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Carollo M, Crisafulli S, Selleri M, Piccoli L, L’Abbate L, Trifirò G. Agreement of Different Drug-Drug Interaction Checkers for Proton Pump Inhibitors. JAMA Netw Open 2024; 7:e2419851. [PMID: 38980677 PMCID: PMC11234238 DOI: 10.1001/jamanetworkopen.2024.19851] [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: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 07/10/2024] Open
Abstract
Importance Proton pump inhibitors (PPIs) are a widely prescribed class of drugs, potentially interacting with a large number of medicines, especially among older patients with multimorbidity and polypharmacy. Beyond summary of product characteristics (SPCs), interaction checkers (ICs) are routinely used tools to help clinicians in medication review interventions. Objective To assess the consistency of information on drugs potentially interacting with PPIs as reported in their SPCs and different ICs. Design, Setting, and Participants This cross-sectional study was conducted using data from SPCs for 5 PPIs (omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole) and 5 ICs (ie, INTERCheck WEB, Micromedex, Lexicomp, Epocrates, and drugs.com). Information from the SPCs and the ICs were extracted between July 15 and 30, 2023. Main Outcomes and Measures The main outcome was the level of agreement among SPCs and the 5 ICs in identifying drugs potentially interacting with PPIs and attributing drug-drug interaction (DDI) severity categories. The level of agreement was computed using Gwet AC1 statistic on the 5 ICs and by comparing 4-sets and 2-sets of ICs. As a sensitivity analysis, the level of agreement in listing PPI-related DDIs was evaluated using Cohen κ and Fleiss κ coefficients. Results Considering SPCs and the 5 ICs, a total of 518 potentially interacting drugs with omeprazole were reported, 455 for esomeprazole, 433 for lansoprazole, 421 for pantoprazole, and 405 for rabeprazole. As compared with the ICs, the SPCs reported a much smaller number of drugs potentially interacting with PPIs, with proportions ranging from 2.7% (11 potentially interacting drugs) for rabeprazole to 7.6% (33 potentially interacting drugs) for lansoprazole of the total identified drugs at risk of interaction with a PPI. The overall level of agreement among the 5 ICs for identifying potential interactions was poor (from 0.23 [95% CI, 0.21-0.25] for omeprazole to 0.27 [95% CI, 0.24-0.29] for pantoprazole and 0.27 [95% CI, 0.25-0.29] for rabeprazole). Similarly, the level of agreement was low in 4-set and 2-set analyses as well as when restricting the analysis to the potential DDIs identified as severe (range, 0.30-0.32). Conclusions and Relevance This cross-sectional study found significant disagreement among different ICs and SPCs, highlighting the need to focus on standardizing DDI databases. Therefore, to ensure evaluation and prevention of clinically relevant DDIs, it is recommended to revise multiple ICs and consult with specialists, such as clinical pharmacologists, particularly for patients with complex medical conditions.
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Affiliation(s)
- Massimo Carollo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Margherita Selleri
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Luca Piccoli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Luca L’Abbate
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Carollo M, Crisafulli S, Ciccimarra F, Andò G, Diemberger I, Trifirò G. Exploring the level of agreement among different drug-drug interaction checkers: a comparative study on direct oral anticoagulants. Expert Opin Drug Metab Toxicol 2024; 20:157-164. [PMID: 38386102 DOI: 10.1080/17425255.2024.2322134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Direct oral anticoagulants (DOACs) may be involved in drug-drug interactions (DDIs) potentially increasing the risk of adverse drug reactions. This study aimed to evaluate the level of agreement among interaction checkers (ICs) and DOACs' summary of product characteristics (SPCs), in listing DDIs and in attributing DDIs' severity. RESEARCH DESIGN AND METHODS The level of agreement among five ICs (i.e. INTERCheck WEB, Micromedex, Lexicomp, Epocrates, and drugs.com) in identifying potential DDIs and in attributing severity categories was evaluated using Gwet's AC1 on all five ICs and by comparing groups of four- and two-pair sets of ICs. RESULTS A total of 486 potentially interacting drugs with dabigatran, 556 for apixaban, 444 for edoxaban, and 561 for rivaroxaban were reported. The level of agreement among the ICs in identifying potential DDIs was poor (range: 0.12-0.16). Similarly, it was low in 4 and 2 sets analyses. The level of agreement among the ICs in classifying the severity of potential DDIs was poor (range: 0.32-0.34), also in 4 and 2 sets analyses. CONCLUSIONS The heterogeneity among different ICs and SPCs underscores the need to standardize DDI datasets and to conduct real-world studies to generate evidence regarding the frequency and clinical relevance of potential DOAC-related DDIs.
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Affiliation(s)
- Massimo Carollo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Salvatore Crisafulli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesco Ciccimarra
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuseppe Andò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Igor Diemberger
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Eriksson CO, Bahr N, Meckler G, Hansen M, Walker-Stevenson G, Idris A, Aufderheide TP, Daya MR, Fink EL, Jui J, Luetje M, Martin-Gill C, Mcgaughey S, Pelletier J, Thomas D, Guise JM. Adverse Safety Events in Emergency Medical Services Care of Children With Out-of-Hospital Cardiac Arrest. JAMA Netw Open 2024; 7:e2351535. [PMID: 38214931 PMCID: PMC10787316 DOI: 10.1001/jamanetworkopen.2023.51535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
Importance Survival for children with out-of-hospital cardiac arrest (OHCA) remains poor despite improvements in adult OHCA survival. Objective To characterize the frequency of and factors associated with adverse safety events (ASEs) in pediatric OHCA. Design, Setting, and Participants This population-based retrospective cohort study examined patient care reports from 51 emergency medical services (EMS) agencies in California, Georgia, Oregon, Pennsylvania, Texas, and Wisconsin for children younger than 18 years with an OHCA in which resuscitation was attempted by EMS personnel between 2013 and 2019. Medical record review was conducted from January 2019 to April 2022 and data analysis from October 2022 to February 2023. Main Outcomes and Measure Severe ASEs during the patient encounter (eg, failure to give an indicated medication, 10-fold medication overdose). Results A total of 1019 encounters of EMS-treated pediatric OHCA were evaluated; 465 patients (46%) were younger than 12 months. At least 1 severe ASE occurred in 610 patients (60%), and 310 patients (30%) had 2 or more. Neonates had the highest frequency of ASEs. The most common severe ASEs involved epinephrine administration (332 [30%]), vascular access (212 [19%]), and ventilation (160 [14%]). In multivariable logistic regression, the only factor associated with severe ASEs was young age. Neonates with birth-related and non-birth-related OHCA had greater odds of a severe ASE compared with adolescents (birth-related: odds ratio [OR], 7.0; 95% CI, 3.1-16.1; non-birth-related: OR, 3.4; 95% CI, 1.2-9.6). Conclusions and Relevance In this large geographically diverse cohort of children with EMS-treated OHCA, 60% of all patients experienced at least 1 severe ASE. The odds of a severe ASE were higher for neonates than adolescents and even higher when the cardiac arrest was birth related. Given the national increase in out-of-hospital births and ongoing poor outcomes of OHCA in young children, these findings represent an urgent call to action to improve care delivery and training for this population.
