week (median 6.0; IQR 3.5-10.0), but its use decreased over time. The self-management element knowledge and coping increased significantly over time (P=.04). The COPD app was rated on a scale of 1-10, with an average score by patients of 7.7 (SD 1.7) and by nurses of 6.3 (SD 1.2). Preliminary evidence about the readmission rate showed that 13% (5/39) of patients were readmitted within 30 days; 31% (12/39) of patients were readmitted within 20 weeks, compared with 14.1% (48/340) and 21.8% (74/340) in a preresearch cohort, respectively. CONCLUSIONS The use of a mobile self-management app after hospital discharge seems to be feasible only for a small number of patients with COPD. Patients were satisfied with the service; however, use decreased over time, and only knowledge and coping changed significantly over time. Therefore, future research on digital self-management interventions in clinical practice should focus on including more difficult subgroups of target populations, a multidisciplinary approach, technology-related aspects (such as acceptability), and fine-tuning its adoption in clinical pathways. TRIAL REGISTRATION Clinicaltrials.gov NCT04540562; https://clinicaltrials.gov/ct2/show/NCT04540562.
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Affiliation(s)
- Laura Kooij
- Rijnstate Hospital, Arnhem, Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
| | | | | | - Wim H van Harten
- Rijnstate Hospital, Arnhem, Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
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21
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Guo Y, Liu X, Peng S, Jiang X, Xu K, Chen C, Wang Z, Dai C, Chen W. A review of wearable and unobtrusive sensing technologies for chronic disease management. Comput Biol Med 2021; 129:104163. [PMID: 33348217 PMCID: PMC7733550 DOI: 10.1016/j.compbiomed.2020.104163] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022]
Abstract
With the rapidly increasing number of patients with chronic disease, numerous recent studies have put great efforts into achieving long-term health monitoring and patient management. Specifically, chronic diseases including cardiovascular disease, chronic respiratory disease and brain disease can threaten patients' health conditions over a long period of time, thus effecting their daily lives. Vital health parameters, such as heart rate, respiratory rate, SpO2 and blood pressure, are closely associated with patients’ conditions. Wearable devices and unobtrusive sensing technologies can detect such parameters in a convenient way and provide timely predictions on health condition deterioration by tracking these biomedical signals and health parameters. In this paper, we review current advancements in wearable devices and unobtrusive sensing technologies that can provides possible tools and technological supports for chronic disease management. Current challenges and future directions of related techniques are addressed accordingly.
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Affiliation(s)
- Yao Guo
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Xiangyu Liu
- School of Art Design and Media, East China University of Science and Technology, Shanghai, 200237, China
| | - Shun Peng
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Xinyu Jiang
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Ke Xu
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Chen Chen
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Zeyu Wang
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China
| | - Chenyun Dai
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China.
| | - Wei Chen
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, 200433, China.
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22
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Herrero Martín S, Hueto Pérez de Heredia J, Cuesta Remón A, Gómez Fernández M, Antón MM, Cabasés J, García Rey R, Cebollero Rivas P. Is a Mobile Application Useful for Patients with Moderate-Severe Asthma? Arch Bronconeumol 2020; 57:S0300-2896(20)30529-9. [PMID: 33478829 PMCID: PMC7831636 DOI: 10.1016/j.arbres.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 11/01/2022]
Affiliation(s)
- Sonia Herrero Martín
- Servicio de Neumología, Complejo Hospitalario de Navarra (CHN), Pamplona, Navarra, España.
