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Goh KW, Ming LC, Al-Worafi YM, Tan CS, Hermansyah A, Rehman IU, Ali Z. Effectiveness of digital tools for smoking cessation in Asian countries: a systematic review. Ann Med 2024; 56:2271942. [PMID: 38346353 PMCID: PMC11249140 DOI: 10.1080/07853890.2023.2271942] [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: 08/16/2023] [Accepted: 10/12/2023] [Indexed: 02/15/2024] Open
Abstract
AIM The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries. METHODS Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries. RESULTS A total of 25 studies of varying designs were eligible for this study collectively involving a total of n = 22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study. CONCLUSION Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions.
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Affiliation(s)
- Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia
| | - Long Chiau Ming
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
- School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
| | - Yaser Mohammed Al-Worafi
- College of Medical Sciences, Azal University for Human Development, Sana’a, Yemen
- College of Pharmacy, University of Science and Technology of Fujairah, Fujairah, UAE
| | - Ching Siang Tan
- School of Pharmacy, KPJ Healthcare University, Nilai, Malaysia
| | - Andi Hermansyah
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Inayat Ur Rehman
- Department of Pharmacy, Garden Campus, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Zahid Ali
- Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
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Yung HT, Wong MK, Lai SK, Liang J. Perspective of smokers and healthcare professionals toward real-time video counseling smoking cessation program in general out-patient clinics in Hong Kong: a qualitative study. Fam Pract 2024; 41:525-533. [PMID: 36318506 DOI: 10.1093/fampra/cmac118] [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] [Indexed: 03/21/2023] Open
Abstract
OBJECTIVE This study aimed to explore the perceptions and experiences of individuals that currently smoke and healthcare professionals on using real-time video counseling in the Smoking Cessation and Counselling Program in General Out-patient Clinics in Hong Kong. DESIGN This was a qualitative study using face-to-face semi-structured interviews based on the extended technology acceptance model. All interviews were audiotaped and transcribed verbatim. Two investigators coded the transcripts independently. Thematic analysis was adopted. PARTICIPANTS Individuals that currently smoke and healthcare professionals who had experience using real-time video counseling in the Smoking Cessation and Counselling Program in General Out-patient Clinics in Hong Kong were recruited. Purposive sampling was adopted. 18 participants were interviewed to reach data saturation. MAIN OUTCOME MEASURES Themes that emerged from thematic analysis of data were the main outcome measures. The emerged themes were refined and verified via inductive and then deductive processes until data saturation was reached. RESULTS Two core themes, which were in coherence with the extended technology acceptance model, namely (i) perceived ease of use and (ii) perceived usefulness, were identified. Under perceived ease of use, we identified 2 subthemes: (i) convenience and (ii) measures to facilitate the use of real-time video counseling. Three subthemes were identified under perceived usefulness: (i) empathy and rapport, (ii) measures for pandemics, and (iii) service outcome. CONCLUSION Our study provided a culture-specific perspective of users towards real-time video counseling. It identified users' opinions on the easiness and usefulness of the service. Those could provide clues for future improvement and development of using real-time video counseling in healthcare services.
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Affiliation(s)
- Hiu Ting Yung
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, Hong Kong, Hong Kong Special Administrative Region, The People's Republic of China
| | - Man Kin Wong
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, Hong Kong, Hong Kong Special Administrative Region, The People's Republic of China
| | - Shiu Kee Lai
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, Hong Kong, Hong Kong Special Administrative Region, The People's Republic of China
| | - Jun Liang
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, Hong Kong, Hong Kong Special Administrative Region, The People's Republic of China
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Spring B, Garcia SF, Daly E, Jacobs M, Jayeoba M, Jordan N, Kircher S, Kocherginsky M, Mazzetta R, Pollack T, Scanlan L, Scherr C, Hitsman B, Phillips SM. Scalable Telehealth Cancer Care: integrated healthy lifestyle program to live well after cancer treatment. J Natl Cancer Inst Monogr 2024; 2024:83-91. [PMID: 38924795 PMCID: PMC11207740 DOI: 10.1093/jncimonographs/lgae020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/13/2024] [Accepted: 04/16/2024] [Indexed: 06/28/2024] Open
Abstract
Northwestern University's Center for Scalable Telehealth Cancer Care (STELLAR) is 1 of 4 Cancer Moonshot Telehealth Research Centers of Excellence programs funded by the National Cancer Institute to establish an evidence base for telehealth in cancer care. STELLAR is grounded in the Institute of Medicine's vision that quality cancer care includes not only disease treatment but also promotion of long-term health and quality of life (QOL). Cigarette smoking, insufficient physical activity, and overweight and obesity often co-occur and are associated with poorer treatment response, heightened recurrence risk, decreased longevity, diminished QOL, and increased treatment cost for many cancers. These risk behaviors are prevalent in cancer survivors, but their treatment is not routinely integrated into oncology care. STELLAR aims to foster patients' long-term health and QOL by designing, implementing, and sustaining a novel telehealth treatment program for multiple risk behaviors to be integrated into standard cancer care. Telehealth delivery is evidence-based for health behavior change treatment and is well suited to overcome access and workflow barriers that can otherwise impede treatment receipt. This paper describes STELLAR's 2-arm randomized parallel group pragmatic clinical trial comparing telehealth-delivered, coach-facilitated multiple risk behavior treatment vs self-guided usual care for the outcomes of reach, effectiveness, and cost among 3000 cancer survivors who have completed curative intent treatment. This paper also discusses several challenges encountered by the STELLAR investigative team and the adaptations developed to move the research forward.
