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Coakley M, Drohan M, Bruce E, Hughes S, Jackson N, Holmes S. COPD Self-Management: A Patient-Physician Perspective. Pulm Ther 2024; 10:145-154. [PMID: 38758408 PMCID: PMC11282028 DOI: 10.1007/s41030-024-00258-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
This article is co-authored by five patients living with chronic obstructive pulmonary disease (COPD), and a primary care physician who has over 30 years of clinical experience and is involved in educating healthcare professionals. The first section of this article is authored by the patients, who describe their experiences of living with COPD. The section that follows is authored by the physician, who discusses the management of COPD in the context of the patients' experiences.
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Garcia Gonzalez-Moral S, Beyer FR, Oyewole AO, Richmond C, Wainwright L, Craig D. Looking at the fringes of MedTech innovation: a mapping review of horizon scanning and foresight methods. BMJ Open 2023; 13:e073730. [PMID: 37709340 PMCID: PMC10503360 DOI: 10.1136/bmjopen-2023-073730] [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] [Received: 03/16/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Horizon scanning (HS) is a method used to examine signs of change and may be used in foresight practice. HS methods used for the identification of innovative medicinal products cannot be applied in medical technologies (MedTech) due to differences in development and regulatory processes. The aim of this study is to identify HS and other methodologies used for MedTech foresight in support to healthcare decision-making. METHOD A mapping review was performed. We searched bibliographical databases including MEDLINE, Embase, Scopus, Web of Science, IEEE Xplore and Compendex Engineering Village and grey literature sources such as Google, CORE database and the International HTA database. Our searches identified 8888 records. After de-duplication, and manual and automated title, abstracts and full-text screening, 49 papers met the inclusion criteria and were data extracted. RESULTS Twenty-five single different methods were identified, often used in combination; of these, only three were novel (appearing only once in the literature). Text mining or artificial intelligence solutions appear as early as 2012, often practised in patent and social media sources. The time horizon used in scanning was not often justified. Some studies regarded experts both as a source and as a method. Literature searching remains one of the most used methods for innovation identification. HS methods were vaguely reported, but often involved consulting with experts and stakeholders. CONCLUSION Heterogeneous methodologies, sources and time horizons are used for HS and foresight of MedTech innovation with little or no justification provided for their use. This review revealed an array of known methods being used in combination to overcome the limitations posed by single methods. The review also revealed inconsistency in methods reporting, with a lack of any consensus regarding best practice. Greater transparency in methods reporting and consistency in methods use would contribute to increased output quality to support informed timely decision-making.
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Affiliation(s)
- Sonia Garcia Gonzalez-Moral
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona R Beyer
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anne O Oyewole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Wainwright
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Holmen IC, Waibel S, Kaarboe O. Emerging integrated care models for children and youth with mental health difficulties in Norway: a horizon scanning study. BMC Health Serv Res 2023; 23:860. [PMID: 37580679 PMCID: PMC10426212 DOI: 10.1186/s12913-023-09858-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: 08/31/2022] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND The implementation of Integrated Care Models (ICMs) represents a strategy for addressing the increasing issues of system fragmentation and improving service customization according to user needs. Available ICMs have been developed for adult populations, and less is known about ICMs specifically designed for children and youth. The study objective was to summarize and assess emerging ICMs for mental health services targeting children and youth in Norway. METHODS A horizon scanning study was conducted in the field of child and youth mental health. The study encompassed two key components: (i) the identification of ICMs through a review of both scientific and grey literature, as well as input from key informants, and (ii) the evaluation of selected ICMs using semi-structured interviews with key informants. The aim of the interviews was to identify factors that either promote or hinder the successful implementation or scale up of these ICMs. RESULTS Fourteen ICMs were chosen for analysis. These models encompassed a range of treatment philosophies, spanning from self-care and community care to specialized care. Several models placed emphasis on the referral process, prioritizing low-threshold access, and incorporating other sectors such as housing and child welfare. Four of the selected models included family or parents in their target group and five models extended their services to children and youth beyond the legal age of majority. Nine experts in the field willingly participated in the interview phase of the study. Identified challenges and facilitating factors associated with implementation or scale up of ICMs were related to the Norwegian healthcare system, mental health care delivery, as well as child and youth specific factors. CONCLUSION Care delivery targeting children and youth's mental health requires further adaptation to accommodate the intricate nature of their lives. ICMs have been identified as a means to address this complexity by offering accessible services and adopting a holistic approach. This study highlights a selection of promising ICMs that appear capable of meeting some of the specific needs of children and youth. However, it is recommended to subject these models to further assessment and refinement to ensure their effectiveness and the fulfilment of their intended outcomes.