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Affiliation(s)
- Carl O. Eriksson
- Department of Pediatrics, Oregon Health and Science University, Portland
| | - Nathan Bahr
- Department of Emergency Medicine, Oregon Health and Science University, Portland
| | - Garth Meckler
- Department of Pediatric Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Hansen
- Department of Emergency Medicine, Oregon Health and Science University, Portland
| | | | - Ahamed Idris
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Tom P. Aufderheide
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee
| | - Mohamud R. Daya
- Department of Emergency Medicine, Oregon Health and Science University, Portland
| | - Ericka L. Fink
- Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jonathan Jui
- Department of Emergency Medicine, Oregon Health and Science University, Portland
| | - Maureen Luetje
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven Mcgaughey
- Department of Emergency Medicine, Oregon Health and Science University, Portland
| | - Jon Pelletier
- Department of Pediatrics, Akron’s Children’s Hospital, Akron, Ohio
| | - Danny Thomas
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee
| | - Jeanne-Marie Guise
- Department of Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Handa M, Afzal O, Beg S, SanapNasik S, Kaundal RK, Verma RK, Mishra A, Shukla R. Harnessing personalized tailored medicines to digital-based data-enriched edible pharmaceuticals. Drug Discov Today 2023; 28:103555. [PMID: 36931386 DOI: 10.1016/j.drudis.2023.103555] [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: 09/18/2022] [Revised: 02/26/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
Tailoring drug products to personalized medicines poses challenges for conventional dosage forms. The prominent reason is the restricted availability of flexible dosage strengths in the market. Inappropriate dosage strengths lead to adverse drug reactions or compromised therapeutic effects. The situation worsens when the drug has a narrow therapeutic window. To overcome these challenges, data-enriched edible pharmaceuticals (DEEP) are novel concepts for designing solid oral products. DEEP have individualized doses and information embedded in quick response (QR) code form. When data are presented in a QR code, the information is printed with edible ink that contains the drug in tailored doses required for the patients.
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Affiliation(s)
- Mayank Handa
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow, UP 226002, India
| | - Obaid Afzal
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Sarwar Beg
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK.
| | - Sachin SanapNasik
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow, UP 226002, India
| | - Ravinder K Kaundal
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research Raebareli (NIPER-R), Lucknow, UP 226002, India
| | - Rahul K Verma
- Institute of Nano Science and Technology (INST), SAS Nagar, Punjab 140306, India
| | - Awanish Mishra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Guwahati, Changsari, Guwahati 781101, Assam, India
| | - Rahul Shukla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow, UP 226002, India.
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Makic MBF, Svoboda E. Staying Informed of Best Evidence to Guide Practice. AACN Adv Crit Care 2023; 34:63-66. [PMID: 36877643 DOI: 10.4037/aacnacc2023372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Mary Beth Flynn Makic
- Mary Beth Flynn Makic is Professor, University of Colorado Anschutz Medical Campus, College of Nursing, 13120 E 19th Ave, Aurora, CO 80045
| | - Ellie Svoboda
- Ellie Svoboda is Education Informationist and Instructor, University of Colorado Anschutz Medical Campus, Strauss Health Sciences Library, Aurora, Colorado
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Muacevic A, Adler JR. A Comparison of Innovative App-Based Prescriptions With Conventional Prescriptions for Children by General Dentists: A Mixed Methods Study. Cureus 2023; 15:e33583. [PMID: 36788825 PMCID: PMC9910809 DOI: 10.7759/cureus.33583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/11/2023] Open
Abstract
Introduction Writing drug prescriptions for children with accurate drug dosages and clear instructions is a must for general dentists. A digital tool in the form of a software application (app) to write, save and share prescriptions can potentially overcome the possible limitations of handwritten prescriptions such as handwriting illegibility, errors in calculations, and incomplete descriptions. However, it is also important to assess the satisfaction of dentists with making prescriptions using a digital tool such as an android application. A mixed methods study comparing an innovative "app-based" and handwritten prescriptions in dental settings is presented. Methodology An indigenously developed and piloted app "PREscribing children made EASY (PREASY)" was used in this study. Based on the preliminary study, a sample size of 20 was found to be adequate. Twenty-two dentists participated in the study. The conventional handwritten and an Android app PREASY-based prescriptions were compared in terms of the time taken, precision of writing, and satisfaction of the dentists. Qualitative feedback regarding the PREASY app was obtained in Google Forms (Google, Inc., Mountain View, CA, USA). Results A study sample of 20 subjects was calculated based on a pilot study, and 22 dentists were recruited. The mean time taken in seconds for handwritten prescriptions (199.14 (+ 59.18)) was almost four times higher than that for app-based prescriptions (52.05 (+ 23.89)) (t-test, P < 0.00001). The accuracy of handwritten prescriptions versus app-based prescriptions was compared by two examiners independently using analysis of variance (ANOVA) in three domains: dosage accuracy, legible handwriting, and completeness of instructions, the differences (Domain 1 mean + SD: 1.04 + 0.89, Domain 2 mean + SD: 1.38 + 0.40, Domain 3 mean + SD: 0.88 + 0.58) being statistically significant (P < 0.05). The differences in the percentages of the three domains (dosage accuracy: 40.9%, legibility of handwriting: 63.6%, completeness of instructions: 18.1%) were found to be statistically significant (P < 0.05; chi-squared statistic, 9.4017). Of the participants, 59% were very satisfied, 36.3% were satisfied, and 4.5% were neutral (chi-squared test, P < 0.00001). Participants' feedback/comments were categorized under technical suggestions, dosage suggestions, criticism, and positive remarks and were thematically analyzed. Conclusion App-based prescriptions proved to be more instantaneous and detailed than handwritten ones with the majority of dentists satisfied. Valuable feedback pertaining to the limitations of the tool was obtained for improving the app. PREASY-based prescriptions could be recommended for prescribing to pediatric dental patients.
