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Berr K, Ziehfreund S, Welcker M, Biedermann T, Zink A. A qualitative exploration of the patient journey in axial spondyloarthritis towards a people-centered understanding. Sci Rep 2024; 14:19977. [PMID: 39198468 PMCID: PMC11358462 DOI: 10.1038/s41598-024-70420-8] [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: 05/22/2024] [Accepted: 08/16/2024] [Indexed: 09/01/2024] Open
Abstract
This exploratory qualitative study aims to gain a people-centered understanding of the patient journey in axial spondyloarthritis (axSpA). Semi-structured interviews were conducted with 15 individuals diagnosed with axSpA, aged 18 years and older, who were purposively recruited from a rheumatologic practice in southern Germany. The interviews were carried out as web-based video calls between September and October 2021, audio-recorded, transcribed verbatim, and analyzed according to Kuckartz's qualitative content analysis. Patient journey narratives encompassed both healthcare journeys and personal journeys. Healthcare journeys were characterized as fragmented and difficult to navigate, with diagnosis often marking a turning point toward more coordinated care. Post-diagnosis, new challenges emerged (e.g., time management for treatment). Personal journeys comprised perceptions of axSpA in social contexts (e.g., stigmatization) and the continuous interplay of comorbidities and biographical events with healthcare related to axSpA. This study proposes a people-centered perspective on the patient journey in axSpA, emphasizing the interplay of biographies, comorbidities, and social context with healthcare events. Recognizing these personal factors in clinical practice is encouraged to address complex health needs and tailor treatment to each individual. Further efforts should promote collaboration between medical disciplines and integrate healthcare and social support at all stages of the axSpA patient journey.
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Affiliation(s)
- Kristina Berr
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planegg, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Biedersteiner Str. 29, 80802, Munich, Germany.
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Khosravi M, Izadi R, Shojaei P, Delavari S. Strategies to promote patient-centeredness within the healthcare industry: A grey-based multicriteria decision making methods. J Eval Clin Pract 2024. [PMID: 38970257 DOI: 10.1111/jep.14070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 05/09/2024] [Accepted: 06/14/2024] [Indexed: 07/08/2024]
Abstract
RATIONALE The international policy agenda has recently advocated for the development of patient-centeredness in healthcare service delivery. Consequently, various stakeholders in the healthcare systems have expressed a vital need for identifying strategies and tools that can enhance patient-centeredness. AIMS AND OBJECTIVES The objective of this paper was to prioritise and benchmark the strategies that can improve patient-centeredness in healthcare service delivery. METHOD We employed a multi-stage research scenario that consisted of two phases: a phase including of a scoping review to identify the current strategies to improve patient-centeredness (PC); And, a phase including of a multicriteria best-worst method to assign weights to PC principles, and a questionnaire administered to a sample of experts for benchmarking the strategies derived from the literature using the Grey Multi-Attributive Border Approximation Area Comparison (MABAC-G) method. RESULTS The most important principle of patient-centeredness was deemed to be access to care, while telehealth tools and Electronic Health Information Systems were respectively suggested as the most efficacious platforms for promoting patient-centeredness. CONCLUSION We recommend that administrators and policy makers in the healthcare industry prioritise the implementation and research of strategies such as telehealth tools and electronic health information systems to enhance access and patient-centeredness in the healthcare systems.
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Affiliation(s)
- Mohsen Khosravi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhane Izadi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Payam Shojaei
- Department of Management, Shiraz University, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Bousquet J, Schünemann HJ, Sousa-Pinto B, Zuberbier T, Togias A, Samolinski B, Bedbrook A, Czarlewski W, Hofmann-Apitius M, Litynska J, Vieira RJ, Anto JM, Fonseca JA, Brozek J, Bognanni A, Brussino L, Canonica GW, Cherrez-Ojeda I, Cruz AA, Vecillas LDL, Dykewicz M, Gemicioglu B, Giovannini M, Haahtela T, Jacobs M, Jacomelli C, Klimek L, Kvedariene V, Larenas-Linnemann DE, Louis G, Lourenço O, Leemann L, Morais-Almeida M, Neves AL, Nadeau KC, Nowak A, Palamarchuk Y, Palkonen S, Papadopoulos NG, Parmelli E, Pereira AM, Pfaar O, Regateiro FS, Savouré M, Taborda-Barata L, Toppila-Salmi SK, Torres MJ, Valiulis A, Ventura MT, Williams S, Yepes-Nuñez JJ, Yorgancioglu A, Zhang L, Zuberbier J, Abdul Latiff AH, Abdullah B, Agache I, Al-Ahmad M, Al-Nesf MA, Al Shaikh NA, Amaral R, Ansotegui IJ, Asllani J, Balotro-Torres MC, Bergmann KC, Bernstein JA, Bindslev-Jensen C, Blaiss MS, Bonaglia C, Bonini M, Bossé I, Braido F, Caballero-Fonseca F, Camargos P, Carreiro-Martins P, Casale T, Castillo-Vizuete JA, Cecchi L, Teixeira MDC, Chang YS, Loureiro CC, Christoff G, Ciprandi G, Cirule I, Correia-de-Sousa J, Costa EM, Cvetkovski B, de Vries G, Del Giacco S, Devillier P, Dokic D, Douagui H, Durham SR, Enecilla ML, Fiocchi A, Fokkens WJ, Fontaine JF, Gawlik R, Gereda JE, Gil-Mata S, Giuliano AFM, Gotua M, Gradauskiene B, Guzman MA, Hossny E, Hrubiško M, Iinuma T, Irani C, Ispayeva Z, Ivancevich JC, Jartti T, Jeseňák M, Julge K, Jutel M, Kaidashev I, Bennoor KS, Khaltaev N, Kirenga B, Kraxner H, Kull I, Kulus M, Kuna P, Kupczyk M, Kurchenko A, La Grutta S, Lane S, Miculinic N, Lee SM, Le Thi Tuyet L, Lkhagvaa B, Louis R, Mahboub B, Makela M, Makris M, Maurer M, Melén E, Milenkovic B, Mohammad Y, Moniuszko M, Montefort S, Moreira A, Moreno P, Mullol J, Nadif R, Nakonechna A, Navarro-Locsin CG, Neffen HE, Nekam K, Niedoszytko M, Nunes E, Nyembue D, O'Hehir R, Ollert M, Ohta K, Okamoto Y, Okubo K, Olze H, Padukudru MA, Palomares O, Pali-Schöll I, Panzner P, Palosuo K, Park HS, Passalacqua G, Patella V, Pawankar R, Pétré B, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Raciborski F, Ramonaité A, Recto M, Repka-Ramirez S, Roberts G, Robles-Velasco K, Roche N, Rodriguez-Gonzalez M, Romualdez JA, Rottem M, Rouadi PW, Salapatas M, Sastre J, Serpa FS, Sayah Z, Scichilone N, Senna G, Sisul JC, Solé D, Soto-Martinez ME, Sova M, Sozinova O, Stevanovic K, Ulrik CS, Szylling A, Tan FM, Tantilipikorn P, Todo-Bom A, Tomic-Spiric V, Tsaryk V, Tsiligianni I, Urrutia-Pereira M, Rostan MV, Sofiev M, Valovirta E, Van Eerd M, Van Ganse E, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang DY, Waserman S, Wong G, Worm M, Yusuf OM, Zaitoun F, Zidarn M. Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence-Assisted ARIA Care Pathways (ARIA 2024). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00682-2. [PMID: 38971567 DOI: 10.1016/j.jaip.2024.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/16/2024] [Accepted: 06/25/2024] [Indexed: 07/08/2024]
Abstract
The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; ARIA, Montpellier, France.