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Affiliation(s)
- Bonnie Spring
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Sofia F Garcia
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Elyse Daly
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Maia Jacobs
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
- Department of Computer Science, Northwestern University, Evanston, IL 60208, USA
| | - Monisola Jayeoba
- Department of Communication Studies, Northwestern University, Evanston, IL 60208, USA
| | - Neil Jordan
- Department of Psychiatry & Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Sheetal Kircher
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL 60611, USA
- Hematology Oncology, Northwestern Medicine, Chicago, IL 60611, USA
| | - Masha Kocherginsky
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
| | - Rana Mazzetta
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Teresa Pollack
- Quality Division, Northwestern Medicine, Chicago, IL 60611, USA
| | - Laura Scanlan
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Courtney Scherr
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
- Department of Communication Studies, Northwestern University, Evanston, IL 60208, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
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Tabassum Z, Rahman S, Iqbal MT, Amir S, Siddiqui A. An Insight on the Rising Trends in Telemedicine and Health. Ann Biomed Eng 2024; 52:1549-1550. [PMID: 37594568 DOI: 10.1007/s10439-023-03347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Zobia Tabassum
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
| | - Sara Rahman
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | | | - Sidra Amir
- Department of Medicine, DOW University of Health Sciences, Karachi, Pakistan
| | - Amna Siddiqui
- Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan
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Metin M, Kaya Ş, Sözmen K, Altınışık G. Smoking Cessation Support via Video Counseling (e-Cessation): A Promising Field for Telemedicine Implementation. THORACIC RESEARCH AND PRACTICE 2024; 25:121-129. [PMID: 39128028 PMCID: PMC11181302 DOI: 10.5152/thoracrespract.2024.23056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/23/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE The study aimed to investigate the utility of telemedicine conducted via video counseling in comparison to the previous structured approach and to compare prepandemic smoking cessation success rates with traditional counseling. MATERIAL AND METHODS The applicants of the outpatient clinic for smoking cessation support pre- and post-pandemic periods were included in the study. The time intervals were retrospectively between 1 March and 30 August 2021 and the last 3 months of the year 2019. The data were revealed retrospectively. Age, sex, occupation, smoking history as package year, and the score of the Fagerström test for nicotine dependence, accompanying chronic diseases, treatment method, and quitting status between 6 and 9 months of follow-up. RESULTS The number of applicants was 200 (87% male) and 89 (95% male) in groups 1 and 2, respectively. The age difference was not significant. The difference was statistically significant according to having at least 1 accompanying chronic disease, specifically a lung disease. None of the parameters have affected the success of quitting smoking. The smoking cessation rate was 3.9 fold higher in the telemedicine group than in the traditional group. CONCLUSION The main principle appears to be allocating enough time, as required on an individual basis, to clearly assess the situation, including identifying barriers and options. Since immediate systematic physical examination and laboratory testing may not be mandatory for individuals seeking smoking cessation support, telemedicine emerges as a reasonable option and a promising field for comprehensive video counseling.
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Affiliation(s)
- Melis Metin
- Department of Chest Diseases, Buldan Chest Diseases Hospital, Denizli, Türkiye
| | - Şerife Kaya
- Department of Chest Diseases, Tatvan Government Hospital, Bitlis, Türkiye
| | - Kaan Sözmen
- Department of Public Health, Katip Çelebi University, İzmir, Türkiye
| | - Göksel Altınışık
- Department of Chest Diseases, Pamukkale University Faculty of Medicine, Denizli, Türkiye
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Lin MJ, Chen CK. Breaking Sound Barriers: Exploring Tele-Audiology's Impact on Hearing Healthcare. Diagnostics (Basel) 2024; 14:856. [PMID: 38667501 PMCID: PMC11049182 DOI: 10.3390/diagnostics14080856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.
