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bij de Weg JM, de Boer MA, Meijer C, Lugtenburg N, Melles M, de Vries JI, de Groot CJ. The value of a mobile educative Application additional to Standard counselling on aspirin Adherence in Pregnancy: the ASAP study, a randomised controlled trial. PEC INNOVATION 2024; 4:100268. [PMID: 38435238 PMCID: PMC10907203 DOI: 10.1016/j.pecinn.2024.100268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
Objective To assess the added value of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy versus standard counselling alone. Methods Participants were randomly assigned for additional use of a mobile educative application or standard counselling alone. Main outcome measures were adherence to aspirin measured by two validated questionnaires: Simplified Medication Adherence Questionnaire (SMAQ), Believes and Behaviour Questionnaire (BBQ), and patients reported tablet intake >90%. Results A total of 174 women with an indication for aspirin during pregnancy were included. The questionnaires were filled in by 126 out of the 174 participants (72.4%). Similar results were found in the app group and the standard counselling groups for both validated questionnaires. Tablet intake >90% was seen in 88.7% and 87.5% (p = 0.834) of the app group and standard counselling group respectively. Subgroup analyses demonstrated a negative effect of BMI and a positive effect of educational level on adherence. Conclusions Our study revealed no added effect of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy. Tablet intake was equally high in both groups probably explained by our high educated population. Innovation Future studies should focus on tailored counselling on medication to pregnant women's needs including medication reminders, addressing concerns, adequate health literacy and side effects, offering rewards to further stimulate aspirin adherence in pregnancy with optimal outcome for mother and their neonate.
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Affiliation(s)
- Jeske M. bij de Weg
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Marjon A. de Boer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Cynthia Meijer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Noëlle Lugtenburg
- Delft University of Technology, Faculty of Industrial Design Engineering, Department of Human-Centered Design, Delft, Netherlands
| | - Marijke Melles
- Delft University of Technology, Faculty of Industrial Design Engineering, Department of Human-Centered Design, Delft, Netherlands
| | - Johanna I.P. de Vries
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Christianne J.M. de Groot
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
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Ali S, Alizai H, Hagos DJ, Rubio SR, Calabia D, Serrano Jimenez P, Senthil VA, Appel L. mHealth Apps for Dementia, Alzheimer Disease, and Other Neurocognitive Disorders: Systematic Search and Environmental Scan. JMIR Mhealth Uhealth 2024; 12:e50186. [PMID: 38959029 PMCID: PMC11255539 DOI: 10.2196/50186] [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: 08/25/2023] [Revised: 01/30/2024] [Accepted: 04/23/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia. Mobile health (mHealth) apps have been valuable tools in addressing these lifestyle behaviors for general health and well-being, and there is growing recognition of their potential use for brain health and dementia prevention. Effective apps must be evidence-based and safeguard user data, addressing gaps in the current state of dementia-related mHealth apps. OBJECTIVE This study aims to describe the scope of available apps for dementia prevention and risk factors, highlighting gaps and suggesting a path forward for future development. METHODS A systematic search of mobile app stores, peer-reviewed literature, dementia and Alzheimer association websites, and browser searches was conducted from October 19, 2022, to November 2, 2022. A total of 1044 mHealth apps were retrieved. After screening, 152 apps met the inclusion criteria and were coded by paired, independent reviewers using an extraction framework. The framework was adapted from the Silberg scale, other scoping reviews of mHealth apps for similar populations, and background research on modifiable dementia risk factors. Coded elements included evidence-based and expert credibility, app features, lifestyle elements of focus, and privacy and security. RESULTS Of the 152 apps that met the final selection criteria, 88 (57.9%) addressed modifiable lifestyle behaviors associated with reducing dementia risk. However, many of these apps (59/152, 38.8%) only addressed one lifestyle behavior, with mental stimulation being the most frequently addressed. More than half (84/152, 55.2%) scored 2 points out of 9 on the Silberg scale, with a mean score of 2.4 (SD 1.0) points. Most of the 152 apps did not disclose essential information: 120 (78.9%) did not disclose expert consultation, 125 (82.2%) did not disclose evidence-based information, 146 (96.1%) did not disclose author credentials, and 134 (88.2%) did not disclose their information sources. In addition, 105 (69.2%) apps did not disclose adherence to data privacy and security practices. CONCLUSIONS There is an opportunity for mHealth apps to support individuals in engaging in behaviors linked to reducing dementia risk. While there is a market for these products, there is a lack of dementia-related apps focused on multiple lifestyle behaviors. Gaps in the rigor of app development regarding evidence base, credibility, and adherence to data privacy and security standards must be addressed. Following established and validated guidelines will be necessary for dementia-related apps to be effective and advance successfully.
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Affiliation(s)
- Suad Ali
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Women's Brain Health Initiative, Toronto, ON, Canada
| | - Hira Alizai
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Dale Calabia
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Lora Appel
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
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Khafid M, Bramantoro T, Hariyani N, Setyowati D, Palupi R, Ariawantara PAF, Pratamawari DNP, Pindobilowo P, Mohd Nor NA. The Use of Internet of Things (IoT) Technology to Promote Children's Oral Health: A Scoping Review. Eur J Dent 2024; 18:703-711. [PMID: 38198816 PMCID: PMC11290912 DOI: 10.1055/s-0043-1776116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Dental treatments and oral health promotion are now more mobile and versatile thanks to the Internet of Things (IoT)-based healthcare services. This scoping review aims to compile the available data and outline the aims, design, assessment procedures, efficacy, advantages, and disadvantages of the implementation of IoT to improve children's oral health. Articles for this review were gathered from PubMed, Scopus, and Ebscohost databases to identify and construct the keywords and primary research topic. The selected studies were published between 2000 and 2022 and focused on children aged 1 to 18 and/or parents/caregivers of children who received oral health promotion and/or dental disease preventive treatments utilizing the IoT. Each study topic required data extraction. A total of nine papers were included in this review. Two of the nine publications were quasi-experimental, while the remaining six papers were randomized control trials. The nine papers considered in this appraisal have a range of interventions and follow-up periods. Mobile-Health (m-Health), home healthcare, hospital/clinical management, and electronic-Health applications (e-Health) are the most common IoT architecture used as interventions. Three studies assessed oral health knowledge and behavior scores, whereas the bulk of studies (6/7) used m-Health treatments focusing on dental plaque buildup as well as gingival health evaluation to assess oral hygiene. IoT is one of the mediums or instruments that might be used to encourage children's dental health. The studies suggest that the use of IoT could help in improving oral hygiene and oral health, which can further improve children's oral health.
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Affiliation(s)
- Moh Khafid
- Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Dentistry, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ninuk Hariyani
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dini Setyowati
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Palupi
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | | | - Pindobilowo Pindobilowo
- Student of Doctoral Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nor Azlida Mohd Nor
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Malaysia
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Jayousi S, Barchielli C, Alaimo M, Caputo S, Paffetti M, Zoppi P, Mucchi L. ICT in Nursing and Patient Healthcare Management: Scoping Review and Case Studies. SENSORS (BASEL, SWITZERLAND) 2024; 24:3129. [PMID: 38793983 PMCID: PMC11125011 DOI: 10.3390/s24103129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/21/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Over the past few decades, Information and Communication Technologies (ICT) have revolutionized the fields of nursing and patient healthcare management. This scoping review and the accompanying case studies shed light on the extensive scope and impact of ICT in these critical healthcare domains. The scoping review explores the wide array of ICT tools employed in nursing care and patient healthcare management. These tools encompass electronic health records systems, mobile applications, telemedicine solutions, remote monitoring systems, and more. This article underscores how these technologies have enhanced the efficiency, accuracy, and accessibility of clinical information, contributing to improved patient care. ICT revolution has revitalized nursing care and patient management, improving the quality of care and patient satisfaction. This review and the accompanying case studies emphasize the ongoing potential of ICT in the healthcare sector and call for further research to maximize its benefits.
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Affiliation(s)
- Sara Jayousi
- ICT Applications Lab, PIN—Polo Universitario “Città di Prato”, 59100 Prato, Italy
| | - Chiara Barchielli
- Management and Health Laboratory, Institute of Management, Sant’Anna School of Advanced Studies of Pisa, 56127 Pisa, Italy
| | - Marco Alaimo
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Stefano Caputo
- Department of Information Engineering, University of Florence, 50121 Florence, Italy; (S.C.); (L.M.)
| | - Marzia Paffetti
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Paolo Zoppi
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Lorenzo Mucchi
- Department of Information Engineering, University of Florence, 50121 Florence, Italy; (S.C.); (L.M.)
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FarzanehRad A, Allahbakhshian A, Gholizadeh L, Khalili AF, Hasankhani H. Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients. BMC Cardiovasc Disord 2024; 24:244. [PMID: 38724943 PMCID: PMC11080170 DOI: 10.1186/s12872-024-03884-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/09/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF. METHODS A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests. RESULTS The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03-0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03-0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016). CONCLUSIONS Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient's condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.
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Affiliation(s)
- Ameneh FarzanehRad
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran
| | - Atefeh Allahbakhshian
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran.
- School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Azizeh Farshbaf Khalili
- Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran
| | - Hadi Hasankhani
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran
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Piera-Jiménez J, Dedeu T, Pagliari C, Trupec T. Strengthening primary health care in Europe with digital solutions. Aten Primaria 2024; 56:102904. [PMID: 38692228 PMCID: PMC11070233 DOI: 10.1016/j.aprim.2024.102904] [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: 01/17/2024] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 05/03/2024] Open
Abstract
This article provides an in-depth analysis of digital transformation in European primary healthcare (PHC). It assesses the impact of digital technology on healthcare delivery and management, highlighting variations in digital maturity across Europe. It emphasizes the significance of digital tools, especially during the COVID-19 pandemic, in enhancing accessibility and efficiency in healthcare. It discusses the integration of telehealth, remote monitoring, and e-health solutions, showcasing their role in patient empowerment and proactive care. Examples are included from various countries, such as Greece's ePrescription system, Lithuania's adoption of remote consultations, Spain's use of risk stratification solutions, and the Netherlands' advanced use of telemonitoring solutions, to illustrate the diverse implementation of digital solutions in PHC. The article offers insights into the challenges and opportunities of embedding digital technologies into a multidisciplinary healthcare framework, pointing towards future directions for PHC in Europe.
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Affiliation(s)
- Jordi Piera-Jiménez
- Catalan Health Service, Barcelona, Spain; Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain; Faculty of Informatics, Multimedia and Telecommunications, Universitat Oberta de Catalunya, Barcelona, Spain.
| | - Toni Dedeu
- WHO European Centre for Primary Health Centre, Almaty, Kazakhstan
| | - Claudia Pagliari
- Usher Institute and Edinburgh Global Health Academy, The University of Edinburgh, Edinburgh, United Kingdom
| | - Tatjana Trupec
- Care and Public Health Research Institute, Maastricht University, The Netherlands; School of Medicine, University of Zagreb, Croatia
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Blasco JM, Navarro-Bosch M, Aroca-Navarro JE, Hernández-Guillén D, Puigcerver-Aranda P, Roig-Casasús S. A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial. Bioengineering (Basel) 2024; 11:152. [PMID: 38391638 PMCID: PMC10885890 DOI: 10.3390/bioengineering11020152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness of a chatbot to promote adherence to home rehabilitation in patients undergoing RSA. METHODS A randomized pilot trial including patients undergoing RSA and early postoperative rehabilitation was performed. The control group received standard home rehabilitation; the experimental group received the same intervention supervised with a chatbot, with automated interactions that included messages to inform, motivate, and remember the days and exercises for 12 weeks. Compliance with rehabilitation and clinical measures of shoulder function, pain, and quality of life were assessed. RESULTS 31 patients (17 experimental) with an average age of 70.4 (3.6) completed the intervention. Compliance was higher in the experimental group (77% vs. 65%; OR95% = 2.4 (0.5 to 11.4)). Statistically significant between-group differences with a CI of 95% were found in the QuickDASH questionnaire and self-reported quality of life. No differences were found in the rest of the measures. CONCLUSIONS This pilot study suggests that the chatbot tool can be useful in promoting compliance with early postoperative home rehabilitation in patients undergoing RSA. Future randomized trials with adequate power are warranted to determine the clinical impact of the proposal.