| | | | | | | | - María M Antón
- Universidad Pública de Navarra (UPNA), Pamplona, Navarra, España
| | - Juan Cabasés
- Universidad Pública de Navarra (UPNA), Pamplona, Navarra, España
| | - Ruth García Rey
- Navarrabiomed, Centro de Investigación Biomédica, Pamplona, Navarra, España
| | - Pilar Cebollero Rivas
- Servicio de Neumología, Complejo Hospitalario de Navarra (CHN), Pamplona, Navarra, España
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23
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Bousquet J, Grattan CE, Akdis CA, Eigenmann PA, Hoffmann-Sommergruber K, Agache I, Jutel M. Highlights and recent developments in allergic diseases in EAACI journals (2019). Clin Transl Allergy 2020; 10:56. [PMID: 33292572 PMCID: PMC7712618 DOI: 10.1186/s13601-020-00366-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022] Open
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2019 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidities, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and meta-analyses have been the highlights of the last year.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Montpellier, France. .,CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
| | - C E Grattan
- St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - P A Eigenmann
- Pediatric Allergy Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - K Hoffmann-Sommergruber
- Depart of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.,ALL-MED Medical Research Institute, Wrocław, Poland
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24
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Meng Y, Wang C, Zhang L. Advances and novel developments in allergic rhinitis. Allergy 2020; 75:3069-3076. [PMID: 32901931 DOI: 10.1111/all.14586] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/12/2022]
Abstract
Allergic rhinitis (AR) is an upper airway disease with high prevalence in the world, and therefore needs to be thoroughly investigated and treated accordingly. Although the mechanisms underlying the pathology and treatment of AR have been widely studied, many aspects of AR are still unclear and warrant further investigations. The purpose of the present review was therefore to report recently published papers, which highlight the novel mechanisms and treatments of AR. These include role of environment, important proteins and cells, and some other factors in the pathogenesis of AR; as well as the role of immunotherapy and biologics in the treatment of AR.
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Affiliation(s)
- Yifan Meng
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases Chinese Academy of Medical Sciences Beijing China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases Chinese Academy of Medical Sciences Beijing China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases Chinese Academy of Medical Sciences Beijing China
- Department of Allergy Beijing TongRen Hospital Capital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases Beijing Institute of Otolaryngology Beijing China
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25
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Hou IC, Chung TY. The Acceptability Study of Heart Transplantation Self-Management Support mHealth Application (iHeart App) in Taiwan: Mix Method Approaches. (Preprint). JMIR Form Res 2020. [DOI: 10.2196/26087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Seys SF, De Bont S, Fokkens WJ, Bachert C, Alobid I, Bernal‐Sprekelsen M, Bjermer L, Callebaut I, Cardell L, Carrie S, Castelnuovo P, Cathcart R, Constantinidis J, Cools L, Cornet M, Clement G, Cox T, Delsupehe L, Correia‐de‐Sousa J, Deneyer L, De Vos G, Diamant Z, Doulaptsi M, Gane S, Gevaert P, Hopkins C, Hox V, Hummel T, Hosemann W, Jacobs R, Jorissen M, Kjeldsen A, Landis BN, Lemmens W, Leunig A, Lund V, Mariën G, Mullol J, Onerci M, Palkonen S, Proano I, Prokopakis E, Ryan D, Riechelmann H, Sahlstrand‐Johnson P, Salmi‐Toppila S, Segboer C, Speleman K, Steinsvik A, Surda P, Tomazic P, Vanderveken O, Van Gerven L, Van Zele T, Verfaillie J, Verhaeghe B, Vierstraete K, Vlaminck S, Wagenmann M, Pugin B, Hellings PW. Real-life assessment of chronic rhinosinusitis patients using mobile technology: The mySinusitisCoach project by EUFOREA. Allergy 2020; 75:2867-2878. [PMID: 32424899 PMCID: PMC7687134 DOI: 10.1111/all.14408] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient-reported outcomes by mobile technology offers the possibility to better understand real-life burden of CRS. METHODS This study reports on the cross-sectional evaluation of data of 626 users of mySinusitisCoach (mSC), a mobile application for CRS patients. Patient characteristics of mSC users were analysed as well as the level of disease control based on VAS global rhinosinusitis symptom score and adapted EPOS criteria. RESULTS The mSC cohort represents a heterogeneous group of CRS patients with a diverse pattern of major symptoms. Approximately half of patients reported nasal polyps. 47.3% of all CRS patients were uncontrolled based on evaluation of VAS global rhinosinusitis symptom score compared to 40.9% based on adapted EPOS criteria. The impact of CRS on sleep quality and daily life activities was significantly higher in uncontrolled versus well-controlled patients. Half of patients had a history of FESS (functional endoscopic sinus surgery) and reported lower symptom severity compared to patients without a history of FESS, except for patients with a history of more than 3 procedures. Patients with a history of FESS reported higher VAS levels for impaired smell. CONCLUSION Real-life data confirm the high disease burden in uncontrolled CRS patients, clearly impacting quality of life. Sinus surgery improves patient-reported outcomes, but not in patients with a history of more than 3 procedures. Mobile technology opens a new era of real-life monitoring, supporting the evolution of care towards precision medicine.