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Affiliation(s)
- Mien-Jen Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
| | - Chin-Kuo Chen
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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Siemer L, Pieterse ME, Ben Allouch S, Postel MG, Brusse-Keizer MGJ. Comparing the Effectiveness of the Blended Delivery Mode With the Face-to-Face Delivery Mode of Smoking Cessation Treatment: Noninferiority Randomized Controlled Trial. J Med Internet Res 2024; 26:e47040. [PMID: 38376901 PMCID: PMC10915740 DOI: 10.2196/47040] [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: 03/06/2023] [Revised: 11/04/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Tobacco consumption is a leading cause of death and disease, killing >8 million people each year. Smoking cessation significantly reduces the risk of developing smoking-related diseases. Although combined treatment for addiction is promising, evidence of its effectiveness is still emerging. Currently, there is no published research comparing the effectiveness of blended smoking cessation treatments (BSCTs) with face-to-face (F2F) treatments, where web-based components replace 50% of the F2F components in blended treatment. OBJECTIVE The primary objective of this 2-arm noninferiority randomized controlled trial was to determine whether a BSCT is noninferior to an F2F treatment with identical ingredients in achieving abstinence rates. METHODS This study included 344 individuals who smoke (at least 1 cigarette per day) attending an outpatient smoking cessation clinic in the Netherlands. The participants received either a blended 50% F2F and 50% web-based BSCT or only F2F treatment with similar content and intensity. The primary outcome measure was cotinine-validated abstinence rates from all smoking products at 3 and 15 months after treatment initiation. Additional measures included carbon monoxide-validated point prevalence abstinence; self-reported point prevalence abstinence; and self-reported continuous abstinence rates at 3, 6, 9, and 15 months after treatment initiation. RESULTS None of the 13 outcomes showed statistically confirmed noninferiority of the BSCT, whereas 4 outcomes showed significantly (P<.001) inferior abstinence rates of the BSCT: cotinine-validated point prevalence abstinence rate at 3 months (difference 12.7, 95% CI 6.2-19.4), self-reported point prevalence abstinence rate at 6 months (difference 19.3, 95% CI 11.5-27.0) and at 15 months (difference 11.7, 95% CI 5.8-17.9), and self-reported continuous abstinence rate at 6 months (difference 13.8, 95% CI 6.8-20.8). The remaining 9 outcomes, including the cotinine-validated point prevalence abstinence rate at 15 months, were inconclusive. CONCLUSIONS In this high-intensity outpatient smoking cessation trial, the blended mode was predominantly less effective than the traditional F2F mode. The results contradict the widely assumed potential benefits of blended treatment and suggest that further research is needed to identify the critical factors in the design of blended interventions. TRIAL REGISTRATION Netherlands Trial Register 27150; https://onderzoekmetmensen.nl/nl/trial/27150. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-doi.org/10.1186/s12889-016-3851-x.
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Affiliation(s)
- Lutz Siemer
- School of Social Work, Saxion University of Applied Sciences, Enschede, Netherlands
- Department of Psychology, Health and Technology, Centre for eHealth & Well-being Research - Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marcel E Pieterse
- Department of Psychology, Health and Technology, Centre for eHealth & Well-being Research - Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Somaya Ben Allouch
- Digital Life Research Group, Amsterdam University of Applied Science, Amsterdam, Netherlands
- Digital Interactions Lab (DIL), Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Marloes G Postel
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marjolein G J Brusse-Keizer
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
- Health Technology & Services Research, Technical Medical (TechMed) Centre, University of Twente, Enschede, Netherlands
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8
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Sweileh WM. Technology-based interventions for tobacco smoking prevention and treatment: a 20-year bibliometric analysis (2003-2022). Subst Abuse Treat Prev Policy 2024; 19:13. [PMID: 38321493 PMCID: PMC10848402 DOI: 10.1186/s13011-024-00595-w] [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: 06/16/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Substance abuse, particularly tobacco smoking, is a significant global public health concern. Efforts have been made to reduce smoking prevalence and promote cessation, but challenges, such as nicotine addiction, marketing tactics by tobacco industry, and cultural acceptability hinder progress. Technology has emerged as a potential tool to address these challenges by providing innovative scalable interventions. The objective of the study was to analyze and map scientific literature on technology-based intervention for tobacco prevention and treatment. METHODS A bibliometric methodology was conducted. Scopus database was used to retrieve relevant research articles published between 2003 and 2022. The analysis included publication trends, key contributors, research hotspots, research themes, the most impactful articles, and emerging research topics. RESULTS A total of 639 articles were found, with a slow and fluctuating growth pattern observed after 2011. The Journal of Medical Internet Research was the most prominent journal in the field. The United States was the leading country in the field, followed up by the United Kingdom, and the Netherlands. Research hotspots included smoking cessation, randomized controlled trials, and technology-based methods such as internet, mHealth, smartphone apps, text messages, and social media. Four primary research themes were identified: development of smartphone applications, efficacy of text messaging interventions, acceptance and effectiveness of smartphone applications, and interventions targeting young adults and students using mobile phone and social media platforms. The top 10 cited articles demonstrated effectiveness of digital interventions in promoting smoking cessation rates and reducing relapse rates. Emerging research topics included the use of virtual reality interventions, interventions for specific populations through personalized tools, and technology-based interventions in non-Western countries. CONCLUSIONS The findings of the current study highlight the potential of technology to address the challenges associated with tobacco smoking. Further future research in this area is warranted to continue advancing the field and developing effective and evidence-based interventions to combat tobacco smoking.