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Affiliation(s)
- José-María Blasco
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Marta Navarro-Bosch
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
| | - José-Enrique Aroca-Navarro
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
| | - David Hernández-Guillén
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | | | - Sergio Roig-Casasús
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
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Díaz-González Á, Fontanillas N, Gil-Hernández E, Guilabert M, Londoño MC, Noguerol M, Pérez Escanilla F, Mira JJ, Santiñá M. Recommendations and quality criteria to improve the early diagnosis of primary biliary cholangitis. GASTROENTEROLOGIA Y HEPATOLOGIA 2023:S0210-5705(23)00492-2. [PMID: 38109994 DOI: 10.1016/j.gastrohep.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE The study aimed to establish recommendations and quality criteria to enhance the healthcare process of PBC. PATIENTS AND METHODS It was conducted using qualitative techniques, preceded by a literature review. A consensus conference involving five specialists in the field was held, followed by a Delphi process developed in two waves, in which 30 specialist physicians in family and community medicine, digestive system and internal medicine were invited to participate. RESULTS Seven recommendations and 15 sets of quality criteria, indicators and standards were obtained. Those with the highest consensus were «Know the impact on the patient's quality of life. Consider their point of view and agree on recommendations and care» and «Evaluate possible fibrosis at the time of diagnosis and during PBC follow-up, assessing the evolution of factors associated with poor disease prognosis: noninvasive fibrosis (elastography > 2.1 kPa/year), GGT, ALP and bilirubin annually», respectively. CONCLUSIONS The implementation of the consensus recommendations and criteria would provide better patient care. The need for multidisciplinary follow-up and an increased role of primary care is emphasized.
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Affiliation(s)
- Álvaro Díaz-González
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla, Santander, España; Grupo de Investigación Clínica y Traslacional en Enfermedades Digestivas, Instituto de Investigación Valdecilla (IDIVAL), Santander, España
| | - Noelia Fontanillas
- Medicina Familiar y Comunitaria, Centro de Salud Bezana, Cantabria, España; Grupo de Trabajo en Aparato Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Madrid, España
| | - Eva Gil-Hernández
- Grupo ATENEA Investigación, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Sant Joan d'Alacant, España.
| | - Mercedes Guilabert
- Departamento de Psicología de la Universidad Miguel Hernández, Elche, España; Sociedad Española de Calidad Asistencial, Oviedo, España
| | - Maria-Carlota Londoño
- Servicio de Hepatología, Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBEREHD, Barcelona, España
| | - Mar Noguerol
- Medicina Familiar y Comunitaria, Centro de Salud Cuzco, Madrid, España; Grupo de Patología digestiva y hepática de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC), Madrid, España
| | | | - José J Mira
- Grupo ATENEA Investigación, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Sant Joan d'Alacant, España; Departamento de Psicología de la Universidad Miguel Hernández, Elche, España; Sociedad Española de Calidad Asistencial, Oviedo, España
| | - Manuel Santiñá
- Sociedad Española de Calidad Asistencial, Oviedo, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, España
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Park LG, Ng F, Handley MA. The use of the Capability-Opportunity- Motivation Behavior (COM-B) model to identify barriers to medication adherence and the application of mobile health technology in adults with coronary heart disease: A qualitative study. PEC INNOVATION 2023; 3:100209. [PMID: 37753273 PMCID: PMC10518702 DOI: 10.1016/j.pecinn.2023.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/06/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
Objective Among patients with coronary heart disease, we sought to address the research questions of: 1) What is the acceptability of applying a technology-enabled approach to support medication adherence?; and 2) What are barriers to medication adherence using the Capability-Opportunity-Motivation Behavior (COM-B) model as a guiding framework? Methods Applying qualitative research methods, we employed a series of 3 focus groups per individual (total 9 sessions). Coded data from thematic analysis were mapped to the COM-B model components for meaningful associations. Results Fourteen participants were recruited (median age 69.5 ± 11, 50% female). Barriers to medication adherence were organized along these COM-B domains: psychological capability (forgetfulness, distractions, fear of side effects), physical opportunity (inaccessible medications, inability to renew prescriptions), reflective (burdening family members), and automatic motivation (medication fatigue, health decline). Conclusions Tailored text messaging and mobile phone apps were perceived as helpful tools for medication adherence. The COM-B model was useful to provide a comprehensive, theory-driven evaluation of patients' beliefs and motivations on whether to engage in medication adherence. Innovation To date, text messaging and mobile applications have not been widely implemented in the clinical setting and provide a major opportunity to innovate on approaches to address medication adherence.
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Affiliation(s)
- Linda G. Park
- University of California, San Francisco School of Nursing, Department of Community Health Systems, San Francisco Veterans Affair Medical Center, 2 Koret Way, Room 531A, San Francisco, CA 94143-0610, United States of America
| | - Fion Ng
- Department of Community Health Programs for Youth, San Francisco Department of Public Health, United States of America
| | - Margaret A. Handley
- Departments of Epidemiology and Biostatistics and Medicine, Division of General Internal Medicine, University of California, San Francisco, United States of America
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Zvulunov A, Lenevich S, Migacheva N. A Mobile Health App for Facilitating Disease Management in Children With Atopic Dermatitis: Feasibility and Impact Study. JMIR DERMATOLOGY 2023; 6:e49278. [PMID: 38090787 PMCID: PMC10753416 DOI: 10.2196/49278] [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: 05/25/2023] [Revised: 10/07/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Inadequate control of atopic dermatitis (AD) increases the frequency of exacerbations and reduces the quality of life. Mobile health apps provide information and communication technology and may increase treatment adherence and facilitate disease management at home. The mobile health app, Atopic App, designed for patients and their caregivers, and the associated web-based patient education program, Atopic School, provide an opportunity for improving patients' and caregivers' engagement and adherence to the management of AD. OBJECTIVE This noninterventional, observational study aimed to explore the feasibility and potential impact on the management of AD in children by caregivers using the Atopic App mobile health app. METHODS The patient-oriented eczema measure (POEM) and numerical rating scale for the grading of pruritus were used as severity scores (scale range: 0-28). The artificial intelligence model of the app was used to assess the severity of AD based on the eczema area and severity index approach. The deidentified data enabled the analysis of the severity of AD, treatment plan history, potential triggers of flare-ups, usage of available features of the app, and the impact of patient education. RESULTS During a 12-month period, of the 1223 users who installed the app, 910 (74.4%) registered users were caregivers of children with AD. The web-based Atopic School course was accessed by 266 (29.2%) caregivers of children with AD, 134 (50.4%) of whom completed the course. Usage of the app was significantly more frequent among those who completed the Atopic School program than among those who did not access or did not complete the course (P<.001). Users who completed a second POEM 21 to 27 days apart exhibited a significant improvement of AD severity based on the POEM score (P<.001), with an average improvement of 3.86 (SD 6.85) points. The artificial intelligence severity score and itching score were highly correlated with the POEM score (r=0.35 and r=0.52, respectively). CONCLUSIONS The Atopic App provides valuable real-world data on the epidemiology, severity dynamics, treatment patterns, and exacerbation-trigger correlations in patients with AD. The significant reduction in the POEM score among users of the Atopic App indicates a potential impact of this tool on health care engagement by caregivers of children with AD.
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Affiliation(s)
- Alex Zvulunov
- Sheba Medical Center, Reichman University, Herzliya, Ramat Gan, Israel
| | | | - Natalia Migacheva
- Department of Pediatrics, Samara State Medical University, Samara, Russian Federation
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Mitchaï PM, Mapinduzi J, Verbrugghe J, Michiels S, Janssens L, Kossi O, Bonnechère B, Timmermans A. Mobile technologies for rehabilitation in non-specific spinal disorders: a systematic review of the efficacy and potential for implementation in low- and middle-income countries. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4077-4100. [PMID: 37794182 DOI: 10.1007/s00586-023-07964-2] [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: 05/22/2023] [Revised: 05/22/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE The aim of this systematic review was primarily to identify the types of mHealth technologies for the rehabilitation of non-specific spinal disorders, second to evaluate their efficacy, and finally to determine their applicability in LMICs. METHODS Three databases (Scopus, PubMed, and Web of Science) were searched for randomized controlled trials and clinical trials from January 2012 until December 2022. Studies were found eligible when using mHealth technologies for the rehabilitation of non-specific spinal disorders. To evaluate efficacy, the primary outcome was pain intensity, and the secondary outcomes were disability and quality of life. To evaluate the applicability in LMICs, information about financial and geographical accessibility, offline usability, and languages was extracted. RESULTS Fifteen studies were included comprising 1828 participants who suffer from non-specific low back pain (86.05%) and non-specific neck pain (13.95%). Fourteen distinct smartphone-based interventions and two sensor system interventions were found, with a duration ranging from four weeks to six months. All mHealth interventions demonstrated efficacy for the improvement of pain, disability and quality of life in non-specific spinal disorders, particularly low back pain. Five of the evaluated smartphone applications were free of charge accessible and had language features that could be adapted for use in LMICs. CONCLUSION mHealth interventions can be used and integrated into the conventional treatment of non-specific spinal disorders in rehabilitation. They have demonstrated efficacy and could be implemented in LMICs with minor adaptations to overcome language barriers and the absolute necessity of the internet.
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Affiliation(s)
- Pénielle Mahutchegnon Mitchaï
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, 03 BP 10, Parakou, Benin
| | - Jean Mapinduzi
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- Department of Physiotherapy, National Institute of Public Health, University of Bujumbura, Bujumbura, Burundi
| | - Jonas Verbrugghe
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Sarah Michiels
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Lotte Janssens
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Oyéné Kossi
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, 03 BP 10, Parakou, Benin.
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin.
| | - Bruno Bonnechère
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Annick Timmermans
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
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Chapman-Goetz J, Packham N, Yu K, Gabb G, Potts C, Prosser A, Arstall MA, Burdeniuk C, Chan A, Wilson T, Hotham E, Suppiah V. NPS MedicineWise application in supporting medication adherence in chronic heart failure: an acceptability and feasibility pilot study. Front Digit Health 2023; 5:1274355. [PMID: 38034908 PMCID: PMC10684918 DOI: 10.3389/fdgth.2023.1274355] [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: 08/08/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Heart failure (HF) is an increasing global concern. Despite evidence-based pharmacotherapy, associated morbidity and mortality remain high. This study aimed to assess the acceptability, feasibility, and value of the NPS MedicineWise dose reminder app in a tiered, pharmacist-led intervention to address medication non-adherence in patients with HF. Methods This prospective, single-blinded, randomised controlled trial recruited 55 patients with HF between September 2019 and October 2020. Participants were randomly assigned to either the intervention or control arms. Intervention participants used the app which prompted medication administration at each dosing interval. Control participants received standard care and remained blinded to the app throughout the study. Treatment non-adherence prompted a tiered, pharmacist-led intervention. Comparison of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) at baseline and 6-months measured the app's value in supporting medication adherence. Secondary outcome measures included self-reported medication knowledge, health-related quality of life, psychological wellbeing, and signs and symptoms of HF. Data were analysed using standard statistical tests with significance set at α 0.05. Results Approximately half of respondents reported managing HF and medications better by using the MedicineWise app (Tier 1). Most respondents expressed satisfaction with the in-app messages (Tier 2) and pharmacists' phone calls (Tier 3). The intervention participants demonstrated a significant improvement in the SEAMS between baseline and 6-months follow-up. Discussion It is feasible and potentially of value to use the MedicineWise app with a tiered, pharmacist-led intervention to support medication adherence in patients with HF. Our findings provide clinicians with "real-world" information on the practicality and potential value of using mobile health to support treatment adherence in patients with HF. Trial registration number Australian New Zealand Clinical Trials Registry Clinical trial registration number: ACTRN12619000289112p (http://www.ANZCTR.org.au/ACTRN12619000289112p.aspx).