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27
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Al-Ahmad M, Nurkic J, Bachert C, Pfaar O, Schunemann HJ, Czarlewski W, Bedbrook A, Bosquet J. ARIA 2019 Care Pathways for Allergic Rhinitis in the Kuwait Health Care System. Med Princ Pract 2020; 30:320-330. [PMID: 33099546 PMCID: PMC8436665 DOI: 10.1159/000512493] [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: 01/27/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022] Open
Abstract
A worldwide increase in prevalence of allergic diseases has led to adaptations in national and international health care systems. ARIA (Allergic Rhinitis and Its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. In collaboration with international initiatives, ARIA offers updates of real-life integrated care pathways (ICPs) for digitally assisted, integrated, and individualized treatment of allergic rhinitis (AR). This article presents certain aspects of the health care system in Kuwait with reference to the management of AR and the objective of introducing ICPs and adopting the latest ARIA recommendations. Guidelines for ICPs include aspects of patients and health care providers and cover key areas of management of AR. This model of guidelines supports real-life health care better than traditional models. ARIA recommendations will be locally integrated in the health care system with the aim of improving both pharmacotherapy and allergy immunotherapy.
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Affiliation(s)
- Mona Al-Ahmad
- Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait,
- Al-Rashed Allergy Center, Ministry of Health, Kuwait City, Kuwait,
| | - Jasmina Nurkic
- Al-Rashed Allergy Center, Ministry of Health, Kuwait City, Kuwait
| | - Claus Bachert
- Upper Airways Research Laboratory and Department of Oto-Rhino-Laryngology, Ghent University and Ghent University Hospital, Ghent, Belgium
- Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Holger J Schunemann
- Division of Immunology and Allergy, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Anna Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - Jean Bosquet
- Contre les Maladies Chroniques pour un Vieillissement Actif en France, Montpellier, France
- INSERM, Ageing and Chronic Diseases Epidemiological and Public Health, Paris, France
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- University Hospital, Montpellier, France
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28
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Dramburg S, Marchante Fernández M, Potapova E, Matricardi PM. The Potential of Clinical Decision Support Systems for Prevention, Diagnosis, and Monitoring of Allergic Diseases. Front Immunol 2020; 11:2116. [PMID: 33013892 PMCID: PMC7511544 DOI: 10.3389/fimmu.2020.02116] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/05/2020] [Indexed: 12/11/2022] Open
Abstract
Clinical decision support systems (CDSS) aid health care professionals (HCP) in evaluating large sets of information and taking informed decisions during their clinical routine. CDSS are becoming particularly important in the perspective of precision medicine, when HCP need to consider growing amounts of data to create precise patient profiles for personalized diagnosis, treatment and outcome monitoring. In allergy care, several CDSS are being developed and investigated, mainly for respiratory allergic diseases. Although the proposed solutions address different stakeholders, the majority aims at facilitating evidence-based and shared decision-making, incorporating guidelines, and real-time clinical data. We offer here an overview on existing tools, new developments and novel concepts and discuss the potential of digital CDSS in improving prevention, diagnosis and monitoring of allergic diseases.