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Affiliation(s)
- Waleed M Sweileh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Noda M, Kuroda T, Nomura A, Ito M, Yoshizaki T, Fushiki H. Smartphone-Assisted Medical Care for Vestibular Dysfunction as a Telehealth Strategy for Digital Therapy Beyond COVID-19: Scoping Review. JMIR Mhealth Uhealth 2023; 11:e48638. [PMID: 37695671 PMCID: PMC10496931 DOI: 10.2196/48638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/13/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Dizziness and vertigo can be caused by various factors, such as peripheral vestibular and central disorders. Although consultations with specialists are advisable when necessary, patients with severe vertigo symptoms may have limited mobility, which may interfere with hospital visits. The spread of COVID-19 has further limited the number of hospital visits for patients with dizziness; therefore, a method of medical care that enables more accurate treatment under time and geographical constraints is needed. Telemedicine has become widespread, owing to the popularity of smartphone and tablet devices in recent years, and the use of devices and systems has made it possible to provide efficient medical care. However, no previous scoping review has mapped existing studies on telemedicine for vertigo and dizziness, and no recommendations have been made regarding which devices and systems should be used for specific diseases. OBJECTIVE The aim of this review was to map and assess previous studies on the use of information communications technology, smartphones, and apps for treating patients with vertigo and discuss the added value of introducing telemedicine to improve the quality of medical care and create an environment that builds security and trust among patients. METHODS A scoping review was conducted with the methodological framework of Arksey and O'Malley and in accordance with the of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines. The PubMed, MEDLINE, and Cochrane Library databases were searched to retrieve previous reports on smartphone-assisted telemedicine treatment for vertigo published between January 2000 and May 2023. Two authors independently assessed eligibility and extracted data. RESULTS This review included 20 papers that reported devices or systems for telemedicine for vestibular dysfunction. Among studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms, 12 were related to objective examination, 7 were related to remote diagnosis, and 7 were related to treatment and rehabilitation. CONCLUSIONS With the advancement of technology, the use of telemedicine in patients with dizziness may be feasible. In the future, it will be necessary to consider how telemedicine can be used in dizziness treatment and develop an effective treatment system combining in-person medical care and the effective use of devices for the management of severe vertigo and related diseases. The smooth introduction of telemedicine in vertigo treatment is expected to improve the quality of treatment, increase opportunities for patients to receive medical care, and reduce time and travel costs, leading to a sense of security and trust among patients.
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Affiliation(s)
- Masao Noda
- Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan
- Mejiro University Ear Institute Clinic, Saitama, Japan
| | - Tatsuaki Kuroda
- Mejiro University Ear Institute Clinic, Saitama, Japan
- Kuroda Ear, Nose and Throat Clinic, Kumamoto, Japan
| | - Akihiro Nomura
- College of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa, Japan
| | - Makoto Ito
- Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan
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Vilardaga R, Thrul J, DeVito A, Kendzor DE, Sabo P, Khafif TC. Review of strategies to investigate low sample return rates in remote tobacco trials: A call to action for more user-centered design research. ADDICTION NEUROSCIENCE 2023; 7:100090. [PMID: 37424632 PMCID: PMC10327900 DOI: 10.1016/j.addicn.2023.100090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Remote collection of biomarkers of tobacco use in clinical trials poses significant challenges. A recent meta-analysis and scoping review of the smoking cessation literature indicated that sample return rates are low and that new methods are needed to investigate the underlying causes of these low rates. In this paper we conducted a narrative review and heuristic analysis of the different human factors approaches reported to evaluate and/or improve sample return rates among 31 smoking cessation studies recently identified in the literature. We created a heuristic metric (with scores from 0 to 4) to evaluate the level of elaboration or complexity of the user-centered design strategy reported by researchers. Our review of the literature identified five types of challenges typically encountered by researchers (in that order): usability and procedural, technical (device related), sample contamination (e.g., polytobacco), psychosocial factors (e.g., digital divide), and motivational factors. Our review of strategies indicated that 35% of the studies employed user-centered design methods with the remaining studies relying on informal methods. Among the studies that employed user-centered design methods, only 6% reached a level of 3 in our user-centered design heuristic metric. None of the studies reached the highest level of complexity (i.e., 4). This review examined these findings in the context of the larger literature, discussed the need to address the role of health equity factors more directly, and concluded with a call to action to increase the application and reporting of user-centered design strategies in biomarkers research.
