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Raghavendra AS, Jennings K, Guerra G, Tripathy D, Karuturi MS. Patient-reported convenience and effectiveness of telehealth for breast cancer management. Oncologist 2024:oyae165. [PMID: 39017637 DOI: 10.1093/oncolo/oyae165] [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: 02/22/2024] [Accepted: 05/09/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Before the coronavirus disease 2019 (COVID-19) pandemic, telehealth was rarely used for breast cancer management at tertiary care centers. We sought to examine patient satisfaction, experiences, preferences, and perceived effectiveness and technical quality of telehealth visits in follow-up patients receiving routine outpatient care in the breast medical oncology practice at The University of Texas MD Anderson Cancer Center. METHODS We administered a survey to 60 follow-up patients for a duration of 9 months (January 5, 2021 to October 27, 2021) who had at least one telehealth consultation during the COVID-19 pandemic, from April 10, 2020 to October 21, 2021. Descriptive statistics were then generated for each question, each domain, and overall survey scores. Subgroup comparisons within patient populations were done using the chi-square or t-test when appropriate. RESULTS Among the 60 participants, 49 (82%) were undergoing standard follow-up during active treatment for either early-stage or metastatic breast cancer. Telehealth and in-person office visits were considered equivalent in terms of quality of communication by 43 participants (72%). Most participants (n = 49, 82%) felt equally cared for during telehealth and in-person visits, and 40 participants (67%) reported feeling connected to their healthcare professional during both telehealth and in-person visits. In addition, 28 participants (47%) felt that the duration of telehealth visits was similar to in-person visits, 46 (77%) found both telehealth and in-person visits equally comfortable for discussing sensitive topics, 39 (65%) considered telehealth visits convenient, and 42 (70%) perceived the overall quality of care for telehealth to be similar to that of in-person visits. Participants expressed high satisfaction with telehealth appointments, with 42 (70%) rating their experience as very satisfying. Most participants (n = 44, 73%) expressed a strong likelihood of participating in telehealth appointments for breast cancer follow-up care in the future. CONCLUSIONS Our results indicate that telehealth can serve as an effective and satisfactory approach for delivering healthcare services to patients with breast cancer requiring follow-up care. The positive experiences and willingness to continue using telehealth indicate its potential for improving access to care and patient outcomes.
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Affiliation(s)
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gil Guerra
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Meghan S Karuturi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Holm TF, Udsen FW, Færch K, Jensen MH, von Scholten BJ, Hejlesen OK, Hangaard S. The Effectiveness of Digital Health Lifestyle Interventions on People With Prediabetes: Protocol for a Systematic Review, Meta-Analysis, and Meta-Regression. JMIR Res Protoc 2024; 13:e50340. [PMID: 38335018 PMCID: PMC10891485 DOI: 10.2196/50340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND There has been an increasing interest in the use of digital health lifestyle interventions for people with prediabetes, as these interventions may offer a scalable approach to preventing type 2 diabetes. Previous systematic reviews on digital health lifestyle interventions for people with prediabetes had limitations, such as a narrow focus on certain types of interventions, a lack of statistical pooling, and no broader subgroup analysis of intervention characteristics. The identified limitations observed in previous systematic reviews substantiate the necessity of conducting a comprehensive review to address these gaps within the field. This will enable a comprehensive understanding of the effectiveness of digital health lifestyle interventions for people with prediabetes. OBJECTIVE The objective of this systematic review, meta-analysis, and meta-regression is to systematically investigate the effectiveness of digital health lifestyle interventions on prediabetes-related outcomes in comparison with any comparator without a digital component among adults with prediabetes. METHODS This systematic review will include randomized controlled trials that investigate the effectiveness of digital health lifestyle interventions on adults (aged 18 years or older) with prediabetes and compare the digital interventions with nondigital interventions. The primary outcome will be change in body weight (kg). Secondary outcomes include, among others, change in glycemic status, markers of cardiometabolic health, feasibility outcomes, and incidence of type 2 diabetes. Embase, PubMed, CINAHL, and CENTRAL (Cochrane Central Register of Controlled Trials) will be systematically searched. The data items to be extracted include study characteristics, participant characteristics, intervention characteristics, and relevant outcomes. To estimate the overall effect size, a meta-analysis will be conducted using the mean difference. Additionally, if feasible, meta-regression on study, intervention, and participant characteristics will be performed. The Cochrane risk of bias tool will be applied to assess study quality, and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach will be used to assess the certainty of evidence. RESULTS The results are projected to yield an overall estimate of the effectiveness of digital health lifestyle interventions on adults with prediabetes and elucidate the characteristics that contribute to their effectiveness. CONCLUSIONS The insights gained from this study may help clarify the potential of digital health lifestyle interventions for people with prediabetes and guide the decision-making regarding future intervention components. TRIAL REGISTRATION PROSPERO CRD42023426919; http://tinyurl.com/d3enrw9j. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50340.
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Affiliation(s)
- Tanja Fredensborg Holm
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
| | - Flemming Witt Udsen
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
| | - Kristine Færch
- Data Science, Novo Nordisk A/S, Søborg, Denmark
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Morten Hasselstrøm Jensen
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Data Science, Novo Nordisk A/S, Søborg, Denmark
| | | | | | - Stine Hangaard
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
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Wang F, Zhang P, Ren Y, Huang D, Xu F, Ma J, Luo S, Liang X. The estimated effect of increasing fruit interventions on controlling body weight in children and adolescents: A meta-analysis. Prev Med 2024; 179:107785. [PMID: 37992975 DOI: 10.1016/j.ypmed.2023.107785] [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: 05/14/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The impact of increased fruit consumption on weight change remains a matter of debate. OBJECTIVE This study aimed to evaluate the effects of interventions targeted at promoting fruit consumption and managing body weight in children and adolescents. METHODS Four electronic databases, including PubMed, Web of science, Embase, and the Cochrane Library, were searched from January 1, 2000, to October 10th, 2023, to identify Randomized controlled trials (RCTs) that assessed changes in fruit consumption and obesity indicators. RESULTS A total of 22 trials including 12,678 participants who met our inclusion criteria were selected for this review. The meta-analysis demonstrated that the interventions increased fruit intake (MD = 78.58 g/day (95% CI 53.09 to 104.07), P < 0.001) in children and adolescents. The mean reduction of body mass index was 0.27 kg/m2 (95% CI -0.59 to 0.05 kg/m2, P = 0.101). And no significant decreases were observed in body mass index-z scores, but there was a significant decrease in waist circumference (MD = -0.65 cm (95% CI -1.15 to -0.05 cm), P < 0.05). Increased fruit intake was shown to be associated with a lower prevalence of obesity when compared to the control group (odds ratio [OR]: 0.74, 95% CI 0.60 to 0.90), P < 0.05). CONCLUSIONS This meta-analysis provided evidence that interventions aimed at increasing fruit consumption were effective at reducing obesity prevalence.
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Affiliation(s)
- Fengming Wang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Ping Zhang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Fenglin Xu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Jun Ma
- Shimian People's Hospital, Ya'an, China
| | - Shunqing Luo
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
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Abdelhameed F, Pearson E, Parsons N, Barber TM, Panesar A, Summers C, de la Fosse M, Hanson P. Health Outcomes Following Engagement With a Digital Health Tool Among People With Prediabetes and Type 2 Diabetes: Prospective Evaluation Study. JMIR Diabetes 2023; 8:e47224. [PMID: 38016426 PMCID: PMC10784975 DOI: 10.2196/47224] [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: 03/12/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Diabetes is a worldwide chronic condition causing morbidity and mortality, with a growing economic burden on health care systems. Complications from poorly controlled diabetes are associated with increased socioeconomic costs and reduced quality of life. Smartphones have become an influential platform, providing feasible tools such as health apps to deliver tailored support to enhance the ability of patients with diabetes for self-management. Gro Health is a National Health Service division X-certified digital health tool used to deliver educational and monitoring support to facilitate the development of skills and practices for maintaining good health. OBJECTIVE This study aims to assess self-reported outcomes of the Gro Health app among users with diabetes and prediabetes and identify the factors that determine engagement with the digital health tool. METHODS This was a service evaluation of self-reported data collected prospectively by the developers of the Gro Health app. The EQ-5D questionnaire is a standardized tool used to measure health status for clinical and economic appraisal. Gro Health users completed the EQ-5D at baseline and 6 months after using the app. Users provided informed consent for the use of their anonymized data for research purposes. EQ-5D index scores and visual analogue scale (VAS) scores were calculated at baseline and 6 months for individuals with prediabetes and type 2 diabetes. Descriptive statistics and multiple-regression models were used to assess changes in the outcome measures and determine factors that affected engagement with the digital tool. RESULTS A total of 84% (1767/2114) of Gro Health participants completed EQ-5D at baseline and 6 months. EQ-5D index scores are average values that reflect people's preferences about their health state (1=full health and 0=moribund). There was a significant and clinically meaningful increase in mean EQ-5D index scores among app users between baseline (0.746, SD 0.23) and follow-up (0.792, SD 0.22; P<.001). The greatest change was observed in the mean VAS score, with a percentage change of 18.3% improvement (61.7, SD 18.1 at baseline; 73.0, SD 18.8 at follow-up; P<.001). Baseline EQ-5D index scores, age, and completion of educational modules were associated with significant changes in the follow-up EQ-5D index scores, with baseline EQ-5D index scores, race and ethnicity, and completion of educational modules being significantly associated with app engagement (P<.001). CONCLUSIONS This study provides evidence of a significant positive effect on self-reported quality of life among people living with type 2 diabetes engaging with a digital health intervention. The improvements, as demonstrated by the EQ-5D questionnaire, are facilitated through access to education and monitoring support tools within the app. This provides an opportunity for health care professionals to incorporate National Health Service-certified digital tools, such as Gro Health, as part of the holistic management of people living with diabetes.
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Affiliation(s)
- Farah Abdelhameed
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Eilish Pearson
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nick Parsons
- Statistics and Epidemiology Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Arjun Panesar
- Diabetes Digital Media Health, Coventry, United Kingdom
| | | | | | - Petra Hanson
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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AkbariRad M, Dehghani M, Sadeghi M, Torshizian A, Saeedi N, Sarabi M, Sahebi M, Shakeri MT. The Effect of Telenursing on Disease Outcomes in People with Type 2 Diabetes Mellitus: A Narrative Review. J Diabetes Res 2023; 2023:4729430. [PMID: 38098964 PMCID: PMC10721346 DOI: 10.1155/2023/4729430] [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: 04/14/2023] [Revised: 10/27/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
Method A comprehensive search of online databases, including PubMed, Scopus, Cochrane Library, and Google Scholar, was performed using the following MeSH keywords: telenursing, telephone follow-up, diabetes mellitus, disease management, glycemic, self-care, treatment adherence, and quality of life, up to September 2023. Two reviewers independently screened pertinent studies based on the prespecified outcomes (treatment adherence, self-care, glycemic control, and quality of life) and extracted data from all eligible studies. Results Of all retrieved records, 23 studies including 5 quasiexperimental (21%) and 18 randomized controlled trials (RCTs) (79%) from five continents met the inclusion criteria. Both male and female patients were considered in the included studies, with mean age of 56.2 years old and a follow-up range of 12 weeks to 18 months. Findings showed that telenursing or nurse telephone follow-up significantly increased mean self-care efficacy score, improved adherence to the treatment regimen, decreased glycosylated hemoglobin and plasma glucose levels (but not lipid profile and body mass index), and improved quality of life compared to the routine care in people with T2DM. Conclusion Telenursing can effectively supplement healthcare professionals to manage PWT2D. Increasing patients' knowledge about their drugs, insulin administration, and diabetes complications improves self-care behaviors and medical adherence. Consistently, improved self-care and regular use of treatment result in improved metabolic indicators and decreased rate of complications, which is associated with a better quality of life.
