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Labarta JI, Dimitri P, Keiser M, Koledova E, Rivera-Romero O. Evaluating the Usefulness and Ease of Use of a Next-Generation-Connected Drug Delivery Device for Growth Hormone Therapy: Qualitative Study of Health Care Professionals' Perceptions. JMIR Hum Factors 2023; 10:e46893. [PMID: 37531173 PMCID: PMC10433030 DOI: 10.2196/46893] [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: 03/01/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Digital solutions targeting children's health have become an increasingly important element in the provision of integrated health care. For the treatment of growth hormone deficiency (GHD), a unique connected device is available to facilitate the delivery of recombinant human growth hormone (r-hGH) by automating the daily injection process and collecting injection data such that accurate adherence information is available to health care professionals (HCPs), caregivers, and patients. The adoption of such digital solutions requires a good understanding of the perspectives of HCPs as key stakeholders because they leverage data collection and prescribe these solutions to their patients. OBJECTIVE This study aimed to evaluate the third generation of the easypod device (EP3) for the delivery of r-hGH treatment from the HCP perspective, with a focus on perceived usefulness and ease of use. METHODS A qualitative study was conducted, based on a participatory workshop conducted in Zaragoza, Spain, with 10 HCPs experienced in the management of pediatric GHD from 7 reference hospitals in Spain. Several activities were designed to promote discussion among participants about predefined topics based on the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology to provide their perceptions about the new device. RESULTS Participants reported 2 key advantages of EP3 over previous easypod generations: the touch screen interface and the real-time data transmission functionality. All participants (10/10, 100%) agreed that the new device should be part of a digital health ecosystem that provides complementary functionalities including data analysis. CONCLUSIONS This study explored the perceived value of the EP3 autoinjector device for the treatment of GHD by HCPs. HCPs rated the new capabilities of the device as having substantial improvements and concluded that it was highly recommendable for clinical practice. EP3 will enhance decision-making and allow for more personalized care of patients receiving r-hGH.
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Affiliation(s)
- José I Labarta
- Unit of Endocrinology, Department of Pediatrics, Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Paul Dimitri
- Department of Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Matthew Keiser
- Ares Trading SA (an affiliate of Merck KGaA), Eysins, Switzerland
| | - Ekaterina Koledova
- Global Medical Affairs Cardiometabolic & Endocrinology, Merck Healthcare KGaA, Darmstadt, Germany
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Jones S, Hislop JL, Gilmore H, Greenway A, Hibbard J, Monagle P, Newall F. Using an electronic medical record patient portal for warfarin self-management: Empowering children and parents. Res Pract Thromb Haemost 2023; 7:100066. [PMID: 36891277 PMCID: PMC9986642 DOI: 10.1016/j.rpth.2023.100066] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 12/09/2022] [Accepted: 01/08/2023] [Indexed: 02/05/2023] Open
Abstract
Background Many children taking warfarin perform their international normalized ratio (INR) at home, with results phoned to a clinician who instructs warfarin dosing. Data suggest that parents can be supported to make warfarin dosing decisions themselves, a process known as patient self-management (PSM). Objectives This study aimed to determine the suitability and acceptability of warfarin PSM in children using the Epic Patient Portal. Methods Children currently performing INR patient self-testing were eligible. Participation involved an individualized education session, adherence to the PSM program, and participation in phone interviews. Clinical outcomes (INR time in therapeutic range and safety outcomes), patient portal functionality, and family experience were assessed. The hospital human research ethics committee approved the study and consent was obtained from parents/guardians. Results Twenty-four families undertook PSM. The median age of children was 11 years and all children had congenital heart disease. A median of 13 INRs was uploaded to the portal per family (range, 8-47) across a 10-month period. Before PSM, the mean time the INR was in therapeutic range was 71%; this increased to 79.9% during PSM (difference: P < .001). No adverse events were encountered. Eight families participated in a phone interview. The major theme identified was empowerment; minor themes that emerged included "gaining knowledge," "trust and responsibility builds confidence," "saving time," and "resources as a safety net." Conclusion This study demonstrates that communication via the Epic Patient Portal is satisfactory to families and offers a suitable option for PSM for children. Importantly, PSM empowers and builds confidence in families to facilitate management of their child's health.
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Affiliation(s)
- Sophie Jones
- Department of Nursing, The University of Melbourne, Melbourne, Australia.,Haematology Research, Murdoch Children's Research of Institute, Melbourne, Australia.,Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia
| | - Jodi L Hislop
- Haematology Research, Murdoch Children's Research of Institute, Melbourne, Australia
| | - Hollie Gilmore
- Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia
| | - Anthea Greenway
- Haematology Research, Murdoch Children's Research of Institute, Melbourne, Australia.,Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia
| | | | - Paul Monagle
- Haematology Research, Murdoch Children's Research of Institute, Melbourne, Australia.,Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Fiona Newall
- Department of Nursing, The University of Melbourne, Melbourne, Australia.,Haematology Research, Murdoch Children's Research of Institute, Melbourne, Australia.,Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Nursing Research Department, Royal Children's Hospital, Melbourne, Australia
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Barriers and Supports in eHealth Implementation among People with Chronic Cardiovascular Ailments: Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148296. [PMID: 35886149 PMCID: PMC9318125 DOI: 10.3390/ijerph19148296] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
eHealth interventions use information technology to provide attention to patients with chronic cardiovascular conditions, thereby supporting their self-management abilities. OBJECTIVE Identify barriers and aids to the implementation of eHealth interventions in people with chronic cardiovascular conditions from the perspectives of users, health professionals and institutions. METHOD An integrative database review of WoS, Scopus, PubMed and Scielo of publications between 2016 and 2020 reporting eHealth interventions in people with chronic cardiovascular diseases. Keywords used were eHealth and chronic disease. Following inclusion and exclusion criteria application, 14 articles were identified. RESULTS Barriers and aids were identified from the viewpoints of users, health professionals and health institutions. Some notable barriers include users' age and low technological literacy, perceived depersonalization in attention, limitations in technology access and usability, and associated costs. Aids included digital education and support from significant others. CONCLUSIONS eHealth interventions are an alternative with wide potentiality for chronic disease management; however, their implementation must be actively managed.
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