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Affiliation(s)
- Jessica Chapman-Goetz
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Nerida Packham
- Consumer Medicines Information Services, NPS MedicineWise, Surry Hills, NSW, Australia
| | - Kitty Yu
- e-Health, NPS MedicineWise, Melbourne, VIC, Australia
| | - Genevieve Gabb
- Department of Cardiology, Noarlunga GP Plus Super Clinic, Adelaide, SA, Australia
| | - Cassandra Potts
- SA Pharmacy, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Adaire Prosser
- SA Pharmacy, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Christine Burdeniuk
- Department of Cardiology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Alicia Chan
- Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Teena Wilson
- Integrated Cardiovascular Clinical Network, Country Health South Australia, Adelaide, SA, Australia
| | - Elizabeth Hotham
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Vijayaprakash Suppiah
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
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13
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Parvizey S, Nadery Y, Khorasani P, Feizi A. Strategies for Improving Nurses' Performance Regarding Cardiovascular Patient's Adherence to Treatment Regimen: Content Analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:758-763. [PMID: 38205418 PMCID: PMC10775868 DOI: 10.4103/ijnmr.ijnmr_17_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/12/2024]
Abstract
Background Patient adherence to the treatment regimen is an important goal of treatment; finding appropriate strategies to improve treatment adherence is a nursing challenge. This study aimed to explore strategies to improve nurses' performance to enhance cardiovascular patients' adherence to treatment regimens. Materials and Methods This is a qualitative content analysis study that was performed in an educational hospital of the Urmia University of Medical Science. Data were collected through semi-structured individual and group interviews. Sixteen individual interviews were conducted with nurses, patients, and physicians. A focus group was conducted with the presence of six nurses and nursing managers. Data were analyzed by conventional content analysis using MAXQDA 2020. Results After analyzing the interviews, five strategies were explored; these strategies include: follow-up of the patient after discharge (systemic and organizational follow-up, educational follow-up, counseling follow-up, and motivational follow-up), sending reminders for necessary cases to the patients (risk reminders, care reminders); improving patient education methods (modern and up-to-date education, conventional and routine education), improving support services (home care services, social support, Psychological support), and optimizing the structure and processes of the hospital (making structural changes, making process changes). Conclusions Much needs to be done to improve patient's adherence to treatment. Nurses are at the forefront of this work. In this study, we introduced ways to improve nurses' performance in order to increase patient adherence.
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Affiliation(s)
- Soroor Parvizey
- University of Medical Sciences, Tehran, Iran, Pediatric Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Yaghoub Nadery
- University of Medical Sciences, Tehran, Iran, Pediatric Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Khorasani
- Nursing and Midwifery Care Research Center, Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aram Feizi
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Che Pa MF, Makmor-Bakry M, Islahudin F. Digital Health in Enhancing Antiretroviral Therapy Adherence: A Systematic Review and Meta-Analysis. AIDS Patient Care STDS 2023; 37:507-516. [PMID: 37956244 DOI: 10.1089/apc.2023.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
Adherence to antiretroviral therapy (ART) is essential in determining successful treatment of human immunodeficiency virus (HIV). The adoption of digital health is suggested to improve ART adherence among people living with HIV (PLHIV). This study aimed to systematically determine the effect of digital health in enhancing ART adherence among PLHIV from published studies. The systematic search was conducted on Scopus, Web of Science (WoS), PubMed, Ovid, EBSCOHost, and Google Scholar databases up to June 2022. Studies utilized any digital health as an intervention for ART adherence enhancement and ART adherence status as study's outcome was included. Digital health refers to the use of information and communication technologies to improve health. Quality assessment and data analysis were carried out using Review Manager (RevMan) version 5.4. A random-effects model computed the pooled odds ratio between intervention and control groups. The search produced a total of 1864 articles. Eleven articles were eligible for analysis. Digital health was used as follows: six studies used short message service or text message alone, three studies used mobile applications, and two studies used combination method. Four studies showed statistically significant impacts of digital health on ART adherence, while seven studies reported insignificant results. Results showed studies conducted using combination approach of digital health produced more promising outcome in ART adherence compared to single approach. New innovative in combination ways is required to address potential benefits of digital health in promoting ART adherence among PLHIV.
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Affiliation(s)
- Mohd Farizh Che Pa
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Pharmacy, Hospital Tuanku Ja'afar, Seremban, Malaysia
| | - Mohd Makmor-Bakry
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Farida Islahudin
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Willems R, Annemans L, Siopis G, Moschonis G, Vedanthan R, Jung J, Kwasnicka D, Oldenburg B, d'Antonio C, Girolami S, Agapidaki E, Manios Y, Verhaeghe N. Cost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension. NPJ Digit Med 2023; 6:150. [PMID: 37596488 PMCID: PMC10439143 DOI: 10.1038/s41746-023-00876-x] [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: 02/27/2023] [Accepted: 07/07/2023] [Indexed: 08/20/2023] Open
Abstract
Digital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites by searching CINAHL, Cochrane Central, Embase, Medline and PsycInfo for full economic or cost-minimisation studies of digital health interventions in adults with or at risk of T2DM and/or hypertension. Costs and health effects are synthesised narratively. Study quality appraisal using the Consensus on Health Economic Criteria (CHEC) list results in recommendations for future health economic evaluations of digital health interventions. Of 3056 records identified, 14 studies are included (7 studies applied text-messaging, 4 employed smartphone applications, and 5 used websites). Ten studies are cost-utility analyses: incremental cost-utility ratios (ICUR) vary from dominant to €75,233/quality-adjusted life year (QALY), with a median of €3840/QALY (interquartile range €16,179). One study finds no QALY difference. None of the three digital health intervention modes is associated with substantially better cost-effectiveness. Interventions are consistently cost-effective in populations with (pre)T2DM but not in populations with hypertension. Mean quality score is 63.0% (standard deviation 13.7%). Substandard application of time horizon, sensitivity analysis, and subgroup analysis next to transparency concerns (regarding competing alternatives, perspective, and costing) downgrades quality of evidence. In conclusion, smartphone application, text-messaging, and website-based interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold.Registration: PROSPERO (CRD42021247845).
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Affiliation(s)
- Ruben Willems
- Interuniversity Center of Health Economic Research (ICHER), department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Lieven Annemans
- Interuniversity Center of Health Economic Research (ICHER), department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - George Siopis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Jenny Jung
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Dominika Kwasnicka
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Baker Heart and Diabetes Institute, Melbourne, Australia
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Brian Oldenburg
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | | | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Nick Verhaeghe
- Interuniversity Center of Health Economic Research (ICHER), department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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16
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Lutz J, Pratap A, Lenze EJ, Bestha D, Lipschitz JM, Karantzoulis S, Vaidyanathan U, Robin J, Horan W, Brannan S, Mittoux A, Davis MC, Lakhan SE, Keefe R. Innovative Technologies in CNS Trials: Promises and Pitfalls for Recruitment, Retention, and Representativeness. INNOVATIONS IN CLINICAL NEUROSCIENCE 2023; 20:40-46. [PMID: 37817816 PMCID: PMC10561984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Objective Recruitment of a sufficiently large and representative patient sample and its retention during central nervous system (CNS) trials presents major challenges for study sponsors. Technological advances are reshaping clinical trial operations to meet these challenges, and the COVID-19 pandemic further accelerated this development. Method of Research The International Society for CNS Clinical Trials and Methodology (ISCTM; www.isctm.org) Innovative Technologies for CNS Trials Working Group surveyed the state of technological innovations for improved recruitment and retention and assessed their promises and pitfalls. Results Online advertisement and electronic patient registries can enhance recruitment, but challenges with sample representativeness, conversion rates from eligible prescreening to enrolled patients, data privacy and security, and patient identification remain hurdles for optimal use of these technologies. Electronic medical records (EMR) mining with artificial intelligence (AI)/machine learning (ML) methods is promising but awaits translation into trials. During the study treatment phase, technological innovations increasingly support participant retention, including adherence with the investigational treatment. Digital tools for adherence and retention support take many forms, including patient-centric communication channels between researchers and participants, real-time study reminders, and digital behavioral interventions to increase study compliance. However, such tools add technical complexities to trials, and their impact on the generalizability of results are largely unknown. Conclusion Overall, the group found a scarcity of systematic data directly assessing the impact of technological innovations on study recruitment and retention in CNS trials, even for strategies with already high adoption, such as online recruitment. Given the added complexity and costs associated with most technological innovations, such data is needed to fully harness technologies for CNS trials and drive further adoption.
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Affiliation(s)
- Jacqueline Lutz
- Dr. Lutz was with Medical Office, Click Therapeutics, Inc. in New York, New York, at the time of writing; she is now with Biogen Digital Health in Cambridge, Massachusetts, and Boston University School of Medicine in Boston, Massachusetts
| | - Abhishek Pratap
- Dr. Pratap was with Center for Addiction & Mental Health in Toronto, Canada, at the time of writing; he is now with Boehringer Ingelheim in Ridgefield, Connecticut; King's College London in London, United Kingdom; and Department of Biomedical Informatics and Medical Education, University of Washington in Seattle, Washington
| | - Eric J Lenze
- Dr. Lenze is with Department of Psychiatry, Washington University School of Medicine in St. Louis, Missouri
| | - Durga Bestha
- Dr. Bestha is with Atrium Health in Charlotte, North Carolina
| | - Jessica M Lipschitz
- Dr. Lipschitz is with Brigham and Women's Hospital in Boston, Massachusetts, and Harvard Medical School in Boston, Massachusetts
| | | | - Uma Vaidyanathan
- Dr. Vaidyanathan was with Boehringer Ingelheim in Ridgefield, Connecticut, at the time of writing; she is now with Sublimus in Ridgefield, Connecticut
| | - Jessica Robin
- Dr. Robin is with Winterlight Labs, Inc. in Toronto, Canada
| | - William Horan
- Dr. Horan was with WCG VeraSci in Durham, North Carolina, at the time of writing; he is now with Karuna Therapeutics in Boston, Massachusetts, and University of California in Los Angeles, California
| | - Stephen Brannan
- Dr. Brannan is with Karuna Therapeutics in Boston, Massachusetts
| | | | | | - Shaheen E Lakhan
- Dr. Lakhan is with Medical Office, Click Therapeutics, Inc. in New York, New York, and School of Neuroscience, Virginia Tech in Blacksburg, Virginia
| | - Richard Keefe
- Dr. Keefe is with Department of Psychiatry, Duke University Medical Center in Durham, North Carolina
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17
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Maspero M, Hull T. Patient-Reported Outcomes in Colorectal Surgery. Clin Colon Rectal Surg 2023; 36:240-251. [PMID: 37223227 PMCID: PMC10202545 DOI: 10.1055/s-0043-1761607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Given the increased life expectancy and improvements in the treatment of colorectal patients, the success of a treatment course can no longer be determined only by objective outcomes. Health care providers ought to take into consideration the impact an intervention will have on the quality of life of patients. Endpoints that take into account the patient's perspective are defined as patient-reported outcomes (PROs). PROs are assessed through patient-reported outcome measures (PROMs), usually in the form of questionnaires. PROs are especially important in colorectal surgery, whose procedures can often be associated with some degree of postoperative functional impairment. Several PROMs are available for colorectal surgery patients. However, while some scientific societies have offered recommendations, there is no standardization in the field and PROMs are seldom implemented in clinical practice. The routine use of validated PROMs can guarantee that functional outcomes are followed over time; this way, they can be addressed in case of worsening. This review will provide an overview of the most commonly used PROMs in colorectal surgery, both generic and disease specific, as well as a summary of the available evidence in support of their routine utilization.
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Affiliation(s)
- Marianna Maspero
- Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Tracy Hull
- Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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18
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Lewkowicz D, Bottinger E, Siegel M. Economic Evaluation of Digital Therapeutic Care Apps for Unsupervised Treatment of Low Back Pain: Monte Carlo Simulation. JMIR Mhealth Uhealth 2023; 11:e44585. [PMID: 37384379 PMCID: PMC10365619 DOI: 10.2196/44585] [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: 11/25/2022] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Digital therapeutic care (DTC) programs are unsupervised app-based treatments that provide video exercises and educational material to patients with nonspecific low back pain during episodes of pain and functional disability. German statutory health insurance can reimburse DTC programs since 2019, but evidence on efficacy and reasonable pricing remains scarce. This paper presents a probabilistic sensitivity analysis (PSA) to evaluate the efficacy and cost-utility of a DTC app against treatment as usual (TAU) in Germany. OBJECTIVE The aim of this study was to perform a PSA in the form of a Monte Carlo simulation based on the deterministic base case analysis to account for model assumptions and parameter uncertainty. We also intend to explore to what extent the results in this probabilistic analysis differ from the results in the base case analysis and to what extent a shortage of outcome data concerning quality-of-life (QoL) metrics impacts the overall results. METHODS The PSA builds upon a state-transition Markov chain with a 4-week cycle length over a model time horizon of 3 years from a recently published deterministic cost-utility analysis. A Monte Carlo simulation with 10,000 iterations and a cohort size of 10,000 was employed to evaluate the cost-utility from a societal perspective. Quality-adjusted life years (QALYs) were derived from Veterans RAND 6-Dimension (VR-6D) and Short-Form 6-Dimension (SF-6D) single utility scores. Finally, we also simulated reducing the price for a 3-month app prescription to analyze at which price threshold DTC would result in being the dominant strategy over TAU in Germany. RESULTS The Monte Carlo simulation yielded on average a €135.97 (a currency exchange rate of EUR €1=US $1.069 is applicable) incremental cost and 0.004 incremental QALYs per person and year for the unsupervised DTC app strategy compared to in-person physiotherapy in Germany. The corresponding incremental cost-utility ratio (ICUR) amounts to an additional €34,315.19 per additional QALY. DTC yielded more QALYs in 54.96% of the iterations. DTC dominates TAU in 24.04% of the iterations for QALYs. Reducing the app price in the simulation from currently €239.96 to €164.61 for a 3-month prescription could yield a negative ICUR and thus make DTC the dominant strategy, even though the estimated probability of DTC being more effective than TAU is only 54.96%. CONCLUSIONS Decision-makers should be cautious when considering the reimbursement of DTC apps since no significant treatment effect was found, and the probability of cost-effectiveness remains below 60% even for an infinite willingness-to-pay threshold. More app-based studies involving the utilization of QoL outcome parameters are urgently needed to account for the low and limited precision of the available QoL input parameters, which are crucial to making profound recommendations concerning the cost-utility of novel apps.