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Affiliation(s)
- Mina AkbariRad
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Dehghani
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ashkan Torshizian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nikoo Saeedi
- Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Mehrdad Sarabi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Sahebi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Taghi Shakeri
- Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Cohen Rodrigues TR, Breeman LD, Kinik A, Reijnders T, Dusseldorp E, Janssen VR, Kraaijenhagen RA, Atsma DE, Evers AW. Effectiveness of Human-Supported and Self-Help eHealth Lifestyle Interventions for Patients With Cardiometabolic Risk Factors: A Meta-Analysis. Psychosom Med 2023; 85:795-804. [PMID: 37549197 PMCID: PMC10662612 DOI: 10.1097/psy.0000000000001242] [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: 01/06/2023] [Revised: 06/02/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective. METHODS Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique ( N = 20,781) studies were included. RESULTS The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes ( p < .001). However, these effects were not moderated by intervention type ( p = .169), dose ( p = .698), or delivery mode of human support ( p = .557). CONCLUSIONS This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support.Meta-analysis registration: PROSPERO CRD42021269263 .
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Onyia AU, Berhie G, Cecchetti A, Hines A. The Use of Digital Telehealth for the Self-Management of Type 2 Diabetes Patients in Hinds County, Mississippi: A Pilot Study. J Patient Exp 2023; 10:23743735231188835. [PMID: 37817929 PMCID: PMC10561552 DOI: 10.1177/23743735231188835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
Self-management is crucial for the management of type 2 diabetes. Remote patient monitoring via telehealth may enhance self-management and control of diabetes. A three-arm randomized controlled trial involving 90 participants randomized into two intervention groups and one control group was conducted. The purpose of this study is to test whether the use of a mobile phone-based app, with or without telehealth counseling, could improve HbA1c level, self-management, and health-related quality of life compared with usual care. The two intervention groups received a mobile phone with a self-management app. One intervention group additionally received telehealth counseling delivered by a diabetes specialist nurse for 6 months. All three groups continued to receive the usual care from their provider. The primary outcome is a reduction in HbA1c level. Secondary outcomes are self-management, health-related quality of life, depressive symptoms, and lifestyle changes. Data were analyzed using univariate and multivariate (descriptive, t-test, MANOVA) methods. There was a significant reduction in the HbA1c levels of participants after 3 and 6 months. There was also a significant difference in HbA1c levels between the control and two intervention groups. Pre- and posteducation surveys for intervention group 2 showed an improvement in the understanding of type 2 diabetes risk factors, diabetes, and self-management. Digital telehealth demonstrated considerable potential for reducing blood sugar levels, enhancing self-management, and improving the quality of life of type 2 diabetic patients. The addition of telehealth education and counseling further improved the positive outcomes.
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Affiliation(s)
- Austine U Onyia
- Public Health Informatics and Technology, Jackson State University, Jackson, Mississippi, USA
| | - Girmay Berhie
- Public Health Informatics and Technology, Jackson State University, Jackson, Mississippi, USA
| | - Alfred Cecchetti
- Department of Clinical and Translational Sciences, (DCTS) Joan C. Edwards School of Medicine, Marshal University, Huntington, WV, USA
| | - Andre Hines
- Department of Public Policy and Administration, Jackson State University, Jackson, Mississippi, USA
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Kerimaa H, Hakala M, Haapea M, Vähänikkilä H, Serlo W, He HG, Pölkki T. Effectiveness of a Mobile App Intervention for Preparing Preschool Children and Parents for Day Surgery: Randomized Controlled Trial. J Med Internet Res 2023; 25:e46989. [PMID: 37773624 PMCID: PMC10576237 DOI: 10.2196/46989] [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: 03/04/2023] [Revised: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Day surgery allows families to return home quickly. Only a few approaches to preparing for day surgery have demonstrated how digital solutions can support families and children. OBJECTIVE This study aims to evaluate the effectiveness of a mobile app intervention on preschool children's fear and pain and parents' anxiety and stress in preparing children for day surgery. METHODS This study was conducted at the Pediatric Day Surgical Department of a university hospital in Finland between 2018 and 2020. Parents of children (aged 2-6 y) who were in a queue for elective day surgery were randomized into the intervention group (IG; n=36) and control group (CG; n=34). The CG received routine preparations, whereas the IG was prepared using a mobile app. Parents' and children's outcomes were measured using validated scales at 4 different points: at home (T1 and T4) and at the hospital (T2 and T3) before and after surgery. Group differences were analyzed using statistical methods suitable for the material. RESULTS Before surgery, parents in both groups experienced mild anxiety, which decreased after surgery. Parental anxiety did not differ between groups preoperatively (P=.78) or postoperatively (P=.63). Both groups had less anxiety at home after surgery compared with before. The IG showed a significant decrease (P=.003); the CG also improved (P=.002). Preoperatively at home, most parents in both groups experienced no stress or mild stress (P=.61). Preoperatively at the hospital, parents in both groups experienced mild stress; however, parents in the IG experienced more stress during this phase (P=.02). Parents in the IG experienced significantly less stress postoperatively than those in the CG (P=.05). Both groups showed decreased stress levels from before to after surgery (IG: P=.003; CG: P=.004) within each group. There were no significant differences in children's pain levels between the groups and measurement points. This was observed before surgery at home (P=.25), before surgery at the hospital (P=.98), and after surgery at the hospital (P=.72). Children's fear decreased more in the IG (P=.006) than in the CG (P=.44) comparing the phases before and after surgery at home. Fear did not differ between the IG and CG preoperatively at home (P=.20) or at the hospital (P=.59) or postoperatively at the hospital (P=.62) or at home (P=.81). CONCLUSIONS The mobile app intervention did not reduce anxiety or pain. However, it was observed that parents in the IG experienced substantially heightened stress levels before surgery at the hospital, which decreased significantly after surgery at home. In addition, fear levels in children in the IG decreased over time, whereas no significant change was observed in the CG. These results are important for developing health care service chains and providing families with innovative and customer-oriented preparation methods. TRIAL REGISTRATION ClinicalTrials.gov NCT03774303; https://classic.clinicaltrials.gov/ct2/show/NCT03774303.
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Affiliation(s)
- Heli Kerimaa
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Mervi Hakala
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
| | - Marianne Haapea
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Service Unit, Oulu University Hospital, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Willy Serlo
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Division of Pediatric Surgery, Oulu University Hospital, Oulu, Finland, Oulu, Finland
- Oulu University Unit of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Tarja Pölkki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
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Song Y, Nan Y, Feng W. Glycaemic control using mobile-based intervention in patients with diabetes undergoing coronary artery bypass-study protocol for a randomized controlled trial. Trials 2023; 24:585. [PMID: 37705074 PMCID: PMC10498600 DOI: 10.1186/s13063-023-07580-x] [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: 10/06/2021] [Accepted: 08/10/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Applying technology through the use of the Internet and mobile phones can help provide education and trained peer support for patients with diabetes after coronary artery bypass (CABG). We are conducting a randomized controlled trial to evaluate the efficacy and feasibility of mobile-based coaching intervention in improving risk-factor control and secondary prevention in patients with diabetes after CABG. METHODS The glycaemic control using miniprogram-based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management (GUIDE ME) study is a multi-centre, randomized controlled trial of mobile intervention versus standard treatment with 6 months follow-up conducted in 2 hospitals in China. The interventions are education and a reminder system based on the WeChat mini-program. Participants in the intervention groups receive 180 videos (including lines) about secondary prevention education for 6 months as well as the standard treatment. Behavioural change techniques, such as prompting barrier identification, motivational skills, and goal setting, are employed. A total sample size of 820 patients would be adequate for the GUIDE ME study. The primary outcome is the change of glycaemic haemoglobin (HbA1c) at 6 months. Secondary outcomes include a change in the proportions of patients achieving HbA1c, fasting blood glucose, systolic blood pressure, low-density lipoprotein cholesterol (LDL-C) and medication adherence. DISCUSSION This trial is the first to investigate the efficacy of mobile phone WeChat-based video coaching and medication reminder mini-program system to improve self-management in patients with diabetes and coronary heart disease (CHD) after CABG and has the potential to be applied in resource-limited settings across diverse populations. If successful, such mobile intervention could be used and scaled up to improve care for this high-risk group of patients. TRIAL REGISTRATION ClinicalTrials, NCT04192409 . Registered on December 10, 2019.
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Affiliation(s)
- Yangwu Song
- Department of Cardiovascular Surgery, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yifeng Nan
- Department of Cardiovascular Surgery, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Wei Feng
- Department of Cardiovascular Surgery, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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Karia J, Mohamed R, Petrushkin H. Patient-targeted mobile applications in healthcare. Br J Hosp Med (Lond) 2023; 84:1-5. [PMID: 37646550 DOI: 10.12968/hmed.2023.0158] [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] [Indexed: 09/01/2023]
Abstract
There has been an increase in the number of healthcare-related applications targeted at patients for use on mobile phones. With an increasing proportion of the population using such applications, it is important to understand the associated limitations, safety concerns and challenges of legalisation. This article explores the impact of these applications on frontline care and patient wellbeing, evaluating the literature surrounding the benefits and challenges of patient-targeted mobile applications in health care and analysing the limitations of existing research. The proclaimed benefits of such applications are not always evidence based. Furthermore, many healthcare applications are created by laypeople and not validated by healthcare authorities, creating a potential to cause patient harm. Further research is needed to identify long-term effects on both healthcare systems and individuals' psychosocial wellbeing. However, research in this field often lacks a universal perspective and may be influenced by underlying financial motives to promote use of the applications.
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Affiliation(s)
- Janvi Karia
- Division of Medicine, University College London, London, UK
| | - Ryian Mohamed
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Harry Petrushkin
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
- Department of Ophthalmology, Great Ormond Street Hospital, London, UK
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SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial. Contemp Clin Trials 2023; 128:107149. [PMID: 36918092 DOI: 10.1016/j.cct.2023.107149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is common among persons experiencing homelessness (PEH), often inadequately managed, and carries significant costs. mHealth strategies including short messaging service (SMS) texting have been feasible and acceptable, and improved control of chronic diseases including DM. SMS strategies for DM have not been tested among PEH despite the accessibility of mobile phones. We propose an SMS strategy could offer better communication, education, and information management; improve outreach; facilitate care coordination; explore barriers to care; and support behavior changes. METHODS AND ANALYSIS This mixed-methods (RCT and qualitative) study will be implemented in shelter-clinics in New York City in collaboration with community organizations, allowing for sustainability and scalability. Aim 1 will evaluate the efficacy of a 6-month SMS program for DM management versus an attention control on changes in HbA1c and adherence to DM self-care activities, medications, and appointments at 9 months in adult PEH with uncontrolled DM (n = 100). Outcomes will be measured at 0, 3, 6, &9 months. AIM 2 will assess patients' and providers' attitudes, acceptability, and experience of the program through semi-structured interviews with PEH (n = 20) and providers (n = 10). DISCUSSION DM is not well-addressed among PEH. SMS strategies for DM have never been tested in PEH despite evidence of their effectiveness and access to mobile phones among PEH. Results from this study will provide important empirical data to inform evidence-based strategies to avert personal suffering and significant costs. It will have broader policy implications in control of DM and other chronic diseases.
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12
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Seixas MB, Ghisi GLDM, Oh P, Pereira DS, Moreira APB, Jansen AK, Batalha APDB, Cândido GDN, de Almeida JA, Pereira DAG, da Silva LP. Feasibility of Remote Delivering an Exercise and Lifestyle Education Program for Individuals Living with Prediabetes and Diabetes in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16697. [PMID: 36554577 PMCID: PMC9779705 DOI: 10.3390/ijerph192416697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to test the feasibility of remote delivering a 12-week exercise and lifestyle education program (ExLE) or a 12-week exercise program (Ex) for individuals with prediabetes and diabetes in terms of acceptability, implementation, practicality, and limited efficacy. The programs were internet- or telephone-based delivered, depending on the participants' internet access and technology literacy. Of the 196 individuals screened, 15 were included in the study (internet-based delivery (n = 13); telephone-based delivery (n = 2)). Twelve participants completed the program they were randomized to, and most reported being satisfied with the study interventions (acceptability). Data collection procedures, weekly follow-up, study website visits, and educational materials were proper (implementation), and the adherence rate to study interventions ranged from 24% to 58% (practicality). Additionally, both programs (ExLE and Ex) seemed to promote beneficial changes in functional capacity (limited efficacy). The internet-based remote delivery of the interventions showed feasibility. Therefore, in future trials, exercise and educational interventions can be internet-based remote delivered to individuals with prediabetes and diabetes with internet access and technology literacy. In addition, some adjustments to eligibility criteria, study websites, more accessible ways of recording exercise sessions and using educational materials, and an initial supervised exercise session are recommended.