| | - Holger J Schünemann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Md
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Martin Hofmann-Apitius
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Bonn, Germany
| | - Justyna Litynska
- Evidence Prime, Kracow, Poland; Gynecological and Obstetrician Polyclinic, District Hospital, Białystok, Poland
| | - Rafael José Vieira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Department of Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; Department of Epidemiology & Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Joao A Fonseca
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jan Brozek
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Antonio Bognanni
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, Evidence in Allergy group, McMaster University, Hamilton, ON, Canada
| | - Luisa Brussino
- Department of Medical Sciences, University of Torino, Torino, Italy; Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ivan Cherrez-Ojeda
- Research Center 'Respiralab', Universidad Espíritu Santo, Samborondón, Ecuador; Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Leticia de Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mark Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Mo
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, and Institute of Pulmonology & Tuberculosis, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Mattia Giovannini
- Department of Health Sciences, University of Florence, Florence, Italy; Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Marc Jacobs
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Bonn, Germany
| | - Cristina Jacomelli
- "Respiriamo Insieme" Association, Asthma & Allergy Center, Padova, Italy
| | - Ludger Klimek
- Department of Otolaryngology, Head & Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Allergology & Rhinology Department, Wiesbaden, Germany
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Desiree E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Gilles Louis
- Department of Public Health, University of Liège, Liège, Belgium
| | - Olga Lourenço
- Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zürich, Zürich, Switerland
| | | | - Ana Luisa Neves
- Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College, London, United Kingdom
| | - Kari C Nadeau
- Department of Environmental Health, Harvard TH Chan School of Public Health and Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Hospital, Boston, Mass
| | - Artur Nowak
- Evidence Prime, Kracow, Poland; Gynecological and Obstetrician Polyclinic, District Hospital, Białystok, Poland
| | - Yuliia Palamarchuk
- Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | | | - Elena Parmelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ana Margarida Pereira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Marine Savouré
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Luis Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal; UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Sanna K Toppila-Salmi
- Department of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology, University of Eastern Finland and the North Savo Wellbeing Services County, Kuopio, Finland
| | - Maria J Torres
- Allergy Unit, Málaga Regional University Hospital of Málaga, Malaga University, ARADyAL, Malaga, Spain
| | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania; Clinic of Asthma, Allergy, and Chronic Lung Diseases, Asthma & Allergy Department, Vilnius, Lithuania
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy; Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Sian Williams
- International Primary Care Respiratory Group IPCRG, Edinburgh, United Kingdom
| | - Juan J Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá, DC, Colombia; Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá, University Hospital, Bogotá, DC, Colombia
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - Jaron Zuberbier
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Maryam Ali Al-Nesf
- Adult Allergy and Immunology Division-Hamad Medical Corporation, Doha, Qatar
| | - Nada A Al Shaikh
- Otolaryngology Head & Neck Surgery Department, Mouwasat Hospital, Dammam, Saudi Arabia
| | - Rita Amaral
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal; Department of Women's and Children's Health, Paediatric Research, Uppsala University, Uppsala, Sweden
| | - Ignacio J Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Julijana Asllani
- Department of Internal Medicine, University of Medicine, Tirana, Albania
| | | | - Karl-Christian Bergmann
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Jonathan A Bernstein
- Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Michael S Blaiss
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Ga
| | - Cristina Bonaglia
- Institute "Bona Sforza", University for Linguistic Mediators, Bari, Italy
| | - Matteo Bonini
- Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli-IRCCS, Rome, Italy; National Heart and Lung Institute (NHLI), Imperial College London, London, United Kingdom
| | | | - Fulvio Braido
- Respiratory Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy; Respiratory & Allergy Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Paulo Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Pedro Carreiro-Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário de Lisboa Central/ULS São José, Lisbon, Portugal
| | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fla
| | - José-Antonio Castillo-Vizuete
- Department of Respiratory Medicine, Hospital Universitari Dexeus, Barcelona, Spain; The Group of Rhinitis, Rhinosinusitis and Nasal Polyps, Area of Asthma, SEPAR, Barcelona, Spain
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Maria do Ceu Teixeira
- Dr Agostinho Neto University hospital, Epidemiology Department, Praia, Cabo Verde; Immunology, Cabo Verde University, Faculty of Medicine, Praia, Cabo Verde
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Claudia Chaves Loureiro
- Department of Pneumology, Coimbra University Hospital, Faculty of Medicine, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | - George Christoff
- Faculty of Public Health, Sofia Medical University, Sofia, Bulgaria
| | - Giorgio Ciprandi
- Casa di Cura Villa Montallegro, Allergology Department, Genova, Italy
| | - Ieva Cirule
- Latvian Association of Allergists, University Children Hospital, Riga, Latvia
| | - Jaime Correia-de-Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Elisio M Costa
- CINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal
| | - Biljana Cvetkovski
- Woolcock Institute of Medical Research, Quality Use of Respiratory Medicine, Sydney, NSW, Australia
| | | | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - Philippe Devillier
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - Dejan Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of Macedonia
| | - Habib Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - Stephen R Durham
- Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | | | - Alessandro Fiocchi
- Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
| | | | - Radoslaw Gawlik
- Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jose E Gereda
- Clínica Ricardo Palma, Allergy & Immunology Department, Lima, Peru
| | - Sara Gil-Mata
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Antonio F M Giuliano
- Department of Internal Medicine 'A. Murri' and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - Maia Gotua
- Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia
| | - Brigita Gradauskiene
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Maria Antonieta Guzman
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - Elham Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Martin Hrubiško
- Department of Clinical Immunology and Allergy, Oncology Institute of St Elisabeth, Bratislava, Slovakia
| | - Tomohisa Iinuma
- Department of Otorhinolaryngology, Chiba University, Chiba, Japan
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Zhanat Ispayeva
- Department of Allergology and Clinical Immunology, Kazakhstan Association of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Tuomas Jartti
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Miloš Jeseňák
- Department of Pulmonology and Phthisiology, Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia; Institute of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Kaja Julge
- Institute of Clinical Medicine, Children's Clinic, Tartu University, Tartu, Estonia
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; ALL-MED Medical Research Institute, Department of Clinical Immunology, Wroclaw, Poland
| | - Igor Kaidashev
- Poltava State Medical University, Immunology & Allergology Department, Poltava, Ukraine
| | - Kazi S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | | | - Bruce Kirenga
- Makerere University Lung Institute, Pulmonology Medicine Department, Kampala, Uganda
| | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Andriy Kurchenko
- Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine
| | - Stefania La Grutta
- Institute of Translational Pharmacology (IFT)-National Research Council (CNR), Palermo, Italy
| | - Stephen Lane
- Respiratory Medicine, Trinity College, Dublin, Ireland; Respiratory Physician & Allergist, Professorial Respiratory Centre, Tallaght University Hospital & Peamount Healthcare, Dublin, Ireland
| | - Neven Miculinic
- Croatian Pulmonary Society, Clinical Center for Pulmonary Diseases, Zagreb, Croatia
| | - Sang Min Lee
- Dankook University Hospital, ENT Department, Cheonan, Republic of Korea
| | - Lan Le Thi Tuyet
- Asthma, COPD Outpatient Care Unit, University Medical Center, Hô-Chi-Minh City, Vietnam
| | - Battur Lkhagvaa
- Mongolian National University of Medical Sciences, Health Department, Ulan Bator, Mongolia
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium; GIGA I3 Research Group, University of Liège, Liège, Belgium
| | - Bassam Mahboub
- Rashid Hospital, DUBAI Health, Dubai, UAE; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Michael Makris
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Eric Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases, Collaborating with WHO-EMRO Tishreen University School of Medicine, Latakia, Syria; Al-Sham Private University, Pharmacy Department, Damascus, Syria
| | - Marcin Moniuszko
- Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Stephen Montefort
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, MSD, Malta
| | - Andre Moreira
- EPIUnit-Institute of Public Health, University of Porto, and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain; Clinical & Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France; Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Alla Nakonechna
- Clinical Immunology and Allergy Unit, Sheffield Teaching Hospitals, Sheffield, United Kingdom; University of Liverpool, Liverpool, United Kingdom
| | - Cecilia Gretchen Navarro-Locsin
- Department of Otolaryngology-Head & Neck Surgery, St Luke's Medical Center, Quezon City, Philippines; Division of Surgery, Philippine Children's Medical Center, Quezon City, Philippines
| | - Hugo E Neffen
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - Kristof Nekam
- Hungarian Allergy Association, Allergy & Immunology Department, Budapest, Hungary
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Elizabete Nunes
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Dieudonné Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Robyn O'Hehir
- Allergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Ken Ohta
- Japan Antituberculosis Association (JATA), Fukujuji Hospital, Tokyo, Japan
| | - Yoshitaka Okamoto
- Chiba Rosai Hospital, ENT Department, Chiba, Japan; Chiba University Hospital, Department of Otolaryngology, Head and Neck Surgery, Chiba, Japan
| | - Kimihiro Okubo
- Deparment of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - Heidi Olze
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mahesh Anand Padukudru
- Department of Respiratory Medicine, JSS Medical College, JSSAHER Mysuru, Karnataka, India
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Isabella Pali-Schöll
- Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria; Interuniversity Messerli Research Institute of the University of Veterinary Medicine and Medical University Vienna, Vienna, Austria
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Kati Palosuo
- Department of Allergology, University of Helsinki and Hospital for Skin and Allergic Diseases, Helsinki, Finland
| | - Hae S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy; Agency of Health ASL, Division of Allergy and Clinical Immunology, Department of Medicine, Salerno, Italy; Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Benoît Pétré
- Department of Public Health, University of Liège, Liège, Belgium