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Kho BP, Wong SMA, Chiu JWT, Liew E. Preference and usage pattern of mobile medical apps for drug information purposes among hospital pharmacists in Sarawak, Malaysia. BMC Med Inform Decis Mak 2022; 22:199. [PMID: 35906649 PMCID: PMC9338490 DOI: 10.1186/s12911-022-01949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Pharmacists are frequent users of mobile medical apps (MMA) for drug information (DI) and clinical decision-making purposes. However, the wide range of available MMA may be of variable credibility and results in heterogeneous recommendations. The need for subscription may also influence choice of apps. Objective The objective of this study was to determine the usage pattern of MMA among hospital pharmacists, including their perceptions and factors affecting their choice of apps. Methods This cross-sectional study required respondents to fill in an online questionnaire. The questionnaire included sections on respondents' demographic data, MMA usage pattern, perceived usefulness and opinion on subscription fees. Items were adapted from available literature and validated locally. It was made accessible for 6 weeks starting November 2019 for all pharmacists working in the 23 public hospitals in Sarawak to response (universal sampling). Collected data were analysed using descriptive and inferential statistics. Results A response rate of 37.2% was achieved (n = 162). Respondents were heavily reliant on MMA, with 78.4% accessing them multiple times daily. The majority also agreed that MMA contain correct and up-to-date information. A median of 5 apps were downloaded, suggesting an ultimate app catering for all DI needs was lacking. The Malaysian Drug Formulary was the most downloaded app (88.3%), whereas Lexicomp® was the most “well-rounded” in terms of functionality. Clinical pharmacists were significantly more likely to purchase MMA, in particular UpToDate® (p < 0.01) due to their need to access clinical updates. Respondents highly recommended institutional access for either UpToDate® or Lexicomp® be made available. Pre-registration pharmacists should be guided on judicious MMA usage, as they downloaded significantly more apps and were more likely to indicate not knowing which DI recommendation to follow (both p < 0.01). Conclusion MMA has become an indispensable tool for hospital pharmacists, however there was a tendency to download multiple apps for DI needs. Institutional access can be considered for credible apps identified to ensure accuracy and uniformity of DI recommendations, with purchase decision made after surveying the needs and preferences of end users. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01949-9.
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Affiliation(s)
- Boon Phiaw Kho
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, 93586 Tun Ahmad Zaidi Adruce Road, Kuching, Sarawak, Malaysia.
| | - Sheng Ming Andy Wong
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, 93586 Tun Ahmad Zaidi Adruce Road, Kuching, Sarawak, Malaysia
| | - Jin Wei Timothy Chiu
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, 93586 Tun Ahmad Zaidi Adruce Road, Kuching, Sarawak, Malaysia
| | - Eon Liew
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, 93586 Tun Ahmad Zaidi Adruce Road, Kuching, Sarawak, Malaysia
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García-Sánchez S, Somoza-Fernández B, de Lorenzo-Pinto A, Ortega-Navarro C, Herranz-Alonso A, Sanjurjo M. Mobile Health Apps Providing Information on Drugs for Adult Emergency Care: Systematic Search on App Stores and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e29985. [PMID: 35442212 PMCID: PMC9069291 DOI: 10.2196/29985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 12/17/2022] Open
Abstract
Background
Drug-referencing apps are among the most frequently used by emergency health professionals. To date, no study has analyzed the quantity and quality of apps that provide information on emergency drugs.
Objective
This study aimed to identify apps designed to assist emergency professionals in managing drugs and to describe and analyze their characteristics.
Methods
We performed an observational, cross-sectional, descriptive study of apps that provide information on drugs for adult emergency care. The iOS and Android platforms were searched in February 2021. The apps were independently evaluated by 2 hospital clinical pharmacists. We analyzed developer affiliation, cost, updates, user ratings, and number of downloads. We also evaluated the main topic (emergency drugs or emergency medicine), the number of drugs described, the inclusion of bibliographic references, and the presence of the following drug information: commercial presentations, usual dosage, dose adjustment for renal failure, mechanism of action, therapeutic indications, contraindications, interactions with other medicinal products, use in pregnancy and breastfeeding, adverse reactions, method of preparation and administration, stability data, incompatibilities, identification of high-alert medications, positioning in treatment algorithms, information about medication reconciliation, and cost.
Results
Overall, 49 apps were identified. Of these 49 apps, 32 (65%) were found on both digital platforms; 11 (22%) were available only for Android, and 6 (12%) were available only for iOS. In total, 41% (20/49) of the apps required payment (ranging from €0.59 [US $0.64] to €179.99 [US $196.10]) and 22% (11/49) of the apps were developed by non–health care professionals. The mean weighted user rating was 4.023 of 5 (SD 0.71). Overall, 45% (22/49) of the apps focused on emergency drugs, and 55% (27/49) focused on emergency medicine. More than half (29/47, 62%) did not include bibliographic references or had not been updated for more than a year (29/49, 59%). The median number of drugs was 66 (range 4 to >5000). Contraindications (26/47, 55%) and adverse reactions (24/47, 51%) were found in only half of the apps. Less than half of the apps addressed dose adjustment for renal failure (15/47, 32%), interactions (10/47, 21%), and use during pregnancy and breastfeeding (15/47, 32%). Only 6% (3/47) identified high-alert medications, and 2% (1/47) included information about medication reconciliation. Health-related developer, main topic, and greater amount of drug information were not statistically associated with higher user ratings (P=.99, P=.09, and P=.31, respectively).
Conclusions
We provide a comprehensive review of apps with information on emergency drugs for adults. Information on authorship, drug characteristics, and bibliographic references is frequently scarce; therefore, we propose recommendations to consider when developing an app of these characteristics. Future efforts should be made to increase the regulation of drug-referencing apps and to conduct a more frequent and documented review of their clinical content.