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Affiliation(s)
- Mariana Balbi Seixas
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Paul Oh
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | | | - Ann Kristine Jansen
- Department of Nutrition, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Paula Delgado Bomtempo Batalha
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela do Nascimento Cândido
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Josiane Aparecida de Almeida
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
| | - Danielle Aparecida Gomes Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Lilian Pinto da Silva
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
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Eysenbach G, Cotterill S, Hawkes RE, Miles LM, French DP. Changes in a Digital Type 2 Diabetes Self-management Intervention During National Rollout: Mixed Methods Study of Fidelity. J Med Internet Res 2022; 24:e39483. [PMID: 36476723 PMCID: PMC9773035 DOI: 10.2196/39483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/20/2022] [Accepted: 10/07/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND "Healthy Living for People with type 2 Diabetes (HeLP-Diabetes)" was a theory-based digital self-management intervention for people with type 2 diabetes mellitus that encouraged behavior change using behavior change techniques (BCTs) and promoted self-management. HeLP-Diabetes was effective in reducing HbA1c levels in a randomized controlled trial (RCT). National Health Service (NHS) England commissioned a national rollout of HeLP-Diabetes in routine care (now called "Healthy Living"). Healthy Living presents a unique opportunity to examine the fidelity of the national rollout of an intervention originally tested in an RCT. OBJECTIVE This research aimed to describe the Healthy Living BCT and self-management content and features of intervention delivery, compare the fidelity of Healthy Living with the original HeLP-Diabetes intervention, and explain the reasons for any fidelity drift during national rollout through qualitative interviews. METHODS Content analysis of Healthy Living was conducted using 3 coding frameworks (objective 1): the BCT Taxonomy v1, a new coding framework for assessing self-management tasks, and the Template for Intervention Description and Replication. The extent to which BCTs and self-management tasks were included in Healthy Living was compared with published descriptions of HeLP-Diabetes (objective 2). Semistructured interviews were conducted with 9 stakeholders involved in the development of HeLP-Diabetes or Healthy Living to understand the reasons for any changes during national rollout (objective 3). Qualitative data were thematically analyzed using a modified framework approach. RESULTS The content analysis identified 43 BCTs in Healthy Living. Healthy Living included all but one of the self-regulatory BCTs ("commitment") in the original HeLP-Diabetes intervention. Healthy Living was found to address all areas of self-management (medical, emotional, and role) in line with the original HeLP-Diabetes intervention. However, 2 important changes were identified. First, facilitated access by a health care professional was not implemented; interviews revealed this was because general practices had fewer resources in comparison with the RCT. Second, Healthy Living included an additional structured web-based learning curriculum that was developed by the HeLP-Diabetes team but was not included in the original RCT; interviews revealed that this was because of changes in NHS policy that encouraged referral to structured education. Interviewees described how the service provider had to reformat the content of the original HeLP-Diabetes website to make it more usable and accessible to meet the multiple digital standards required for implementation in the NHS. CONCLUSIONS The national rollout of Healthy Living had good fidelity to the BCT and self-management content of HeLP-Diabetes. Important changes were attributable to the challenges of scaling up a digital intervention from an RCT to a nationally implemented intervention, mainly because of fewer resources available in practice and the length of time since the RCT. This study highlights the importance of considering implementation throughout all phases of intervention development.
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Affiliation(s)
| | - Sarah Cotterill
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, United Kingdom
| | - Rhiannon E Hawkes
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Lisa M Miles
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - David P French
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
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He QX, Zhao L, Tong JS, Liang XY, Li RN, Zhang P, Liang XH. The impact of obesity epidemic on type 2 diabetes in children and adolescents: A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:736-744. [PMID: 36184528 DOI: 10.1016/j.pcd.2022.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/15/2022] [Accepted: 09/16/2022] [Indexed: 10/14/2022]
Abstract
AIM To assess the impact of the obesity epidemic on type 2 diabetes (T2D), prediabetes and glycometabolic indices in children and adolescents. METHODS We searched four electronic databases (PubMed, Embase, Cochrane and Web of Science). Cross-sectional or cohort studies that reported on obesity and the prevalence of T2D or prediabetes in children and adolescents were reviewed. The study design, sample size and clinical outcomes were extracted from each study. The prevalence of T2D and prediabetes from the studies were pooled using meta-analysis methods. RESULTS Meta-analysis of 228184 participants showed that the prevalence of T2D was 1.3% (95% confidence interval (CI), 0.6-2.1%) in obese subjects, which was 13 times that in normal weight subjects (0.1%, 95% CI, 0.01-0.2%). The prevalence of prediabetes in obese subjects was 3 times that in normal subjects at 17.0% (13.0-22.0%) vs. 6.0% (0.01-11.0%). Moreover, BMI was positively correlated with the prevalence of T2D, prediabetes and glycometabolic indices in obese children and adolescents. CONCLUSION The pooled results confirm that obesity in children and adolescents leads to statistically significant increases in the prevalence of T2D and prediabetes and in glycometabolic indicator levels.
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Affiliation(s)
| | - Li Zhao
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China
| | - Ji-Shuang Tong
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China
| | - Xiao-Yue Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China; Department of Humanities and Social Sciences, Daqing Campus of Harbin Medical University, Daqing 163319, Heilongjiang Province, China
| | - Ri-Na Li
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China
| | - Ping Zhang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China
| | - Xiao-Hua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400016, China.
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15
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Steinberg JR, Yeh C, Jackson J, Saber R, Niznik CM, Leziak K, Yee LM. Optimizing Engagement in an mHealth Intervention for Diabetes Support During Pregnancy: the Role of Baseline Patient Health and Behavioral Characteristics. J Diabetes Sci Technol 2022; 16:1466-1472. [PMID: 34423677 PMCID: PMC9631537 DOI: 10.1177/19322968211035441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mobile health (mHealth) technology that addresses diabetes mellitus in pregnancy has the potential to improve maternal and child health while diminishing socioeconomic and racial disparities. Little is known about health literacy, electronic health literacy, or patient characteristics that contribute to increased mHealth use. In this pilot study, we aimed to examine patient factors associated with user engagement with a novel app for diabetes support during pregnancy. METHOD Low-income pregnant individuals with gestational or type 2 diabetes mellitus were recruited for a 2-week usability assessment of a novel mHealth smartphone application, "SweetMama," designed to improve diabetes care. This analysis of user characteristics was a pilot assessment of data from the usability study phase. Participants completed assessments of patient health literacy, electronic health literacy, diabetes self-efficacy, and activation. User metrics (eg, sessions and total duration of use) were evaluated by participant characteristics. Descriptive analyses were conducted to assess outcomes with respect to patient's clinical history, health literacy, electronic health literacy, diabetes self-efficacy, and activation. RESULTS Twenty-two diverse, low-income pregnant patients with either gestational or type 2 diabetes engaged with SweetMama for 14 days. Participants with gestational diabetes had greater mean minutes of use per session and mean total duration of use than those with type 2 diabetes. Participants with greater electronic health literacy, lower patient activation, and greater self-efficacy demonstrated greater total duration of use. No user metrics differed significantly by participant general health literacy. CONCLUSIONS Findings of this pilot study suggest engagement with a novel mHealth app for diabetes support during pregnancy varied by baseline behavioral and clinical characteristics. Results could indicate that digital health literacy better differentiates engagement patterns than general health literacy.
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Affiliation(s)
- Jecca R. Steinberg
- Department of Obstetrics and
Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Chen Yeh
- Department of Preventive Medicine,
Division of Biostatistics, Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Jenise Jackson
- Department of Obstetrics and
Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Rana Saber
- Institute for Sexual and Gender
Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Charlotte M. Niznik
- Department of Obstetrics and
Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Karolina Leziak
- Department of Obstetrics and
Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Lynn M. Yee
- Department of Obstetrics and
Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
- Lynn M. Yee, MD, MPH, Department of
Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine,
250 E. Superior Street, #5-2145, Chicago, IL 60611, USA.
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Jeem YA, Andriani RN, Nabila R, Emelia DD, Lazuardi L, Koesnanto H. The Use of Mobile Health Interventions for Outcomes among Middle-Aged and Elderly Patients with Prediabetes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13638. [PMID: 36294218 PMCID: PMC9603799 DOI: 10.3390/ijerph192013638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There are currently limited systematic reviews of mobile health interventions for middle-aged and elderly patients with prediabetes from trial studies. This review aimed to gather and analyze information from experimental studies investigating the efficacy of mobile health usability for outcomes among middle-aged and elderly patients with prediabetes. METHODS We conducted a literature search in five databases: Clinicaltrials.gov, the International Clinical Trials Registry Platform (ICTRP), PubMed, ProQuest, and EBSCO, with a date range of January 2007 to July 2022 written in English, following a registered protocol on PROSPERO (CRD42022354351). The quality and possibility of bias were assessed using the Jadad score. The data extraction and analysis were conducted in a methodical manner. RESULTS A total of 25 studies were included in the qualitative synthesis, with 19 studies using randomized trial designs and 6 studies with non-randomized designs. The study outcomes were the incidence of diabetes mellitus, anthropometric measures, laboratory examinations, measures of physical activity, and dietary behavior. During long-term follow-up, there was no significant difference between mobile health interventions and controls in reducing the incidence of type 2 diabetes. The findings of the studies for weight change, ≥3% and ≥5% weight loss, body mass index, and waist circumference changes were inconsistent. The efficacy of mobile health as an intervention for physical activity and dietary changes was lacking in conclusion. Most studies found that mobile health lacks sufficient evidence to change hbA1c. According to most of these studies, there was no significant difference in blood lipid level reduction. CONCLUSIONS The use of mobile health was not sufficiently proven to be effective for middle-aged and elderly patients with prediabetes.
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Affiliation(s)
- Yaltafit Abror Jeem
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta 55584, Indonesia
| | - Russy Novita Andriani
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta 55584, Indonesia
| | - Refa Nabila
- Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta 55584, Indonesia
| | - Dwi Ditha Emelia
- Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta 55584, Indonesia
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Hari Koesnanto
- Department of Family and Community Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
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Emezue C, Chase JD, Udmuangpia T, Bloom TL. Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1271. [PMID: 36909881 PMCID: PMC9419475 DOI: 10.1002/cl2.1271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors. OBJECTIVES To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors. SEARCH METHODS We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis. SELECTION CRITERIA We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English. DATA COLLECTION AND ANALYSIS We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes (Outcome by Time) were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's d) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the Z-statistic with a p-value of 0.05. Cochran's Q test and Higgins' I 2 statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis. MAIN RESULTS Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced depression among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), anxiety among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, p = 0.00, I 2 = 25%), and physical violence victimization among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce PTSD (SMD = -0.04, 95% CI = -0.14 to 0.06, p = .46, I 2 = 0%), or sexual violence victimization (SMD = -0.02, 95% CI = -0.14 to 0.11, I 2 = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses. AUTHORS' CONCLUSIONS The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family NursingRush University College of NursingChicagoIllinoisUSA
| | - Jo‐Ana D. Chase
- Sinclair School of NursingUniversity of MissouriColumbiaMissouriUSA
| | - Tipparat Udmuangpia
- Department of Maternal‐Child Health and MidwiferyBoromarajonani College of NursingKhon KaenThailand
| | - Tina L. Bloom
- School of NursingNotre Dame of Maryland UniversityBaltimoreMarylandUSA
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Oliaei S, Karimi A, Shamsabadi A, Mirzapour P, Mojdeganlou H, Nazeri Z, Bagheri AB, Nazarian N, Jashaninejad R, Qodrati M, Amiri Fard I, Ghanadinezhad F, Afzalian A, Heydari M, Mehraeen E, SeyedAlinaghi S. Design, development, and evaluation of a registry system for hyperbaric oxygen therapy: A methodological study. Health Sci Rep 2022; 5:e768. [PMID: 35949684 PMCID: PMC9358536 DOI: 10.1002/hsr2.768] [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: 02/01/2022] [Revised: 05/19/2022] [Accepted: 06/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Hyperbaric oxygen therapy (HBOT), utilizes 100% oxygen at pressures greater than sea‐level atmospheric pressure, for the treatment of conditions in which the tissues starve for oxygen. The Undersea and Hyperbaric Medical Society (UHMS) has granted HBOT approval for the treatment of various conditions. On the other hand, applying informatics registry systems can improve care delivery, ameliorate outcomes, and reduce the costs and medical errors for the patients receiving HBOT treatment. Therefore, we aimed to design, develop, and evaluate a registry system for patients undergoing HBOT. Methods In the first phase, the conceptual and logical models were designed after conducting symposiums with experts and having other experts review the models. In the second phase, the system was developed on the web using ASP.NET and C# programming languages frameworks. The last phase involved Nielsen's heuristic evaluation method for the system's usability. Five experts evaluated the system, including three health information management specialists and two medical informatics specialists. Results The hyperbaric patient information registry system (HPIRS) interacts with three types of users—a specialist physician, a nurse, and a system administrator. A scenario for each predefined activity was designed, and all the information was stored in the SQL servers. The five experts independently found 152 issues, of which 84 were duplicates. The 68 distinct issues of the system were then resolved. Conclusions The design and development of such registry systems can make data available and stored carefully to improve clinical care and medical research and decrease costs and errors. These registries can provide the healthcare systems with E‐health applications, improved data management, more secure data transfer, and support for statistical reporting. The implemented heuristic evaluation method can also provide a low‐cost and readily available system to fix the issues of the designed systems.