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Affiliation(s)
- Daniel Lewkowicz
- Digital Health Center, Hasso Plattner Insitute, University of Potsdam, Potsdam, Germany
| | - Erwin Bottinger
- Digital Health Center, Hasso Plattner Insitute, University of Potsdam, Potsdam, Germany
| | - Martin Siegel
- Department of Empirical Health Economics, Technische Universität Berlin, Berlin, Germany
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Blasco JM, Díaz-Díaz B, Igual-Camacho C, Pérez-Maletzki J, Hernández-Guilén D, Roig-Casasús S. Effectiveness of using a chatbot to promote adherence to home physiotherapy after total knee replacement, rationale and design of a randomized clinical trial. BMC Musculoskelet Disord 2023; 24:491. [PMID: 37322506 DOI: 10.1186/s12891-023-06607-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Rehabilitation is essential to optimize outcomes after surgical procedures in musculoskeletal disorders. However, adherence to rehabilitation continues to be an important barrier, since compliance with the programs is not always as desired, which may have a negative impact on clinical results. METHODS Randomized controlled trial aimed at to determining the effectiveness of using a virtual assistant (i.e., chatbot) to promote adherence to home rehabilitation. Overall, seventy patients under 75, undergoing total knee replacement, who have a personal smartphone and are familiar with its use, will be assigned into the control (standard care) or the experimental (standard care plus virtual assistant) group. Adherence (primary outcome) will be assessed three months after surgery. The WOMAC questionnaire, knee pain and system usability scale will be also outcomes of interest at three months and one year. Overall, an analysis of variance will look for possible time, group and time*group interactions. DISCUSSION The expected result is to determine whether the use of a chatbot that interacts with the patient can increase adherence to post-surgical home physiotherapy, and result in better clinical results (functional and pain) than standard care. TRIAL REGISTRATION clinicaltrials.gov id. NCT05363137.
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Affiliation(s)
- José-María Blasco
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain.
- IRIMED, Joint Research Unit La Fe-UV, Valencia, Spain.
| | - Beatriz Díaz-Díaz
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Hospital Clínic i Universitari de València, Valencia, Spain
| | - Celedonia Igual-Camacho
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Hospital Clínic i Universitari de València, Valencia, Spain
| | - José Pérez-Maletzki
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
| | - David Hernández-Guilén
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
| | - Sergio Roig-Casasús
- Group in Physiotherapy in the Ageing Processess: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Hospital Universitari i Politècnic la Fe de València, Valencia, Spain
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Reliability and Validity of the Japanese Version of the Basel Assessment of Adherence to Immunosuppressive Medications Scale in Kidney Transplant Recipients. Transplant Direct 2023; 9:e1457. [PMID: 36860659 PMCID: PMC9970284 DOI: 10.1097/txd.0000000000001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/22/2022] [Accepted: 01/07/2023] [Indexed: 03/03/2023] Open
Abstract
A valid and reliable instrument that can measure adherence is needed to identify nonadherent patients and to improve adherence. However, there is no validated Japanese self-report instrument to evaluate adherence to immunosuppressive medications for transplant patients. The purpose of this study was to determine the reliability and validity of the Japanese version of the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Methods We translated the BAASIS into Japanese and developed the Japanese version of the BAASIS (J-BAASIS) according to the International Society of Pharmacoeconomics and Outcomes Research task force guidelines. We analyzed the reliability (test-retest reliability and measurement error) and validity of the J-BAASIS (concurrent validity with the medication event monitoring system and the 12-item Medication Adherence Scale) referring to the COSMIN Risk of Bias checklist. Results A total of 106 kidney transplant recipients were included in this study. In the analysis of test-retest reliability, Cohen's kappa coefficient was found to be 0.62. In the analysis of measurement error, the positive and negative agreement were 0.78 and 0.84, respectively. In the analysis of concurrent validity with the medication event monitoring system, sensitivity and specificity were 0.84 and 0.90, respectively. In the analysis of concurrent validity with the 12-item Medication Adherence Scale, the point-biserial correlation coefficient for the "medication compliance" subscale was 0.38 (P < 0.001). Conclusions The J-BAASIS was determined to have good reliability and validity. Using the J-BAASIS to evaluate adherence can help clinicians to identify medication nonadherence and institute appropriate corrective measures to improve transplant outcomes.
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LaValley SA, Brady LA, Nguyen M, Jacobs D. Family Caregivers of Older Adults: Strategies, Tools, and Technologies for Medication Management. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:291-302. [PMID: 35850634 DOI: 10.1080/01634372.2022.2100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Susan A LaValley
- Department of Family Medicine, Primary Care Research Institute, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Laura A Brady
- Jacobs School of Medicine and Biomedical Sciences, Primary Care Research Institute, University at Buffalo, Buffalo, New York, USA
| | - Melanie Nguyen
- School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA
| | - David Jacobs
- School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA
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22
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Langarizadeh M, Nadjarzadeh A, Maghsoudi B, Fatemi Aghda SA. The nutritional content required to design an educational application for infertile women. BMC Womens Health 2023; 23:22. [PMID: 36650480 PMCID: PMC9843656 DOI: 10.1186/s12905-023-02156-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Infertility has been considered as a critical health problem for couples and society. Given the worldwide exponential rise of infertility, mobile phone-based applications are drastic ways to deliver nutrition educational content to women with infertility. The present study aimed to prepare the required educational content for designing a mobile phone-based nutrition educational application for women with infertility. METHODS Educational contents were initially determined based on the literature review and library studies. As a result, a researcher-made questionnaire was designed containing 28 items in six dimensions. To ensure about the questionnaire's validity, a panel of experts (15 nutritionists and 5 infertility specialists) was asked to review the items, make revisions (if necessary), and confirm the final contents. The questionnaire reliability was also corroborated using the KR-20 coefficient (0.89). RESULTS While the amount of consumed calories per meal and between meals were not significantly effective on fertility, factors such as main definitions, disease and treatment instructions, personal activities and habits, and menstruation were deemed necessary by the respondents. Participants also suggested adding sections entailing introductions to different types of diets, users' suggestions and opinions, and of the address and contact information of senior nutrition centers to the questionnaire. CONCLUSIONS Followed by obtaining the required valid and reliable contents, a mobile phone- based nutrition education application can be designed to improve the patients' knowledge and facilitate their treatment process.
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Affiliation(s)
- Mostafa Langarizadeh
- grid.411746.10000 0004 4911 7066Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Nadjarzadeh
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Banafshe Maghsoudi
- grid.411746.10000 0004 4911 7066Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fatemi Aghda
- grid.411746.10000 0004 4911 7066Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran ,grid.412505.70000 0004 0612 5912Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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23
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Fernández C, Vicente MA, Guilabert M, Carrillo I, Mira JJ. Developing a mobile health app for chronic illness management: Insights from focus groups. Digit Health 2023; 9:20552076231210662. [PMID: 37928329 PMCID: PMC10621305 DOI: 10.1177/20552076231210662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.
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Affiliation(s)
- César Fernández
- Telematics Engineering, Miguel Hernandez University, Elche, Spain
| | | | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
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24
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Pratiwi H, Kristina SA, Widayanti AW, Prabandari YS, Kusuma IY. A Systematic Review of Compensation and Technology-Mediated Strategies to Maintain Older Adults' Medication Adherence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:803. [PMID: 36613130 PMCID: PMC9819645 DOI: 10.3390/ijerph20010803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 06/16/2023]
Abstract
Elderly medication adherence is a challenge in health care. The elderly are often at higher risk for non-adherence, and more likely to be on multiple prescription medications for many comorbidities. This systematic review aimed to explore the current strategies for maintaining older adults' medication adherence with compensation and technology-mediated strategies. We conducted a systematic review to examine related articles published in the PubMed, Web of Science, and Scopus databases, as well as Google Scholar for additional reference sources by cross-reference review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this review. A total of 217 articles were screened, and 27 studies fulfilled the inclusion criteria. Older adults applied a variety of methods to maintain or enhance their medication adherence. Three studies indicated compensation strategies, 19 studies reported technological assistance, two studies used other strategies (community-offered help or caregivers help), and three studies used a combination of compensation with another strategy or technology. Studies identified various compensation- and technology-based strategies carried out by older adults to help remind them to take medication. This review identified potential benefits of technology and compensation strategy implementation in older adults to increase medication adherence. Although we are conscious of the heterogeneity of the included studies, it remains challenging to determine which elements underpin the most effective approaches.
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Affiliation(s)
- Hening Pratiwi
- Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto 53122, Indonesia
| | - Susi Ari Kristina
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Anna Wahyuni Widayanti
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Yayi Suryo Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Ikhwan Yuda Kusuma
- Pharmacy Study Program, Faculty of Health, Universitas Harapan Bangsa, Purwokerto 53182, Indonesia
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25
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Buis L, Etingen B, Lipschitz JM, Shimada SL, McMahon N, Bolivar D, Bixler FR, Irvin D, Wacks R, Cutrona S, Frisbee KL, Smith BM. Factors Associated With Self-reported Use of Web and Mobile Health Apps Among US Military Veterans: Cross-sectional Survey. JMIR Mhealth Uhealth 2022; 10:e41767. [PMID: 36583935 PMCID: PMC9840102 DOI: 10.2196/41767] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/26/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Despite their prevalence and reported patient interest in their use, uptake of health-related apps is limited. The Veterans Health Administration (VHA) has developed a variety of apps to support veterans; however, uptake remains low nationally. OBJECTIVE We examined the prevalence of VHA health-related app use and how veterans learned about these apps in order to identify factors associated with their use. METHODS As part of a VHA quality improvement initiative, we recruited a national cohort of veterans to obtain feedback on their use of technology for health and collected data from them via a cross-sectional survey. The survey data were supplemented with VHA administrative data. We used descriptive statistics to examine demographic and health characteristics, health-related technology use, and how veterans learned about apps. We assessed factors associated with app use using bivariate analyses and multiple logistic regression models. RESULTS We had complete data on 1259 veterans. A majority of the sample was male (1069/1259, 84.9%), aged older than 65 years (740/1259, 58.8%), White (1086/1259, 86.3%), and non-Hispanic (1218/1259, 96.7%). Most respondents (1125/1259, 89.4%) reported being very comfortable and confident using computers, over half (675/1259, 53.6%) reported being an early adopter of technology, and almost half (595/1259, 47.3%) reported having used a VHA health-related app. Just over one-third (435/1259, 34.6%) reported that their VHA care team members encouraged them to use health-related apps. Respondents reported learning about available VHA health-related apps by reading about them on the VHA's patient portal (468/1259, 37.2%), being told about them by their VHA health care team (316/1259, 25.1%), and reading about them on the VHA's website (139/1259, 11%). Veterans who self-reported having used VHA health-related apps were more likely to receive care at the VHA (OR [odds ratio] 1.3, 95% CI 1.0-1.7), be in worse health (as assessed by Hierarchical Condition Community score; OR 1.1, 95% CI 1.0-1.2), report owning a desktop or laptop computer (OR 1.8, 95% CI 1.1-3.1), have posttraumatic stress disorder (OR 1.4, 95% CI 1.1-1.9), and report having VHA health care team members encourage them to use the apps (OR 2.7, 95% CI 2.1-3.4). CONCLUSIONS We found strong associations between self-reported use by veterans of VHA health-related apps and multiple variables in our survey. The strongest association was observed between a veteran self-reporting app use and having received encouragement from their VHA health care team to use the apps. Veterans who reported receiving encouragement from their VHA care team members had nearly 3 times higher odds of using VHA apps than veterans who did not report receiving such encouragement. Our results add to growing evidence suggesting that endorsement of apps by a health care system or health care team can positively impact patient uptake and use.