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Affiliation(s)
- Sebastián García-Sánchez
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Beatriz Somoza-Fernández
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana de Lorenzo-Pinto
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Ortega-Navarro
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Herranz-Alonso
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Sanjurjo
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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The Impact of Using mHealth Apps on Improving Public Health Satisfaction during the COVID-19 Pandemic: A Digital Content Value Chain Perspective. Healthcare (Basel) 2022; 10:healthcare10030479. [PMID: 35326957 PMCID: PMC8954858 DOI: 10.3390/healthcare10030479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
The use of mobile technology and equipment has been found to be successful in the governance of public health. In the context of the coronavirus disease 2019 (COVID-19) pandemic, mobile health (mhealth) apps are expected to play an important role in the governance of public health. This study establishes a structural equation model based on the digital content value chain framework, identifies the main values created by mhealth apps in the prevention and control of COVID-19, and surveys 500 citizens of China. The data were analyzed using an independent t-test and partial least squares structural equations (PLS-SEM). The results showed that people who use mhealth apps are more satisfied with public health governance than those who do not; the healthcare assurance value of mhealth apps and healthcare confidence positively influence the interaction between users and mhealth app functions, the interaction with information, and the interaction with doctors to improve users’ satisfaction with public health governance; and the parasocial relationships between doctors and users of mhealth apps positively affect the interactions between users and doctors to improve users’ satisfaction with public health governance. This study confirms the potential of mhealth apps toward improving public health governance during the COVID-19 pandemic from a new perspective and provides a new theoretical basis whereby mobile technology can contribute toward improving public health governance.
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Garcés-Jiménez A, Calderón-Gómez H, Gómez-Pulido JM, Gómez-Pulido JA, Vargas-Lombardo M, Castillo-Sequera JL, Aguirre MP, Sanz-Moreno J, Polo-Luque ML, Rodríguez-Puyol D. Medical Prognosis of Infectious Diseases in Nursing Homes by Applying Machine Learning on Clinical Data Collected in Cloud Microservices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13278. [PMID: 34948885 PMCID: PMC8704304 DOI: 10.3390/ijerph182413278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND treating infectious diseases in elderly individuals is difficult; patient referral to emergency services often occurs, since the elderly tend to arrive at consultations with advanced, serious symptoms. AIM it was hypothesized that anticipating an infectious disease diagnosis by a few days could significantly improve a patient's well-being and reduce the burden on emergency health system services. METHODS vital signs from residents were taken daily and transferred to a database in the cloud. Classifiers were used to recognize patterns in the spatial domain process of the collected data. Doctors reported their diagnoses when any disease presented. A flexible microservice architecture provided access and functionality to the system. RESULTS combining two different domains, health and technology, is not easy, but the results are encouraging. The classifiers reported good results; the system has been well accepted by medical personnel and is proving to be cost-effective and a good solution to service disadvantaged areas. In this context, this research found the importance of certain clinical variables in the identification of infectious diseases. CONCLUSIONS this work explores how to apply mobile communications, cloud services, and machine learning technology, in order to provide efficient tools for medical staff in nursing homes. The scalable architecture can be extended to big data applications that may extract valuable knowledge patterns for medical research.
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Affiliation(s)
- Alberto Garcés-Jiménez
- Foundation for Biomedical Research, Hospital Príncipe de Asturias, 28805 Alcalá de Henares, Spain; (A.G.-J.); (J.S.-M.)
- Center for Studies and Innovation in Knowledge Management, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Huriviades Calderón-Gómez
- Department of Computer Science, Universidad de Alcalá, 28805 Alcalá de Henares, Spain; (H.C.-G.); (J.M.G.-P.); (J.L.C.-S.)
- E-Health and Supercomputing Research Group, Technological University of Panama, Panama City 0819-07289, Panama
| | - José M. Gómez-Pulido
- Department of Computer Science, Universidad de Alcalá, 28805 Alcalá de Henares, Spain; (H.C.-G.); (J.M.G.-P.); (J.L.C.-S.)
- Ramón y Cajal Institute for Health Research, 28034 Madrid, Spain;
| | - Juan A. Gómez-Pulido
- Department of Technologies of Computers and Communications, Universidad de Extremadura, 10003 Cáceres, Spain;
| | - Miguel Vargas-Lombardo
- E-Health and Supercomputing Research Group, Technological University of Panama, Panama City 0819-07289, Panama
| | - José L. Castillo-Sequera
- Department of Computer Science, Universidad de Alcalá, 28805 Alcalá de Henares, Spain; (H.C.-G.); (J.M.G.-P.); (J.L.C.-S.)
- Ramón y Cajal Institute for Health Research, 28034 Madrid, Spain;
| | - Miguel Pablo Aguirre
- Department of Electrical and Electronic Engineering, Technological Institute of Buenos Aires, Buenos Aires C1437FBG, Argentina;
| | - José Sanz-Moreno
- Foundation for Biomedical Research, Hospital Príncipe de Asturias, 28805 Alcalá de Henares, Spain; (A.G.-J.); (J.S.-M.)
| | - María-Luz Polo-Luque
- Ramón y Cajal Institute for Health Research, 28034 Madrid, Spain;
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28805 Alcalá de Henares, Spain
| | - Diego Rodríguez-Puyol
- Department of Medicine and Medical Specialties, Research Foundation of the University Hospital Príncipe de Asturias, IRYCIS, Universidad de Alcalá, 28805 Alcalá de Henares, Spain;
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Stanislawski MA, Stamper CE, Stearns-Yoder KA, Hoisington AJ, Brostow DP, Forster JE, Postolache TT, Lowry CA, Brenner LA. Characterization of the gut microbiota among Veterans with unique military-related exposures and high prevalence of chronic health conditions: A United States-Veteran Microbiome Project (US-VMP) study. Brain Behav Immun Health 2021; 18:100346. [PMID: 34988495 PMCID: PMC8710413 DOI: 10.1016/j.bbih.2021.100346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/06/2021] [Accepted: 09/11/2021] [Indexed: 02/07/2023] Open
Abstract
The gut microbiome is impacted by environmental exposures and has been implicated in many physical and mental health conditions, including anxiety disorders, affective disorders, and trauma- and stressor-related disorders such as posttraumatic stress disorder (PTSD). United States (US) military Veterans are a unique population in that their military-related exposures can have consequences for both physical and mental health, but the gut microbiome of this population has been understudied. In this publication, we describe exposures, health conditions, and medication use of Veterans in the US Veteran Microbiome Project (US-VMP) and examine the associations between these characteristics and the gut microbiota. This cohort included 331 US Veterans seeking healthcare with the Veterans Health Administration who were 83% male with an average (±SD) age of 47.6 ± 13.4 years. The cohort displayed a high prevalence of PTSD (49.8%) and history of traumatic brain injuries (76.1%), and high current use of prescription medications (74.9%) to treat various acute and chronic conditions. We observed significant associations between the gut microbiota composition and gastroenteritis, peripheral vascular disease (PVD), bipolar disorders, symptoms of severe depression based on the Beck Depression Inventory, stimulant and opioid use disorders, beta-blockers, serotonin and norepinephrine reuptake inhibitor antidepressants, diabetes medications, and proton pump inhibitors. Many of the Veteran characteristics examined were associated with altered relative abundances of specific taxa. We found that PVD and cardiovascular disease were associated with lower microbiota diversity in the gut (i.e., α-diversity), while supplemental vitamin use was associated with higher α-diversity. Our study contributes novel insights as to whether the unique exposures of Veterans in this cohort correlate with gut microbiota characteristics and, in line with previous findings with other population-level studies of the microbiome, confirms associations between numerous health conditions and medications with the gut microbiome.