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Affiliation(s)
- Stephanie Dramburg
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - María Marchante Fernández
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ekaterina Potapova
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paolo Maria Matricardi
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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29
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Pfaar O, Gerth van Wijk R, Klimek L, Bousquet J, Creticos PS. Clinical trials in allergen immunotherapy in the age group of children and adolescents: current concepts and future needs. Clin Transl Allergy 2020; 10:11. [PMID: 32346471 PMCID: PMC7181492 DOI: 10.1186/s13601-020-00314-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/19/2020] [Indexed: 12/12/2022] Open
Abstract
Allergen immunotherapy (AIT) is the only treatment option available for allergic patients with disease-modifying intention. Both efficacy and safety has been demonstrated for multiple trials in children, adolescents and adults. Though regulatory requirements for marketing authorization have been clearly outlined and an increasing number of high quality trials has been initiated, multiple concepts and details in study design may be further elaborated, harmonized and improved. An international group of experts in the field of AIT has thoroughly reviewed and discussed current concepts and provided an outlook on further improvement especially in the age group of children and adolescents. Emphasis of the group's discussion as a basis for this article was put on (i) the regulatory background of marketing authorization of AIT products including the 'Pediatric Investigational Plan', (ii) patient reported outcomes and endpoints in AIT trials, (iii) considerations regarding the 'minimal clinically important difference', (iv) the role of placebo effects in AIT clinical trials and clinical routine and (v) the potential of mobile Health for future development of AIT. Current concepts in AIT have been optimized throughout the recent decades, but there remains room for improvement e.g., in the topics outlined in this article.
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Affiliation(s)
- O Pfaar
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - R Gerth van Wijk
- 2Section of Allergology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - J Bousquet
- MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,5INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France, Universite Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - P S Creticos
- 6Division of Allergy & Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD 21224 USA.,Creticos Research Group, Crownsville, MD 21032 USA
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30
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Xu X, Ong YK, Wang DY. Novel findings in immunopathophysiology of chronic rhinosinusitis and their role in a model of precision medicine. Allergy 2020; 75:769-780. [PMID: 31512248 DOI: 10.1111/all.14044] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/26/2019] [Accepted: 09/01/2019] [Indexed: 02/06/2023]
Abstract
Our understanding of the pathophysiology of chronic rhinosinusitis (CRS) is continuously evolving. The traditional description of CRS in terms of two phenotypes based on the presence or absence of nasal polyps belies the underlying intricate immunopathophysiological processes responsible for this condition. CRS is being increasingly recognized as a disease spectrum encompassing a range of inflammatory states in the sinonasal cavity, with non-type 2 inflammatory disease on one end, type 2 inflammatory, eosinophil-heavy disease on the other and an overlap of both in different proportions in between. Abundance in research on the immune mechanisms of CRS has revealed various new endotypes that hold promise as biomarkers for the development of targeted therapies in severe, uncontrolled CRS. The introduction of precision medicine to manage this chronic, complex condition is a step forward in providing individualized care for all patients with CRS. In this review, the latest research on the pathophysiology of CRS with a focus on potential novel biomarkers and treatment options over the last 2 years are summarized and integrated into a suggested model of precision medicine in CRS.
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Affiliation(s)
- Xinni Xu
- Department of Otolaryngology‐Head and Neck Surgery National University Hospital System (NUHS) Singapore Singapore
| | - Yew Kwang Ong
- Department of Otolaryngology‐Head and Neck Surgery National University Hospital System (NUHS) Singapore Singapore
| | - De Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
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31
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Mathioudakis AG, Janssens W, Sivapalan P, Singanayagam A, Dransfield MT, Jensen JUS, Vestbo J. Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits. Thorax 2020; 75:520-527. [PMID: 32217784 PMCID: PMC7279206 DOI: 10.1136/thoraxjnl-2019-214484] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/21/2020] [Accepted: 03/01/2020] [Indexed: 12/12/2022]
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant mortality, health and economic burden. Their diagnosis, assessment and management remain suboptimal and unchanged for decades. Recent clinical and translational studies revealed that the significant heterogeneity in mechanisms and outcomes of exacerbations could be resolved by grouping them etiologically. This is anticipated to lead to a better understanding of the biological processes that underlie each type of exacerbation and to allow the introduction of precision medicine interventions that could improve outcomes. This review summarises novel data on the diagnosis, phenotyping, targeted treatment and prevention of COPD exacerbations.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.,North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Wim Janssens