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Affiliation(s)
| | - Sina Waibel
- Faculty of Medicine, University of British Columbia, 317 – 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Oddvar Kaarboe
- Department of Economics and IGS, University of Bergen, Bergen, Norway
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Althobiani MA, Khan B, Shah AJ, Ranjan Y, Mendes RG, Folarin A, Mandal S, Porter JC, Hurst JR. Clinicians' Perspectives of Wearable Technology to Detect and Monitor Exacerbations of Chronic Obstructive Pulmonary Disease: Mixed-Method Survey. Int J Chron Obstruct Pulmon Dis 2023; 18:1401-1412. [PMID: 37456915 PMCID: PMC10349580 DOI: 10.2147/copd.s405386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To investigate clinicians' perspectives on the current use of wearable technology for detecting COPD exacerbations, and to identify potential facilitators and barriers to its adoption in clinical settings. Methods A mixed-method survey was conducted through an online survey platform involving clinicians working with COPD patients. The questionnaires were developed by an expert panel specialising in respiratory medicine at UCL. The questionnaire evaluated clinicians' perspectives on several aspects: the current extent of wearable technology utilisation, the perceived feasibility, and utility of these devices, as well as the potential facilitators and barriers that hinder its wider implementation. Results Data from 118 clinicians were included in the analysis. Approximately 80% of clinicians did not currently use information from wearable devices in routine clinical care. A majority of clinicians did not have confidence in the effectiveness of wearables and their consequent impact on health outcomes. However, clinicians highlighted the potential value of wearables in helping deliver personalised care and more rapid assistance. Ease of use, technical support and accessibility of data were considered facilitating factors for wearable utilisation. Costs and lack of technical knowledge were the most frequently reported barriers to wearable utilisation. Conclusion Clinicians' perspectives of the use of wearable technology to detect and monitor COPD exacerbations are variable. While accessibility and technical support facilitate wearable implementation, cost, technical issues, and knowledge act as barriers. Our findings highlight the facilitators and barriers to using wearables in patients with COPD and emphasise the need to assess patients' perspectives on wearable acceptability.
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Affiliation(s)
- Malik A Althobiani
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bilal Khan
- UCL Respiratory, University College London, London, UK
| | - Amar J Shah
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Yatharth Ranjan
- Department of Health Informatics and Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Renata G Mendes
- UCL Respiratory, University College London, London, UK
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - Amos Folarin
- Department of Health Informatics and Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Swapna Mandal
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Joanna C Porter
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Medicine, University College London Hospital (UCLH), London, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK
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5
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Adhikari TB, Paudel K, Paudel R, Bhusal S, Rijal A, Högman M, Neupane D, Sigsgaard T, Kallestrup P. Burden and risk factors of chronic respiratory diseases in Nepal, 1990-2019: An analysis of the global burden of diseases study. Health Sci Rep 2023; 6:e1091. [PMID: 36741854 PMCID: PMC9887632 DOI: 10.1002/hsr2.1091] [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: 04/10/2022] [Revised: 01/13/2023] [Accepted: 01/20/2023] [Indexed: 02/01/2023] Open
Abstract
Background and Aims Chronic respiratory diseases (CRDs) substantially contribute to morbidity and mortality globally and in Nepal. However, there is a paucity of evidence on the trend and the burden of CRDs in Nepal. This study reports the trend of the burden and contribution of major risk factors to CRDs in Nepal from 1990 to 2019. Methods This study is an observational study using publicly available data from Global Burden of Disease 2019 estimations for Nepal. The age-standardized and age-specific prevalence, incidence, mortality, disability-adjusted life years (DALYs), and risk factors for CRDs in Nepal were extracted to measure the burden and its trend. The data are presented as percentages or as rates per 100,000 population. Results The age-standardized incidence rate of CRDs in Nepal in 2019 was 913.6 per 100,000 (95% uncertainty interval [UI]: 828.7-1000.1), which was an increase of 7.7% from 848.6 per 100,000 (95% UI: 780.2-918.2) in 1990. However, the age-standardized prevalence rate [4453/100,000 (4234.2-4671.8) in 1990; 4457.1/100,000 (4255.2-4666.8) in 2019] was almost stagnant. Most CRDs attributed to deaths and DALYs were due to chronic obstructive pulmonary disease. Conclusions Air pollution and smoking are the main risk factors for DALYs due to CRDs in Nepal. This surging burden of the incidence rate of CRDs in Nepal calls for more effective actions to curb the risk factors and diseases.