| | | | - Davor Plavec
- Prima Nova, Healthcare Institution, Zagreb, Croatia; Medical Faculty, University JJ Strossmayer of Osijek, Osijek, Croatia
| | - Todor A Popov
- Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
| | - Francesca Puggioni
- IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Agné Ramonaité
- Department of Pulmonology and Allergology, Klaipeda National Hospital, Klaipeda, Lithuania; Vilnius University Medical Faculty, Department of Political Behaviour and Institutions, Vilnius, Lithuania
| | - Marysia Recto
- Division of Adult and Pediatric Allergy and Immunology, University of the Philippines - Philippines General Hospital, Manila, Philippines
| | - Susana Repka-Ramirez
- Department of Allergy, Clinics Hospital, National University, San Lorenzo, Paraguay
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom; The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Karla Robles-Velasco
- Research Center 'Respiralab', Universidad Espíritu Santo, Samborondón, Ecuador; Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - Nicolas Roche
- Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France; UMR 1016, Institut Cochin, Paris, France; Inserm, Epidemiology Department, CESP, Villejuif, France
| | | | - Joel A Romualdez
- Faculty of Medicine & Surgery, University of Santo Tomas, Manila, Philippines
| | - Menachem Rottem
- Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon; Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | | | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain
| | - Faradiba S Serpa
- Asthma Reference Center-School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil
| | - Zineb Sayah
- SMAIC Société Marocaine d'Allergologie et Immunologie Clinique, Rabat, Morocco
| | | | - Gianenrico Senna
- Asthma-Allergy Unit, University Hospital of Verona, Verona, Italy
| | - Juan Carlos Sisul
- Clínica Sisul, Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Manuel E Soto-Martinez
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica
| | - Milan Sova
- Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
| | - Olga Sozinova
- Head of Laboratory of Atmospheric processes and Aerobiology, University of Latvia, Riga, Latvia
| | - Katarina Stevanovic
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna Szylling
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Frances M Tan
- Department of Pediatrics, Victor R Potenciano Medical Center, Mandaluyong, Philippines
| | - Pongsakorn Tantilipikorn
- Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ana Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Vesna Tomic-Spiric
- Clinic of Allergology and Immunology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladyslav Tsaryk
- Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine
| | - Ioanna Tsiligianni
- International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom; Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Marylin Valentin Rostan
- Pediatrics, Allergy & Immunology, Latín American Society of Allergy, Asthma & immunology (SLAAi), Montevideo, Uruguay
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland
| | | | - Eric Van Ganse
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Pneumologie et Medicine Respiratoire, Groupement Hospitalier Nord, Hôpital de la Croix Rousse, Lyon, France
| | - Tuula Vasankari
- FiLHA, Finnish Lung Health Association, Helsinki, Finland; Department of Clinical Medicine, Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Pakit Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Dana Wallace
- Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Fla
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Gary Wong
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Osman M Yusuf
- The Allergy and Asthma Institute, Allergy & Asthma Department, Islamabad, Pakistan
| | - Fares Zaitoun
- Clemenceau Medical Center DHCC, Lebanese-American University, Dubai, UAE
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Pulmonary & Allergy Department, Golnik, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Pfaar O, Sousa-Pinto B, Papadopoulos NG, Larenas-Linnemann DE, Ordak M, Torres MJ, Mösges R, Klimek L, Zuberbier T, Matricardi PM, Berger UE, Berger M, Dramburg S, Mahler V, Toppila-Salmi SK, Bergmann KC, Ollert M, Tripodi S, Jutel M, Agache I, Eguiluz-Gracia I, Canonica GW, Akdis CA, Sokolowska M, Sofiev M, Shamji MH, Czarlewski W, Fonseca JA, Bedbrook A, Bousquet J. Digitally-enabled, person-centred care (PCC) in allergen immunotherapy: An ARIA-EAACI Position Paper. Allergy 2024. [PMID: 38700063 DOI: 10.1111/all.16135] [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: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024]
Abstract
In rhinitis and asthma, several mHealth apps have been developed but only a few have been validated. However, these apps have a high potential for improving person-centred care (PCC), especially in allergen immunotherapy (AIT). They can provide support in AIT initiation by selecting the appropriate patient and allergen shared decision-making. They can also help in (i) the evaluation of (early) efficacy, (ii) early and late stopping rules and (iii) the evaluation of (carried-over) efficacy after cessation of the treatment course. Future perspectives have been formulated in the first report of a joint task force (TF)-Allergic Rhinitis and Its Impact on Asthma (ARIA) and the European Academy of Allergy and Clinical Immunology (EAACI)-on digital biomarkers. The TF on AIT now aims to (i) outline the potential of the clinical applications of mHealth solutions, (ii) express their current limitations, (iii) make proposals regarding further developments for both clinical practice and scientific purpose and (iv) suggest which of the tools might best comply with the purpose of digitally-enabled PCC in AIT.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Michal Ordak
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
| | - Maria J Torres
- Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, Universidad de Malaga, RICORS de Enfermedades Inflamatorias, Malaga, Spain
| | - Ralph Mösges
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
- ClinCompetence Cologne GmbH, Cologne, Germany
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Paolo M Matricardi
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- Department of Pediatric Respiratory Medecine, Immunology and Critical Care Medicine, Charité-Universitaetsmedizin - Berlin, Berlin, Germany
| | - Uwe E Berger
- Department of Botany, University of Innsbruck, Innsbruck, Austria
- European Aeroallergen Network (EAN), Vienna, Austria
| | - Markus Berger
- Department of Botany, University of Innsbruck, Innsbruck, Austria
- European Aeroallergen Network (EAN), Vienna, Austria
- Department of Oto-Rhino-Laryngology, Klinik Hietzing, Wiener Gesundheitsverbund, Vienna, Austria
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Medecine, Immunology and Critical Care Medicine, Charité-Universitaetsmedizin - Berlin, Berlin, Germany
| | | | - Sanna K Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karl-Christian Bergmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | | | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland
- ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Ioana Agache
- Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, Universidad de Malaga, RICORS de Enfermedades Inflamatorias, Malaga, Spain
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Asthma and Allergy Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | | | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Anna Bedbrook
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
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Aimo A, Tono I, Benelli E, Morfino P, Panichella G, Damone AL, Speltri MF, Airò E, Monti S, Passino C, Lazzarini M, De Rosis S, Nuti S, Morelli MS, Evangelista C, Poletti R, Emdin M, Bergamasco M. The Fondazione Toscana Gabriele Monasterio app: a digital health system to improve wellbeing of inpatients with heart or lung disease. J Cardiovasc Med (Hagerstown) 2024; 25:294-302. [PMID: 38305137 DOI: 10.2459/jcm.0000000000001593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND An app providing material for education and entertaining is a possible way to support patients and healthcare providers in achieving person-centered care. METHODS An app tailored on the Fondazione Toscana Gabriele Monasterio (FTGM), a research hospital treating cardiac and lung disorders, was created. A pilot evaluation project was conducted on consecutive patients hospitalized for heart or lung disorders. Patients were asked to complete an assessment questionnaire. RESULTS The FTGM app provides information on diagnostic and therapeutic investigations, hospital and healthcare personnel, and includes content for entertainment and learning. It was tested on 215 consecutive patients (75% men, 66% aged >60 years, and 40% with a primary or middle school degree). Sixty-nine percentage of patients used the FTGM app, including 67% of patients aged >80 years and 65% of those with an elementary education (65%). Patients gave positive feedback on the app layout. Many (76%) looked for information on doctors and nurses in the 'People' section. Sixty-five percent of responders had used at least one of the sections called 'Music' and 'Museum visits'. The app helped many patients perceive the hospital as a more liveable place (68%), and to feel less anxious (76%), and more engaged in the diagnostic and therapeutic workup (65%). Overall, the majority of responders (87%) rated the app as 'excellent' or 'good', and almost all (95%) would have recommended other patients to use the app. CONCLUSIONS The FTGM app is a possible tool to improve patient wellbeing during hospitalization.
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Affiliation(s)
- Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Ilaria Tono
- Fondazione Toscana Gabriele Monasterio
- Istituto di Management e Sanità
| | | | - Paolo Morfino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | - Giorgia Panichella
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | | | | | | | | | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | | | - Sabina De Rosis
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Istituto di Management e Sanità
| | - Sabina Nuti
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Istituto di Management e Sanità
| | | | - Chiara Evangelista
- Istituto di Intelligenza Meccanica, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Massimo Bergamasco
- Istituto di Intelligenza Meccanica, Scuola Superiore Sant'Anna, Pisa, Italy
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6
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Mboweni SH. Strategies that enabled access to chronic care during the COVID-19 pandemic and beyond in South Africa. Health SA 2024; 29:2412. [PMID: 38628228 PMCID: PMC11019043 DOI: 10.4102/hsag.v29i0.2412] [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: 04/12/2023] [Accepted: 11/27/2023] [Indexed: 04/19/2024] Open
Abstract
Background The COVID-19 epidemic has revealed disturbing information about how chronic diseases are treated globally. Healthcare providers and coronavirus response teams have primarily reported on how individuals with chronic conditions sought care and treatment. However, individuals' experiences of patients are yet unknown. Aim This study aimed to explore those strategies that enabled patients with chronic diseases access to chronic care and treatment during and beyond the COVID-19 pandemic. Setting The study was conducted in the predominantly rural district of the Northwest Province, South Africa. Methods An explorative qualitative research design was followed. Information-rich participants were chosen using a purposive sampling technique. Individual face-to-face interviews were used to gather data. Data saturation was achieved after interviewing n = 28 people in total. The six steps of Braun and Clarke thematic data analysis were used to analyse the data. Results The study revealed three themes, which includes improved healthcare structural systems, shift from traditional chronic care to digital care services and medication refill and buddy system. Conclusion The findings of this study revealed a range of effective and noteworthy approaches that facilitated access to treatment and continuity of care. As a result, enhancing telemedicine as well as structural systems such as appointment scheduling, decanting choices, mobile and medication home delivery can improve access to care and treatment. Contribution The burden of disease and avoidable death will be eventually addressed by maximising the use of telemedicine and sustaining the new norm of ongoing care through digital and remote care and decanting strategies.