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Affiliation(s)
- Roger Vilardaga
- Access to Behavioral Health for All (ABHA) Laboratory, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Human Centered Design and Engineering, University of Washington, Seattle, Washington, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Anthony DeVito
- Access to Behavioral Health for All (ABHA) Laboratory, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Darla E. Kendzor
- The TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Patricia Sabo
- Access to Behavioral Health for All (ABHA) Laboratory, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Tatiana Cohab Khafif
- Access to Behavioral Health for All (ABHA) Laboratory, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Campbell K, Greenfield G, Li E, O'Brien N, Hayhoe B, Beaney T, Majeed A, Neves AL. The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review. J Med Internet Res 2023; 25:e48920. [PMID: 37647117 PMCID: PMC10500356 DOI: 10.2196/48920] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The adoption of virtual consultations, catalyzed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. OBJECTIVE This study aims to evaluate the impact of virtual consultations on the quality of primary care. METHODS A total of 6 databases were searched. Studies that evaluated the impact of virtual consultations, for any disease, were included. Title and abstract screening and full-text screening were performed by 2 pairs of investigators. Risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis of the results was performed. RESULTS In total, 30 studies (5,469,333 participants) were included in this review. Our findings suggest that virtual consultations are equally effective to or more effective than face-to-face care for the management of certain conditions, including mental illness, excessive smoking, and alcohol consumption. Overall, 4 studies indicated positive impacts on some aspects of patient-centeredness; however, a negative impact was noted on patients' perceived autonomy support (ie, the degree to which people perceive those in positions of authority to be autonomy supportive). Virtual consultations may reduce waiting times, lower patient costs, and reduce rates of follow-up in secondary and tertiary care settings. Evidence for the impact on clinical safety is extremely limited. Evidence regarding equity was considerably mixed. Overall, it appears that virtual care is more likely to be used by younger, female patients, with disparities among other subgroups depending on contextual factors. CONCLUSIONS Our systematic review demonstrated that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalizing on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
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Affiliation(s)
- Kate Campbell
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Geva Greenfield
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Edmond Li
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Niki O'Brien
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Benedict Hayhoe
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Ana Luísa Neves
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Thrul J, Howe CL, Devkota J, Alexander A, Allen AM, Businelle MS, Hébert ET, Heffner JL, Kendzor DE, Ra CK, Gordon JS. A Scoping Review and Meta-analysis of the Use of Remote Biochemical Verification Methods of Smoking Status in Tobacco Research. Nicotine Tob Res 2023; 25:1413-1423. [PMID: 36449414 PMCID: PMC10347976 DOI: 10.1093/ntr/ntac271] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/30/2022] [Accepted: 11/28/2022] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Increasing digital delivery of smoking cessation interventions has resulted in the need to employ novel strategies for remote biochemical verification. AIMS AND METHODS This scoping review and meta-analysis aimed to investigate best practices for remote biochemical verification of smoking status. The scientific literature was searched for studies that reported remotely obtained (not in-person) biochemical confirmation of smoking status (ie, combustible tobacco). A meta-analysis of proportions was conducted to investigate key outcomes, which included rates of returned biological samples and the ratio of biochemically verified to self-reported abstinence rates. RESULTS A total of 82 studies were included. The most common samples were expired air (46%) and saliva (40% of studies), the most common biomarkers were carbon monoxide (48%) and cotinine (44%), and the most common verification methods were video confirmation (37%) and mail-in samples for lab analysis (26%). Mean sample return rates determined by random-effects meta-analysis were 70% for smoking cessation intervention studies without contingency management (CM), 77% for CM studies, and 65% for other studies (eg, feasibility and secondary analyses). Among smoking cessation intervention studies without CM, self-reported abstinence rates were 21%, biochemically verified abstinence rates were 10%, and 47% of individuals who self-reported abstinence were also biochemically confirmed as abstinent. CONCLUSIONS This scoping review suggests that improvements in sample return rates in remote biochemical verification studies of smoking status are needed. Recommendations for reporting standards are provided that may enhance confidence in the validity of reported abstinence rates in remote studies. IMPLICATIONS This scoping review and meta-analysis included studies using remote biochemical verification to determine smoking status. Challenges exist regarding implementation and ensuring high sample return rates. Higher self-reported compared to biochemically verified abstinence rates suggest the possibility that participants in remote studies may be misreporting abstinence or not returning samples for other reasons (eg, participant burden, inconvenience). Remote biochemical confirmation of self-reported smoking abstinence should be included in smoking cessation studies whenever feasible. However, findings should be considered in the context of challenges to sample return rates. Better reporting guidelines for future studies in this area are needed.