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Affiliation(s)
- Tara Ballav Adhikari
- Nepal Health FrontiersTokha‐5KathmanduNepal
- COBIN ProjectNepal Development SocietyChitwanNepal
- Department of Public Health, Section for Environment, Occupation & HealthAarhus UniversityAarhusDenmark
| | | | | | | | - Anupa Rijal
- Nepal Health FrontiersTokha‐5KathmanduNepal
- COBIN ProjectNepal Development SocietyChitwanNepal
- Department of Regional Health Research, The Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Marieann Högman
- Department of Medical Sciences, Respiratory, Allergy and Sleep ResearchUppsala UniversityUppsalaSweden
| | - Dinesh Neupane
- COBIN ProjectNepal Development SocietyChitwanNepal
- Department of International Health, Johns Hopkins Bloomberg School of Public HealthJohns Hopkins UniversityMDBaltimoreUSA
| | - Torben Sigsgaard
- Department of Public Health, Section for Environment, Occupation & HealthAarhus UniversityAarhusDenmark
| | - Per Kallestrup
- Department of Public Health, Section for Global HealthAarhus UniversityAarhusDenmark
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Dong T, Santos S, Yang Z, Yang S, Kirkhus NE. Sputum and salivary protein biomarkers and point-of-care biosensors for the management of COPD. Analyst 2020; 145:1583-1604. [PMID: 31915768 DOI: 10.1039/c9an01704f] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) has become one of the most fatal diseases of the century considering mortality and morbidity levels worldwide. This disease is an inflammatory response to environmental stress and tobacco smoking. Although spirometry is the gold-standard diagnostic test administrated in primary and secondary care, it often exhibits low accuracy in cases of predicting disease worsening and possible bias due to the operator, patient, and conditions. Recent developments in proteomics research suggest that the presence of protein biomarkers can aid in the accurate diagnosis and prediction of disease outcomes. This review presents the cutting-edge research progress in the area of protein biomarkers towards the management of COPD. The literature review was confined to protein biomarkers in saliva and sputum because testing these bodily fluids shows great promise for point-of-care (POC) testing due to its practicality, non-invasiveness and inexpensive handling and sampling. Although it is conclusive that more studies on sputum and saliva are needed, this review studies the promising clinical value of interleukin (IL)-6 and IL-8, matrix metalloproteinase (MMP)-8 and MMP-9, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and neutrophil elastase (NE). Following the critical analysis of salivary and sputum biomarkers, the recent development of POC biosensors for the multiplexed detection of biomarkers is also reported. Overall, the review aims to explore the possibility for the future development of POC sensors for chronic lung disease management utilizing clinically relevant biomarkers in saliva and sputum.
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Affiliation(s)
- Tao Dong
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing 400067, China and Department of Microsystems (IMS), Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Postboks 235, 3603 Kongsberg, Norway.
| | - Simão Santos
- Department of Microsystems (IMS), Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Postboks 235, 3603 Kongsberg, Norway.