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Affiliation(s)
- Sheillah H Mboweni
- Department of Health Studies, Collage of Human Sciences, University of South Africa, Pretoria, South Africa
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7
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Carrera A, Manetti S, Lettieri E. Rewiring care delivery through Digital Therapeutics (DTx): a machine learning-enhanced assessment and development (M-LEAD) framework. BMC Health Serv Res 2024; 24:237. [PMID: 38395905 PMCID: PMC10885456 DOI: 10.1186/s12913-024-10702-z] [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: 12/04/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Digital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Digital Therapeutics offer an innovative approach to disease management and treatment. Care delivery is increasingly patient-centered, data-driven, and based on real-time information. These technological innovations can lead to better patient outcomes and support for healthcare professionals, also considering resource scarcity. As these digital technologies continue to evolve, the healthcare field must be ready to integrate them into processes to take advantage of their benefits. This study aims to develop a framework for the development and assessment of Digital Therapeutics. METHODS The study was conducted relying on a mixed methodology. 338 studies about Digital Therapeutics resulting from a systematic literature review were analyzed using descriptive statistics through RStudio. Machine learning algorithms were applied to analyze variables and find patterns in the data. The results of these analytical analyses were summarized in a framework qualitatively tested and validated through expert opinion elicitation. RESULTS The research provides M-LEAD, a Machine Learning-Enhanced Assessment and Development framework that recommends best practices for developing and assessing Digital Therapeutics. The framework takes as input Digital Therapeutics characteristics, regulatory aspects, study purpose, and assessment domains. The framework produces as outputs recommendations to design the Digital Therapeutics study characteristics. CONCLUSIONS The framework constitutes the first step toward standardized guidelines for the development and assessment of Digital Therapeutics. The results may support manufacturers and inform decision-makers of the relevant results of the Digital Therapeutics assessment.
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Khatri RB, Wolka E, Nigatu F, Zewdie A, Erku D, Endalamaw A, Assefa Y. People-centred primary health care: a scoping review. BMC PRIMARY CARE 2023; 24:236. [PMID: 37946115 PMCID: PMC10633931 DOI: 10.1186/s12875-023-02194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Integrated people-centred health services (IPCHS) are vital for ensuring comprehensive care towards achieving universal health coverage (UHC). The World Health Organisation (WHO) envisions IPCHS in delivery and access to health services. This scoping review aimed to synthesize available evidence on people-centred primary health care (PHC) and primary care. METHODS We conducted a scoping review of published literature on people-centred PHC. We searched eight databases (PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, Web of Science, and Google Scholar) using search terms related to people-centred and integrated PHC/primary care services. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to select studies. We analyzed data and generated themes using Gale's framework thematic analysis method. Themes were explained under five components of the WHO IPCHS framework. RESULTS A total of fifty-two studies were included in the review; most were from high-income countries (HICs), primarily focusing on patient-centred primary care. Themes under each component of the framework included: engaging and empowering people and communities (engagement of community, empowerment and empathy); strengthening governance and accountability (organizational leadership, and mutual accountability); reorienting the model of care (residential care, care for multimorbidity, participatory care); coordinating services within and across sectors (partnership with stakeholders and sectors, and coordination of care); creating an enabling environment and funding support (flexible management for change; and enabling environment). CONCLUSIONS Several people-centred PHC and primary care approaches are implemented in HICs but have little priority in low-income countries. Potential strategies for people-centred PHC could be engaging end users in delivering integrated care, ensuring accountability, and implementing a residential model of care in coordination with communities. Flexible management options could create an enabling environment for strengthening health systems to deliver people-centred PHC services.
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Affiliation(s)
- Resham B Khatri
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia.
- Health Social Science and Development Research Institute, Kathmandu, Nepal.
| | - Eskinder Wolka
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Anteneh Zewdie
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Daniel Erku
- Centre for Applied Health Economics, School of Medicine, Griffith University, Southport, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Aklilu Endalamaw
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia
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Kaihlanen AM, Laukka E, Nadav J, Närvänen J, Saukkonen P, Koivisto J, Heponiemi T. The effects of digitalisation on health and social care work: a qualitative descriptive study of the perceptions of professionals and managers. BMC Health Serv Res 2023; 23:714. [PMID: 37386423 DOI: 10.1186/s12913-023-09730-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Today, digitalisation is strongly present in health and social care, and it increasingly affects the organisation of work, work requirements, tasks and tools. Due to the constant change in work, up-to-date knowledge is needed about these micro-level effects of digitalisation and how professionals experience the effects in their work. Furthermore, even though managers play a key role in implementing new digital services, their perceptions of the effects of digitalisation and whether they match the views of professionals remain unknown. This study examined how health and social care professionals and managers perceive the effects of digitalisation on the work of professionals. METHODS We used a qualitative approach and conducted eight semi-structured focus group interviews with health and social care professionals (n = 30) and 21 individual interviews with managers in 2020 in four health centres in Finland. The qualitative content analysis included both an inductive and a deductive approach. RESULTS Digitalisation was perceived to have changed professionals' 1) workload and pace, 2) the field and nature of work, 3) work community communication and interaction, and 4) information flow and security. Both professionals and managers identified effects such as accelerated work, reduction in workload, constant learning of technical skills, complicated work due to vulnerable information systems, and reduction in face-to-face encounters. However, managers did not bring up all the effects that professionals considered important, such as the creation of new work tasks, increased and duplicated work, or insufficient time to get acquainted with the systems. CONCLUSIONS The findings suggest that some of the effects of digitalisation on professionals' work and changes in the workplace may receive too little or no recognition from managers. This increases the risk that the potential negative effects may be overlooked and that managers will adopt systems that do not support the work of professionals. To reach a common understanding of the effects of digitalisation, continuous discussions between employees and different management levels are required. This contributes to professionals' well-being and adaptation to changes, as well as the provision of quality health and social services.
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Affiliation(s)
- Anu-Marja Kaihlanen
- Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
| | - Elina Laukka
- Research Unit of Nursing Science and Health Management, University of Oulu, 90230, Oulu, Finland
| | - Janna Nadav
- Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
| | - Johanna Närvänen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Petra Saukkonen
- Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
| | - Juha Koivisto
- Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
| | - Tarja Heponiemi
- Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
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Dahlberg M, Lek M, Malmqvist Castillo M, Bylund A, Hasson H, Riggare S, Reinius M, Wannheden C. Objectives and outcomes of patient-driven innovations published in peer-reviewed journals: a qualitative analysis of publications included in a scoping review. BMJ Open 2023; 13:e071363. [PMID: 37263703 PMCID: PMC10255190 DOI: 10.1136/bmjopen-2022-071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/20/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to gain a deeper understanding of the objectives and outcomes of patient-driven innovations that have been published in the scientific literature, focusing on (A) the unmet needs that patient-driven innovations address and (B) the outcomes for patients and healthcare that have been reported. METHODS We performed an inductive qualitative content analysis of scientific publications that were included in a scoping review of patient-driven innovations, previously published by our research group. The review was limited to English language publications in peer-reviewed journals, published in the years 2008-2020. RESULTS In total, 83 publications covering 21 patient-driven innovations were included in the analysis. Most of the innovations were developed for use on an individual or community level without healthcare involvement. We created three categories of unmet needs that were addressed by these innovations: access to self-care support tools, open sharing of information and knowledge, and patient agency in self-care and healthcare decisions. Eighteen (22%) publications reported outcomes of patient-driven innovations. We created two categories of outcomes: impact on self-care, and impact on peer interaction and healthcare collaboration. CONCLUSIONS The patient-driven innovations illustrated a diversity of innovative approaches to facilitate patients' and informal caregivers' daily lives, interactions with peers and collaborations with healthcare. As our findings indicate, patients and informal caregivers are central stakeholders in driving healthcare development and research forward to meet the needs that matter to patients and informal caregivers. However, only few studies reported on outcomes of patient-driven innovations. To support wider implementation, more evaluation studies are needed, as well as research into regulatory approval processes, dissemination and governance of patient-driven innovations.