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Affiliation(s)
| | - Bella Etingen
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, United States
| | - Jessica M Lipschitz
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Stephanie L Shimada
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States.,Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Nicholas McMahon
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
| | - Derek Bolivar
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
| | - Felicia R Bixler
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, United States
| | - Dawn Irvin
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, United States
| | - Rachel Wacks
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
| | - Sarah Cutrona
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kathleen L Frisbee
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Office of Connected Care, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, United States
| | - Bridget M Smith
- eHealth Partnered Evaluation Initiative, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.,Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, Hines, IL, United States.,Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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26
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Siniarski A, Sobieraj P, Samel-Kowalik P, Sińska B, Milewska M, Bzikowska-Jura A. Nutrition-related mobile applications - Should they be used for dietary prevention and treatment of cardiovascular diseases? Nutr Metab Cardiovasc Dis 2022; 32:2505-2514. [PMID: 36064687 DOI: 10.1016/j.numecd.2022.07.010] [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: 02/07/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND AIMS There is no prior research on the usefulness that popular nutrition-related mobile applications would have in assessing fatty acids intake. In this study, we examine these applications through their utilization in the assessment of consumption of saturated (SFAs) and polyunsaturated (PUFAs) fatty acids against the Polish reference method (RM, Dieta 6.0). This report does also include the information about monounsaturated fatty acids and cholesterol intake. METHODS AND RESULTS SFAs and PUFAs intake was assessed using two-day dietary recalls obtained from 120 individuals by 3 selected mobile applications (App1 = Yazio, App2 = MyFitnessPal, App3 = Fitatu) and compared with RM. Despite strong (SFAs by App1 and App3) and moderate (SFAs by App2 and PUFAs by App1, App2, App3) correlations with RM, Bland-Altman analyses showed relevant biases and wide range between limits of agreement. Considering SFAs and MUFAs intake, App1 had the best agreement. App1 had high sensitivity (94.6%) in recognition of subjects with SFAs intake >10% with moderate specificity (67.9%), while App2 had poor sensitivity (27.2%) and high specificity (100%). App3 showed moderate sensitivity and specificity (77.2% and 75%, respectively). CONCLUSIONS Mobile applications are not accurate tools in SFAs and PUFAs assessment when compared to the RM. Nonetheless, their ability to recognize SFAs intake >10% energy intake may suggest that further development of mobile applications could potentially become an attractive tool in clinical practice.
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Affiliation(s)
- Aleksander Siniarski
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland; John Paull II Hospital in Krakow, Poland
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Poland
| | - Piotr Samel-Kowalik
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Beata Sińska
- Department of Human Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Milewska
- Department of Clinical Dietetics, Medical University of Warsaw, Warsaw, Poland
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27
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Singer P. Post-transplant education for kidney recipients and their caregivers. Pediatr Nephrol 2022:10.1007/s00467-022-05744-6. [PMID: 36227432 DOI: 10.1007/s00467-022-05744-6] [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: 05/22/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
Successful outcomes in pediatric kidney transplantation require the involvement of the transplant team as well as recipients and their caregivers. Enhancing patient and family understanding of the disease and of post-transplant care can result in improved adherence and outcomes. Educational strategies should aim to be broad, understandable, innovative, and inclusive while maintaining a tailored approach to individualized care. Teaching should not be viewed as a one-time event but rather as an ongoing conversation throughout the duration of care, emphasizing different aspects throughout the patient's various developmental stages. The following review article discusses the content and methods of post-transplant education.
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Affiliation(s)
- Pamela Singer
- Department of Pediatrics, Cohen Children's Medical Center-Long Island Jewish Medical Center, 269-01 76th Ave, New Hyde Park, NY, 11040, USA.
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28
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Ottaviani AC, Monteiro DQ, Oliveira D, Gratão ACM, Jacinto AF, Campos CRF, Barham EJ, de Souza Orlandi F, da Cruz KCT, Corrêa L, Zazzetta MS, Pavarini SCI. Usability and acceptability of internet-based interventions for family carers of people living with dementia: systematic review. Aging Ment Health 2022; 26:1922-1932. [PMID: 34511028 DOI: 10.1080/13607863.2021.1975095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: Internet-based interventions can help carers of people living with dementia to cope with care-related challenges and can help improve their wellbeing. This systematic review aimed at investigating the criteria of usability and acceptability of self-guided internet-based interventions for family carers of people living with dementia. Method: Searches were conducted on PubMed, Virtual Health Library Regional Portal (Americas), MEDLINE, PsycINFO, Scopus, and Cochrane. Studies published up to December 2019, in English, Portuguese, or Spanish, were eligible. We followed the definition/criteria from ISO ISO-9241-11 for usability (efficiency, effectiveness, and satisfaction) and acceptability (barriers for using and utility). Methodological quality was evaluated using specific tools according to each study design. Results: Ten studies were included, all of which had high methodological quality. Carers of people living with dementia indicated that internet-based interventions were mostly effective, efficient, and satisfactory. They considered these to be informative, relevant, and functional, highlighting the utility and intention of using the resource in the future. The high heterogeneity in the terms and methods used to evaluate usability and acceptability hindered cross-study comparisons, however internet-based interventions were considered useful and acceptable by most carers. Conclusion: Future research should consider expanding the criteria of usability and acceptability to better reflect the needs of this population.
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Affiliation(s)
- Ana Carolina Ottaviani
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Diana Quirino Monteiro
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Déborah Oliveira
- Department of Psychiatry, School of Medicine, Universidade Federal de São Paulo, São Paul, Brazil
| | - Aline Cristina Martins Gratão
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | | | | | - Elizabeth Joan Barham
- Graduate Program in Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Fabiana de Souza Orlandi
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | | | - Larissa Corrêa
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Marisa Silvana Zazzetta
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | - Sofia Cristina Iost Pavarini
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
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Adherence to Antibiotic Prescription of Dental Patients: The Other Side of the Antimicrobial Resistance. Healthcare (Basel) 2022; 10:healthcare10091636. [PMID: 36141247 PMCID: PMC9498878 DOI: 10.3390/healthcare10091636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
Since non-adherence to antibiotic therapy can cause several problems, including antimicrobial resistance (AMR) and treatment failures, the present study evaluated adherence to oral antibiotic therapy and AMR awareness among consecutively enrolled dental patients. Data concerning age, gender, socioeconomic status, education level, cohabitation, and general health were retrieved from medical records. AMR awareness was investigated through direct questions and adherence to antibiotic treatment was assessed through a modified Italian version of the Morisky medical scale-8 items. Participants’ characteristics were analyzed in relation to treatment adherence and AMR, using a Χ2 independence test (significance level of α <0.1). Dental patients generally showed a low (51.82%) adherence to oral antibiotic therapy, and medium and high adherence was reported only by 29.37% and 18.81% of participants. Treatment adherence was similar in relation to participants’ gender and age but significantly lower in subjects with only secondary school graduation and higher in participants with higher education levels. Non-cohabitants were significantly more adherent than cohabitants. AMR awareness was declared by 42.15% of males and 38.70% of females: 56.52% of dental patients aware of AMR were 18−38 years old, 35.20% were 39−59 years old, and 26.95% were aged between 60 and 80. Further studies are needed to develop adequate strategies, expanding dental patients’ knowledge of AMR, thus optimizing the benefits and reducing the risks of antibiotic administration in dental patients.
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30
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Romero-Jimenez R, Escudero-Vilaplana V, Chamorro-de-Vega E, Ais-Larisgoitia A, Lobato-Matilla E, Somoza-Fernández B, Ruiz-Briones P, González C, Baniandrés O, Menchén L, Lobo-Rodríguez C, Herranz A, Sanjurjo M. Design and implementation of a mobile app for the pharmacotherapeutic follow-up of patients diagnosed with immune-mediated inflammatory diseases: eMidCare. Front Immunol 2022; 13:915578. [PMID: 35967330 PMCID: PMC9367980 DOI: 10.3389/fimmu.2022.915578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPharmacotherapeutic management of immune-mediated inflammatory diseases (IMID) has become more complex due to the development of new treatments, such as biological therapies. Mobile health, especially apps, can provide IMID patients with greater autonomy and facilitate communication with healthcare professionals. Our objective was to design and implement an app for remote monitoring and communication with IMID patients.MethodsA multidisciplinary group was created to design and develop an app for IMID patients in a tertiary hospital. The app functionalities were identified through a focus group with IMID patients and through an observational, descriptive study of available apps for IMID patients at App Store and Play Store platforms. Once the app was designed and developed, we offered the app to IMID patients who initiated a new biological therapy. The inclusion period was from December 2020 to August 2021. We performed an observational, longitudinal study to assess the app’s impact on medication safety, communication, satisfaction, and usability.ResultsWe designed an app (eMidCare®) with the following modules: My Medication, My Questionnaires, Adverse Events, Useful Information, Messages, and Patient Profile. A total of 85 patients were installed with the app. The median (range) follow-up time for app use was 123 (5-270) days. In the My Medication module, 100% of patients registered their biological therapy and 25.9% also used this module to record each dose of medication administered. A total of 82 adverse events (AEs) were registered. Thirty-two percent of the patients registered at least 1 AE. The most frequent AEs were fatigue, injection site reaction, headache, and nausea. Fifty-two percent of patients used the Messages module to communicate with healthcare professionals. The most frequent messages concerned doubts about managing AEs (26.2%) and drug interactions (18.9%). The satisfaction survey yielded a median (range) score of 9.1 (7-10) out of 10.ConclusionsWe developed an app, eMidCare®, which reminds patients to take their medication, enables them to record AEs, and helps them communicate with healthcare professionals. Approximately one-third of the patients registered the administration of the biological therapies and registered at least 1 AE. The most used and most satisfactory functionality was communication with health professionals.
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Affiliation(s)
- Rosa Romero-Jimenez
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Vicente Escudero-Vilaplana
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- *Correspondence: Vicente Escudero-Vilaplana,
| | - Esther Chamorro-de-Vega
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Arantza Ais-Larisgoitia
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Elena Lobato-Matilla
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Beatriz Somoza-Fernández
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Paula Ruiz-Briones
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carlos González
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ofelia Baniandrés
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Dermatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Luis Menchén
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Gastroenterology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Carmen Lobo-Rodríguez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Nursing Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Herranz
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - María Sanjurjo
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Can Digital Health Solutions Fill in the Gap for Effective Guideline Implementation in Cardiovascular Disease Prevention: Hope or Hype? Curr Atheroscler Rep 2022; 24:747-754. [PMID: 35761153 DOI: 10.1007/s11883-022-01050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To evaluate the use of digital health solutions in improving the implementation of cardiovascular disease (CVD) prevention guidelines and review current evidence supporting it. RECENT FINDINGS Healthy diet guideline recommendations can be improved by text-messaging programs and apps for reinforcing healthy food intake and reducing unhealthy nutrients purchase and consumption. Wearable activity trackers are also effective in increasing physical activity levels. Text-messaging programs for smoking cessation have demonstrated benefits in increasing quitting rates; however, evidence on smartphone apps for smoking cessation is still lacking. Smartphone apps have the potential to improve medication adherence; however, better quality evidence is needed. Digital pills are another promising digital solution to improve medication adherence. The use of digital health solutions in CVD prevention is an evolving field and, to date, there is an increasing body of evidence that supports that such technologies are effective in improving CVD prevention guideline implementation.