- Respiratory Division, Department of Clinical and Experimental Medicine, University Hospital Leuven & KU Leuven, Leuven, Belgium
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Aran Singanayagam
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Alabama, USA
| | - Jens-Ulrik Stæhr Jensen
- Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark.,PERSIMUNE&CHIP: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK .,North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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32
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Yorgancıoğlu AA, Gemicioğlu B, Cingi C, Kalaycı Ö, Kalyoncu AF, Bachert C, Hellings P, Pfaar O, Schünemann HJ, Wallace D, Bedbrook A, Czarlewski W, Bousquet J. ARIA 2019, Allerjik Rinite Tedavi Yaklaşımı-Türkiye. Turk Thorac J 2020; 21:122-133. [PMID: 32203003 DOI: 10.5152/turkthoracj.2019.19084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/06/2019] [Indexed: 11/22/2022]
Abstract
Gerçek yaşamda, çevresel maruziyetlerin de etkilediği rinit ve astım mültimorbidite durumlarında, dijitalleşmiş ve kişiye odaklanan tedaviler için bütünleştirilmiş tedavi yollarının değerlendirilmesi önerilmektedir. Gerçek yaşamdaki bu durum mültisipliner bir yaklaşımla basamaklandırılıp, rehberilerinde ülkelerdeki gereksinimlere göre değiştilmesini gerektirebilir. Allerjik rinitte hem farmakoterapi hem immünoterapi açısından acil yeni yaklaşımlara ihtiyaç olduğu görülmüştür. 3. Aralık 2018'de Paris'te bir toplantı yapılmış ve iki ayrı belge hazırlanmıştır. Bu yayında bunlara ait bir özet sunulup, ülkeye ve sağlık sistemine uygun kullanımın çerçevesi oluşturulmak istenmiştir.
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Affiliation(s)
| | - Bilun Gemicioğlu
- Department of Chest Diseases, İstanbul University-Cerrahpaşa, Cerrahpasa School of Medicine, İstanbul, Turkey
| | - Cemal Cingi
- Department of Ear Nose Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ömer Kalaycı
- Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Fuat Kalyoncu
- Department of Chest Diseases, Hacettepe University School of Medicine, Ankara, Turkey
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium
| | - Peter Hellings
- Department of Otorhinolaryngology, University Hospitals Leuven, Belgium, and Academic Medical Center, University of Amsterdam, The Netherlands and Euforea, Brussels, Belgium
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Anna Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | | | - Jean Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
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33
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Dantas LO, Weber S, Osani MC, Bannuru RR, McAlindon TE, Kasturi S. Mobile health technologies for the management of systemic lupus erythematosus: a systematic review. Lupus 2020; 29:144-156. [PMID: 31924145 DOI: 10.1177/0961203319897139] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We aimed to perform a standardized review of available mobile health (mHealth) applications (apps) for systemic lupus erythematosus (SLE) and to conduct a systematic review of the literature on mHealth technologies in SLE. METHODS Google Play and AppStore in the United States of America were queried and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Web of Science, EMBASE, Medline, and Cochrane databases were systematically searched from inception through June 2019. RESULTS Of 324 mHealth apps found, 20 were eligible for inclusion; 10 focused on education, 7 offered tools to track patient-reported symptoms, 5 included interactive online communities, and 1 enabled emoji sharing. The reviewed apps scored poorly on the MARS quality scale with a mean score 2.3 (0.6) out of 5. Of 1147 studies identified in the literature review, 21 were eligible for inclusion; 11 studies (52.4%) focused on the development and use of mHealth for providing patient information, while only 2 (9.5%) were randomized trials of mHealth interventions. CONCLUSIONS Although there is growing interest in the development of mHealth technologies to support SLE patients, currently available tools are of poor quality and limited functionality, and the literature examining this area is sparse.
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Affiliation(s)
- L O Dantas
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
- Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - S Weber
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - M C Osani
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - R R Bannuru
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - T E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - S Kasturi
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
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34
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Bousquet J, Farrell J, Illario M. Aligning the Good Practice MASK With the Objectives of the European Innovation Partnership on Active and Healthy Ageing. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:238-258. [PMID: 32009320 PMCID: PMC6997284 DOI: 10.4168/aair.2020.12.2.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Santé good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation.