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Affiliation(s)
- Marie Dahlberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Madelen Lek
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Moa Malmqvist Castillo
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Ami Bylund
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholms Lans Landsting, Stockholm, Sweden
| | - Sara Riggare
- Participatory eHealth and Health Data, Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Maria Reinius
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
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11
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Leviton A, Patel AD, Loddenkemper T. Self-management education for children with epilepsy and their caregivers. A scoping review. Epilepsy Behav 2023; 144:109232. [PMID: 37196451 DOI: 10.1016/j.yebeh.2023.109232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023]
Abstract
Self-management education programs have been highly successful in preparing people to manage medical conditions with recurring events. A detailed curriculum for epilepsy patients, and their caretakers, is lacking. Here we assess what is available for patients who have disorders with recurring events and offer an approach to developing a potential self-care curriculum for patients with seizures and their caregivers. Among the anticipated components are a baseline efficacy assessment and training tailored to increasing self-efficacy, medication compliance, and stress management. Those at risk of status epilepticus will also need guidance in preparing a personalized seizure action plan and training in how to decide when rescue medication is appropriate and how to administer the therapy. Peers, as well as professionals, could teach and provide support. To our knowledge, no such programs are currently available in English. We encourage their creation, dissemination, and widespread use.
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Affiliation(s)
- Alan Leviton
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Anup D Patel
- Nationwide Children's Hospital, 700 Childrens Drive, Columbus, OH 43205, USA.
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Mathijssen E, de Lange W, Bleijenberg N, van Houwelingen T, Jaarsma T, Trappenburg J, Westland H. Factors That Influence the Use of eHealth in Home Care: Scoping Review and Cross-sectional Survey. J Med Internet Res 2023; 25:e41768. [PMID: 36892935 PMCID: PMC10037173 DOI: 10.2196/41768] [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: 08/08/2022] [Revised: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In home care, eHealth implementation requires health care professionals and home care clients to change their behavior because they have to incorporate the use of eHealth into their daily routines. Knowledge of factors that influence the use of eHealth in home care is needed to optimize implementation strategies. However, a comprehensive overview of such factors is lacking. OBJECTIVE The aims of this study were to (1) provide insight into the types of eHealth that are used and preferred in home care and (2) identify factors that influence the use of eHealth in home care according to health care professionals and home care clients. METHODS A scoping review and online, cross-sectional survey were conducted sequentially. The survey was conducted among Dutch health care professionals with a nursing background who were working for a home care organization at the time. The capability, opportunity, motivation, behavior (COM-B) model, which posits that for any behavior (B) to occur, a person must have the capability (C), opportunity (O), and motivation (M) to perform the behavior, was used to identify influencing factors. The use of a theoretical model may contribute to a better understanding of how to achieve and sustain behavior change in clinical practice. RESULTS We included 30 studies in the scoping review. The most frequently studied type of eHealth was a telecommunication/telemonitoring system. The survey was completed by 102 participants. The most frequently used types of eHealth were electronic health records, social alarms, and online client portals. A health app was the most frequently preferred type of eHealth. We identified 22 factors that influence the use of eHealth in home care according to health care professionals and home care clients. Influencing factors were organized into the components of the COM-B model, namely capability (n=6), opportunity (n=10), and motivation (n=6). We found that there is no single influencing factor that is key to the complexity of eHealth implementation. CONCLUSIONS Different types of eHealth are used, and many types of eHealth are preferred by health care professionals. The identified factors that influence the use of eHealth in home care relate to all components of the COM-B model. These factors need to be addressed and embedded in implementation strategies of eHealth to optimize the use of eHealth in home care.
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Affiliation(s)
- Elke Mathijssen
- The Healthcare Innovation Center, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Wendela de Lange
- The Healthcare Innovation Center, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nienke Bleijenberg
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Research Group Proactive Care for Older People Living at Home, University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Thijs van Houwelingen
- Research Group Technology for Innovations in Healthcare, University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Tiny Jaarsma
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jaap Trappenburg
- The Healthcare Innovation Center, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Heleen Westland
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Kocher A, Simon M, Dwyer AA, Blatter C, Bogdanovic J, Künzler-Heule P, Villiger PM, Dan D, Distler O, Walker UA, Nicca D. Patient Assessment Chronic Illness Care (PACIC) and its associations with quality of life among Swiss patients with systemic sclerosis: a mixed methods study. Orphanet J Rare Dis 2023; 18:7. [PMID: 36624535 PMCID: PMC9828378 DOI: 10.1186/s13023-022-02604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The Chronic Care Model (CCM) is a longstanding and widely adopted model guiding chronic illness management. Little is known about how CCM elements are implemented in rare disease care or how patients' care experiences relate to health-related quality of life (HRQoL). We engaged patients living with systemic sclerosis (SSc) to assess current care according to the CCM from the patient perspective and their HRQoL. METHODS We employed an explanatory sequential mixed methods design. First, we conducted a cross-sectional quantitative survey (n = 101) using the Patient Assessment of Chronic Illness Care (PACIC) and Systemic Sclerosis Quality of Life (SScQoL) questionnaires. Next, we used data from individual patient interviews (n = 4) and one patient focus group (n = 4) to further explore care experiences of people living with SSc with a focus on the PACIC dimensions. RESULTS The mean overall PACIC score was 3.0/5.0 (95% CI 2.8-3.2, n = 100), indicating care was 'never' to 'generally not' aligned with the CCM. Lowest PACIC subscale scores related to 'goal setting/tailoring' (mean = 2.5, 95% CI 2.2-2.7) and 'problem solving/contextual counselling' (mean = 2.9, 95% CI 2.7-3.2). No significant correlations were identified between the mean PACIC and SScQoL scores. Interviews revealed patients frequently encounter major shortcomings in care including 'experiencing organized care with limited participation', 'not knowing which strategies are effective or harmful' and 'feeling left alone with disease and psychosocial consequences'. Patients often responded to challenges by 'dealing with the illness in tailored measure', 'taking over complex coordination of care' and 'relying on an accessible and trustworthy team'. CONCLUSIONS The low PACIC mean overall score is comparable to findings in patients with common chronic diseases. Key elements of the CCM have yet to be systematically implemented in Swiss SSc management. Identified gaps in care related to lack of shared decision-making, goal-setting and individual counselling-aspects that are essential for supporting patient self-management skills. Furthermore, there appears to be a lack of complex care coordination tailored to individual patient needs.
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Affiliation(s)
- Agnes Kocher
- Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. .,Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Michael Simon
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.5734.50000 0001 0726 5157Department of Nursing, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew A. Dwyer
- grid.208226.c0000 0004 0444 7053Boston College, Connell School of Nursing, Chestnut Hill, MA USA ,grid.32224.350000 0004 0386 9924Center for Nursing Research, Massachusetts General Hospital Munn, Boston, MA USA
| | - Catherine Blatter
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Jasmina Bogdanovic
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Patrizia Künzler-Heule
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.413349.80000 0001 2294 4705Department of Gastroenterology/Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland ,grid.413349.80000 0001 2294 4705Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | | | - Diana Dan
- grid.9851.50000 0001 2165 4204Service of Rheumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Oliver Distler
- grid.7400.30000 0004 1937 0650Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ulrich A. Walker
- grid.410567.1Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Dunja Nicca
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.7400.30000 0004 1937 0650Department of Global and Public Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
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Wai Wong WC, Zhao IY, Ma YX, Dong WN, Liu J, Pang Q, Lu XQ, Molassiotis A, Holroyd E. Primary Care Physicians' and Patients' Perspectives on Equity and Health Security of Infectious Disease Digital Surveillance. Ann Fam Med 2023; 21:33-39. [PMID: 36635084 PMCID: PMC9870645 DOI: 10.1370/afm.2895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic facilitated the rapid development of digital detection surveillance (DDS) for outbreaks. This qualitative study examined how DDS for infectious diseases (ID) was perceived and experienced by primary care physicians and patients in order to highlight ethical considerations for promoting patients' autonomy and health care rights. METHODS In-depth interviews were conducted with a purposefully selected group of 16 primary care physicians and 24 of their patients. The group was reflective of a range of ages, educational attainment, and clinical experiences from urban areas in northern and southern China. Interviews were audio recorded, transcribed, and translated. Two researchers coded data and organized it into themes. A third researcher reviewed 15% of the data and discussed findings with the other researchers to assure accuracy. RESULTS Five themes were identified: ambiguity around the need for informed consent with usage of DDS; importance of autonomous decision making; potential for discrimination against vulnerable users of DDS for ID; risk of social inequity and disparate care outcomes; and authoritarian institutions' responsibility for maintaining health data security. The adoption of DDS meant some patients would be reluctant to go to the hospital for fear of either being discriminated against or forced into quarantine. Certain groups (older people and children) were thought to be vulnerable to DDS misappropriation. CONCLUSIONS These findings indicate the paramount importance of establishing national and international ethical frameworks for DDS implementation. Frameworks should guide all aspects of ID surveillance, addressing privacy protection and health security, and underscored by principles of social equity and accountability.Annals "Online First" article.