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Affiliation(s)
- Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Carol L Howe
- University of Arizona Health Sciences Library, Tucson, AZ, USA
| | - Janardan Devkota
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam Alexander
- Department of Family and Preventive Medicine and TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Alicia M Allen
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Michael S Businelle
- Department of Family and Preventive Medicine and TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Jaimee L Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Darla E Kendzor
- Department of Family and Preventive Medicine and TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chaelin K Ra
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, NJ, USA
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13
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Naja S, Alchawa M, Adli N, Ahmed WM, Abdu Y, Singh R, Muraikhi HA, Baker WA, Bougmiza I. Telephone versus face-to-face consultation on smoking cessation at primary health care centers in Qatar during COVID-19 pandemic. Prev Med Rep 2023; 33:102174. [PMID: 36937076 PMCID: PMC10007712 DOI: 10.1016/j.pmedr.2023.102174] [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: 10/08/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Abstract
Smoking cessation leads to a reduction in risks of smoking-related morbidity and mortality. During the coronavirus 2019 (COVID-19) pandemic, smoking cessation services were interrupted. Providing smoking cessation counseling by telephone could be a convenient and safe alternative to traditional face-to-face service. However, the effectiveness of telephone smoking cessation counseling has not yet been thoroughly investigated. This study evaluated telephone smoking cessation counseling compared to face-to-face consultations during the COVID-19 era. In addition, it investigated the association between sociodemographic and health-related factors and cessation rates. A retrospective cohort design was used. Participants were randomly selected from two lists: (1) telephone counseling and (2) face-to-face counseling in smoking cessation clinics in five primary health care centers in Qatar between March 2020 and March 2021. Cessation rates were compared between the two groups at 1, 2, 4, 8, and 12 weeks. A multivariable logistic regression analysis was used to identify the significant associations with smoking cessation. Smokers who underwent telephone consultations had significantly lower quit rates at all follow-ups compared to those who attended face-to-face visits. At the 12-week follow-up, the adjusted odd ratio for quitting through face-to-face consultations was 1.96 (95% CI [1.15-3.35]) times higher than that achieved through telephone consultations. In addition to receiving face-to-face counseling, higher self-efficacy to cease smoking was an independent predictor of successful cessation. Providing smoking cessation counseling by telephone could be a safer but less effective mode of delivery versus traditional face-to-face encounters during the pandemic.
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Affiliation(s)
- Sarah Naja
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Corresponding author at: Hamad Medical Corporation, Alrayyan Street, Doha P.O.Box: 3050, Qatar.
| | - Mohamad Alchawa
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Nada Adli
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Yasamin Abdu
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Cardiology Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Hissa Al Muraikhi
- Wellness Program, Preventive Medicine, Primary Health Care Corporation, Doha, Qatar
| | - Wadha Al Baker
- Wellness Program, Preventive Medicine, Primary Health Care Corporation, Doha, Qatar
| | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
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Taylor KL, Webster MA, Philips JG, Whealan JM, Lobo T, Davis KM, Breece CJ, Wheeley JR, Childs JE, Le AQ, Williams RM, Veytsman IG, Kim C. Integrating Tobacco Use Assessment and Treatment in the Oncology Setting: Quality Improvement Results from the Georgetown Lombardi Smoking Treatment and Recovery Program. Curr Oncol 2023; 30:3755-3775. [PMID: 37185398 PMCID: PMC10136485 DOI: 10.3390/curroncol30040285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
As part of the NCI’s Cancer Center Cessation (C3i) initiative, we initiated, expanded, and maintained an evidence-based tobacco treatment program at the Georgetown Lombardi Comprehensive Cancer Center. We present a quality improvement (QI) assessment of the implementation process and patient-level outcomes. At two hematology/oncology outpatient clinical sites, five oncology-based teams (clinical administrators, clinical staff, pharmacy, information technology, and tobacco treatment staff) developed implementation strategies for opt-out patient assessment and enrollment, centralized tobacco treatment, audit, feedback, and staff training. Among eligible patients (tobacco use in ≤30 days), we assessed demographic, clinical, and tobacco-related characteristics to examine predictors of enrollment (baseline completed), treatment engagement (≥one sessions completed), and self-reported 7-day abstinence (6 months post-enrollment). Across both sites, medical assistants screened 19,344 (82.4%) patients for tobacco use, which identified 1345 (7.0%) current tobacco users, in addition to 213 clinician referrals. Of the 687/1256 (54.7%) eligible patients reached, 301 (43.8%) enrolled, and 199 (29.0%) engaged in treatment, of whom 74.5% were African American and 68% were female. At the larger site, significant multivariate predictors of enrollment included African American race (vs. white/other) and clinician referral (vs. MA assessment). Treatment engagement was predicted by greater nicotine dependence, and abstinence (27.4%) was predicted by greater treatment engagement. In summary, the systematic utilization of multiple oncology-based teams and implementation strategies resulted in the development and maintenance of a high-quality, population-based approach to tobacco treatment. Importantly, these strategies addressed inequities in tobacco treatment, as the program reached and engaged a majority-African-American patient population. Finally, the opt-out patient assessment strategy has been implemented in multiple oncology settings at MedStar Health through the Commission on Cancer’s Just Ask program.