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Kessler RC, Kazdin AE, Aguilar‐Gaxiola S, Al‐Hamzawi A, Alonso J, Altwaijri YA, Andrade LH, Benjet C, Bharat C, Borges G, Bruffaerts R, Bunting B, de Almeida JMC, Cardoso G, Chiu WT, Cía A, Ciutan M, Degenhardt L, de Girolamo G, de Jonge P, de Vries Y, Florescu S, Gureje O, Haro JM, Harris MG, Hu C, Karam AN, Karam EG, Karam G, Kawakami N, Kiejna A, Kovess‐Masfety V, Lee S, Makanjuola V, McGrath J, Medina‐Mora ME, Moskalewicz J, Navarro‐Mateu F, Nierenberg AA, Nishi D, Ojagbemi A, Oladeji BD, O'Neill S, Posada‐Villa J, Puac‐Polanco V, Rapsey C, Ruscio AM, Sampson NA, Scott KM, Slade T, Stagnaro JC, Stein DJ, Tachimori H, ten Have M, Torres Y, Viana MC, Vigo DV, Williams DR, Wojtyniak B, Xavier M, Zarkov Z, Ziobrowski HN. Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys. World Psychiatry 2022; 21:272-286. [PMID: 35524618 PMCID: PMC9077614 DOI: 10.1002/wps.20971] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.
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Affiliation(s)
| | | | | | - Ali Al‐Hamzawi
- College of MedicineAl‐Qadisiya University, Diwaniya GovernorateIraq
| | - Jordi Alonso
- Health Services Research UnitIMIM‐Hospital del Mar Medical Research InstituteBarcelonaSpain
| | - Yasmin A. Altwaijri
- Epidemiology SectionKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
| | - Laura H. Andrade
- Núcleo de Epidemiologia Psiquiátrica ‐ LIM 23Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico CityMexico
| | - Chrianna Bharat
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Guilherme Borges
- Department of Epidemiologic and Psychosocial ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico CityMexico
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum ‐ Katholieke Universiteit LeuvenLeuvenBelgium
| | | | - José Miguel Caldas de Almeida
- Lisbon Institute of Global Mental Health and Chronic Diseases Research CenterNOVA University of LisbonLisbonPortugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health and Chronic Diseases Research CenterNOVA University of LisbonLisbonPortugal
| | - Wai Tat Chiu
- Department of Health Care PolicyHarvard Medical SchoolBostonMAUSA
| | - Alfredo Cía
- Anxiety Disorders Research CenterBuenos AiresArgentina
| | - Marius Ciutan
- National School of Public HealthManagement and Professional DevelopmentBucharestRomania
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | | | - Peter de Jonge
- Department of Developmental PsychologyUniversity of GroningenGroningenThe Netherlands
| | - Ymkje Anna de Vries
- Department of Developmental PsychologyUniversity of GroningenGroningenThe Netherlands
| | - Silvia Florescu
- National School of Public HealthManagement and Professional DevelopmentBucharestRomania
| | - Oye Gureje
- Department of PsychiatryUniversity College HospitalIbadanNigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAMUniversitat de BarcelonaBarcelonaSpain
| | - Meredith G. Harris
- School of Public HealthUniversity of Queensland, Herston, and Queensland Centre for Mental Health ResearchWacolQLDAustralia
| | - Chiyi Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning HospitalShenzhenChina
| | - Aimee N. Karam
- Institute for Development, ResearchAdvocacy and Applied CareBeirutLebanon
| | - Elie G. Karam
- Institute for Development, ResearchAdvocacy and Applied CareBeirutLebanon,Department of Psychiatry and Clinical PsychologySt. George Hospital University Medical CenterBeirutLebanon
| | - Georges Karam
- Institute for Development, ResearchAdvocacy and Applied CareBeirutLebanon,Department of Psychiatry and Clinical PsychologySt. George Hospital University Medical CenterBeirutLebanon
| | - Norito Kawakami
- Department of Mental Health, Graduate School of MedicineUniversity of TokyoTokyoJapan
| | - Andrzej Kiejna
- Psychology Research Unit for Public HealthWSB UniversityTorunPoland
| | - Viviane Kovess‐Masfety
- Laboratoire de Psychopathologie et Processus de Santé EA 4057Université de ParisParisFrance
| | - Sing Lee
- Department of PsychiatryChinese University of Hong KongTai PoHong Kong
| | | | - John J. McGrath
- School of Public HealthUniversity of Queensland, Herston, and Queensland Centre for Mental Health ResearchWacolQLDAustralia,National Centre for Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Maria Elena Medina‐Mora
- Department of Epidemiologic and Psychosocial ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico CityMexico
| | | | - Fernando Navarro‐Mateu
- Unidad de Docencia, Investigación y Formación en Salud MentalUniversidad de MurciaMurciaSpain
| | - Andrew A. Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Department of PsychiatryMassachusetts General HospitalBostonMAUSA
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of MedicineUniversity of TokyoTokyoJapan
| | - Akin Ojagbemi
- Department of PsychiatryUniversity College HospitalIbadanNigeria
| | | | | | - José Posada‐Villa
- Colegio Mayor de Cundinamarca UniversityFaculty of Social SciencesBogotaColombia
| | | | - Charlene Rapsey
- Department of Psychological MedicineUniversity of OtagoDunedinNew Zealand
| | | | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMAUSA
| | - Kate M. Scott
- Department of Psychological MedicineUniversity of OtagoDunedinNew Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud MentalUniversidad de Buenos AiresBuenos AiresArgentina
| | - Dan J. Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental DisordersUniversity of Cape Town and Groote Schuur HospitalCape TownSouth Africa
| | - Hisateru Tachimori
- National Institute of Mental HealthNational Center for Neurology and PsychiatryKodairaTokyoJapan
| | - Margreet ten Have
- Trimbos‐InstituutNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Yolanda Torres
- Center for Excellence on Research in Mental HealthCES UniversityMedellinColombia
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public HealthFederal University of Espírito SantoVitoriaBrazil
| | - Daniel V. Vigo
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada,Department of Global Health and Social MedicineHarvard Medical SchoolBostonMAUSA
| | - David R. Williams
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Bogdan Wojtyniak
- Centre of Monitoring and Analyses of Population HealthNational Institute of Public Health ‐ National Research InstituteWarsawPoland
| | - Miguel Xavier
- Lisbon Institute of Global Mental Health and Chronic Diseases Research CenterNOVA University of LisbonLisbonPortugal
| | - Zahari Zarkov
- Department of Mental HealthNational Center of Public Health and AnalysesSofiaBulgaria
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García-Sánchez S, Somoza-Fernández B, de Lorenzo-Pinto A, Ortega-Navarro C, Herranz-Alonso A, Sanjurjo M. Mobile Health Apps Providing Information on Drugs for Adult Emergency Care: Systematic Search on App Stores and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e29985. [PMID: 35442212 PMCID: PMC9069291 DOI: 10.2196/29985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 12/17/2022] Open
Abstract
Background
Drug-referencing apps are among the most frequently used by emergency health professionals. To date, no study has analyzed the quantity and quality of apps that provide information on emergency drugs.
Objective
This study aimed to identify apps designed to assist emergency professionals in managing drugs and to describe and analyze their characteristics.
Methods
We performed an observational, cross-sectional, descriptive study of apps that provide information on drugs for adult emergency care. The iOS and Android platforms were searched in February 2021. The apps were independently evaluated by 2 hospital clinical pharmacists. We analyzed developer affiliation, cost, updates, user ratings, and number of downloads. We also evaluated the main topic (emergency drugs or emergency medicine), the number of drugs described, the inclusion of bibliographic references, and the presence of the following drug information: commercial presentations, usual dosage, dose adjustment for renal failure, mechanism of action, therapeutic indications, contraindications, interactions with other medicinal products, use in pregnancy and breastfeeding, adverse reactions, method of preparation and administration, stability data, incompatibilities, identification of high-alert medications, positioning in treatment algorithms, information about medication reconciliation, and cost.
Results
Overall, 49 apps were identified. Of these 49 apps, 32 (65%) were found on both digital platforms; 11 (22%) were available only for Android, and 6 (12%) were available only for iOS. In total, 41% (20/49) of the apps required payment (ranging from €0.59 [US $0.64] to €179.99 [US $196.10]) and 22% (11/49) of the apps were developed by non–health care professionals. The mean weighted user rating was 4.023 of 5 (SD 0.71). Overall, 45% (22/49) of the apps focused on emergency drugs, and 55% (27/49) focused on emergency medicine. More than half (29/47, 62%) did not include bibliographic references or had not been updated for more than a year (29/49, 59%). The median number of drugs was 66 (range 4 to >5000). Contraindications (26/47, 55%) and adverse reactions (24/47, 51%) were found in only half of the apps. Less than half of the apps addressed dose adjustment for renal failure (15/47, 32%), interactions (10/47, 21%), and use during pregnancy and breastfeeding (15/47, 32%). Only 6% (3/47) identified high-alert medications, and 2% (1/47) included information about medication reconciliation. Health-related developer, main topic, and greater amount of drug information were not statistically associated with higher user ratings (P=.99, P=.09, and P=.31, respectively).
Conclusions
We provide a comprehensive review of apps with information on emergency drugs for adults. Information on authorship, drug characteristics, and bibliographic references is frequently scarce; therefore, we propose recommendations to consider when developing an app of these characteristics. Future efforts should be made to increase the regulation of drug-referencing apps and to conduct a more frequent and documented review of their clinical content.
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Affiliation(s)
- Sebastián García-Sánchez
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Beatriz Somoza-Fernández
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana de Lorenzo-Pinto
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Ortega-Navarro
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Herranz-Alonso
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Sanjurjo
- Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Khadam S, Chu T, Deekes N, FitzGerald D, Preston A, Duncan N. An investigation of the use of app technology to support clinical management of patients with chronic myeloid leukaemia (CML). J Oncol Pharm Pract 2022:10781552221090904. [DOI: 10.1177/10781552221090904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The availability of healthcare apps to support patient self-management of various medical conditions, including cancer, has increased considerably in the past decade. However, there are limited published data on the role of apps in the management of chronic myeloid leukaemia (CML). The primary aim of this study was to investigate the current and future role of apps as a means of supporting patients with CML. Methods A 31-item questionnaire was developed and distributed to patients via three on-line CML support groups. Results Responses were received from 286 patients. There was an approximate 2:1 female: male split and the majority (54%, n = 155) resided in the United Kingdom. 91% (n = 260) of respondents were currently receiving drug treatment for their CML. 23.4% (n = 67) of respondents were aware that apps were available to support their CML management and 11.5% (n = 33) had experience of using such an app. 94.1% (n = 238) of those who had not used a patient support app in the past stated that they would consider using an app in the future to help manage their disease. App awareness was significantly higher amongst male patients (30.3% vs. 19.9%). Likelihood of being a current or previous app user was higher amongst younger patients (16.3% for <55 years old vs. 5.6% for ≥55 years old) whilst younger patients and those with a more recent diagnosis of CML were both more likely to be interested in using an app in the future. When asked about potential app functionality, a drug interaction checker was the feature of greatest interest to respondents. Conclusions We have identified both a lack of awareness of and a low uptake of patient support apps amongst CML patients. Importantly, we have demonstrated a clear interest in CML-specific apps amongst this population. Based on the functionality that study participants were most interested in, we will work with health care professionals, app developers and patients to develop a new app to deliver holistic support to CML patients.
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Affiliation(s)
- Saffiya Khadam
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Teresa Chu
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | - Andrea Preston
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Nick Duncan
- School of Pharmacy, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Bendig J, Wolf AS, Mark T, Frank A, Mathiebe J, Scheibe M, Müller G, Stahr M, Schmitt J, Reichmann H, Loewenbrück KF, Falkenburger BH. Feasibility of a Multimodal Telemedical Intervention for Patients with Parkinson's Disease-A Pilot Study. J Clin Med 2022; 11:jcm11041074. [PMID: 35207351 PMCID: PMC8875136 DOI: 10.3390/jcm11041074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 01/13/2023] Open
Abstract
Symptoms of Parkinson’s disease (PD) can be controlled well, but treatment often requires expert judgment. Telemedicine and sensor-based assessments can allow physicians to better observe the evolvement of symptoms over time, in particular with motor fluctuations. In addition, they potentially allow less frequent visits to the expert’s office and facilitate care in rural areas. A variety of systems with different strengths and shortcomings has been investigated in recent years. We designed a multimodal telehealth intervention (TelePark) to mitigate the shortcomings of individual systems and assessed the feasibility of our approach in 12 patients with PD over 12 weeks in preparation for a larger randomized controlled trial. TelePark uses video visits, a smartphone app, a camera system, and wearable sensors. Structured training included setting up the equipment in patients’ homes and group-based online training. Usability was assessed by questionnaires and semi-standardized telephone interviews. Overall, 11 out of 12 patients completed the trial (5 female, 6 male). Mean age was 65 years, mean disease duration 7 years, mean MoCA score 27. Adherence was stable throughout the study and 79% for a short questionnaire administered every second day, 62% for medication confirmation, and 33% for an electronic Hauser diary. Quality of life did not change in the course of the study, and a larger cohort will be required to determine the effect on motor symptoms. Interviews with trial participants identified motivations to use such systems and areas for improvements. These insights can be helpful in designing similar trials.