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Affiliation(s)
- William Chi Wai Wong
- Department of Family Medicine and Primary Care, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ivy Yan Zhao
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong
| | - Ye Xuan Ma
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wei Nan Dong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jia Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qin Pang
- Department of Information Technology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xiao Qin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Alex Molassiotis
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong
| | - Eleanor Holroyd
- Office of the Dean, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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15
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Maas VK, Dibbets FH, Peters VJT, Meijboom BR, van Bijnen D. The never-ending patient journey of chronically ill patients: A qualitative case study on touchpoints in relation to patient-centered care. PLoS One 2023; 18:e0285872. [PMID: 37195966 DOI: 10.1371/journal.pone.0285872] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 05/03/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Healthcare professionals caring for chronically ill patients increasingly want to provide patient-centered care (PCC). By understanding each individual patient journey, they can significantly improve the quality of PCC. A patient journey consists of patient interactions, so-called touchpoints, with healthcare professionals distributed over three periods: pre-service, service, and post-service period. The aim of this study was to ascertain chronically ill patients' needs for digital alternatives for touchpoints. Specifically, we aimed to explore which digital alternatives patients would like to see implemented into their patient journey to help healthcare professionals providing PCC. METHODS Eight semi-structured interviews were conducted either face-to-face or via Zoom. Participants were included if they had visited the department of internal medicine and had received treatment for either arteriosclerosis, diabetes, HIV, or kidney failure. The interviews were analyzed utilizing a thematic analysis approach. RESULTS The results suggest that the patient journey of chronically ill patients is a continuous cycle. Furthermore, the results showed that chronically ill patients would like to see digital alternatives for touchpoints implemented into their patient journey. These digital alternatives consisted of video calls, digitally checking in before a physical appointment, digitally self-monitoring one's medical condition and personally uploading monitoring results into the patient portal, and viewing their own medical status in a digital format. Particularly, patients who were familiar with their healthcare professional(s) and were in a stable condition mostly opted for digital alternatives. CONCLUSION In the cyclical patient journey, digitalization can help put the wishes and needs of the chronically ill patients at the center of care. It is recommended that healthcare professionals implement digital alternatives for touchpoints. Most chronically ill patients consider digital alternatives to lead to more efficient interactions with their healthcare professionals. Furthermore, digital alternatives support patients to be better informed about the progress of their chronical illness.
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Affiliation(s)
- Vera K Maas
- Department of Internal Medicine, Catharina Ziekenhuis, Eindhoven, Noord-Brabant, the Netherlands
| | - Frederik H Dibbets
- Department of Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, Noord-Brabant, the Netherlands
| | - Vincent J T Peters
- Department of Internal Medicine, Catharina Ziekenhuis, Eindhoven, Noord-Brabant, the Netherlands
- Department of Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, Noord-Brabant, the Netherlands
| | - Bert R Meijboom
- Department of Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, Noord-Brabant, the Netherlands
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, the Netherlands
| | - Daniëlle van Bijnen
- Department of Internal Medicine, Catharina Ziekenhuis, Eindhoven, Noord-Brabant, the Netherlands
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Azevedo S, Guede-Fernández F, von Hafe F, Dias P, Lopes I, Cardoso N, Coelho P, Santos J, Fragata J, Vital C, Semedo H, Gualdino A, Londral A. Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care. Front Digit Health 2022; 4:1006447. [PMID: 36569802 PMCID: PMC9768029 DOI: 10.3389/fdgth.2022.1006447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background COVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles. Objective This study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services. Methods Using a case study strategy, we described the PAR team's (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach. Results The approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%). Conclusion The scalability and implementation of RPM services must consider contextual factors, such as individuals' and organizations' interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers.
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Affiliation(s)
- Salomé Azevedo
- Value for Health CoLAB, Lisbon, Portugal,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal,CEG-IST, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - Federico Guede-Fernández
- Value for Health CoLAB, Lisbon, Portugal,LIBPhys (Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics), NOVA School of Science and Technology, Campus de Caparica, Caparica, Portugal
| | - Francisco von Hafe
- Value for Health CoLAB, Lisbon, Portugal,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Pedro Dias
- Value for Health CoLAB, Lisbon, Portugal,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Inês Lopes
- Fraunhofer Portugal AICOS, Porto, Portugal
| | | | - Pedro Coelho
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Jorge Santos
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - José Fragata
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Clara Vital
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Helena Semedo
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Ana Gualdino
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Ana Londral
- Value for Health CoLAB, Lisbon, Portugal,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal,Correspondence: Ana Londral
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Cowan RP, Rapoport AM, Blythe J, Rothrock J, Knievel K, Peretz AM, Ekpo E, Sanjanwala BM, Woldeamanuel YW. Diagnostic accuracy of an artificial intelligence online engine in migraine: A multi‐center study. Headache 2022; 62:870-882. [PMID: 35657603 PMCID: PMC9378575 DOI: 10.1111/head.14324] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
Objective This study assesses the concordance in migraine diagnosis between an online, self‐administered, Computer‐based, Diagnostic Engine (CDE) and semi‐structured interview (SSI) by a headache specialist, both using International Classification of Headache Disorders, 3rd edition (ICHD‐3) criteria. Background Delay in accurate diagnosis is a major barrier to headache care. Accurate computer‐based algorithms may help reduce the need for SSI‐based encounters to arrive at correct ICHD‐3 diagnosis. Methods Between March 2018 and August 2019, adult participants were recruited from three academic headache centers and the community via advertising to our cross‐sectional study. Participants completed two evaluations: phone interview conducted by headache specialists using the SSI and a web‐based expert questionnaire and analytics, CDE. Participants were randomly assigned to either the SSI followed by the web‐based questionnaire or the web‐based questionnaire followed by the SSI. Participants completed protocols a few minutes apart. The concordance in migraine/probable migraine (M/PM) diagnosis between SSI and CDE was measured using Cohen’s kappa statistics. The diagnostic accuracy of CDE was assessed using the SSI as reference standard. Results Of the 276 participants consented, 212 completed both SSI and CDE (study completion rate = 77%; median age = 32 years [interquartile range: 28–40], female:male ratio = 3:1). Concordance in M/PM diagnosis between SSI and CDE was: κ = 0.83 (95% confidence interval [CI]: 0.75–0.91). CDE diagnostic accuracy: sensitivity = 90.1% (118/131), 95% CI: 83.6%–94.6%; specificity = 95.8% (68/71), 95% CI: 88.1%–99.1%. Positive and negative predictive values = 97.0% (95% CI: 91.3%–99.0%) and 86.6% (95% CI: 79.3%–91.5%), respectively, using identified migraine prevalence of 60%. Assuming a general migraine population prevalence of 10%, positive and negative predictive values were 70.3% (95% CI: 43.9%–87.8%) and 98.9% (95% CI: 98.1%–99.3%), respectively. Conclusion The SSI and CDE have excellent concordance in diagnosing M/PM. Positive CDE helps rule in M/PM, through high specificity and positive likelihood ratio. A negative CDE helps rule out M/PM through high sensitivity and low negative likelihood ratio. CDE that mimics SSI logic is a valid tool for migraine diagnosis.
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Affiliation(s)
- Robert P. Cowan
- Division of Headache and Facial Pain, Department of Neurology and Neurological Sciences Stanford University School of Medicine Stanford California USA
| | | | - Jim Blythe
- Information Sciences Institute University of Southern California Los Angeles California USA
| | - John Rothrock
- Neurology The George Washington University School of Medicine and Health Sciences Washington District of Columbia USA
| | - Kerry Knievel
- Neurology Barrow Neurological Institute Phoenix Arizona USA
| | - Addie M. Peretz
- Division of Headache and Facial Pain, Department of Neurology and Neurological Sciences Stanford University School of Medicine Stanford California USA
| | - Elizabeth Ekpo
- Neurology University of California Davis Davis California USA
| | - Bharati M. Sanjanwala
- Division of Headache and Facial Pain, Department of Neurology and Neurological Sciences Stanford University School of Medicine Stanford California USA
| | - Yohannes W. Woldeamanuel
- Division of Headache and Facial Pain, Department of Neurology and Neurological Sciences Stanford University School of Medicine Stanford California USA
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18
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Lampickienė I, Davoody N. Healthcare Professionals' Experience of Performing Digital Care Visits-A Scoping Review. Life (Basel) 2022; 12:913. [PMID: 35743944 PMCID: PMC9225275 DOI: 10.3390/life12060913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023] Open
Abstract
The use of digital care visits has been increasing during the COVID-19 pandemic. Learning more about healthcare professionals' technology experiences provides valuable insight and a basis for improving digital visits. This study aimed to explore the existing literature on healthcare professionals' experience performing digital care visits. A scoping review was performed following Arksey & O'Malley's proposed framework using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The collected data were analyzed using thematic content analysis. Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, barriers, and suggestions for improvement. Healthcare professionals mostly reported having an overall positive experience with digital visits and discovered benefits for themselves and the patients. However, opinions were mixed or negative regarding the complexity of decision making, workload and workflow, suitability of this type of care, and other challenges. The suggestions for improvement included training and education, improvements within the system and tools, along with support for professionals. Despite overall positive experiences and benefits for both professionals and patients, clinicians reported challenges such as physical barriers, technical issues, suitability concerns, and others. Digital care visits could not fully replace face-to-face visits.