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Affiliation(s)
- Kathryn L Taylor
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Marguerite A Webster
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Joanna G Philips
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Julia M Whealan
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Tania Lobo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Kimberly M Davis
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
- Department of Psychiatry, Georgetown University Hospital, MedStar Health, Washington, DC 20007, USA
| | - Chavalia J Breece
- Department of Pulmonary Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, USA
- Department of Medical Oncology, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Jennifer R Wheeley
- Department of Medical Oncology, MedStar Washington Hospital Center, Washington, DC 20010, USA
| | - Jack E Childs
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Ariel Q Le
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Randi M Williams
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Irina G Veytsman
- Department of Medical Oncology, MedStar Washington Hospital Center, Washington, DC 20010, USA
| | - Chul Kim
- Department of Medicine, Georgetown University Medical Center, Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA
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15
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Noda Y, So R, Sonoda M, Tabuchi T, Nomura A. The Usefulness of a Smartphone App-Based Smoking Cessation Program for Conventional Cigarette Users, Heated Tobacco Product Users, and Dual Users: Retrospective Study. J Med Internet Res 2023; 25:e42776. [PMID: 36930197 PMCID: PMC10131758 DOI: 10.2196/42776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/28/2022] [Accepted: 02/26/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Heated tobacco products (HTPs) are widespread in Japan, and smoking cessation of such products has become an important issue owing to the spread of harmful effects from HTPs. The efficacy of online digital therapy has been reported in smoking cessation treatment; however, we have limited evidence of online smoking cessation programs for HTP users. OBJECTIVE In this study, we evaluate the usefulness of the Ascure program for HTP users (defined as exclusive HTP use or dual use of HTP and cigarettes) compared with exclusive cigarette users. METHODS This was a retrospective study. We recruited adult smokers participating in the Ascure online smoking cessation program in Japan from June 2019 to February 2021. The Ascure smartphone app provided four elements: (1) educational video tutorials to enhance the understanding of nicotine dependence, (2) a personalized to-do list for behavior change, (3) a digital diary for record keeping, and (4) interactive chat sessions for relief from cravings or withdrawal symptoms. The primary outcome was the continuous abstinence rate (CAR) at weeks 21 to 24, biochemically validated using salivary cotinine testing. We considered those who dropped out of the program as smoking cessation failures. We analyzed the primary outcome using inverse probability weighting against tobacco product type estimated by multinomial propensity scores. We also assessed CAR at weeks 9 to 12 and program adherence. RESULTS We analyzed data from 2952 participants, including 52% (1524/3478) in the cigarette group, 35% (1038/3478) in the HTP group, and 13% (390/3478) in the dual-use group, who had a mean age of 43.4 (SD 10.8) years and included 17% (513/2952) women. CAR at weeks 21 to 24 showed that exclusive HTP users were more likely to stop tobacco use than exclusive cigarette smokers (CAR 52.6% for cigarette users vs CAR 64.8% for HTP users; odds ratio [OR] 1.17, 95% CI 1.12-1.22; P<.001). There was no significant difference between the exclusive cigarette users and the dual users (CAR 52.6% for cigarette users vs CAR 48.7% for dual users; OR 0.99, 95% CI 0.93-1.05; P=.77). CAR at weeks 9 to 12 was 56.7% (95% CI 54.2%-59.2%) for the exclusive cigarette users, 68.3% (95% CI 65.5%-71.1%) for the exclusive HTP users, and 58.2% (95% CI 53.3%-63.1%) for the dual users. The program adherence rate at week 24 was 70.7% overall (68.4% for cigarette users, 75% for HTP users, and 67.9% for dual users). CONCLUSIONS Exclusive HTP users had higher CARs and adherence compared with exclusive cigarette users, indicating a higher affinity for the Ascure online smoking cessation program. This program might be a useful smoking cessation option for HTP users, as well as for cigarette smokers.
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Affiliation(s)
- Yuko Noda
- Department of Biomedical Informatics, CureApp Institute, Karuizawa, Japan
- Department of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa, Japan
- CureApp Inc, Tokyo, Japan
| | | | | | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- Tokyo Foundation for Policy Research, Toyko, Japan
| | - Akihiro Nomura
- Department of Biomedical Informatics, CureApp Institute, Karuizawa, Japan
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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16
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Shibata S, Hoshide S. Current situation of telemedicine research for cardiovascular risk in Japan. Hypertens Res 2023; 46:1171-1180. [PMID: 36849580 PMCID: PMC9969376 DOI: 10.1038/s41440-023-01224-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
Hypertension continues to be a principal risk factor for the occurrence of cardiovascular disorders, stroke, and kidney diseases. Although more than 40 million subjects suffer from hypertension in Japan, its optimal control is achieved only a subpopulation of patients, highlighting the need for novel approaches to manage this disorder. Toward the better control of blood pressure, the Japanese Society of Hypertension has developed the Future Plan, in which the application of the state-of-art information and communication technology, including web-based resources, artificial intelligence, and big data analysis, is considered as one of the promising solutions. In fact, the rapid advance of digital health technologies, as well as ongoing coronavirus disease 2019 pandemic, has triggered the structural changes in the healthcare system globally, increasing demand for the remote delivery of the medical services. Nonetheless, it is not entirely clear what evidence exists that support the widespread use of telemedicine in Japan. Here, we summarize the current status of telemedicine research, particularly in the field of hypertension and other cardiovascular risk factors. We note that there have been very few interventional studies in Japan that clearly showed the superiority or noninferiority of telemedicine over standard care, and that the methods of online consultation considerably varied among studies. Clearly, more evidence is necessary for wide implementation of telemedicine in hypertensive patients in Japan, and also those with other cardiovascular risk factors.