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Affiliation(s)
- Shahram Oliaei
- HBOT Research Center, Golestan Hospital, Islamic Republic of Iran Navy and AJA Medical University Tehran Iran
| | - Amirali Karimi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology Esfarayen Faculty of Medical Sciences Esfarayen Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors Tehran University of Medical Sciences Tehran Iran
| | | | - Zahra Nazeri
- Department of Health Information Management Tehran University of Medical Sciences Tehran Iran
| | - Amir B. Bagheri
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Interdisciplinary Consortium on Advanced Motion Performance Baylor College of Medicine Houston Texas USA
- Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | | | - Reyhaneh Jashaninejad
- Department of Epidemiology, School of Public Health Hamadan University of Medical Sciences Hamadan Iran
| | - Mohammad Qodrati
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors Tehran University of Medical Sciences Tehran Iran
| | - Iman Amiri Fard
- Department of Community Health Nursing and Geriatric Nursing, School of Nursing and Midwifery Iran University of Medical Sciences Tehran Iran
| | | | - Arian Afzalian
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Mohammad Heydari
- Department of Health Information Technology Khalkhal University of Medical Sciences Khalkhal Iran
| | - Esmaeil Mehraeen
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors Tehran University of Medical Sciences Tehran Iran
- Department of Health Information Technology Khalkhal University of Medical Sciences Khalkhal Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors Tehran University of Medical Sciences Tehran Iran
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Chapel B, Alexandre F, Heraud N, Ologeanu-Taddei R, Cases AS, Bughin F, Hayot M. Standardization of the assessment process within telerehabilitation in chronic diseases: a scoping meta-review. BMC Health Serv Res 2022; 22:984. [PMID: 35918690 PMCID: PMC9344755 DOI: 10.1186/s12913-022-08370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background Telerehabilitation (TR) interventions are receiving increasing attention. They have been evaluated in various scientific areas through systematic reviews. However, there is a lack of data on how to standardize assessment and report on their domains to guide researchers across studies and bring together the best evidence to assess TR for chronic diseases. Aims and objectives The aim of this study was to identify domains of assessment in TR and to qualitatively and quantitatively analyze how and when they are examined to gain an overview of assessment in chronic disease. Methods A scoping meta-review was carried out on 9 databases and gray literature from 2009 to 2019. The keyword search strategy was based on "telerehabilitation", “evaluation", “chronic disease" and their synonyms. All articles were subjected to qualitative analysis using the Health Technology Assessment (HTA) Core Model prior to further analysis and narrative synthesis. Results Among the 7412 identified articles, 80 studies met the inclusion criteria and addressed at least one of the noncommunicable diseases (NCD) categories of cardiovascular disease (cardiovascular accidents), cancer, chronic respiratory disease, diabetes, and obesity. Regarding the domains of assessment, the most frequently occurring were “social aspect” (n = 63, 79%) (e.g., effects on behavioral changes) and “clinical efficacy” (n = 53, 66%), and the least frequently occurring was “safety aspects” (n = 2, 3%). We also identified the phases of TR in which the assessment was conducted and found that it most commonly occurred in the pilot study and randomized trial phases and least commonly occurred in the design, pretest, and post-implementation phases. Conclusions Through the HTA model, this scoping meta-review highlighted 10 assessment domains which have not been studied with the same degree of interest in the recent literature. We showed that each of these assessment domains could appear at different phases of TR development and proposed a new cross-disciplinary and comprehensive method for assessing TR interventions. Future studies will benefit from approaches that leverage the best evidence regarding the assessment of TR, and it will be interesting to extend this assessment framework to other chronic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08370-y.
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Affiliation(s)
- Blandine Chapel
- University of Montpellier, Montpellier Research of Management, Montpellier, France.
| | - François Alexandre
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | - Nelly Heraud
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | | | - Anne-Sophie Cases
- University of Montpellier, Montpellier Research of Management, Montpellier, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
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20
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Santos DS, Batistelli CRS, Lara MMDS, Ferreira EDS, Moreira TR, Cotta RMM. The effectiveness of the use of telehealth programs in the care of individuals with hypertension and, or diabetes mellitus: systematic review and meta-analysis. Diabetol Metab Syndr 2022; 14:76. [PMID: 35643495 PMCID: PMC9148205 DOI: 10.1186/s13098-022-00846-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Diabetes Mellitus and Hypertension are some of the main Chronic Noncommunicable Diseases, representing a big challenge for global health. In this context, Telehealth programs are presented as a tool with exciting potential to complement and support health care. This paper aimed to analyze the effectiveness of the use of Telehealth programs in the care of individuals with Hypertension and/or Diabetes Mellitus. METHODS A systematic review with meta-analysis was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol methodology. The following databases were used: PubMed, EMBASE, SciELO, ScienceDirect and Cochrane Library. Papers were included if they addressed the use of technologies that allow two-way communication at a distance between health professionals and patients affected by Hypertension and/or Diabetes Mellitus, type 1 or type 2. Experimental, cross-sectional, case-control, cohort, and clinical trials were included in the review. RESULTS We included 164 papers in the review and 45 in the meta-analysis final synthesis. The systematic review results showed a prevalence of telemonitoring as the main form of Telehealth. The study showed a reduction in expenses with the use of Telehealth, both for the users and for the health systems providers, followed by greater satisfaction. Our meta-analysis showed that Telehealth is an effective tool in the care of diabetic patients, providing a 0.353% reduction in HbA1c compared to traditional care. No studies on Hypertension that met our eligibility criteria for inclusion in the meta-analysis were found. CONCLUSIONS Telehealth is an effective tool for the care of people with Diabetes Mellitus and/or Hypertension.
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Affiliation(s)
- Daniel Souza Santos
- Department of Medicine and Nursing, Federal University of Viçosa (UFV), Viçosa, MG, 36570-900, Brazil.
| | | | | | - Emily de Souza Ferreira
- Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, MG, 36570-900, Brazil
| | - Tiago Ricardo Moreira
- Department of Medicine and Nursing, Federal University of Viçosa (UFV), Viçosa, MG, 36570-900, Brazil
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21
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Barengo NC, Apolinar LM, Estrada Cruz NA, Fernández Garate JE, Correa González RA, Diaz Valencia PA, Gonzalez CAC, Rodriguez JAG, González NC, Arellano Flores ML, Ledesma Muñoz ME, Gonzalez Sotelo DA, Davila Maldonado OM, Gomez Garcia JG, Laureano Hernandez FJ, Jimenez JEZ, Pulido Garcia BA, Vazquez HR, Ramirez Dorantes AA, Gonzalez Fierro LA, Hernandez Hernandez JC, Perez JZ. Development of an information system and mobile application for the care of type 2 diabetes patients at the primary care level for the health sector in Mexico: study protocol for a randomized controlled, open-label trial. Trials 2022; 23:253. [PMID: 35379298 PMCID: PMC8981629 DOI: 10.1186/s13063-022-06177-0] [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: 09/08/2021] [Accepted: 03/16/2022] [Indexed: 12/05/2022] Open
Abstract
Background Providing optimal care for type 2 diabetes (DM2) patients remains a challenge for all healthcare systems. Patients often encounter various barriers in adhering to self-management programs due to lack of knowledge and understanding of self-care activities, lack of individualized and coordinated care, inconvenient and costly education sessions, and poor patient-provider communication. Mobile technologies such as cell phones/smartphones, handheld tablets, and other wireless devices offer new and exciting opportunities for addressing some of these challenges. The purpose of this study is to compare a diabetes management strategy using an information board and a mobile application versus standard care in patients with uncontrolled DM2. Method The SANENT (Sistema de Análisis de Enfermedades No Transmisibles) trial is a primary care-based, prospective, two-arm, randomized controlled, open-label, blinded-endpoint study. We aim to recruit 1440 DM2 patients during a period of 6 months until the requested number of participants has been achieved. The total length of the intervention will be 1 year. Both men and women treated for DM2 with an HbA1c > 8.5% and ≥ 20 years of age are eligible to participate in the study. The primary outcome of the study is improved diabetes control measured by changes in HbA1c in the study participants. HbA1c will be measured at baseline, 3-month, 6-month, 9-month, and 12-month follow-up visits in all participants. The main analysis will be based on the intention-to-treat principle. The primary endpoint of the study will be the change in HbA1C within the groups and the differences between the groups. This will be assessed by a repeated measurement approach based on mixed models which contain both fixed effects and random effects. Discussion The overall goal of this project is to contribute to the evidence for the use of mobile technology to improve the treatment and regulation of poorly controlled DM2 patients living in Mexico. Our proposed project will show how mobile health technology tools can be used in the treatment of patients with uncontrolled DM2 in primary health care in a Latin American population, and particularly how they could help diabetes patients take better care of themselves. Trial registration ClinicalTrials.gov, US National Institutes of Health NCT04974333. Prospectively registered on July 13, 2021. Protocol version number 1, dated August 15th, 2021.
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22
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Harte R, Norton L, Whitehouse C, Lorincz I, Jones D, Gerald N, Estrada I, Sabini C, Mitra N, Long JA, Cappella J, Glanz K, Volpp KG, Kangovi S. Design of a randomized controlled trial of digital health and community health worker support for diabetes management among low-income patients. Contemp Clin Trials Commun 2022; 25:100878. [PMID: 34977421 PMCID: PMC8688867 DOI: 10.1016/j.conctc.2021.100878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/14/2021] [Accepted: 12/04/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Insulin-dependent diabetes is a challenging disease to manage and involves complex behaviors, such as self-monitoring of blood glucose. This can be especially challenging in the face of socioeconomic barriers and in the wake of the COVID-19 pandemic. Digital health self-monitoring interventions and community health worker support are promising and complementary best practices for improving diabetes-related health behaviors and outcomes. Yet, these strategies have not been tested in combination. This protocol paper describes the rationale and design of a trial that measures the combined effect of digital health and community health worker support on glucose self-monitoring and glycosylated hemoglobin. METHODS The study population was uninsured or publicly insured; lived in high-poverty, urban neighborhoods; and had poorly controlled diabetes mellitus with insulin dependence. The study consisted of three arms: usual diabetes care; digital health self-monitoring; or combined digital health and community health worker support. The primary outcome was adherence to blood glucose self-monitoring. The exploratory outcome was change in glycosylated hemoglobin. CONCLUSION The design of this trial was grounded in social justice and community engagement. The study protocols were designed in collaboration with frontline community health workers, the study aim was explicit about furthering knowledge useful for advancing health equity, and the population was focused on low-income people. This trial will advance knowledge of whether combining digital health and community health worker interventions can improve glucose self-monitoring and diabetes-related outcomes in a high-risk population.