| | - Zhaochu Yang
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing 400067, China
| | - Shuai Yang
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing 400067, China
| | - Niels E Kirkhus
- Horten Kommune - Kommuneoverlege, Enhetsleder Legetjenester, Vestfold, Norway
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7
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Singh G, Tee A, Trakoolwilaiwan T, Taha A, Olivo M. Method of respiratory rate measurement using a unique wearable platform and an adaptive optical-based approach. Intensive Care Med Exp 2020; 8:15. [PMID: 32449051 PMCID: PMC7246231 DOI: 10.1186/s40635-020-00302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022] Open
Abstract
Background An efficient and accurate method of respiratory rate measurement is still missing in hospital general wards and triage. The goal of this study is to propose a method of respiratory rate measurement that has a potential to be used in general wards, triage, and different hospital settings with comparable performance. We propose a method of respiratory rate measurement that combines a unique wearable platform with an adaptive and optical approach. The optical approach is based on a direct-contact optical diffuse reflectance phenomenon. An adaptive algorithm is developed that computes the first respiratory rate and uses it to select a band. The band then chooses a set of unique optimized parameters in the algorithm to calculate and improve the respiratory rate. We developed a study to compare the proposed method against reference manual counts from 82 patients diagnosed with respiratory diseases. Results We found good agreement between the proposed method of respiratory rate measurement and reference manual counts. The performance of the proposed method highlighted deviations with a 95% confidence interval (C.I.) of − 3.34 and 3.67 breaths per minute (bpm) and a mean bias and standard deviation (STD) of 0.05 bpm and 2.56 bpm, respectively. Conclusions The performance of the proposed method of respiratory rate measurement is comparable with current manual counting and other respiratory rate devices reported. The method has additional advantages that include ease-of-use, quick setup time, and being mobile for wider clinical use. The proposed method has the potential as a tool to measure respiratory rates in a number of use cases.
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Affiliation(s)
- Gurpreet Singh
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore.
| | - Augustine Tee
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore, Singapore
| | - Thanawin Trakoolwilaiwan
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
| | - Aza Taha
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore, Singapore
| | - Malini Olivo
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
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8
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A Low-Cost Breath Analyzer Module in Domiciliary Non-Invasive Mechanical Ventilation for Remote COPD Patient Monitoring. SENSORS 2020; 20:s20030653. [PMID: 31991608 PMCID: PMC7038329 DOI: 10.3390/s20030653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/14/2020] [Accepted: 01/17/2020] [Indexed: 02/07/2023]
Abstract
Smart Breath Analyzers were developed as sensing terminals of a telemedicine architecture devoted to remote monitoring of patients suffering from Chronic Obstructive Pulmonary Disease (COPD) and home-assisted by non-invasive mechanical ventilation via respiratory face mask. The devices based on different sensors (CO2/O2 and Volatile Organic Compounds (VOCs), relative humidity and temperature (R.H. & T) sensors) monitor the breath air exhaled into the expiratory line of the bi-tube patient breathing circuit during a noninvasive ventilo-therapy session; the sensor raw signals are transmitted pseudonymized to National Health Service units by TCP/IP communication through a cloud remote platform. The work is a proof-of-concept of a sensors-based IoT system with the perspective to check continuously the effectiveness of therapy and/or any state of exacerbation of the disease requiring healthcare. Lab tests in controlled experimental conditions by a gas-mixing bench towards CO2/O2 concentrations and exhaled breath collected in a sampling bag were carried out to test the realized prototypes. The Smart Breath Analyzers were also tested in real conditions both on a healthy volunteer subject and a COPD suffering patient.
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9
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Puente-Maestu L, Gallardo Bermejo M, Girón-Matute WI. Las futuras técnicas diagnósticas en neumología, cambiar el chip. Arch Bronconeumol 2019; 55:457-458. [DOI: 10.1016/j.arbres.2019.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 11/24/2022]
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10
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Ding EY, Ensom E, Hafer N, Buchholz B, Picard MA, Dunlap D, Rogers E, Lawton C, Koren A, Lilly C, Fitzgibbons TP, McManus DD. Point-of-care technologies in heart, lung, blood and sleep disorders from the Center for Advancing Point-of-Care Technologies. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2019; 11:58-67. [PMID: 32582870 PMCID: PMC7314358 DOI: 10.1016/j.cobme.2019.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Recent advancements in point-of-care technologies have transformed care for patients with heart, lung, blood, and sleep disorders by providing rapid, cost-effective, and accessible solutions to challenges in the detection and management of many health conditions. However, major barriers exist throughout the technology development process that inhibit the actualization of many promising and potentially successful ideas. The Center for Advancing Point of Care Technologies has established a system for supporting further innovation in this field and bridging the gap between initial idea conception and implementation. We highlight current and emerging point-of-care technologies throughout the development spectrum and emphasize the need for a needs-driven model of health technology development that involve appropriate stakeholders in the process.