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Kjörk EK, Sunnerhagen KS, Lundgren-Nilsson Å, Andersson AK, Carlsson G. Development of a Digital Tool for People With a Long-Term Condition Using Stroke as a Case Example: Participatory Design Approach. JMIR Hum Factors 2022; 9:e35478. [PMID: 35657650 PMCID: PMC9206198 DOI: 10.2196/35478] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/29/2022] [Accepted: 05/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background In patient care, demand is growing for digital health tools to enable remote services and enhance patient involvement. People with chronic conditions often have multiple health problems, and long-term follow-up is recommended to meet their needs and enable access to appropriate support. A digital tool for previsit preparation could enhance time efficiency and guide the conversation during the visit toward the patient’s priorities. Objective This study aims to develop a digital previsit tool and explore potential end user’s perceptions, using a participatory approach with stroke as a case example. Methods The digital tool was developed and prototyped according to service design principles, informed by qualitative participant data and feedback from an expert panel. All features were processed in workshops with a team that included a patient partner. The resulting tool presented questions about health problems and health information. Study participants were people with stroke recruited from an outpatient clinic and patient organizations in Sweden. Development and data collection were conducted in parallel. For conceptualization, the initial prototype was based on the Post-Stroke Checklist and research. Needs and relevance were explored in focus groups, and we used a web survey and individual interviews to explore perceived utility, ease of use, and acceptance. Data were thematically analyzed following the Framework Method. Results The development process included 22 participants (9 women) with a median age of 59 (range 42-83) years and a median of 51 (range 4-228) months since stroke. Participants were satisfied or very satisfied with using the tool and recommended its use in clinical practice. Three main themes were constructed based on focus group data (n=12) and interviews (n=10). First, valuable accessible information illuminated the need for information to confirm experiences, facilitate responses, and invite engagement in their care. Amendments to the information in turn reconfigured their expectations. Second, utility and complexity in answering confirmed that the questions were relevant and comprehensible. Some participants perceived the answer options as limiting and suggested additional space for free text. Third, capturing needs and value of the tool highlighted the tool’s potential to identify health problems and the importance of encouraging further dialog. The resulting digital tool, Strokehälsa [Strokehealth] version 1.0, is now incorporated into a national health platform. Conclusions The participatory approach to tool development yielded a previsit digital tool that the study group perceived as useful. The holistic development process used here, which integrated health information, validated questions, and digital functionality, offers an example that could be applicable in the context of other long-term conditions. Beyond its potential to identify care needs, the tool offers information that confirms experiences and supports answering the questions in the tool. The tool is freely shared for adaptation in different contexts. Trial Registration researchweb 236341; https://www.researchweb.org/is/vgr/project/236341
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Affiliation(s)
- Emma K Kjörk
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Lundgren-Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Gunnel Carlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Svedbo Engström M, Johansson UB, Leksell J, Linder E, Eeg-Olofsson K. Implementing the Digital Diabetes Questionnaire as a Clinical Tool in Routine Diabetes Care: Focus Group Discussions With Patients and Health Care Professionals. JMIR Diabetes 2022; 7:e34561. [PMID: 35612885 PMCID: PMC9178456 DOI: 10.2196/34561] [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: 10/29/2021] [Revised: 01/27/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Diabetes Questionnaire is a digital patient-reported outcome and experience measure for adults living with diabetes. The Diabetes Questionnaire is intended for use in routine clinical visits in diabetes care and to enable patient perspectives to be integrated into the Swedish National Diabetes Register. The Diabetes Questionnaire was developed on the basis of patients' perspectives, and evidence for its measurement qualities has been demonstrated. Patients receive an invitation to complete the questionnaire before clinical visits, and the patient and health care professional (HCP) can discuss the findings, which are instantly displayed during the visit. Implementation processes for new tools in routine care need to be studied to understand the influence of contextual factors, the support needed, and how patients and HCPs experience clinical use. OBJECTIVE The aim of this study was to describe patients' and HCPs' experiences of initiating the use of the digital Diabetes Questionnaire as a clinical tool in routine diabetes care, supported by a structured implementation strategy involving initial education, local facilitators, and regular follow-ups. METHODS In this qualitative study, semistructured focus group discussions were conducted 12 months after the use of the Diabetes Questionnaire was initiated. Participants were diabetes specialist nurses and physicians (20 participants in 4 groups) at hospital-based outpatient clinics or primary health care clinics and adults with type 1 or type 2 diabetes (15 participants in 4 groups). The audiotaped transcripts were analyzed using inductive qualitative content analysis. RESULTS The results revealed 2 main categories that integrated patients' and HCPs' experiences, which together formed an overarching theme: While implementation demands new approaches, the Diabetes Questionnaire provides a broader perspective. The first main category (The Diabetes Questionnaire supports person-centered clinical visits) comprised comments expressing that the digital Diabetes Questionnaire can initiate and encourage reflection in preparation for clinical visits, bring important topics to light during clinical visits, and broaden the scope of discussion by providing additional information. The second main category (The process of initiating the implementation of the Diabetes Questionnaire) comprised comments that described differences in engagement among HCPs and their managers, challenges of establishing new routines, experiences of support during implementation, thoughts about the Diabetes Questionnaire, need to change local administrative routines, and opportunities and concerns for continued use. CONCLUSIONS The Diabetes Questionnaire can broaden the scope of health data in routine diabetes care. While implementation demands new approaches, patients and HCPs saw potential positive impacts of using the questionnaire at both the individual and group levels. Our results can inform further development of implementation strategies to support the clinical use of the questionnaire.
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Affiliation(s)
- Maria Svedbo Engström
- School of Health and Welfare, Dalarna University, Falun, Sweden.,Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Unn-Britt Johansson
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Janeth Leksell
- Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ebba Linder
- Swedish National Diabetes Register, Center of Registers Västra Götaland, Gothenburg, Sweden
| | - Katarina Eeg-Olofsson
- Swedish National Diabetes Register, Center of Registers Västra Götaland, Gothenburg, Sweden.,Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
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21
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Lo Presti L, Testa M, Maggiore G, Marino V. Key drivers involved in the telemonitoring of covid-19 for self-health management: an exploratory factor analysis. BMC Health Serv Res 2022; 22:520. [PMID: 35440043 PMCID: PMC9016691 DOI: 10.1186/s12913-022-07828-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/15/2022] [Indexed: 12/20/2022] Open
Abstract
Background The recent COVID-19 pandemic and the shortage of general practitioners has determined a strong pressure on the Italian health system. This critical issue highlighted the fundamental support of e-health services not only to lighten the workload of doctors, but also to offer patients a health service tailored to real needs. Therefore, the digital engagement platforms represent a valid aid, as they reconcile the efficiency needs of the healthcare system with the benefits for the patients involved. In this perspective, little is known about the main factors associated with use of telemonitoring platforms and their effectiveness. This paper investigates the critical success factors of telemonitoring platforms during COVID-19 in order to understand the mechanisms underlying patient participation with the health engagement platforms. Methods An exploratory factor analysis was used to explain the main dimensions of patient participation in the COVID-19 telemonitoring. A sample of 119 patients with a suspected or confirmed infection was used in the investigation. Moreover, an analysis of variance was calculated to identify the differences between three types of patients (infected, uninfected, with suspected infection) and verify the effectiveness of the platform. Main Findings There are six main factors underlying the use of the COVID-19 telemonitoring platform. “Self-Health Engagement” emerges as a novel factor. Moreover, compared to other platforms, cognitive engagement is a crucial trigger for effective telemonitoring. Discussion By identifying the main triggers involved in the use of health engagement platforms, we can improve the satisfaction of telemonitoring services for appropriate health-crisis management. Furthermore, the COVID-19 telemonitoring platform appears to improve health management for both patients and health care providers as it provides the patient with the necessary tools for Self-Health Management (SHM), as well as helping to enrich the literature on health care. Conclusion A new construct emerges in the study of digital telemonitoring platforms: “health self-engagement”, that is, an engagement based on self-care that demonstrates the decisive role assumed by both digital technology and patient participation in self-management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07828-3.