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Affiliation(s)
- Rory Harte
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Lindsey Norton
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Christina Whitehouse
- Villanova University M. Louise Fitzpatrick College of Nursing, Villanova, PA, USA
| | - Ilona Lorincz
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Denerale Jones
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Norma Gerald
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Irene Estrada
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Carolyn Sabini
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
| | - Nandita Mitra
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Judith A. Long
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Joseph Cappella
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin G. Volpp
- Penn Center for Health Incentives and Behavioral Economics, Departments of Medical Ethics and Health Policy and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shreya Kangovi
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Center for Community Health Workers, Penn Medicine, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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User Engagement and Abandonment of mHealth: A Cross-Sectional Survey. Healthcare (Basel) 2022; 10:healthcare10020221. [PMID: 35206837 PMCID: PMC8872344 DOI: 10.3390/healthcare10020221] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 02/04/2023] Open
Abstract
Mobile health (mHealth) apps have great potential to improve health outcomes. Given that mHealth apps have become ubiquitous, there is limited focus on their abandonment. Data concerning crucial metrics, including reasons for adoption and discontinued use, are limited. This study aims to gain broad insights into utilization of mHealth and game-like features promoting user engagement. We conducted a cross-sectional survey of 209 mHealth users worldwide. The 17-item survey assessed sociodemographics, as well as the key motivators for mHealth uptake and discontinued use. Our findings show that sports and fitness activity tracking were the most common categories of health apps, with most users engaging with them at least several times a week. Interestingly, the most downloaded mHealth apps among younger adults include MyFitnessPal, Fitbit, Nike Run Club, and Samsung Health. Critical drivers of abandonment of mHealth apps were amotivation, loss of interest, and experimenting with different apps to identify the most suitable tool. Additionally, the financial cost of mHealth apps is crucial, with most participants advocating for free or more affordable apps. The study findings suggest that while many individuals utilize mHealth, several factors drive their abandonment. Moreover, data indicate that mHealth developers need to consider gamification strategies to sustain user commitment, as well as psychological variables, such as intrinsic motivation.
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Yoon S, Ng JH, Kwan YH, Low LL. Healthcare Professionals' Views of Factors Influencing Diabetes Self-Management and the Utility of a mHealth Application and Its Features to Support Self-Care. Front Endocrinol (Lausanne) 2022; 13:793473. [PMID: 35282452 PMCID: PMC8907617 DOI: 10.3389/fendo.2022.793473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The perspectives of healthcare professionals (HCPs) are pivotal to co-development of self-management strategies for patients with diabetes. However, literature has been largely limited to perspectives of patients within the context of a Western healthcare setting. This study aims to explore factors influencing diabetes self-management in adult patients with diabetes from the perspectives of HCPs and their views of the value of mHealth application for diabetes self-management. MATERIALS AND METHODS We conducted focus group discussions (FGD) with purposively selected HCPs in Singapore. All FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted using NVivo 12. RESULTS A total of 56 HCPs participated in the study. Barriers to self-management included limited patient commitment to lifestyle changes, suboptimal adherence to medication and treatment, patient resistance to insulin initiation and insufficient rapport between patients and HCPs. Patients' perceived susceptibility to complications, social support from family and community, multidisciplinary team care and patient's understanding of the benefits of self-care were viewed as facilitating self-management. HCPs saw mHealth apps as a vital opportunity to engage patients in the self-management of conditions and empower them to foster behavior changes. Yet, there were concerns regarding patient's limited digital literacy, lack of integration into routine electronic system and reluctance. DISCUSSION We identified a set of factors influencing self-management in adult patients with diabetes and useful app features that can empower patients to manage their conditions. Findings will inform the development of a mHealth application, and its features designed to improve self-care.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore
| | - Jun Hao Ng
- Duke-NUS Medical School, Singapore, Singapore
| | - Yu Heng Kwan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Internal Medicine Residency Programme, SingHealth Residency, Singapore, Singapore
| | - Lian Leng Low
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
- *Correspondence: Lian Leng Low,
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25
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Yee LM, Leziak K, Jackson J, Strohbach A, Saber R, Niznik CM, Simon MA. Patient and Provider Perspectives on a Novel Mobile Health Intervention for Low-Income Pregnant Women With Gestational or Type 2 Diabetes Mellitus. J Diabetes Sci Technol 2021; 15:1121-1133. [PMID: 32627582 PMCID: PMC8442184 DOI: 10.1177/1932296820937347] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Management of diabetes mellitus (DM) during pregnancy is burdensome given the intensity of required patient engagement and skills, especially for women with greater social disadvantage. Mobile health (mHealth) technology is a promising avenue for DM health promotion, but few evidence-based mHealth tools exist for pregnancy. Thus, we designed a theory-driven mHealth tool called SweetMama, and planned a priori to gather usability and acceptability feedback from patients and providers to ensure a user-centered design. METHODS In this qualitative assessment, we solicited patient and provider feedback on this novel educational and motivational mobile application for low-income pregnant women with type 2 or gestational DM. Patients and providers participated in separate focus groups. Participants shared feedback regarding SweetMama's visual appeal, architecture, and content. SweetMama modifications were made in an iterative manner. Transcripts were analyzed using the constant comparative technique. RESULTS Patient (N = 16) and provider (N = 29) feedback was organized as positive feedback, negative feedback, or additional desired features. Within each category, themes addressed SweetMama visual features, information, or functional features. The majority of negative feedback was addressed and multiple desired features were implemented via iterative application development, resulting in a user-friendly, efficient, and potentially impactful mHealth app designed to support the unique needs of this population. CONCLUSIONS SweetMama users had largely positive feedback about the mHealth tool's appeal, content, and functionality. Suggested improvements were incorporated in preparation for further evaluation steps, which include longitudinal usability testing, feasibility trials, and larger trials to determine the efficacy of SweetMama use for improving perinatal outcomes.
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Affiliation(s)
- Lynn M. Yee
- Department of Obstetrics and Gynecology,
Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA
- Lynn M. Yee, MD, MPH, Department of
Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern
University Feinberg School of Medicine, 250 E. Superior Street, #5-2145,
Chicago, IL 60611-3008, USA.
| | - Karolina Leziak
- Department of Obstetrics and Gynecology,
Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA
| | - Jenise Jackson
- Department of Obstetrics and Gynecology,
Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA
| | - Angelina Strohbach
- Department of Obstetrics and Gynecology,
Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA
| | - Rana Saber
- Institute for Sexual and Gender Minority
Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Charlotte M. Niznik
- Department of Obstetrics and Gynecology,
Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of
Medicine, Chicago, IL, USA
| | - Melissa A. Simon
- Departments of Obstetrics and Gynecology
and Preventive Medicine, Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
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Lee H, Kim JE, Amarilla A, Kang Y, Boram B, Nam EW. Social determinants of overweight and obesity in Paraguayan adults using quantile regression. J Public Health Res 2021; 10:2196. [PMID: 34340299 PMCID: PMC8764552 DOI: 10.4081/jphr.2021.2196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/07/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) defines the double burden of malnutrition as the new face of malnutrition. This is a serious problem in Latin American countries, especially Paraguay, which has a high obesity rate. This study aimed to gather data to inform a national strategy for confronting the double-burden challenge in Paraguay by 1) identifying whether the body mass index (BMI) of study subjects differed significantly according to social determinants, and 2) assessing the factors affecting BMI and the extent of their impact according to BMI quantile levels. DESIGN AND METHODS Data were collected using a questionnaire adapted from the WHO World Health Survey. We collected 2,200 responses from September 16 to October 7, 2018. After excluding the questionnaires with missing data, we analyzed 1,994 respondents aged 17 years and older living in Limpio, Paraguay. The analyses included t-test and chi-squared test to identify significant differences and 10th quantile regression to assess associations. RESULTS Analyses showed significant differences in participants' BMI levels based on age and diagnoses of diabetes or hypertension. In quantile regression analyses, age was significantly associated with BMI quantiles at all but one level. Educational attainment was significantly associated with the 10%-40% and 60%-70% quantiles of BMI. CONCLUSIONS Age, education level, diabetes, and hypertension were significant predictors of obesity. Obesity programs that focus on people aged more than 60 years are required. In addition, targeted nutritional education may be a useful intervention.
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Affiliation(s)
- Hocheol Lee
- Yonsei Global Health Center, Yonsei University, Wonju.
| | - Ji Eon Kim
- Yonsei Global Health Center, Yonsei University, Wonju.
| | | | - Yanghee Kang
- Yonsei Global Health Center, Yonsei University, Wonju.
| | - Boram Boram
- Health Insurance Review and Assessment Service (HIRA), Wonju.
| | - Eun Woo Nam
- Department of Health Administration, College of Health Science, Yonsei University, Wonjum .
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Bischoff LL, Baumann H, Meixner C, Nixon P, Wollesen B. App-Tailoring Requirements to Increase Stress Management Competencies Within Families: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e26376. [PMID: 34328439 PMCID: PMC8367136 DOI: 10.2196/26376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background Families experiencing high levels of psychological distress are considered a particularly vulnerable population for adverse effects on mental and physical health. Moreover, highly stressed individuals engage less in mental health promoting activities and show low stress management competencies. App-based stress interventions seem promising for the treatment and prevention of stress outcomes and might be a low-threshold solution. Objective The aim of this study was to identify the requirements for a tailored app to reduce stress in a cohort of highly stressed families that have low stress management skills. Methods Parents (n=1008; age: mean 47.7 years, SD 6.1; female: 599/1008, 59.7%) completed an extensive web-based survey and were subdivided into a target (stressed individuals with low stress competency) and nontarget group according to their reported stress level and stress management competencies. Group differences were analyzed using analysis of variance. In principal component analysis with Kaiser varimax rotation, personally defined stress management goals were grouped into components. Linear regression models were also calculated. Results A 3-factor solution cumulatively explained 56% of the variance in personally defined goals of interest for stress management with (1) active strategies (25.61% explained variance), (2) general competency (17.95% explained variance) and (3) passive strategies (12.45% explained variance). The groups differed in age (F1,978=27.67, P<.001), health index (F1,958=246.14, P<.001), personally defined general-competency goal (F1,958=94.16 P<.001), as well as “information acquisition” (F1,971=14.75, P<.001) and “need for stimulation” (F1,981=54.49, P<.001) personality traits. A regression model showed that for the active strategies goals of interest, only app feature information or instructional videos had a significant effect (P=.02). The general competency factor showed none, and the passive strategies factor showed significant effects for 2 app features—suggestions for planning possible activities with the family (P=.01) and diaries for documentation and development of strategies (P=.03). Conclusions The results of this survey study highlight the need to develop an app to increase stress management competencies that takes into consideration perceived stress level, stress management skills, personality, and personally defined goals of the user. The content of the app should be tailored to previously detected personality traits, especially selective information acquisition and low need for stimulation. Furthermore, personally defined stress management goals seem to affect interest in some features.
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Affiliation(s)
- Laura Luise Bischoff
- Department of Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany
| | - Hannes Baumann
- Department of Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany
| | - Charlotte Meixner
- Department of Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany
| | - Patricia Nixon
- Fitbase Institute for Online Prevention GmbH, Hamburg, Germany
| | - Bettina Wollesen
- Department of Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany.,Biopsychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
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He Q, Zhao X, Wang Y, Xie Q, Cheng L. Effectiveness of smartphone application-based self-management interventions in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2021; 78:348-362. [PMID: 34324218 DOI: 10.1111/jan.14993] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/24/2021] [Accepted: 07/11/2021] [Indexed: 01/09/2023]
Abstract
AIMS To synthesize evidences on smartphone application-based intervention and determine its effectiveness on glycaemic control, self-management behaviours, psychological well-being, quality of life and cardiometabolic risk factors. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES Major English and Chinese electronic databases were searched from January 2008 to January 2021, including PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang and Sinomed. REVIEW METHODS RCTs were screened and selected if they used smartphone applications to support patients in the self-management of diabetes. Data extraction and methodological assessment were performed by two reviewers independently. Meta-analysis was performed to pool the intervention effect on outcomes of interest using RevMan 5.3. RESULTS Across 19 included trials involving 2585 participants, smartphone application-based interventions were associated with a clinically and statistically significant reduction of glycated haemoglobin (HbA1c). Beneficial effects were also observed in participants' behavioural performance, especially in medication adherence. Intervention effects on psychological status, quality of life and cardiometabolic risk factors were nonsignificant. Subgroup analysis showed interactive approach with medium frequency or flexible facilitator-patient interaction induced a larger effect on HbA1c reduction. Besides, patients with baseline HbA1c ≥9% benefited more than those with HbA1c <9% from the use of smartphone applications. CONCLUSIONS Smartphone application-based diabetes self-management intervention could optimize patients' glycaemic control and enhance participants' self-management performance. Further endeavour is required to examine the long-term effects and cost-effectiveness of smartphone application-based intervention before promoting the adoption and dissemination of such intervention. IMPACT This review supports the potential of smartphone application-based intervention as effective approach to optimize glycaemic control and promote self-management engagement among patients with type 2 diabetes. Suggestions for future research and practice are provided and discussed.