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Affiliation(s)
- Eric Y Ding
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Emily Ensom
- Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nathaniel Hafer
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Bryan Buchholz
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
- Department of Work Environment, University of Massachusetts Lowell, Lowell, MA, USA
| | - Mary Ann Picard
- Massachusetts Medical Device Development Center, University of Massachusetts, Worcester/Lowell, MA, USA
| | - Denise Dunlap
- The Manning School of Business, University of Massachusetts Lowell, Lowell, MA, USA
| | - Eugene Rogers
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Carl Lawton
- Department of Chemical Engineering, University of Massachusetts Lowell, Lowell, M A, USA
| | - Ainat Koren
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA
| | - Craig Lilly
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Timothy P Fitzgibbons
- Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
| | - David D McManus
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
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11
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D'Urzo A, Chapman KR, Donohue JF, Kardos P, Maleki-Yazdi MR, Price D. Inhaler Devices for Delivery of LABA/LAMA Fixed-Dose Combinations in Patients with COPD. Pulm Ther 2019; 5:23-41. [PMID: 32026426 PMCID: PMC6967354 DOI: 10.1007/s41030-019-0090-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 02/07/2023] Open
Abstract
Inhaled fixed-dose combinations (FDCs) of a long-acting β-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) have become the cornerstone for the maintenance treatment of symptomatic COPD patients. In this regard, global COPD treatment guidelines have recognized the importance of inhaler devices as integral contributors to the effectiveness of LABA/LAMA FDCs and recommend regular assessment of inhaler device use by the patients in order to improve long-term clinical outcomes. Optimal disease control is also highly dependent upon patient preferences and adherence to inhaler devices. This review objectively examines and compares the major inhaler devices used to deliver different LABA/LAMA FDCs, discusses the inhaler device characteristics that determine drug deposition in the airways, real-life preference for inhaler devices, and handling of inhaler devices that impact the results of the long-term management of COPD. The introduction of new LABA/LAMA FDCs, new inhaler devices, and more clinical studies have created confusion among physicians in choosing the optimal inhaled therapy for COPD patients; in this context, this review attempts to provide an evidence-based framework for informed decision-making with a particular focus on the inhaler devices.Funding. The preparation of this manuscript was funded by Novartis Pharma AG.
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Affiliation(s)
- Anthony D'Urzo
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Kenneth R Chapman
- Asthma and Airway Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - James F Donohue
- Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Peter Kardos
- Group Practice and Centre for Allergy, Respiratory and Sleep Medicine, Red Cross Maingau Hospital, Frankfurt, Germany
| | - M Reza Maleki-Yazdi
- Division of Respiratory Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - David Price
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Observational and Pragmatic Research Institute, Singapore, Singapore
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12
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The successful uptake and sustainability of rapid infectious disease and antimicrobial resistance point-of-care testing requires a complex 'mix-and-match' implementation package. Eur J Clin Microbiol Infect Dis 2019; 38:1015-1022. [PMID: 30710202 PMCID: PMC6520316 DOI: 10.1007/s10096-019-03492-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/18/2019] [Indexed: 11/03/2022]
Abstract
The emergence and spread of antimicrobial resistance is one of the major global issues currently threatening the health and wealth of nations, with effective guidelines and intervention strategies urgently required. Such guidelines and interventions should ideally be targeted at individuals, communities, and nations, requiring international coordination for maximum effect. In this respect, the European Joint Programming Initiative on Antimicrobial Resistance Transnational Working Group 'Antimicrobial Resistance - Rapid Diagnostic Tests' (JPIAMR AMR-RDT) is proposing to consider a 'mix-and-match' package for the implementation of point-of-care testing (PoCT), which is described in this publication. The working group was established with the remit of identifying barriers and solutions to the development and implementation of rapid infectious disease PoCT for combatting the global spread of antimicrobial resistance. It constitutes a multi-sectoral collaboration between medical, technological, and industrial opinion leaders involved in in vitro diagnostics development, medical microbiology, and clinical infectious diseases. The mix-and-match implementation package is designed to encourage the implementation of rapid infectious disease and antimicrobial resistance PoCT in transnational medical environments for use in the fight against increasing antimicrobial resistance.