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Affiliation(s)
- Jonas Bendig
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
| | - Anna-Sophie Wolf
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
| | - Tony Mark
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
| | - Anika Frank
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
- German Center for Neurodegenerative Diseases (DZNE), 01307 Dresden, Germany
| | - Josephine Mathiebe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.M.); (M.S.); (G.M.); (J.S.)
| | - Madlen Scheibe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.M.); (M.S.); (G.M.); (J.S.)
| | - Gabriele Müller
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.M.); (M.S.); (G.M.); (J.S.)
| | - Marcus Stahr
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
- Department of Psychiatry, Sächsisches Krankenhaus Arnsdorf, 01477 Arnsdorf, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.M.); (M.S.); (G.M.); (J.S.)
| | - Heinz Reichmann
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
| | - Kai F. Loewenbrück
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
| | - Björn H. Falkenburger
- Department of Neurology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (J.B.); (A.-S.W.); (T.M.); (A.F.); (M.S.); (H.R.); (K.F.L.)
- German Center for Neurodegenerative Diseases (DZNE), 01307 Dresden, Germany
- Correspondence:
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Lewkowicz D, Wohlbrandt AM, Bottinger E. Digital Therapeutic Care Apps With Decision-Support Interventions for People With Low Back Pain in Germany: Cost-Effectiveness Analysis. JMIR Mhealth Uhealth 2022; 10:e35042. [PMID: 35129454 PMCID: PMC8861873 DOI: 10.2196/35042] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Digital therapeutic care apps provide a new effective and scalable approach for people with nonspecific low back pain (LBP). Digital therapeutic care apps are also driven by personalized decision-support interventions that support the user in self-managing LBP, and may induce prolonged behavior change to reduce the frequency and intensity of pain episodes. However, these therapeutic apps are associated with high attrition rates, and the initial prescription cost is higher than that of face-to-face physiotherapy. In Germany, digital therapeutic care apps are now being reimbursed by statutory health insurance; however, price targets and cost-driving factors for the formation of the reimbursement rate remain unexplored. OBJECTIVE The aim of this study was to evaluate the cost-effectiveness of a digital therapeutic care app compared to treatment as usual (TAU) in Germany. We further aimed to explore under which circumstances the reimbursement rate could be modified to consider value-based pricing. METHODS We developed a state-transition Markov model based on a best-practice analysis of prior LBP-related decision-analytic models, and evaluated the cost utility of a digital therapeutic care app compared to TAU in Germany. Based on a 3-year time horizon, we simulated the incremental cost and quality-adjusted life years (QALYs) for people with nonacute LBP from the societal perspective. In the deterministic sensitivity and scenario analyses, we focused on diverging attrition rates and app cost to assess our model's robustness and conditions for changing the reimbursement rate. All costs are reported in Euro (€1=US $1.12). RESULTS Our base case results indicated that the digital therapeutic care strategy led to an incremental cost of €121.59, but also generated 0.0221 additional QALYs compared to the TAU strategy, with an estimated incremental cost-effectiveness ratio (ICER) of €5486 per QALY. The sensitivity analysis revealed that the reimbursement rate and the capability of digital therapeutic care to prevent reoccurring LBP episodes have a significant impact on the ICER. At the same time, the other parameters remained unaffected and thus supported the robustness of our model. In the scenario analysis, the different model time horizons and attrition rates strongly influenced the economic outcome. Reducing the cost of the app to €99 per 3 months or decreasing the app's attrition rate resulted in digital therapeutic care being significantly less costly with more generated QALYs, and is thus considered to be the dominant strategy over TAU. CONCLUSIONS The current reimbursement rate for a digital therapeutic care app in the statutory health insurance can be considered a cost-effective measure compared to TAU. The app's attrition rate and effect on the patient's prolonged behavior change essentially influence the settlement of an appropriate reimbursement rate. Future value-based pricing targets should focus on additional outcome parameters besides pain intensity and functional disability by including attrition rates and the app's long-term effect on quality of life.
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Affiliation(s)
- Daniel Lewkowicz
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Attila M Wohlbrandt
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Erwin Bottinger
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
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Chapman-Goetz J, Packham N, Gabb G, Potts C, Yu K, Prosser A, Hotham E, Suppiah V. Acceptability and feasibility of the NPS MedicineWise mobile phone application in supporting medication adherence in patients with chronic heart failure: Protocol for a pilot study. PLoS One 2022; 17:e0263284. [PMID: 35120174 PMCID: PMC8815969 DOI: 10.1371/journal.pone.0263284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Heart failure (HF) is an increasing global concern. Despite evidence-based pharmacotherapy, morbidity and mortality remain high in HF. Medication non-adherence is a crucial factor in optimising clinical outcomes. A growing number of smartphone applications (apps) assist management. While evidence support their use to promote treatment adherence, apps alone may not be the solution. The objective of this pilot study is to assess the acceptability and feasibility of a tiered intervention added to the NPS MedicineWise dose reminder app (MedicineWise app) in supporting medication adherence in HF. METHODS AND ANALYSIS This prospective, single-blinded, randomised controlled trial will recruit 55 Australian patients with HF to be randomly assigned to either intervention (MedicineWise app + usual care) or control (usual care alone) arm. Control participants will remain unaware of the intervention throughout the study. At baseline, intervention participants will be instructed in the MedicineWise app. A reminder will then prompt medication administration at each dosing interval. If non-adherence is suggested from 24 hourly reports (critical medications) or 72 hours (non-critical medications), the individual/s will be escalated through a tiered, pharmacist-led intervention. The primary outcome will be the acceptability and feasibility of this approach in supporting adherence. Between-group comparison of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) at baseline, 3 and 6 months will be used to measure the app's value in supporting adherence. Secondary outcome measures include self-reported medication adherence and knowledge, health-related quality of life, psychological wellbeing, signs and symptoms of HF, and medication and HF knowledge. ETHICS AND DISSEMINATION The protocol received ethics approval from Central Adelaide Clinical Human Research Ethics Committee (Protocol number R20190302) and University of South Australia Human Research Ethics Committee (Protocol number 202450). Findings will be disseminated through peer-reviewed journals. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry Clinical trial number: ACTRN12619000289112p (http://www.ANZCTR.org.au/ACTRN12619000289112p.aspx).
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Affiliation(s)
| | - Nerida Packham
- Consumer Medicines Information Services, NPS Medicine Wise, Sydney, Australia
| | - Genevieve Gabb
- Department of Cardiology, Noarlunga GP Plus Super Clinic, Adelaide, Australia
| | | | - Kitty Yu
- e-Health, NPS Medicine Wise, Melbourne, Australia
| | - Adaire Prosser
- SA Pharmacy, Flinders Medical Centre, Adelaide, Australia
| | - Elizabeth Hotham
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Vijayaprakash Suppiah
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia
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Scherrenberg M, Marinus N, Giallauria F, Falter M, Kemps H, Wilhelm M, Prescott E, Vigorito C, De Kluiver E, Cipriano G, Dendale P, Hansen D. The need for long-term personalized management of frail CVD patients by rehabilitation and telemonitoring: a framework. Trends Cardiovasc Med 2022:S1050-1738(22)00023-8. [PMID: 35121082 DOI: 10.1016/j.tcm.2022.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
Abstract
Due to advances in cardiovascular medicine and preventive cardiology, patients benefit from a better prognosis, even in case of significant disease burden such as acute and chronic coronary syndromes, advanced valvular heart disease and chronic heart failure. These advances have allowed CVD patients to increase their life expectancy, but on the other hand also experience aging-related syndromes such as frailty. Despite being underrecognized, frailty is a critical, common, and co-existent condition among older CVD patients, leading to exercise intolerance and compromised adherence to cardiovascular rehabilitation. Moreover, frail patients need a different approach for CR and are at very high risk for adverse events, but yet are underrepresented in conventional CR. Fortunately, recent advances have been made in technology, allowing remote monitoring, coaching and supervision of CVD patients in secondary prevention programs with promising benefits. Similarly, we hypothesized that such programs should also be implemented to treat frailty in CVD patients. However, considering frail patients' particular needs and challenges, telerehabilitation interventions should thus be appropriately adapted. Our purpose is to provide, for the first time and based on expert opinions, a framework of how such a cardiac telerehabilitation program could be developed and implemented to manage a prevention and rehabilitation program for CVD patients with frailty.
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Affiliation(s)
- Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium; Faculty of Medicine and Health Sciences, Antwerp University, Belgium
| | - Nastasia Marinus
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL, Hasselt, Belgium
| | | | - Maarten Falter
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium; Faculty of Medicine, Department of Cardiology, KULeuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hareld Kemps
- Department of Cardiology, Máxima Medical Center, The Netherlands; Department of Industrial Design, Technical University Eindhoven, The Netherlands
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, NW, Denmark
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University of Naples
| | | | | | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL, Hasselt, Belgium.
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Astasio-Picado Á, Cobos-Moreno P, Gómez-Martín B, Verdú-Garcés L, Zabala-Baños MDC. Efficacy of Interventions Based on the Use of Information and Communication Technologies for the Promotion of Active Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031534. [PMID: 35162555 PMCID: PMC8834991 DOI: 10.3390/ijerph19031534] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 12/03/2022]
Abstract
Nowadays, the study of how new media and technologies can be used to carry out health education by bringing these tools closer to the elderly population is interesting. It is a way of offering them access not only to greater knowledge, but to greater communication and relationship with their surroundings, a range of new possibilities and resources at their disposal that also represent a way to reduce the generation gap and bring them closer to the rest of the community. Objectives: to evaluate and analyze the studies that show the efficacy of interventions based on the use of information and communication technologies for the promotion of active aging in people older than or equal to 65 years who live in the community. Data sources, study eligibility criteria: the search for the articles was carried out from January 2012 to March 2021, in 6 databases (Pubmed, Cochrane Library, Scopus, Scielo, Google Academic and WOS) based on the clinical question, using the keywords derived from the DeCS and MeSH thesauri, combined with the Boolean operators “AND”, “NOT” and “OR”. The search was limited to publications from the last 9 years, in English and Spanish. Results: after applying the selection criteria and evaluating the quality of the methodology, 7.91% (n = 17) of the 215 results were included with filters: 7 systematic review, 5 of Cohorts and 5 of Randomized Controlled Trial. Conclusions and implications of key findings: the use of communication technologies reduces the feeling of loneliness, as well as the use of virtual reality to exercise, train memory or perform rehabilitation. The most difficult barrier to overcome is the prior ignorance of the majority of the elderly to the technology that is overcome by working as a team throughout the community, especially in the health and educational sector, as well as the family or social nucleus.
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Affiliation(s)
- Álvaro Astasio-Picado
- Nursing and Physiotherapy Department, Faculty of Health Sciences, University of Castilla-La Mancha, Real Fábrica de Sedas, s/n., 45600 Toledo, Spain; (L.V.-G.); (M.d.C.Z.-B.)
- Correspondence:
| | - Paula Cobos-Moreno
- Nursing Department, University of Extremadura, 10600 Cáceres, Spain; (P.C.-M.); (B.G.-M.)
| | - Beatriz Gómez-Martín
- Nursing Department, University of Extremadura, 10600 Cáceres, Spain; (P.C.-M.); (B.G.-M.)
| | - Lorena Verdú-Garcés
- Nursing and Physiotherapy Department, Faculty of Health Sciences, University of Castilla-La Mancha, Real Fábrica de Sedas, s/n., 45600 Toledo, Spain; (L.V.-G.); (M.d.C.Z.-B.)
| | - María del Carmen Zabala-Baños
- Nursing and Physiotherapy Department, Faculty of Health Sciences, University of Castilla-La Mancha, Real Fábrica de Sedas, s/n., 45600 Toledo, Spain; (L.V.-G.); (M.d.C.Z.-B.)