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Affiliation(s)
- Qianyu He
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyan Zhao
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qinqin Xie
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
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Aceti VM, Santoro RV, Velarde LGC, Brandão DN, da Cruz RA, Taboada GF. Educating diabetic patients through an SMS intervention: a randomized controlled trial at a Brazilian public hospital. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:695-703. [PMID: 34283906 DOI: 10.20945/2359-3997000000390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Diabetes mellitus (DM) has a high healthcare system cost worldwide. Educational strategies are important to improve self-care and control this disease. This study aimed to evaluate satisfaction and clinical efficacy of a Short Message Service (SMS) educational intervention in self-care and nutrition at a Brazilian university hospital. Methods We conducted a trial of educational intervention and assigned eligible patients with DM to either receive weekly educational SMS for 6 months (intervention group [IG]) or no SMS at all (control group). A satisfaction questionnaire was applied before and after the intervention in both groups. Laboratory (fasting glucose, hemoglobin [Hb] A1c, total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein) and clinical (blood pressure) data were also collected. Data were analyzed using nonparametric tests with the Statistical Package for the Social Sciences. Results We included 128 patients (64 in each group). Responses to the satisfaction questionnaire with self-care and healthcare professionals from 112 patients revealed an improvement in the perception of receiving information regarding helpful eating habits and in healthy eating behavior and an improvement in satisfaction with their diabetes care in the IG. In the post-intervention period, improved systolic blood pressure and HbA1c levels were observed in the IG as illustrated by delta % (post-intervention minus pre-intervention data divided by pre-intervention data multiplied by 100) reductions of 2.3% and 3.9%, respectively. Conclusion SMS intervention was useful as an educational tool for improving satisfaction and glycemic and blood pressure control of patients with DM observed at a Brazilian university hospital.
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Affiliation(s)
- Viviane Moura Aceti
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | | | | | - Diego Nunes Brandão
- Centro Federal de Educação Tecnológica Celso Suckow da Fonseca, Rio de Janeiro, RJ, Brasil
| | - Rubens Antunes da Cruz
- Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Giselle F Taboada
- Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil,
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Tu YZ, Chang YT, Chiou HY, Lai K. The Effects of Continuous Usage of a Diabetes Management App on Glycemic Control in Real-world Clinical Practice: Retrospective Analysis. J Med Internet Res 2021; 23:e23227. [PMID: 34264192 PMCID: PMC8323018 DOI: 10.2196/23227] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 05/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background The efficacy of digital technology in improving diabetes management has typically been demonstrated through studies such as randomized controlled trials, which have reported a steeper reduction in hemoglobin A1c (HbA1c) values for patients who adopted a digital solution. However, evidence from real-world clinical practice is still limited. Objective This study aimed to evaluate the effectiveness of digital interventions by tracking HbA1c improvements over 1 year in real-world clinical settings. Methods Patients used the Health2Sync mobile app to track self-measured outcomes and communicate with health care professionals (HCPs). HCPs used the web-based Patient Management Platform to monitor patient data, view test results from clinical laboratories, and communicate with patients. Patients who have been onboarded for at least 13 months and have consecutive HbA1c findings for 5 quarters were included in the analysis. They were then stratified into 3 groups (high, mid, and low retention) based on their level of use of Health2Sync in the first 6 months of onboarding. A mixed model was built to compare the slopes of the rate of reduction in HbA1c among the groups. In addition, these patients’ retention on the app from the seventh to the 12th month was verified through multiple comparisons. Results A sample of 2036 users was included in the analysis. With the mixed model coefficient estimates, we found that app users had significant HbA1c percentage reductions as the passed quarter count increased (t=–9.869; P<.001), and that effectiveness increased in the high (t=–5.173) and mid retention (t=–6.620) groups as the interaction effects were significantly negative compared to that in the low retention group (P<.001) in the passed quarter count. The low retention group also had the highest average HbA1c value at the end of 13 months (high: 7.01%, SD 1.02%; mid: 6.99%, SD 1.00%; low: 7.17%, SD 1.14%) (Bonferroni correction: high vs low, P=.07; mid vs low, P=.02; high vs mid, P>.99). The level of use of the app remained consistent in the seventh to the 12th month after onboarding (high: 5.23 [SD 1.37] months, mid: 2.43 [SD 1.68] months, low: 0.41 [SD 0.97] months) (P<.001). Conclusions Our analysis shows that continuous usage of the diabetes management app is associated with better glycemic control in real-world clinical practice. Further studies are required to reveal the efficacy for specific diabetes types and to observe effects beyond 1 year.
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Affiliation(s)
| | | | - Hung-Yi Chiou
- School of Public Health, Taipei Medical University, Taipei, Taiwan
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Abu-El-Noor NI, Aljeesh YI, Bottcher B, Abu-El-Noor MK. Impact of a mobile phone app on adherence to treatment regimens among hypertensive patients: A randomised clinical trial study. Eur J Cardiovasc Nurs 2021; 20:428-435. [PMID: 32631080 DOI: 10.1177/1474515120938235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hypertension is one of the most prevalent long-term diseases seen in many countries, including Palestine. Patients with poorly controlled blood pressure are more likely to develop several complications. Therefore; it is imperative to control their blood pressure by improving their adherence to the treatment regimen. AIM The objective of this study was to evaluate the impact of using a mobile phone app on the level of adherence to treatment regimens among hypertensive patients in the Gaza Strip. METHODS AND RESULTS This study used an experimental design with a pre and post-intervention assessment. Using the Hill-Bone compliance to high blood pressure therapy scale, 191 participants completed the study: 94 in the control group and 97 in the intervention group. The intervention group used a phone app which reminds participants to take their medication, reminding them about their follow-up appointments and sending educational information about hypertension management. After 3 months of intervention, the level of adherence to treatment was reassessed. Results showed that participants in both groups showed a significant improvement in adherence levels, with higher improvements in the intervention group in the total score as well as all three domain scores: adherence to medication, diet and keeping appointments. CONCLUSION The use of a mobile phone app resulted in improvements in adherence to hypertension treatment. Thus, this study confirms the potential effectiveness of mobile technology in improving treatment adherence in hypertension and an opportunity to reduce cardiovascular mortality and morbidity. However, wider adoption has to be accompanied by ongoing evaluation and integration in public health systems.
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Kang J, Chen Y, Zhao Y, Zhang C. Effect of remote management on comprehensive management of diabetes mellitus during the COVID-19 epidemic. Prim Care Diabetes 2021; 15:417-423. [PMID: 33422431 PMCID: PMC7836521 DOI: 10.1016/j.pcd.2020.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We learned about the health condition of people with diabetes during the COVID-19 epidemic through a questionnaire survey. We conducted a randomized controlled study to confirm the effectiveness of remote management using the mobile phone WeChat app on comprehensive management of diabetes mellitus during the COVID-19 epidemic. METHODS We distributed questionnaires that collected information on the health condition of people with diabetes during the COVID-19 epidemic through the WeChat app. We assigned 90 cases to the intervention group and 90 cases to the control group. The intervention group was managed remotely through the WeChat app, and the control group received traditional medical treatment. The blood glucose, blood pressure, body mass index (BMI), time in range (TIR) and incidence of hypoglycemia were compared after three months of follow-up. RESULTS The BMI and postprandial blood glucose (PBG) of the control group at 3 months was significantly higher than that at baseline (P < 0.001), and TIR decreased at 3 months (P < 0.05). There was no significant difference in blood pressure compared with baseline in the control group, while blood pressure decreased in the intervention group (P < 0.05). In the intervention group, fast blood glucose(FBG) and PBG decreased compared with their baseline values, and the TIR level increased, both of which were statistically significant (P < 0.001). The FBG, PBG, and TIR of the intervention group were better than those in the control group at 3 months (P < 0.05). There was no difference in the incidence of hypoglycemia between the two groups. CONCLUSION During the COVID-19 epidemic, diabetes treatment has been facing new challenges, and the traditional treatment mode is limited. Remote management can increase TIR without increasing the risk of hypoglycemia. Remote management can prevent weight gain and improve patients' self-management and compliance during the COVID-19 epidemic.
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Affiliation(s)
- Jing Kang
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, PR China.
| | - Yan Chen
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, PR China.
| | - Ying Zhao
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, PR China.
| | - Chuan Zhang
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, PR China.
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Effects of a mobile health diabetes self-management program on HbA1C, self-management and patient satisfaction in adults with uncontrolled type 2 diabetes: a randomized controlled trial. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-02-2021-0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
This study aimed to examine the effects of a three-month mobile health diabetes self-management program (MHDSMP) on glycemic control, diabetes self-management (DSM) behaviors and patient satisfaction in adults with uncontrolled type 2 diabetes (T2DM) in Thailand.
Design/methodology/approach
This was a three-arm, parallel-group, randomized controlled trial among 129 adults with uncontrolled T2DM who attended the medical outpatient department in a medical center. The participants were randomly assigned to the three study groups (n = 43 per group), including MHDSMP, telephone follow-up (TF) and usual care (UC). MHDSMP encompassed four components, including DSM engagement, DSM mobile application, motivational text messages and telephone coaching. Outcomes were evaluated at three-month end-of-study by using HbA1C and response to the Summary of Diabetes Self-Care Activities (SDSCA) and the Client Satisfaction Questionnaire (CSQ-8). Data were analyzed by using descriptive statistics and multivariate analysis of covariance (MANCOVA).
Findings
The findings revealed that at the end-of-study, HbA1C decreased from 7.80 to 7.17% (p < 0.001) in MHDSMP group, from 7.72 to 7.65% (p = 0.468) in TF group, and from 7.89 to 7.72% (p = 0.074) in UC group. Significantly higher SDSCA and CSQ-8 scores were also observed in MHDSMP compared to TF and UC groups (F = 12.283, F = 19.541, F = 8.552, p < 0.001, respectively).
Originality/value
This study demonstrated that MHDSMP adjunct with usual care is beneficial for patient outcomes in adults with uncontrolled T2DM in Thailand, compared to TF and UC groups.
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D'Anza B, Pronovost PJ. Digital Health: Unlocking Value in a Post-Pandemic World. Popul Health Manag 2021; 25:11-22. [PMID: 34042532 DOI: 10.1089/pop.2021.0031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has forever changed health care, spurring a revolution in digital health technologies. Across the world, hundreds of thousands of health care systems are considering a central question: how do we connect with our patients? Digital health has been used as a stopgap in many cases to continue the essential functions of health systems. As the post-pandemic world and our "new normal" come into focus, further needs will have to be met with a digital patient interaction, with an eye toward value transformation. One barrier to fully leveraging digital tools is the lack of a framework for classifying the type of digital health care. This can limit our ability to design, deploy, evaluate, and communicate through digital means. This article presents 3 categories of digital health and their relationships to value metrics: (1) telehealth or direct care delivery, (2) digital access tools, and (3) digital monitoring. An evidence-based discussion reveals past successes, current promises, and future challenges in reducing defects in value through digital care. In the coming years, value transformation will become more crucial to the success of health care systems. By using the taxonomy in this article, health systems can better implement digital tools with a value-driven purpose. Defining the role of digital health in the post-pandemic world is needed to assist health systems and practices to build a bridge to value-based care.