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Affiliation(s)
- Maggie A. Stanislawski
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
| | - Christopher E. Stamper
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kelly A. Stearns-Yoder
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrew J. Hoisington
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Systems Engineering & Management, Air Force Institute of Technology, Wright-Patterson AFB, OH, USA
| | - Diana P. Brostow
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jeri E. Forster
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Teodor T. Postolache
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA
- VISN 5 MIRECC, Department of Veterans Affairs, Baltimore, MD, USA
| | - Christopher A. Lowry
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa A. Brenner
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Personalized and Self-Management: Systematic Search and Evaluation Quality Factors and User Preference of Drug Reference Apps in Taiwan. J Pers Med 2021; 11:jpm11080790. [PMID: 34442435 PMCID: PMC8400514 DOI: 10.3390/jpm11080790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Drug reference apps promote self-management and improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. This study aimed to describe a systematic and stepwise process to identify drug reference apps in Taiwan, assess the quality of these apps, and analyze the influential factors for user ratings. Methods: A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. Results: A total of 23 drug reference apps in Taiwan were identified and analyzed. Generally, these drug reference apps were evaluated as acceptable quality with an average MARS score of 3.23. Higher user engagement, more functionality, better aesthetics, and more information associated with higher user ratings. Navigation is the most influential factor on higher user ratings (AME: 13.15%) followed by performance (AME: 11.03%), visual appeal (AME: 10.87%), credibility (AME: 10.67%), and quantity of information (AME: 10.42%). Conclusions: User experience and information clearly affect user ratings of drug reference apps. Five key factors should be considered when designing drug reference apps.
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Ayalew MB, Dieberg G, Quirk F, Spark MJ. Development and validation of explicit criteria to identify potentially inappropriate prescribing for adults with type 2 diabetes mellitus. Res Social Adm Pharm 2021; 18:2989-2996. [PMID: 34330635 DOI: 10.1016/j.sapharm.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early detection and timely resolution of potentially inappropriate prescribing (PIP) prevents adverse outcomes and improves patient care. An explicit tool specifically designed to detect PIP among people with Type 2 Diabetes Mellitus (T2DM) has not been published. OBJECTIVES This study aims to develop and validate the Inappropriate Medication Prescribing Assessment Criteria for Type 2 Diabetes Mellitus (IMPACT2DM); an explicit tool that can be used to identify PIP for adults with T2DM. METHODS Current national and international guidelines for the management of T2DM and drug information software programs were used to generate potential items. The content of the IMPACT2DM was validated by 2 consecutive rounds of Delphi method. Physicians and clinical pharmacists experienced in providing care for people with diabetes and authors of selected diabetes guidelines were invited to participate in the Delphi panel. Consensus was assumed if 90% (first round) and 85% (second round) of expert panelists showed agreement to include or exclude an item. RESULTS A total of 95 potential items were generated from selected diabetes guidelines and drug information software programs. After the first Delphi round 27 items had ≥90% agreement and were included in the tool; 19 items were considered not PIP and were excluded from the tool. The second round contained 49 items; of these 43 were included and 6 were excluded from the tool. The final IMPACT2DM contains 70 items categorized by type of PIP and arranged in terms of medical conditions and medication classes. IMPACT2DM can be applied using information on medical charts and requires minimal or no clinical knowledge to assess quality of diabetes care and improve medication selection. CONCLUSIONS IMPACT2DM has been developed from current quality evidence and undergone content validation. It is the first explicit tool specifically designed to identify PIP for adults with T2DM.
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Affiliation(s)
- Mohammed Biset Ayalew
- Pharmacy, School of Rural Medicine, University of New England, Armidale, 2351, Australia; Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Gudrun Dieberg
- Biomedical Science, School of Science and Technology, University of New England, Armidale, 2351, Australia
| | - Frances Quirk
- Faculty of Medicine and Health, University of New England, Armidale, 2351, Australia
| | - M Joy Spark
- Pharmacy, School of Rural Medicine, University of New England, Armidale, 2351, Australia.
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Differences in information accessed in a pharmacologic knowledge base using a conversational agent vs traditional search methods. Int J Med Inform 2021; 153:104530. [PMID: 34332466 DOI: 10.1016/j.ijmedinf.2021.104530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/27/2021] [Accepted: 06/16/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Clinicians rely on pharmacologic knowledge bases to answer medication questions and avoid potential adverse drug events. In late 2018, an artificial intelligence-based conversational agent, Watson Assistant (WA), was made available to online subscribers to the pharmacologic knowledge base, Micromedex®. WA allows users to ask medication-related questions in natural language. This study evaluated search method-dependent differences in the frequency of information accessed by traditional methods (keyword search and heading navigation) vs conversational agent search. MATERIALS AND METHODS We compared the proportion of information types accessed through the conversational agent to the proportion of analogous information types accessed by traditional methods during the first 6 months of 2020. RESULTS Addition of the conversational agent allowed early adopters to access 22 different information types contained in the 'quick answers' portion of the knowledge base. These information types were accessed 117,550 times with WA during the study period, compared to 33,649,651 times using traditional search methods. The distribution across information types differed by method employed (c2 test, P < .0001). Single drug/dosing, FDA/non-FDA uses, adverse effects, and drug administration emerged as 4 of the top 5 information types accessed by either method. Intravenous compatibility was accessed more frequently using the conversational agent (7.7% vs. 0.6% for traditional methods), whereas dose adjustments were accessed more frequently via traditional methods (4.8% vs. 1.4% for WA). CONCLUSION In a widely used pharmacologic knowledge base, information accessed through conversational agents versus traditional methods differed. User-centered studies are needed to understand these differences.