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13
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Wu J, Dong M, Rigatto C, Liu Y, Lin F. Lab-on-chip technology for chronic disease diagnosis. NPJ Digit Med 2018; 1:7. [PMID: 31304292 PMCID: PMC6550168 DOI: 10.1038/s41746-017-0014-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/28/2017] [Accepted: 12/11/2017] [Indexed: 02/03/2023] Open
Abstract
Various types of chronic diseases (CD) are the leading causes of disability and death worldwide. While those diseases are chronic in nature, accurate and timely clinical decision making is critically required. Current diagnosis procedures are often lengthy and costly, which present a major bottleneck for effective CD healthcare. Rapid, reliable and low-cost diagnostic tools at point-of-care (PoC) are therefore on high demand. Owing to miniaturization, lab-on-chip (LoC) technology has high potential to enable improved biomedical applications in terms of low-cost, high-throughput, ease-of-operation and analysis. In this direction, research toward developing new LoC-based PoC systems for CD diagnosis is fast growing into an emerging area. Some studies in this area began to incorporate digital and mobile technologies. Here we review the recent developments of this area with the focus on chronic respiratory diseases (CRD), diabetes, and chronic kidney diseases (CKD). We conclude by discussing the challenges, opportunities and future perspectives of this field.
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Affiliation(s)
- Jiandong Wu
- 1Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB Canada
| | - Meili Dong
- 1Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB Canada.,2Institute of Applied Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui China
| | | | - Yong Liu
- 2Institute of Applied Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui China
| | - Francis Lin
- 1Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB Canada
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Utilizing a Homecare Platform for Remote Monitoring of Patients with Idiopathic Pulmonary Fibrosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017. [DOI: 10.1007/978-3-319-57348-9_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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Huygens MWJ, Swinkels ICS, de Jong JD, Heijmans MJWM, Friele RD, van Schayck OCP, de Witte LP. Self-monitoring of health data by patients with a chronic disease: does disease controllability matter? BMC FAMILY PRACTICE 2017; 18:40. [PMID: 28320330 PMCID: PMC5360032 DOI: 10.1186/s12875-017-0615-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is a growing emphasis on self-monitoring applications that allow patients to measure their own physical health parameters. A prerequisite for achieving positive effects is patients' willingness to self-monitor. The controllability of disease types, patients' perceived self-efficacy and health problems could play an essential role in this. The purpose of this study is to investigate the relationship between patients' willingness to self-monitor and a range of disease and patient specific variables including controllability of disease type, patients' perceived self-efficacy and health problems. METHODS Data regarding 627 participants with 17 chronic somatic disease types from a Dutch panel of people with chronic diseases have been used for this cross-sectional study. Perceived self-efficacy was assessed using the general self-efficacy scale, perceived health problems using the Physical Health Composite Score (PCS). Participants indicated their willingness to self-monitor. An expert panel assessed for 17 chronic disease types the extent to which patients can independently keep their disease in control. Logistic regression analyses were conducted. RESULTS Patients' willingness to self-monitor differs greatly among disease types: patients with diabetes (71.0%), asthma (59.6%) and hypertension (59.1%) were most willing to self-monitor. In contrast, patients with rheumatism (40.0%), migraine (41.2%) and other neurological disorders (42.9%) were less willing to self-monitor. It seems that there might be a relationship between disease controllability scores and patients' willingness to self-monitor. No evidence is found of a relationship between general self-efficacy and PCS scores, and patients' willingness to self-monitor. CONCLUSIONS This study provides the first evidence that patients' willingness to self-monitor might be associated with disease controllability. Further research should investigate this association more deeply and should focus on how disease controllability influences willingness to self-monitor. In addition, since willingness to self-monitor differed greatly among patient groups, it should be taken into account that not all patient groups are willing to self-monitor.
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Affiliation(s)
- Martine W J Huygens
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Centre for Care Technology Research, Maastricht, The Netherlands.
| | - Ilse C S Swinkels
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Judith D de Jong
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands
| | - Monique J W M Heijmans
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands
| | - Roland D Friele
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tranzo, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Luc P de Witte
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Research Center Technology in Care, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN, Heerlen, The Netherlands.,Centre for Assistive Technology and Connected Healthcare (CATCH), University of Sheffield, 217 Portobello, Sheffield, S1 4DP, UK.,Centre for Care Technology Research, Maastricht, The Netherlands
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