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Affiliation(s)
- Letizia Lo Presti
- Department of Law and Economics, University of Rome "Unitelma Sapienza", Rome, Italy.
| | - Mario Testa
- Department of Management and Innovation Systems, University of Salerno, Fisciano, SA, Italy
| | - Giulio Maggiore
- Department of Law and Economics, University of Rome "Unitelma Sapienza", Rome, Italy
| | - Vittoria Marino
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
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22
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Singh H, Tahsin F, Nie JX, McKinstry B, Thavorn K, Upshur R, Harvey S, Wodchis WP, Gray CS. Exploring the perspectives of primary care providers on use of the electronic Patient Reported Outcomes tool to support goal-oriented care: a qualitative study. BMC Med Inform Decis Mak 2021; 21:366. [PMID: 34965860 PMCID: PMC8714873 DOI: 10.1186/s12911-021-01734-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Digital health technologies can support primary care delivery, but clinical uptake in primary care is limited. This study explores enablers and barriers experienced by primary care providers when adopting new digital health technologies, using the example of the electronic Patient Reported Outcome (ePRO) tool; a mobile application and web portal designed to support goal-oriented care. To better understand implementation drivers and barriers primary care providers' usage behaviours are compared to their perspectives on ePRO utility and fit to support care for patients with complex care needs. METHODS This qualitative sub-analysis was part of a larger trial evaluating the use of the ePRO tool in primary care. Qualitative interviews were conducted with providers at the midpoint (i.e. 4.5-6 months after ePRO implementation) and end-point (i.e. 9-12 months after ePRO implementation) of the trial. Interviews explored providers' experiences and perceptions of integrating the tool within their clinical practice. Interview data were analyzed using a hybrid thematic analysis and guided by the Technology Acceptance Model. Data from thirteen providers from three distinct primary care sites were included in the presented study. RESULTS Three core themes were identified: (1) Perceived usefulness: perceptions of the tool's alignment with providers' typical approach to care, impact and value and fit with existing workflows influenced providers' intention to use the tool and usage behaviour; (2) Behavioural intention: providers had a high or low behavioural intention, and for some, it changed over time; and (3) Improving usage behaviour: enabling external factors and enhancing the tool's perceived ease of use may improve usage behaviour. CONCLUSIONS Multiple refinements/iterations of the ePRO tool (e.g. enhancing the tool's alignment with provider workflows and functions) may be needed to enhance providers' usage behaviour, perceived usefulness and behavioural intention. Enabling external factors, such as organizational and IT support, are also necessary to increase providers' usage behaviour. Lessons from this study advance knowledge of technology implementation in primary care. TRIAL REGISTRATION Clinicaltrials.gov Identified NCT02917954. Registered September 2016, https://www.clinicaltrials.gov/ct2/show/study/NCT02917954.
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Affiliation(s)
- Hardeep Singh
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, Canada.
- March of Dimes Canada, Toronto, Canada.
| | - Farah Tahsin
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, L5B 1B8, Canada
| | - Brian McKinstry
- Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarah Harvey
- Logibec Inc., 1751, Richardson Street, Suite 1.060, Montréal, QC, H3K 1G6, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, L5B 1B8, Canada
| | - Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
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Huhtakangas M, Tuomikoski AM, Laukka E, Kääriäinen M, Kanste O. Adult patients' experiences of patient-professional communication in patient portals: a qualitative systematic review protocol. JBI Evid Synth 2021; 20:689-695. [PMID: 34719661 PMCID: PMC8860204 DOI: 10.11124/jbies-21-00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: The objective of the review is to identify, critically appraise, and synthesize the best available evidence on adult patients’ experiences of patient-professional communication in patient portals. Introduction: Alongside face-to-face communication, patient portals can improve care quality and patients’ self-management of chronic diseases. It is important to examine how patients experience patient-professional communication in patient portals because this digital environment inherently lacks non-verbal messages, which can lead to misunderstandings. Inclusion criteria: Qualitative studies that describe patients’ experiences of reciprocal patient-professional communication in patient portals will be included. Patients must be over the age of 18 years and have a need for long-term care delivered by a health care professional (eg, patients with chronic diseases, such as cancer or diabetes). The health care professionals considered for inclusion are the members of the patient's health care team who communicate with the patient using patient portals. A patient portal is defined as a personal health record, which is either an independent webpage or interconnected with an electronic health record. Methods: The following databases will be searched: MEDLINE (PubMed), CINAHL (EBSCO), ProQuest (Abi/Inform), Scopus, Medic, Google Scholar, Science Direct and Cochrane CENTRAL. Gray literature will be searched in MedNar. Studies published in English, Finnish, or Swedish will be considered, and there is no date limitation. Studies will be screened and critically appraised for methodological quality by two independent researchers. Data will be extracted using a standardized tool from JBI SUMARI. Data synthesis will be conducted according to the meta-aggregation approach. Confidence in the evidence will be assessed using the ConQual approach. Systematic review registration number: PROSPERO CRD42021286177
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Affiliation(s)
- Moona Huhtakangas
- Department of Nursing Science and Health Management, University of Oulu, Oulu, Finland The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland Oulu University of Applied Sciences, University of Oulu, Oulu, Finland Finnish Institute for Health and Welfare, Health and Social Service System Research Team, Helsinki, Finland
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Ingvar M, Blom MC, Winsnes C, Robinson G, Vanfleteren L, Huff S. On the Annotation of Health Care Pathways to Allow the Application of Care-Plans That Generate Data for Multiple Purposes. Front Digit Health 2021; 3:688218. [PMID: 34713160 PMCID: PMC8521921 DOI: 10.3389/fdgth.2021.688218] [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: 03/30/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Procedural interoperability in health care requires information support and monitoring of a common work practice. Our aim was to devise an information model for a complete annotation of actions in clinical pathways that allow use of multiple plans concomitantly as several partial processes underlie any composite clinical process. Materials and Methods: The development of the information model was based on the integration of a defined protocol for clinical interoperability in the care of patients with chronic obstructive pulmonary disease and an observational study protocol for cohort characterization at the group level. In the clinical process patient reported outcome measures were included. Results: The clinical protocol and the observation study protocol were developed on the clinical level and a single plan definition was developed by merging of the protocols. The information model and a common data model that had been developed for care pathways was successfully implemented and data for the medical records and the observational study could be extracted independently. The interprofessional process support improved the communication between the stakeholders (health care professionals, clinical scientists and providers). Discussion: We successfully merged the processes and had a functionally successful pilot demonstrating a seamless appearance for the health care professionals, while at the same time it was possible to generate data that could serve quality registries and clinical research. The adopted data model was initially tested and hereby published to the public domain. Conclusion: The use of a patient centered information model and data annotation focused on the care pathway simplifies the annotation of data for different purposes and supports sharing of knowledge along the patient care path.
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Affiliation(s)
- Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- Department of Clinical Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Greg Robinson
- International Consortium for Health Outcomes Measurement, Boston, MA, United States
| | - Lowie Vanfleteren
- University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stan Huff
- Department of Biomedical Informatics, Intermountain Health Care, University of Utah, Salt Lake City, UT, United States
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Mühlensiepen F, Kurkowski S, Krusche M, Mucke J, Prill R, Heinze M, Welcker M, Schulze-Koops H, Vuillerme N, Schett G, Knitza J. Digital Health Transition in Rheumatology: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052636. [PMID: 33807952 PMCID: PMC7967307 DOI: 10.3390/ijerph18052636] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022]
Abstract
The global COVID-19 pandemic has led to drastic changes in the management of patients with rheumatic diseases. Due to the imminent risk of infection, monitoring intervals of rheumatic patients have prolonged. The aim of this study is to present insights from patients, rheumatologists, and digital product developers on the ongoing digital health transition in rheumatology. A qualitative and participatory semi-structured fishbowl approach was conducted to gain detailed insights from a total of 476 participants. The main findings show that digital health and remote care are generally welcomed by the participants. Five key themes emerged from the qualitative content analysis: (1) digital rheumatology use cases, (2) user descriptions, (3) adaptation to different environments of rheumatology care, and (4) potentials of and (5) barriers to digital rheumatology implementation. Codes were scaled by positive and negative ratings as well as on micro, meso, and macro levels. A main recommendation resulting from the insights is that both patients and rheumatologists need more information and education to successfully implement digital health tools into clinical routine.
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Affiliation(s)
- Felix Mühlensiepen
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany;
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14476 Potsdam, Germany;
- Correspondence:
| | - Sandra Kurkowski
- Department of Palliative Medicine, CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Martin Krusche
- Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Johanna Mucke
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University, 40225 Duesseldorf, Germany;
| | - Robert Prill
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14476 Potsdam, Germany;
- Department of Orthopaedics and Trauma Surgery, Brandenburg Medical School Theodor Fontane, Municipal Clinic Brandenburg, 14770 Brandenburg, Germany
| | - Martin Heinze
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany;
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, 15562 Rüdersdorf, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, 82152 Planegg, Germany;
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Medicine IV, Ludwig-Maximilians-Universität München, 80336 Munich, Germany;
| | - Nicolas Vuillerme
- AGEIS, Faculty of Medicine, Université Grenoble Alpes, 38706 Grenoble, France; (N.V.); (J.K.)
- Institut Universitaire de France, 75006 Paris, France
- LabCom Telecom4Health, Université Grenoble Alpes & Orange Labs, 38400 Grenoble, France
| | - Georg Schett
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany;
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Johannes Knitza
- AGEIS, Faculty of Medicine, Université Grenoble Alpes, 38706 Grenoble, France; (N.V.); (J.K.)
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany;
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
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