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Affiliation(s)
- Brian D'Anza
- Department of Digital Health/Telehealth, University Hospitals, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Peter J Pronovost
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,University Hospitals, Cleveland, Ohio, USA.,Francis Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.,Weatherhead School of Management, Case Western Reserve University, Cleveland, Ohio, USA
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Alenazi F, Peddle M, Bressington D, Mahzari M, Gray R. A study protocol for a feasibility trial of telephone-delivered Adherence Therapy for adults with type 2 diabetes. Nurs Open 2021; 8:1510-1519. [PMID: 33471963 PMCID: PMC8046149 DOI: 10.1002/nop2.735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/08/2020] [Accepted: 11/05/2020] [Indexed: 01/13/2023] Open
Abstract
AIMS Adherence therapy is a candidate intervention to improve medication adherence and clinical outcomes in patients with type 2 diabetes. The feasibility of conducting a trial of adherence therapy in this population has not been established. The objective of this study is therefore to test the feasibility of conducting a randomized controlled trial of adherence therapy in a Middle Eastern context. DESIGN A single-centre randomized controlled feasibility trial of adherence therapy in patients with type 2 diabetes. METHODS We will undertake an initial cultural adaptation of a telephone-delivered form of adherence therapy in four patients in a Middle Eastern context. Our subsequent feasibility trial will aim to recruit 40 non-adherent diabetic patients that will be randomly allocated to receive eight weekly 30-min telephone adherence therapy sessions delivered by a diabetes educator versus treatment as usual. Key outcomes of interest include the number of patients invited to take part in the trial that consent to participate and then go on to complete treatment. RESULT The findings of this study will determine the feasibility of undertaking a full randomized controlled trial of adherence therapy in patients with type 2 diabetes.
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Affiliation(s)
- Fatimah Alenazi
- College of Science Health and EngineeringLa Trobe UniversityBundooraVICAustralia
- Department of Public HealthCollege of Public Health and Health InformaticsQassim UniversityAlBukayriyahSaudi Arabia
| | - Monica Peddle
- Lecturer in NursingSchool of Nursing and MidwiferyCollege of Science Health and EngineeringLa Trobe UniversityMelbourneAustralia
| | - Daniel Bressington
- Associate ProfessorSchool of NursingHong Kong Polytechnic UniversityKowloonHong Kong
- Adjunct Professor‐College of Nursing & MidwiferyCharles Darwin UniversityBundooraAustralia
| | - Moeber Mahzari
- Assistant professor of Medicine‐EndocrinologyKing Saud Bin Abdulaziz University for Health SciencesCollege of MedicineRiyadhKSASaudi Arabia
- Department of MedicineDivision of Endocrinology – Ministry of National Guard – Health AffairsRiyadhKSASaudi Arabia
- King Abdullah International Medical Research CenterRiyadhKSASaudi Arabia
| | - Richard Gray
- Professor of Clinical Nursing PracticeLa Trobe UniversityMelbourneAustralia
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Jafari J, Karlgren K, Moonaghi HK, Layegh P, Bonacina S, Masiello I. Designing internet-enabled patient education for self-management of T2D diabetes-The case of the Razavi-Khorasan province in Iran. PLoS One 2021; 16:e0250781. [PMID: 33905458 PMCID: PMC8078778 DOI: 10.1371/journal.pone.0250781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The number of people with diabetes is estimated to increase to 642 million by 2040, with most having type 2 diabetes. Patients with diabetes require continuous monitoring and possible treatment changes. Patient education is the process of enabling individuals to make informed decisions about their personal health-related behaviours and internet-enabled interventions have the potential to provide support and information to patients with diabetes. OBJECTIVE The aim of the study was to design a portal prototype based onto two models of care and a contextualised education programme to support the self-management of diabetes patients by involving stakeholders in the Iranian province of Razavi-Khorasan. METHODS A Design-Based Research framework was adopted. A qualitative research method was used to analyse interviews with patients and care givers. Mock-ups were developed first and designed with features of user-driven and self-care models of care. The mock-ups also had adaptation features, such as for control of the disease, ability to cure self, and family support. The portal prototype was developed iteratively by building on the mock-ups and evaluated through interviews. The features and elements of the mock-ups and the portal prototype were evaluated in an outpatient diabetes clinic in Mashhad. RESULTS Thirty-three participants were involved in the study. The evaluation of the mock-ups resulted in two themes and seven categories: 1) self-care improvement, including self-care requirements and self-management, and 2) educational usefulness, including medical information, information mode, mobility, interaction, and efficiency. The mock-up evaluation was used as a basis for designing a portal prototype. Next, the portal prototype was evaluated, and three categories emerged from the interview data: 1) user experience, 2) functionality, and 3) interactivity. Participants were not able to prioritise between the two care models. Some functionalities of the portal could benefit from the development within a cultural context to determine differences to the best way to present material. CONCLUSIONS A portal prototype has been designed to include two care models to support self-management and functionalities that support aspects of culture-specific diabetes self-care. This study provides guidance on developing an internet-enabled educational portal, aimed at providing support for patients in their social context.
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Affiliation(s)
- Javad Jafari
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Education, Development and Innovation, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hossein Karimi Moonaghi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Layegh
- Endocrine Research Center, Imam Reza Hospital, School of Medicine Mashhad University of Medical Sciences, Mashhad, Iran
| | - Stefano Bonacina
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Italo Masiello
- Faculty of Technology, Department of Computer Science and Media Technology, Linnaeus University, Växjö, Sweden
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Ku EJ, Park JI, Jeon HJ, Oh T, Choi HJ. Clinical efficacy and plausibility of a smartphone-based integrated online real-time diabetes care system via glucose and diet data management: a pilot study. Intern Med J 2021; 50:1524-1532. [PMID: 31904890 DOI: 10.1111/imj.14738] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 12/06/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Smartphones have become novel healthcare tools for patients with diabetes. However, it is uncertain whether the smartphone application support system helps in glycaemic control in patients with type 2 diabetes. AIMS To evaluate the efficacy and plausibility of smartphone-based integrated online real-time diabetes care. METHODS Forty patients with type 2 diabetes were randomly assigned to the smartphone-based care (SC) (n = 20) and conventional care (CC) (n = 20) groups for 12 weeks. The SC group was instructed to use smartphone application (Noom Coach) and a glucose meter, and was provided medical supervision based on blood glucose level and food intake information sent to the central database server. The efficacy was evaluated by glycated haemoglobin (A1C ≤ 6.5%). The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was collected at baseline and at week 12. RESULTS Seventeen and 18 patients of the SC and CC groups completed the study respectively. In the SC group, more patients achieved target A1C compared with the CC group (47.1% vs 11.1%, P = 0.019). In both group, SDSCA scores excluding the exercise item showed overall improvement (general diet, 1.4 ± 2.0 → 2.6 ± 2.3 vs 0.4 ± 1.1 → 1.8 ± 2.2; specific diet, 4.2 ± 1.7 → 5.4 ± 1.2 vs 3.8 ± 1.6 → 5.1 ± 1.1; blood glucose test, 3.3 ± 2.8 → 4.9 ± 2.3 vs 1.0 ± 2.2 → 4.7 ± 2.3; foot care, 1.5 ± 1.6 → 3.6 ± 2.8 vs 1.4 ± 1.9 → 6.1 ± 1.4; all P < 0.05). There was no difference between both groups other than the aspect of foot care (P = 0.008). CONCLUSIONS The smartphone-based integrated online real-time diabetes care system through glucose and diet data management showed clinical plausibility in glucose control in real clinical practice.
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Affiliation(s)
- Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Ji-In Park
- Department of Anesthesiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Hyun Jeong Jeon
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Taekeun Oh
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Hyung Jin Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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Ibrahim N, Treluyer JM, Briand N, Godot C, Polak M, Beltrand J. Text message reminders for adolescents with poorly controlled type 1 diabetes: A randomized controlled trial. PLoS One 2021; 16:e0248549. [PMID: 33720997 PMCID: PMC7959392 DOI: 10.1371/journal.pone.0248549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Among adolescents with type 1 diabetes, some experience great difficulties with treatment adherence, putting them at high risk of complications. We assessed the effect of text messaging (Short Messaging Service [SMS]) on glycemic control. Methods A two-arm open label randomized controlled trial enrolled adolescents with type 1 diabetes aged 12–21 years with baseline HbA1c ≥ 69 mmol/mol (8.5%). The intervention group received daily SMS reminders at self-selected times about insulin injections while the control group received standard of care. The patients allocated to the control group were not aware of the intervention. Results 92 patients were randomized, 45 in the SMS arm and 47 in the control arm. After 6 months, median HbA1c level was significantly lower in the intervention arm: 73 mmol/mol (8.8%) in the SMS arm and 83 mmol/mol (9.7%) in the control arm in the intent-to-treat analysis (P = 0.03) but no longer in the per protocol analysis (P = 0.65). When we consider the proportions of patients whose HbA1c level decreased by at least 1% between baseline and 6 months, we find a significant difference among patients whose baseline HbA1c was ≥ 80 mmol/mol (9.5%) (n = 56): 60% in the SMS arm and 30.6% in the control arm had lowered their HbA1c level (P = 0.03) in the intent-to-treat analysis but not in the per-protocol analysis (P = 0.50). Patients in the SMS arm reported high satisfaction with the intervention. Conclusions While there is a trend to lower HbA1c in the intervention group, no firm conclusions can yet be drawn. Further studies are needed to address methodological issues as we believe these interventions can support behavior change among adolescents with poorly controlled type 1 diabetes. ClinicalTrials.gov identifier: NCT02230137.
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Affiliation(s)
- Nour Ibrahim
- Clinical Research Unit, Paris Descartes, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
- French Clinical Research Group in Adolescent Medicine and Health, Paris, France
- * E-mail:
| | - Jean-Marc Treluyer
- Clinical Research Unit, Paris Descartes, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
- Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Nelly Briand
- Clinical Research Unit, Paris Descartes, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
| | - Cécile Godot
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
| | - Jacques Beltrand
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Assistance Publique-Hôpitaux de Paris, Necker University Hospital, Paris, France
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Emezue C, Bloom TL. PROTOCOL: Technology-based and digital interventions for intimate partner violence: A meta-analysis and systematic review. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1132. [PMID: 37050972 PMCID: PMC8356356 DOI: 10.1002/cl2.1132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Studies show digital interventions such as mobile and wireless platforms (e.g., smartphone apps, text messaging) and web-based platforms (online support groups and telehealth services) can improve the mental health outcomes for victims/survivors of partner abuse. Depression, posttraumatic stress disorder (PTSD), and anxiety are three to five times higher among victims than nonvictims and are thus popular targets of digital interventions. Even then, the evidence is scant. The current review uses both narrative and quantitative (meta-analysis) techniques to present extensive evidence on the effects of intimate partner violence (IPV) digital interventions on the mental health outcomes among survivors of partner violence across all genders and ages, specifically, depression, anxiety, and PTSD. This is the first meta-analysis on IPV-related mental health outcomes targeted by digital interventions. OBJECTIVES To synthesize current evidence on the intervention and treatment effects of digital and technology-based interventions (mHealth and eHealth) addressing IPV mental health outcomes (depression, anxiety, and PTSD) among survivors of IPV. This study's research questions are as follows: (a) What are the overall average treatment effects of IPV digital interventions on IPV survivors' mental health outcomes? (b) Do these mental health outcomes vary based on methodological study designs, sample characteristics, and intervention characteristics? METHODS An extensive search strategy will be utilized to find qualifying studies. Various electronic bibliographic databases will be searched for studies since 2009 (coinciding with the onset of mobile health interventions). Other databases, such as government databases, grey literature databases, trial registers, specialty journals, and citations in other studies will be searched. Also, we will search "grey databases," such as Google Scholar. Ethical and safety concerns preclude the randomization of IPV survivors to specific intervention conditions. Therefore, we will not exclude studies based on a lack of random assignment. Studies will be full-text accessible, published in any language (translatable into English). We will also contact researchers where needed data is missing in their report. Neither language, study location, nor study settings will be a limiter for searches. Keyword and MeSH headings will be used. Effect sizes (Hedges' g) will be estimated with a Type I error rate set at an alpha of .05. RESULTS All studies will measure IPV-related mental health as an outcome and provide outcome data to calculate effect sizes for PTSD, anxiety, depression, and victimization (physical, psychological, and sexual violence). CONCLUSION Digital interventions may clinically reduce depression, anxiety, PTSD, and IPV victimization. Summary effect sizes ranging from small to large will signal the usefulness of digital interventions to IPV survivors contending with common mental health issues. Future studies beyond this one may identify other active intervention ingredients of digital interventions, best modes of delivery, and guidelines to increase their feasibility and acceptability.