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Martin-Payo R, Carrasco-Santos S, Cuesta M, Stoyan S, Gonzalez-Mendez X, Fernandez-Alvarez MDM. Spanish adaptation and validation of the User Version of the Mobile Application Rating Scale (uMARS). J Am Med Inform Assoc 2021; 28:2681-2686. [PMID: 34613400 PMCID: PMC8633643 DOI: 10.1093/jamia/ocab216] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/16/2021] [Accepted: 09/30/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE While the professional version of the Mobile App Rating Scale (MARS) has already been translated, and validated into the Spanish language, its user-centered counterpart has not yet been adapted. Furthermore, no other similar tools exist in the Spanish language. The aim of this paper is to adapt and validate User Version of the MARS (uMARS) into the Spanish language. MATERIALS AND METHODS Cross-cultural adaptation, translation, and metric evaluation. The internal consistency and test-retest reliability of the Spanish version of the uMARS were evaluated using the RadarCovid app. Two hundred and sixteen participants rated the app using the translated scale. The app was then rated again 2 weeks later by 21 of these participants to measure test-retest reliability. RESULTS No major differences were observed between the uMARS original and the Spanish version. Discrimination indices (item-scale correlation) obtained appropriate results for both raters. The Spanish uMARS presented with excellent internal consistency, α = .89 and .67 for objective and subjective quality, respectively, and temporal stability (r > 0.82 for all items and subscales). DISCUSSION The Spanish uMARS is a useful tool for health professionals to recommend high-quality mobile apps to their patients based on the user's perspective and for researchers and app developers to use end-user feedback and evaluation, to help them identify highly appraised and valued components, as well as areas for further development, to continue ensuring the increasing quality and prominence of the area of mHealth. CONCLUSION uMARS Spanish version is an instrument with adequate metric properties to assess the quality of health apps from the user perspective.
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Affiliation(s)
- Ruben Martin-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Sergio Carrasco-Santos
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain.,Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | | | - Stoyan Stoyan
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,Division of Advocacy and Research, Yourtown, Brisbane, Australia
| | - Xana Gonzalez-Mendez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain.,Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | - María Del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.,PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
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Bonn MM, Alvarez L, Graham L, Thompson JW, Dickey JP. Biofeedback as an intervention for persistent post-concussive symptoms: A randomized feasibility trial. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211046459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible. Purpose To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms. Methods Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention. Results Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups. Conclusions Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&draw=2&rank=1 ).
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Affiliation(s)
- Marquise M Bonn
- Health and Rehabilitation Sciences, Western University, Canada
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A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910316. [PMID: 34639618 PMCID: PMC8507754 DOI: 10.3390/ijerph181910316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in myopic children. Willingness for commitment from both parents and children contributes to the success of OK treatment. We aimed to develop and assess the usability of a mobile application on OK lens wear by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). Moreover, the preliminary outcome was also evaluated in this study. The app was developed and tested using a co-design approach involving key stakeholders. Two prototype tests were conducted during the feasibility and utility assessment. The app features include self-reported compliance documentation, analytics, and personalized and generalized messages for compliance behaviors of OK lenses. After the trial period, the full usage of app functions ranged from 40% to 60% among the enrolled parents. After app implementation, the compliance with follow-up visits substantially improved. Qualitative data show that the high-satisfaction app functions reported by parents were the app’s reminder and axial length recording, although it was recommended that the number of compliance questions should be reduced to minimize the survey completion time. Additionally, who should complete the recording of the axial length data as well as the management and reminder for the follow-up visit remained controversial. This is the first app developed to improve parents of myopic children’s compliance with OK lens wear and to assist ECPs and parents in collaboratively monitoring and managing the use and care of OK lenses among myopic children. This study highlights the importance of interdisciplinary collaboration in the design, development, and validation of such an app.
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Shade M, Rector K, Kupzyk K. Voice Assistant Reminders and the Latency of Scheduled Medication Use in Older Adults With Pain: Descriptive Feasibility Study. JMIR Form Res 2021; 5:e26361. [PMID: 34581677 PMCID: PMC8512193 DOI: 10.2196/26361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/01/2021] [Accepted: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background Pain is difficult to manage in older adults. It has been recommended that pain management in older adults should include both nonpharmacologic and pharmacologic strategies. Unfortunately, nonadherence to pain medication is more prevalent than nonadherence to any other chronic disease treatment. Technology-based reminders have some benefit for medication adherence, but adherence behavior outcomes have mostly been verified by self-reports. Objective We aimed to describe objective medication adherence and the latency of medication use after a voice assistant reminder prompted participants to take pain medications for chronic pain. Methods A total of 15 older adults created a voice assistant reminder for taking scheduled pain medications. A subsample of 5 participants were randomly selected to participate in a feasibility study, in which a medication event monitoring system for pain medications was used to validate medication adherence as a health outcome. Data on the subsample’s self-assessed pain intensity, pain interference, concerns and necessity beliefs about pain medications, self-confidence in managing pain, and medication implementation adherence were analyzed. Results In the 5 participants who used the medication event monitoring system, the overall latency between voice assistant reminder deployment and the medication event (ie, medication bottle cap opening) was 55 minutes. The absolute latency (before or after the reminder) varied among the participants. The shortest average time taken to open the cap after the reminder was 17 minutes, and the longest was 4.5 hours. Of the 168 voice assistant reminders for scheduled pain medications, 25 (14.6%) resulted in the opening of MEMS caps within 5 minutes of the reminder, and 107 (63.7%) resulted in the opening of MEMS caps within 30 minutes of the reminder. Conclusions Voice assistant reminders may help cue patients to take scheduled medications, but the timing of medication use may vary. The timing of medication use may influence treatment effectiveness. Tracking the absolute latency time of medication use may be a helpful method for assessing medication adherence. Medication event monitoring may provide additional insight into medication implementation adherence during the implementation of mobile health interventions.
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Affiliation(s)
- Marcia Shade
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, United States
| | - Kyle Rector
- Department of Computer Science, University of Iowa, Iowa City, IA, United States
| | - Kevin Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, United States
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Bascuñana-Ambrós H, Nadal-Castells MJ, Ramírez-Mirabal E, Beranuy-Rodriguez M, Pintor-Ojeda A, Perrot-González JC. Emerging Concepts and Evidence in Telematics Novel Approaches or Treatments for Spasticity Management After Botulinum Injection. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:720505. [PMID: 36188770 PMCID: PMC9397790 DOI: 10.3389/fresc.2021.720505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022]
Abstract
There is a strong recommendation for the use of intramuscular botulinum toxin in patients with persistent or progressive spasticity affecting one or more joints and who have an identifiable therapeutic target. After a botulinum toxin injection, a stretching intervention improves the results of the treatment, and it should be performed by patients and/or caregivers after being trained by a therapist. Adherence to this recommendation remains low once the therapist stops following the patient. The COVID-19 pandemic has increased the use of telemedicine with different approaches to treat patients. There has been an increased use of motivational applications, with virtual reality software and real-life videos, which provide a gaming experience that increases adherence. There are programs with synchronous telehealth exercises guided by physical therapists or software with sensor-based technology that shows the range of motion (ROM) and strength of the muscles of a particular joint. These new approaches to patient follow-up appear to increase adherence to exercise because they need to be “watched and controlled” is achieved.
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Islam SMS, Mishra V, Siddiqui MU, Moses JC, Adibi S, Nguyen L, Wickramasinghe N. Smartphone Apps for Diabetes Medication Adherence: A Systematic Review (Preprint). JMIR Diabetes 2021; 7:e33264. [PMID: 35727613 PMCID: PMC9257622 DOI: 10.2196/33264] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/24/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
| | - Vinaytosh Mishra
- College of Healthcare Management and Economics, Gulf Medical University, Ajman, United Arab Emirates
| | - Muhammad Umer Siddiqui
- Department of Internal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | | | - Sasan Adibi
- School of Information Technology, Deakin University, Burwood, Australia
| | - Lemai Nguyen
- School of Information Technology, Deakin University, Burwood, Australia
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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Personalized and Self-Management: Systematic Search and Evaluation Quality Factors and User Preference of Drug Reference Apps in Taiwan. J Pers Med 2021; 11:jpm11080790. [PMID: 34442435 PMCID: PMC8400514 DOI: 10.3390/jpm11080790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Drug reference apps promote self-management and improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. This study aimed to describe a systematic and stepwise process to identify drug reference apps in Taiwan, assess the quality of these apps, and analyze the influential factors for user ratings. Methods: A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. Results: A total of 23 drug reference apps in Taiwan were identified and analyzed. Generally, these drug reference apps were evaluated as acceptable quality with an average MARS score of 3.23. Higher user engagement, more functionality, better aesthetics, and more information associated with higher user ratings. Navigation is the most influential factor on higher user ratings (AME: 13.15%) followed by performance (AME: 11.03%), visual appeal (AME: 10.87%), credibility (AME: 10.67%), and quantity of information (AME: 10.42%). Conclusions: User experience and information clearly affect user ratings of drug reference apps. Five key factors should be considered when designing drug reference apps.
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Delamarche E, Temiz Y, Lovchik RD, Christiansen MG, Schuerle S. Capillary Microfluidics for Monitoring Medication Adherence. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Yuksel Temiz
- IBM Research Europe Saeumerstrasse 4 Rueschlikon Switzerland
| | | | - Michael G. Christiansen
- Institute for Translational Medicine Department of Health Sciences and Technology ETH Zurich Vladimir-Prelog-Weg 1–5/10 8092 Zurich Switzerland
| | - Simone Schuerle
- Institute for Translational Medicine Department of Health Sciences and Technology ETH Zurich Vladimir-Prelog-Weg 1–5/10 8092 Zurich Switzerland
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Abstract
BACKGROUND Many patients are discharged with aspirin (ASA) as an anticoagulant after joint replacement surgery. In studies in which ASA was prescribed, doses were frequently missed. Adherence to postoperative ASA regimen is critical to preventing thrombotic complications. This randomized controlled study evaluated the impact of an existing medication adherence smartphone application (app) on adherence to twice daily ASA 81 mg for 35 days after knee or hip arthroplasty. METHODOLOGY Patients were randomized to either the app (intervention) group or the usual care (control) group. All patients received a baseline interview with a survey and demographics collected prior to randomization, a 36-day follow-up call for phone pill count, and a 6-week in-office interview with surveys and an in-person pill count. A convenience sample of 195 patients enrolled; 122 completed pill counts at both baseline and end of study. Ages ranged from 29 to 89 (mean: 60.4, SD: 10.1) years. The majority had a bachelor's degree or higher (59.3%), made more than $75,000 (or were retired; 51.9%), were of White race (75.9%), and female (53.8%). There were no significant demographic differences between the groups. RESULTS There were no significant group differences in final pill counts, adherence (reasons for missed pills), or ASA Medication self-efficacy scores. However, the intervention group scored significantly higher on the ASA Adherence measure (general ease in and ability to take ASA; p = .020). Higher ASA Adherence scores were associated with lower pill counts at the end of study (better adherence) in the intervention group. There was a high rate of attrition related to failure to bring the ASA to hospital or to the follow-up appointment. CONCLUSIONS Although there were no significant differences in final pill counts between groups, the app group reported more ease in taking pills. With smartphone use virtually ubiquitous, this project provided an opportunity to educate patients and nurses about how technology can support medication adherence. It was also an excellent opportunity to involve clinical nurses in a funded research project.
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Mira JJ. How to reduce medication errors in patients over the age of 65? Expert Opin Pharmacother 2021; 22:2417-2421. [PMID: 34187264 DOI: 10.1080/14656566.2021.1947241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- José Joaquín Mira
- Health Psychology Department, Universidad Miguel Hernandez de Elche, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain
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Sustaining Personal Activism: Behavior Analysts as Antiracist Accomplices. Behav Anal Pract 2021; 15:1066-1073. [PMID: 34093982 PMCID: PMC8171226 DOI: 10.1007/s40617-021-00580-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2021] [Indexed: 12/15/2022] Open
Abstract
One pervasive social issue that has received little attention within the behavior-analytic community is racism and the systemic oppression of Black, Indigenous, and non-Black people of color. The present article offers guidance and examples of how each of us as behavior analysts might build individualized self-management behavior change plans that support initiating and sustaining socially significant antiracism work as we move from allies to accomplices within our own sphere of influence. This article introduces the concept of self-managed antiracism behavior change plans that (a) operationally define antiracist action using measurable outcomes and strategies for data collection on specific antiracist and support actions, (b) provide choices to improve engagement and reduce barriers to adherence, and (c) use effective behavioral interventions to alter the availability of discriminative stimuli or reduce their influence, and increase the availability of reinforcers that are compatible with the goal of the behavior change plan for increasing antiracism behavior and dismantling structures perpetuating racial inequities.
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