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Comparing Potential Drug-Drug Interactions in Companion Animal Medications Using Two Electronic Databases. Vet Sci 2021; 8:vetsci8040060. [PMID: 33917796 PMCID: PMC8068153 DOI: 10.3390/vetsci8040060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 01/14/2023] Open
Abstract
Multiple-drug prescriptions can cause drug–drug interactions (DDIs), which increase risks associated with healthcare in veterinary medicine. Moreover, many human medicines are used in canine patients under the responsibility of veterinarians and may cause severe problems due to off-label use. Currently, many electronic databases are being used as tools for potential DDI prediction, for example, Micromedex and Drugs.com, which may benefit the prediction of potential DDIs for drugs used in canine. The purpose of this study was to examine different abilities for the identification of potential DDIs in companion animal medicine, especially in canine patients, by Micromedex and Drugs.com. Micromedex showed 429 pairs of potential DDIs, while Drugs.com showed 842 pairs of potential DDIs. The analysis comparing results between the two databases showed 139 pairs (12.28%) with the same severity and 993 pairs (87.72%) with different severities. The major mechanisms of contraindicated and major potential DDIs were cytochrome P450 induction–inhibition and QT interval prolongation. Veterinarians should interpret potential DDIs from several databases with caution and keep in mind that the results might not be reliable due to differences in sensitivity to drugs, drug-metabolizing enzymes, and elimination pathway between animals and humans.
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Vansimaeys C, Benamar L, Balagué C. Digital health and management of chronic disease: A multimodal technologies typology. Int J Health Plann Manage 2021; 36:1107-1125. [PMID: 33786849 DOI: 10.1002/hpm.3161] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/19/2021] [Accepted: 03/13/2021] [Indexed: 11/08/2022] Open
Abstract
This cross-sectional descriptive study aims to (1) describe the current digital technology (DT) use of people with chronic diseases (CD) by identifying different user profiles and (2) determine whether those profiles have specific characteristics regarding health-related variables and patient-doctor relationship quality (RQ). An online questionnaire assessing the uses of multiple types of DT (the Internet, mobile applications and connected devices) and several dimensions related to health and patient-doctor RQ was completed by 954 individuals living with CD. DT user groups were obtained by k-means cluster analysis and then compared using Mann-Whitney tests. The results show three profiles of DT users: (1) hyperconnected (8.9%, regular users of all DTs), (2) biconnected (19.1%, regular users of the Internet and mobile apps) and (3) hypoconnected (72%, casual users of the Internet only). The hyperconnected and biconnected groups are more empowered, more knowledgeable about their treatment and more committed to their doctors than the hypoconnected group. Nonadherence to treatment, health motivations, self-efficacy for health management and the trust dimension of the patient-doctor RQ did not differ between groups. We conclude by discussing the low use of the most recent technologies in the CD population, although these technologies seem to provide access to health information that empowers patients and leads to a better relationship with their doctors.
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Affiliation(s)
- Camille Vansimaeys
- LITEM, Univ Evry, IMT-BS, Université Paris-Saclay, Evry, France.,Université de Paris, LPPS, Boulogne Billancourt, France
| | - Lamya Benamar
- LITEM, Univ Evry, IMT-BS, Université Paris-Saclay, Evry, France
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Hammar T, Hamqvist S, Zetterholm M, Jokela P, Ferati M. Current Knowledge about Providing Drug-Drug Interaction Services for Patients-A Scoping Review. PHARMACY 2021; 9:69. [PMID: 33805205 PMCID: PMC8103271 DOI: 10.3390/pharmacy9020069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022] Open
Abstract
Drug-drug interactions (DDIs) pose a major problem to patient safety. eHealth solutions have the potential to address this problem and generally improve medication management by providing digital services for health care professionals and patients. Clinical decision support systems (CDSS) to alert physicians or pharmacists about DDIs are common, and there is an extensive body of research about CDSS for professionals. Information about DDIs is commonly requested by patients, but little is known about providing similar support to patients. The aim of this scoping review was to explore and describe current knowledge about providing digital DDI services for patients. Using a broad search strategy and an established framework for scoping reviews, 19 papers were included. The results show that although some patients want to check for DDIs themselves, there are differences between patients, in terms of demands and ability. There are numerous DDI services available, but the existence of large variations regarding service quality implies potential safety issues. The review includes suggestions about design features but also indicates a substantial knowledge gap highlighting the need for further research about how to best design and provide digital DDI to patients without risking patient safety or having other unintended consequences.
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Affiliation(s)
- Tora Hammar
- Department of Medicine and Optometry, The eHealth Institute, Linnaeus University, 391 82 Kalmar, Sweden;
| | - Sara Hamqvist
- Department of Media and Journalism, Linnaeus University, 391 82 Kalmar, Sweden;
| | - My Zetterholm
- Department of Medicine and Optometry, The eHealth Institute, Linnaeus University, 391 82 Kalmar, Sweden;
- Department of Informatics, Linnaeus University, 391 82 Kalmar, Sweden; (P.J.); (M.F.)
| | - Päivi Jokela
- Department of Informatics, Linnaeus University, 391 82 Kalmar, Sweden; (P.J.); (M.F.)
| | - Mexhid Ferati
- Department of Informatics, Linnaeus University, 391 82 Kalmar, Sweden; (P.J.); (M.F.)
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Ming LC, Untong N, Aliudin NA, Osili N, Kifli N, Tan CS, Goh KW, Ng PW, Al-Worafi YM, Lee KS, Goh HP. Mobile Health Apps on COVID-19 Launched in the Early Days of the Pandemic: Content Analysis and Review. JMIR Mhealth Uhealth 2020; 8:e19796. [PMID: 32609622 PMCID: PMC7505686 DOI: 10.2196/19796] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background Mobile health (mHealth) app use is a major concern because of the possible dissemination of misinformation that could harm the users. Particularly, it can be difficult for health care professionals to recommend a suitable app for coronavirus disease (COVID-19) education and self-monitoring purposes. Objective This study aims to analyze and evaluate the contents as well as features of COVID-19 mobile apps. The findings are instrumental in helping health care professionals to identify suitable mobile apps for COVID-19 self-monitoring and education. The results of the mobile apps’ assessment could potentially help mobile app developers improve or modify their existing mobile app designs to achieve optimal outcomes. Methods The search for the mHealth apps available in the android-based Play Store and the iOS-based App Store was conducted between April 18 and May 5, 2020. The region of the App Store where we performed the search was the United States, and a virtual private network app was used to locate and access COVID-19 mobile apps from all countries on the Google Play Store. The inclusion criteria were apps that are related to COVID-19 with no restriction in language type. The basic features assessment criteria used for comparison were the requirement for free subscription, internet connection, education or advisory content, size of the app, ability to export data, and automated data entry. The functionality of the apps was assessed according to knowledge (information on COVID-19), tracing or mapping of COVID-19 cases, home monitoring surveillance, online consultation with a health authority, and official apps run by health authorities. Results Of the 223 COVID-19–related mobile apps, only 30 (19.9%) found in the App Store and 28 (44.4%) in the Play Store matched the inclusion criteria. In the basic features assessment, most App Store (10/30, 33.3%) and Play Store (10/28, 35.7%) apps scored 4 out of 7 points. Meanwhile, the outcome of the functionality assessment for most App Store apps (13/30, 43.3%) was a score of 3 compared to android-based apps (10/28, 35.7%), which scored 2 (out of the maximum 5 points). Evaluation of the basic functions showed that 75.0% (n=36) of the 48 included mobile apps do not require a subscription, 56.3% (n=27) provide symptom advice, and 41.7% (n=20) have educational content. In terms of the specific functions, more than half of the included mobile apps are official mobile apps maintained by a health authority for COVID-19 information provision. Around 37.5% (n=18) and 31.3% (n=15) of the mobile apps have tracing or mapping and home monitoring surveillance functions, respectively, with only 17% (n=8) of the mobile apps equipped with an online consultation function. Conclusions Most iOS-based apps incorporate infographic mapping of COVID-19 cases, while most android-based apps incorporate home monitoring surveillance features instead of providing focused educational content on COVID-19. It is important to evaluate the contents and features of COVID-19 mobile apps to guide users in choosing a suitable mobile app based on their requirements.