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Affiliation(s)
- J Bousquet
- CHU Arnaud de Villeneuve, Montpellier, France.,MACVIA-France, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - J Farrell
- LANUA International Healthcare Consultancy, Belfast, Northern Ireland, UK
| | - M Illario
- Division for Health Innovation, Campania Region.,Federico II University Hospital Naples (R&D and DISMET) Naples, Italy
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ARIA guideline 2019: treatment of allergic rhinitis in the German health system. Allergol Select 2019; 3:22-50. [PMID: 32176226 PMCID: PMC7066682 DOI: 10.5414/alx02120e] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background: The number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. Methods: ARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system. Results: The present ICP (integrated care pathway) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers. Discussion: A comprehensive ICP guideline can reflect real-life care better than traditional guideline models.
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36
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Seys SF, Quirce S, Agache I, Akdis CA, Alvaro‐Lozano M, Antolín‐Amérigo D, Bjermer L, Bobolea I, Bonini M, Bossios A, Brinkman P, Bush A, Calderon M, Canonica W, Chanez P, Couto M, Davila I, Del Giacco S, Del Pozo V, Erjefält JS, Gevaert P, Hagedoorn P, G. Heaney L, Heffler E, Hellings PW, Jutel M, Kalayci O, Kurowski MM, Loukides S, Nair P, Palomares O, Polverino E, Sanchez‐Garcia S, Sastre J, Schwarze J, Spanevello A, Ulrik CS, Usmani O, Van den Berge M, Vasakova M, Vijverberg S, Diamant Z. Severe asthma: Entering an era of new concepts and emerging therapies: Highlights of the 4th international severe asthma forum, Madrid, 2018. Allergy 2019; 74:2244-2248. [PMID: 31021446 DOI: 10.1111/all.13843] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Sven F. Seys
- Laboratory of Clinical Immunology, Department of Clinical Immunology KU Leuven Leuven Belgium
| | - Santiago Quirce
- Department of Allergy Hospital Universitario La Paz, CIBER of Respiratory Diseases (CIBERES) Madrid Spain
| | - Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Montserrat Alvaro‐Lozano
- Pediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Déu, Universitat de Barcelona Esplugues (Barcelona) Spain
| | | | - Leif Bjermer
- Skane University hospital, Lund University Lund Sweden
| | - Irina Bobolea
- Allergy Section/ Severe Asthma Unit, Department of Pulmonology and Respiratory Allergy Hospital Clinic Barcelona Barcelona Spain
| | - Matteo Bonini
- National Heart and Lung Institute, Imperial College London London UK
- Department of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A. Gemelli, IRCCS Rome Italy
- Universita’ Cattolica del Sacro Cuore Rome Italy
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy Karolinska University Hospital Huddinge Sweden
- Department of Medicine Karolinska Institutet Stockholm Sweden
| | - Paul Brinkman
- Department of Respiratory Medicine Amsterdam UMC Amsterdam The Netherlands
| | - Andy Bush
- Department of Paediatrics and Paediatric Respiratory Medicine Imperial College and Royal Brompton Hospital London UK
| | - Moises Calderon
- Section of Allergy and Clinical Immunology Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital London UK
| | - Walter Canonica
- Personalized Medicine, Asthma and Allergy ‐ Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Sciences Humanitas University Pieve Emanuele Italy
| | - Psacal Chanez
- Assistance Publique des Hôpitaux de Marseille ‐ Clinique des bronches, allergies et sommeil Aix Marseille Université Marseille France
| | | | - Ignacio Davila
- Department of Biomedical and Diagnostic Sciences Universidad de Salamanca Salamanca Spain
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health "M. Aresu" University of Cagliari Cagliari Italy
| | - Victoria Del Pozo
- Department of Immunology IIS‐Fundación Jiménez Díaz, and CIBERES Madrid Spain
| | - Jonas S. Erjefält
- Unit of Airway Inflammation, Department of Respiratory Medicine Lund University Lund Sweden