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Affiliation(s)
- Chuka Emezue
- Sinclair School of NursingUniversity of Missouri‐ColumbiaColumbiaMOUSA
| | - Tina L. Bloom
- Sinclair School of NursingUniversity of Missouri‐ColumbiaColumbiaMOUSA
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Zahmatkeshan M, Zakerabasali S, Farjam M, Gholampour Y, Seraji M, Yazdani A. The use of mobile health interventions for gestational diabetes mellitus: a descriptive literature review. J Med Life 2021; 14:131-141. [PMID: 34104235 PMCID: PMC8169150 DOI: 10.25122/jml-2020-0163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/02/2021] [Indexed: 11/23/2022] Open
Abstract
This study attempted to review the evidence for or against the effectiveness of mobile health (m-health) interventions on health outcomes improvement and/or gestational diabetes mellitus (GDM) management. PubMed, Web of Science, Scopus, and Embase databases were searched from 2000 to 10 July 2018 to find studies investigating the effect of m-health on GDM management. After removing duplications, a total of 27 articles met our defined inclusion criteria. m-health interventions were implemented by smartphone, without referring to its type, in 26% (7/27) of selected studies, short message service (SMS) in 14.9% (4/27), mobile-based applications in 33.3% (9/27), telemedicine-based on smartphones in 18.5% (5/27), and SMS reminder system in 7.1% (2/27). Most of the included studies (n=23) supported the effectiveness of m-health interventions on GDM management and 14.3% (n=4) reported no association between m-health interventions and pregnancy outcomes. Based on our findings, m-health interventions could enhance GDM patients' pregnancy outcomes. A majority of the included studies suggested positive outcomes. M-health can be one of the most prominent technologies for the management of GDM.
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Affiliation(s)
- Maryam Zahmatkeshan
- Noncommunicable Diseases Research Center, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Somayyeh Zakerabasali
- Department of Health Information Management, Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
- Clinical Research Development Unit, Valie-Asr Hospital, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Maryam Seraji
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azita Yazdani
- Department of Health Information Management, Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Heales LJ, Randall S, Vicenzino B, Coombes BK, Obst S. An evidence-based evaluation of mobile health apps for the management of individuals with lateral elbow tendinopathy using a systematic review framework. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1885584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Luke J. Heales
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Samantha Randall
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitations Sciences, The University of Queensland, Brisbane, Australia
| | - Brooke K. Coombes
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Steven Obst
- School of Health, Medical, and Applied Sciences, Central Queensland University, Bundaberg, Australia
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Varma N, Cygankiewicz I, Turakhia MP, Heidbuchel H, Hu YF, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini JP, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society. Circ Arrhythm Electrophysiol 2021; 14:e009204. [PMID: 33573393 PMCID: PMC7892205 DOI: 10.1161/circep.120.009204] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Supplemental Digital Content is available in the text. This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society describes the current status of mobile health technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mobile health. The promises of predictive analytics but also operational challenges in embedding mobile health into routine clinical care are explored.
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Affiliation(s)
- Niraj Varma
- Cleveland Clinic, OH (N.V., J.D.E., R.M., R.E.R.)
| | | | | | | | - Yu-Feng Hu
- Taipei Veterans General Hospital, Taiwan (Y.-F.H.)
| | | | | | | | | | | | | | - Reena Mehra
- Cleveland Clinic, OH (N.V., J.D.E., R.M., R.E.R.)
| | - Alex Page
- University of Rochester, NY (J.-P.C., A.P., J.S.S.)
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL (R. Passman)
| | | | - Ewa Piotrowicz
- National Institute of Cardiology, Warsaw, Poland (E.P., R. Piotrowicz)
| | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (A.L.R.)
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ (A.M.R.)
| | - David Slotwiner
- Cardiology Division, New York-Presbyterian Queens, NY (D.S.)
| | | | - Emma Svennberg
- Karolinska University Hospital, Stockholm, Sweden (E.S.)
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2021 ISHNE/HRS/EHRA/APHRS Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2021; 2:4-54. [PMID: 35265889 PMCID: PMC8890358 DOI: 10.1016/j.cvdhj.2020.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. Ann Noninvasive Electrocardiol 2021; 26:e12795. [PMID: 33513268 PMCID: PMC7935104 DOI: 10.1111/anec.12795] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/ Heart Rhythm Society/ European Heart Rhythm Association/ Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
| | | | | | - Hein Heidbuchel
- Antwerp University and University Hospital, Antwerp, Belgium
| | - Yufeng Hu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester, Rochester, NY, USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - David Slotwiner
- Cardiology Division, NewYork-Presbyterian Queens, and School of Health Policy and Research, Weill Cornell Medicine, New York, NY, USA
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. J Arrhythm 2021; 37:271-319. [PMID: 33850572 PMCID: PMC8022003 DOI: 10.1002/joa3.12461] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health (“mHealth”) technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
| | | | | | | | - Yufeng Hu
- Taipei Veterans General Hospital Taipei Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester Rochester NY USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina Centro de Telessaúde Hospital das Clínicas and Departamento de Clínica Médica Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | | | - David Slotwiner
- Cardiology Division NewYork-Presbyterian Queens and School of Health Policy and Research Weill Cornell Medicine New York NY USA
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc J, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE / HRS / EHRA / APHRS Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology / Heart Rhythm Society / European Heart Rhythm Association / Asia Pacific Heart Rhythm Society. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:7-48. [PMID: 36711170 PMCID: PMC9708018 DOI: 10.1093/ehjdh/ztab001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology / Heart Rhythm Society / European Heart Rhythm Association / Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
- Niraj Varma
- Cleveland Clinic, Cleveland, OH, USA,Correspondence: Niraj Varma, Cleveland Clinic, Cleveland, OH, USA.
| | | | | | - Hein Heidbuchel
- Antwerp University and University Hospital, Antwerp, Belgium
| | - Yufeng Hu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester, Rochester, NY, USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - David Slotwiner
- Cardiology Division, NewYork-Presbyterian Queens, and School of Health, Policy and Research, Weill Cornell Medicine, New York, NY, USA
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Islam SMS, George ES, Maddison R. Effectiveness of a mobile phone text messaging intervention on dietary behaviour in patients with type 2 diabetes: a post-hoc analysis of a randomised controlled trial. Mhealth 2021; 7:10. [PMID: 33634193 PMCID: PMC7882278 DOI: 10.21037/mhealth-2020-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/08/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Evidence suggests that mobile phone health (mHealth) programs may improve healthy behaviours and clinical outcomes in patients with type 2 diabetes mellitus (T2DM). However, data on mHealth dietary behaviour is scarce in low-and-middle-income countries. This study aims to determine the effectiveness of a text messaging program on dietary habits in patients with T2DM. METHODS We performed a post-hoc analysis of a randomised controlled trial of text messaging intervention in 236 patients with T2DM recruited from a tertiary hospital. Data were collected on socio-demographics, mobile phone use, family and medical history, self-reported diseases, medication use, health-seeking behaviour, diet and physical activity. Dietary behaviour was assessed using a modified version of WHO STEPS and the Indian Migration Study Food Frequency Questionnaire. Intervention participants received one message/day over six months focusing on lifestyle modification. Dietary intake of fruits, vegetables, sugar beverages and teaspoons of sugar in tea/coffee were determined in serves-per-week and were analysed using Chi-square tests. Poisson regression models, adjusted for age, sex and baseline values following an intention-to-treat approach were performed and expressed as an estimate of effect size. RESULTS At 6 months, the adjusted difference in vegetable consumption was -0.02 serves/week [95% confidence interval (CI): -0.11-0.06, P>0.05] and fruit intake was 0.02 serves/week (95% CI: -0.15-0.21, P>0.05). Consumption of sugar beverages reduced in both groups at 6 months with an adjusted difference of -0.34 serves/week (95% CI: -1.10-0.42, P>0.05). Teaspoons of sugar in tea reduced to 0.1±0.3 teaspoons/week in the control group, however, remained the same at 0.2±0.6 teaspoons/week in the intervention group with an adjusted difference of 0.94 teaspoons/week (95% CI: 0.04-1.84, P<0.05). CONCLUSIONS Our results suggest that a text messaging program did not significantly improve dietary behaviour in patients with T2DM. Further studies are warranted to explore the effectiveness of text messaging on dietary behaviour in adults with T2DM. TRIAL REGISTRATION German Clinical Trials Register DRKS00005188, http://www.drks.de.
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Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Elena S George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Technological innovations to improve health outcome in type 2 diabetes mellitus: A randomized controlled study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Leibowitz A, Satre DD, Lu W, Weisner C, Corriveau C, Gizzi E, Sterling S. A Telemedicine Approach to Increase Treatment of Alcohol Use Disorder in Primary Care: A Pilot Feasibility Study. J Addict Med 2021; 15:27-33. [PMID: 32467415 PMCID: PMC7704783 DOI: 10.1097/adm.0000000000000666] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Unhealthy drinking is a leading threat to health, yet few people with alcohol use disorder (AUD) receive treatment. This pilot tested the feasibility of addiction medicine video consultations in primary care for improving AUD medication adoption and specialty treatment initiation. METHODS Primary care providers (PCPs) received training and access to on-call addiction medicine consultations. Feasibility measures were training attendance, intention to use the service and/or AUD pharmacotherapy, and user feedback. Secondary outcomes were utilization, prescription and treatment initiation rates, and case reports. χ2 tests were used to compare prescription and treatment initiation rates for consult recipients and non-recipients. RESULTS Ninety-one PCPs (71.1%) attended a training, and 60 (65.9%) provided feedback. Of those, 37 (64.9%) mentioned pharmacotherapy and 41 (71.9%) intended to use the video consult service. Of 27 users, 19 provided feedback; 12 (63.1%) rated its value at 8 or above, on a scale of 1 to 10 (average 6.9). The most useful aspect was immediacy, and users wanted an easier workflow and increased consultant availability. Of 32 patients who received a consult, 11 (34.4%) were prescribed naltrexone, versus 43 (6.4%) of non-recipients (P < 0.0001); 11 (34.4%) initiated specialty treatment, versus 105 (19.7%) of non-recipients (P < 0.05). CONCLUSIONS PCP training attendance and feedback suggest that an addiction telemedicine consult service would be valuable to PCPs and might increase AUD medication uptake and specialty addiction treatment initiation. However, future research should include significant modifications to the piloted telemedicine model: robust staffing and simpler, more flexible methods for PCPs to obtain consults.
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Affiliation(s)
- Amy Leibowitz
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612-2403
| | - Derek D. Satre
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612-2403
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143
| | - Wendy Lu
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612-2403
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612-2403
| | - Caroline Corriveau
- The Permanente Medical Group, Addiction Medicine and Recovery Services, 380 W MacArthur Blvd, Oakland, CA 94609
| | - Elio Gizzi
- The Permanente Medical Group, East Bay Technology, 901 Nevin Avenue, Richmond, CA 94801
| | - Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612-2403
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Whittemore R, Siverly L, Wischik DL, Whitehouse CR. An Umbrella Review of Text Message Programs for Adults With Type 2 Diabetes. DIABETES EDUCATOR 2020; 46:514-526. [DOI: 10.1177/0145721720965464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose The purpose of this umbrella review was to synthesize the evidence from published systematic reviews on the effectiveness of text message programs for adults with type 2 diabetes (T2DM) on glycemic management (A1C), self-management, and other clinical outcomes. The effect of directionality of the program was also explored. Methods A systematic search was conducted using multiple databases. Inclusion criteria were systematic review of text message programs for adults with T2DM, evaluated A1C, and English language. Quality assessment was completed using AMSTAR-2 guidelines. Data were extracted by multiple coders, and results were synthesized. Results The final sample included 9 systematic reviews published between 2011 and 2019, with 72 unique international studies. Text message programs focused on diabetes self-management and reducing health risks through educational and motivational content with some providing personalized feedback. A meta-analysis of program effect on A1C was conducted in 5 reviews with a pooled difference in A1C from −0.38% to −0.8%. Adults with T2DM of shorter duration and lower A1C had better treatment effects. Evidence on unidirectional versus bidirectional programs is conflicting; however, both improve outcomes. Evidence of text message programs targeting medication engagement was inconclusive. Some programs improved blood pressure, lipids, self-management, self-efficacy, and health behaviors. High satisfaction and an average of 9.6% to 18.7% attrition was reported. Conclusions Text messaging programs can improve T2DM outcomes, are a highly accessible mode of communication, are relatively inexpensive, and are an underutilized adjunct to clinical care.
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Affiliation(s)
| | - Lauren Siverly
- School of Nursing, Yale University, New Haven, Connecticut
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