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Affiliation(s)
- Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Noorazrina Untong
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Nur Amalina Aliudin
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Norliza Osili
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Nurolaini Kifli
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Ching Siang Tan
- School of Pharmacy, KPJ Healthcare University College, Nilai, Malaysia
| | - Khang Wen Goh
- Faculty of Science and Technology, Quest International University Perak, Ipoh, Malaysia
| | - Pit Wei Ng
- Department of Pharmacy, National University Health System, Singapore, Singapore
| | - Yaser Mohammed Al-Worafi
- College of Pharmacy, University of Science and Technology of Fujairah, Fujairah, United Arab Emirates.,College of Pharmacy, University of Science and Technology, Sana'a, Yemen
| | - Kah Seng Lee
- Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Malaysia
| | - Hui Poh Goh
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
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Abstract
Depression is one of the most common comorbidities of many chronic medical diseases including cancer and cardiovascular, metabolic, inflammatory and neurological disorders. Indeed, the prevalence of depression in these patient groups is often substantially higher than in the general population, and depression accounts for a substantial part of the psychosocial burden of these disorders. Many factors can contribute to the occurrence of comorbid depression, such as shared genetic factors, converging biological pathways, social factors, health behaviours and psychological factors. Diagnosis of depression in patients with a medical disorder can be particularly challenging owing to symptomatic overlap. Although pharmacological and psychological treatments can be effective, adjustments may need to be made for patients with a comorbid medical disorder. In addition, symptoms or treatments of medical disorders may interfere with the treatment of depression. Conversely, symptoms of depression may decrease adherence to treatment of both disorders. Thus, comprehensive treatment plans are necessary to optimize care.
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Ng JY, Mooghali M, Munford V. eHealth technologies assisting in identifying potential adverse interactions with complementary and alternative medicine (CAM) or standalone CAM adverse events or side effects: a scoping review. BMC Complement Med Ther 2020; 20:239. [PMID: 32727531 PMCID: PMC7388448 DOI: 10.1186/s12906-020-02963-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/19/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND While there are several existing eHealth technologies for drug-drug interactions and stand-alone drug adverse effects, it appears that considerably less attention is focussed on that of complementary and alternative medicine (CAM). Despite poor knowledge of their potential interactions and side effects, many patients use CAM. This justifies the need to identify what eHealth technologies are assisting in identifying potential 1) adverse drug interactions with CAM, 2) adverse CAM-CAM interactions or 3) standalone CAM adverse events or side effects. METHODS A scoping review was conducted to identify eHealth technologies assisting in identifying potential adverse interactions with CAM or standalone CAM adverse events or side effects, following Arksey and O'Malley's five-stage scoping review framework. MEDLINE, EMBASE, and AMED databases and the Canadian Agency for Drugs and Technologies in Health website were systematically searched. Eligible articles had to have assessed or referenced an eHealth technology assisting in identifying potential one or more of the three aforementioned items. We placed no eligibility restrictions on type of eHealth technology. RESULTS Searches identified 3467 items, of which 2763 were unique, and 2674 titles and abstracts were eliminated, leaving 89 full-text articles to be considered. Of those, 48 were not eligible, leaving a total of 41 articles eligible for review. From these 41 articles, 69 unique eHealth technologies meeting our eligibility criteria were identified. Themes which emerged from our analysis included the following: the lack of recent reviews of CAM-related healthcare information; a large number of databases; and the presence of government adverse drug/event surveillance. CONCLUSIONS The present scoping review is the first, to our knowledge, to provide a descriptive map of the literature and eHealth technologies relating to our research question. We highlight that while an ample number of resources are available to healthcare providers, researchers, and patients, we caution that the quality and update frequency for many of these resources vary widely, and until formally assessed, remain unknown. We identify that a need exists to conduct an updated and systematically-searched review of CAM-related healthcare or research resources, as well as develop guidance documents associated with the development and evaluation of CAM-related eHealth technologies.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Maryam Mooghali
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada
| | - Vanessa Munford
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada
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Rodrigues AT, Sousa CT, Pereira J, Figueiredo IV, Lima TDM. Mobile Applications (Apps) to Support the Hepatitis C Treatment: A Systematic Search in App Stores. Ther Innov Regul Sci 2020; 55:152-162. [PMID: 32700147 DOI: 10.1007/s43441-020-00201-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
The purpose of this review was to identify apps to support the HCV treatment and perform a quality assessment. A comprehensive search was conducted until February 2020 in Apple App Store (iOs) and Google Play Store (Android) using search term such "hepatitis", "hepatology", and "HCV". Two independent authors identified the apps and performed data extraction and quality assessment using Mobile App Rating Scale (MARS). Spearman's correlation analysis was used to analyze the relationships between user's star ratings found in the app stores and quality app defined by the MARS instrument. A total of 316 potential apps were identified, of which 12 apps fully met the eligibility criteria. Most apps were available in both App Stores and developed by commercial developers for healthcare provider. Almost all of apps were updated within the last two year and received 3.7 or above star ratings from users. Overall, only one app was considered with a good quality. The average scores for objective and subjective MARS quality of these apps were 3.54 (SD = 0.65) and 3.27 (SD = 0.76), respectively. Moreover, a majority of apps received objective scores between 3.29 and 4.37/5. However, MARS items such "interactivity", "visual appeal", "quality information", and "credibility" obtained minimum acceptable scores. MARS scores were not significantly correlation the user's star ratings. This systematic search found gaps in apps to support the HCV treatment; 12 apps were identified in this study and only one app achieved a good quality. There is a need that users use these apps cautiously as well as involve expert healthcare professionals in the development of new HCV apps.