| | - Philippe Gevaert
- Department of Otorhinolaryngology Ghent University Ghent Belgium
| | - Paul Hagedoorn
- Pharmaceutical Technology and Biopharmacy Groningen Research Institute of Pharmacy, University of Groningen Groningen The Netherlands
| | - Liam G. Heaney
- Centre for Experimental Medicine Queen's University of Belfast Belfast UK
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy ‐ Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Sciences Humanitas University Pieve Emanuele Italy
| | | | - Marek Jutel
- ALL‐MED Medical Research Institute Wroclaw Poland
- Department of Clinical Immunology Wroclaw Medical University Wrocław Poland
| | - Omer Kalayci
- Hacettepe University School of Medicine Ankara Turkey
| | | | - Stelios Loukides
- Medical School, 2nd Respiratory Medicine Department National Kapodistrian University of Athens Athens Greece
| | - Parameswaran Nair
- Department of Medicine St Joseph’s Healthcare & McMaster University Hamilton Ontario Canada
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, Chemistry School Complutense University of Madrid Madrid Spain
| | - Eva Polverino
- Respiratory Disease Dept Hospital Universitari Vall d'Hebron (HUVH) Institut de Recerca Vall d'Hebron (VHIR) Passeig Vall d'Hebron, CIBERES Barcelona Spain
| | | | - Joaquin Sastre
- Department of Allergy CIBER of Respiratory Diseases (CIBERES) Fundación Jiménez Díaz Madrid Spain
| | - Jürgen Schwarze
- Child Life and Health and Centre for Inflammation Research The University of Edinburgh Edinburgh UK
| | | | - Charlotte S. Ulrik
- Respiratory Research Unit, Department of Respiratory Medicine Hvidovre Hospital and Institute of Clinical Medicine, University of Copenhagen Copenhagen Denmark
| | - Omar Usmani
- National Heart and Lung Institute, Imperial College London London UK
| | - Maarten Van den Berge
- University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Pulmonology Groningen Research Institute for Asthma and COPD Research Institute Groningen The Netherlands
| | - Martina Vasakova
- Department of Respiratory Medicine First Faculty of Medicine of Charles University, Thomayer Hospital Prague Czech
| | - Susanne Vijverberg
- Department of Respiratory Medicine Amsterdam UMC Amsterdam The Netherlands
| | - Zuzana Diamant
- Skane University hospital, Lund University Lund Sweden
- University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Pulmonology Groningen Research Institute for Asthma and COPD Research Institute Groningen The Netherlands
- Department of Respiratory Medicine First Faculty of Medicine of Charles University, Thomayer Hospital Prague Czech
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Gaga M, Powell P, Almagro M, Tsiligianni I, Loukides S, Roca J, Cullen M, Simonds AK, Ward B, Saraiva I, Troosters T, Robalo Cordeiro C. ERS Presidential Summit 2018: multimorbidities and the ageing population. ERJ Open Res 2019; 5:00126-2019. [PMID: 31579675 PMCID: PMC6759575 DOI: 10.1183/23120541.00126-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/29/2019] [Indexed: 11/12/2022] Open
Abstract
As the average age of the population increases, so will the prevalence of chronic respiratory diseases and associated multimorbidity. This will result in a more complex clinical environment. Part of the solution will be to allow patients to be co-creators in the design of their care. It will also require clinicians to shift in their current approaches to care, step out of the disease- or pathology-oriented approach and embrace new ideas. In an effort to prepare the respiratory community for the challenge, we reflect on concepts to empower patients via multidisciplinary systems, new technologies and transition from end-of-life care to advanced care planning.
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Affiliation(s)
- Mina Gaga
- 7th Resp. Med. Dept and Asthma Center, Athens, Greece
| | | | - Marta Almagro
- ELF Bronchiectasis Patient Advisory Committee, Sheffield, UK
| | | | | | - Josep Roca
- University of Barcelona, Barcelona, Spain
| | | | | | - Brian Ward
- European Respiratory Society, Brussels, Belgium
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