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Affiliation(s)
| | | | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research, University Coimbra, Coimbra, Portugal
| | | | - Tácio de Mendonça Lima
- Department of Pharmaceutical Sciences, Federal Rural University of Rio de Janeiro, Integrated Health Science Centre, Rua R. UAJ s/n, Zona Rural, Seropédica, RJ, 23897-090, Brazil.
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22
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Kc B, Lim D, Low CC, Chew C, Blebil AQ, Dujaili JA, Alrasheedy AA. Positioning and Utilization of Information and Communication Technology in Community Pharmacies of Selangor, Malaysia: Cross-Sectional Study. JMIR Med Inform 2020; 8:e17982. [PMID: 32463787 PMCID: PMC7381007 DOI: 10.2196/17982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Information and communication technology (ICT) is an essential element of modern "smart" cities. These smart cities have integrated housing, marketplace, public amenities, services, business, and transportation via ICT. ICT is also now widely used in urban health care delivery. OBJECTIVE The aim of this study was to determine the positioning and roles of ICT in community pharmacies in the state of Selangor, Malaysia. METHODS A cross-sectional study was conducted from November 2018 to January 2019 across 9 different subdistricts in the state of Selangor, including Subang Jaya, Cheras, Puchong, Port Klang, Kota Kemuning, Selayang, Chow Kit, Ampang, and Seri Kembangan. A total of 90 community pharmacists were approached from the 9 subdistricts and invited to participate in the study. RESULTS Of the 90 community pharmacies approached, 60 agreed to participate in the study, representing a response rate of 67%. The majority (36/60, 60%) of the respondents were women, and more than half (32/60, 53%) of the community pharmacies were run by young adults (ie, 30 years old and younger). More than three-quarters of the community pharmacies (46/60, 77%) used electronic health records. Half of the community pharmacies used online social media platforms for advertising and promoting their pharmacies. The vast majority of the community pharmacies (55/60, 92%) were using modern electronic payment systems, and some were also using other new electronic payment methods. Moreover, most of the community pharmacies (41/60, 68%) were using software and programs for accounting and logistics purposes. In addition, 47/60 (78%) of the community pharmacies used a barcode reading system for medicines/health products, and 16/60 (27%) of the pharmacies had online stores, and consumers could buy medicines and health products from these pharmacies via their online portal. In addition, 20/60 (33%) of the community pharmacies used at least one of the common online business platforms available in Southeast Asia to sell products/medicines. The telephone was the most commonly used means of communication with patients, although some pharmacies also used email, WhatsApp, SMS text messaging, and other communication platforms. CONCLUSIONS This study showed that the majority of community pharmacies in Selangor, Malaysia are using ICT for different purposes. However, there is still limited use of mobile apps to provide health services. Overall, community pharmacies have been adopting ICT apps for pharmacy services but the rate of adoption is relatively slower than that in other sectors of Malaysia.
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Affiliation(s)
- Bhuvan Kc
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Dorothy Lim
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Chia Chia Low
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Connie Chew
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ali Qais Blebil
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | - Alian A Alrasheedy
- Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia.,Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia
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23
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Berauk VLA, Murugiah MK, Soh YC, Sheng YC, Wong TW, Ming LC. Mobile Health Applications for Caring of Older People: Review and Comparison. Ther Innov Regul Sci 2018; 52:374-382. [DOI: 10.1177/2168479017725556] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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24
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Chen Y, Yang L, Zhang M, Yang J. Central or peripheral? Cognition elaboration cues’ effect on users’ continuance intention of mobile health applications in the developing markets. Int J Med Inform 2018; 116:33-45. [DOI: 10.1016/j.ijmedinf.2018.04.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 03/27/2018] [Accepted: 04/20/2018] [Indexed: 11/29/2022]
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25
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Morse SS, Murugiah MK, Soh YC, Wong TW, Ming LC. Mobile Health Applications for Pediatric Care: Review and Comparison. Ther Innov Regul Sci 2017; 52:383-391. [PMID: 29714538 DOI: 10.1177/2168479017725557] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite the surge in mobile health (mHealth) applications (apps) about pediatric care in commercial app stores, to our knowledge, reviews of the quality of such apps are lacking. Consequently, it is a great challenge for health care professionals (HCPs) to identify appropriate and reliable mHealth apps for delivering health care services. Thus, we performed a structured review of the extant literature about mHealth apps in pediatric care and quality assessment of selected apps found in commercial app stores. METHODS A review and comparison of mHealth apps in pediatric care found in Google's Play Store (Android system) and Apple's App Store (iOS system) were performed. For the structured review of the available literature, Google Scholar, PubMed, IEEE Xplore Digital Library, and Science Direct online databases were used for the literature search. The assessment criteria used for comparison included requirement for Internet connection, size of application, information on disease, diagnostic tools, medical calculator, information on disease treatments, dosage recommendations, and drug interaction checker. RESULTS Fifty mHealth apps for general pediatric care and 8 mHealth apps for specific pediatric diseases were discussed in the literature. Of the 90 mHealth apps we reviewed, 27 that fulfilled the study criteria were selected for quality assessment. Medscape, Skyscape, and iGuideline scored the highest (score=7), while PediaBP scored the lowest (score=3). CONCLUSIONS Medscape, Skyscape, and iGuideline are the most comprehensive mHealth apps for HCPs as quick references for pediatric care. More studies about mHealth apps in pediatric care are warranted to ensure the quality and reliability of mHealth apps.
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Affiliation(s)
| | - Muthu Kumar Murugiah
- 2 Penang State Health Department, Pharmaceutical Services Division, Penang, Malaysia
| | - Yee Chang Soh
- 3 Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Tin Wui Wong
- 1 Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia.,4 Non-Destructive Biomedical and Pharmaceutical Research Centre, iPROMISE, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
| | - Long Chiau Ming
- 5 Unit for Medication Outcomes Research and Education (UMORE), Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.,6 School of Pharmacy, KPJ Healthcare University College, Nilai, Negeri Sembilan, Malaysia
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