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Affiliation(s)
- Shigeru Shibata
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Satoshi Hoshide
- grid.410804.90000000123090000Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Amiri S, Khan MAB. Digital interventions for smoking abstinence: a systematic review and meta-analysis of randomized control trials. J Addict Dis 2023; 41:4-29. [PMID: 35426355 DOI: 10.1080/10550887.2022.2058300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Technological advancements have improved patients' health and clinical care through digital interventions. This study investigated the effects of digital interventions on smoking abstinence. METHODS PubMed, the Cochrane Library, and Scopus were systematically searched from inception until December 2021. Meta-analysis was carried out using a random-effects model. The degree of heterogeneity, quality, and publication bias of the selected studies was further evaluated. RESULTS A total of 43 randomized control trial studies were eligible for this study. 38,814 participants from 18 countries were included in the analysis. Digital interventions on seven-day point prevalence abstinence (1 month) showed increased smoking abstinence. The odds ratio was 2.02 and confidence interval (CI) was 1.67-2.43; p < 0.001; I2 = 55.1%) . The result for a 30-day point prevalence abstinence (1 month) was 1.63 (CI 1.09-2.46; p = 0.018; I2 = 0%). Digital intervention also had a significant effect on continuous abstinence (odds ratio = 1.68; CI 1.29-2.18; p < 0.001; I2 = 70.1%) and prolonged abstinence (odds ratio = 1.60; CI 1.19-2.15; p = 0.002; I2 = 53.6%). There was evidence of heterogeneity and publication bias. CONCLUSIONS Digital interventions led to increased smoking abstinence and can be a valuable tool in smoking cessation. Further research is required to evaluate the long-term impact of digital interventions on outcomes related to smoking cessation.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Moien A B Khan
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.,Primary Care, NHS North West London, London, UK
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Stellefson M, Kinder C, Boyd I, Elijah O, Naher S, McFadden N. COPD Self-Management for Adults Living in Rural Areas: Systematic Review of Telehealth and Non-Telehealth Interventions. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Zhang X, Sun Y, Cheung DYT, Wang MP, Wu Y, Chak KY, Chen J, Leung LT, Li WHC, Lam TH, Ho SY. Changes in Tobacco Use in the Early Phase of Coronavirus Disease 2019 Pandemic in Hong Kong: A Qualitative Study. Nicotine Tob Res 2022; 25:309-317. [PMID: 35716072 PMCID: PMC9384294 DOI: 10.1093/ntr/ntac147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/02/2022] [Accepted: 06/15/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Changes in tobacco use and related personal and environmental factors amid the coronavirus disease 2019 (COVID-19) pandemic can be captured by qualitative studies, but they are few in non-Western populations. AIMS AND METHODS We assessed the perceived links between tobacco use and COVID-19, and changes in the use of cigarettes, electronic cigarettes (ECs), and heated tobacco products (HTPs) in the early phase of the pandemic in Hong Kong, where lockdown was not implemented. Semi-structured telephone interviews were conducted from January to June 2021 in 95 participants (36 EC users, 28 HTP users, and 32 exclusive cigarette users). Transcriptions were coded using deductive and inductive approaches, and factors for changes were nested in the social-ecological model. RESULTS Two-thirds of participants perceived their infection susceptibility was the same as never tobacco users, and 44.2% perceived more severe COVID-19 disease if infected. Amid the pandemic, tobacco use decreased overall but increased indoors for all three products. Increased tobacco use was mostly attributed to increased emotional distress, while decreases were attributed to various personal (health concerns) and environmental factors (e.g., COVID-19 regulations). Perceived convenience and lower costs were reasons for increased EC use. Limited access to HTPs was compensated by cigarette use. CONCLUSIONS Many participants were unaware of the potential harm of tobacco use on COVID-19. Overall tobacco use decreased due to COVID-19 regulations, which may not be sustainable post-pandemic. Indoor consumption increased, supporting a comprehensive smoke-free policy that covers private indoor areas. Better cessation services targeting EC, HTP, and cigarette use are needed. IMPLICATIONS Smokers need better awareness of the risk of tobacco use on COVID-19. Smoking cessation services can be improved by offering brief advice, strengthening advocacy against secondhand smoke, and covering EC and HTP use, highlighting their potential harms to users and others, and their risk of addiction and relapse to cigarette use.
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Affiliation(s)
| | | | | | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Kin Yeung Chak
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Jianjiu Chen
- School of Public Health, University of Hong Kong, Hong Kong SAR, China,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lok Tung Leung
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | | | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Sai Yin Ho
- Corresponding Author: Sai Yin Ho, PhD, School of Public Health, The University of Hong Kong, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, 999077 Hong Kong SAR, China. Telephone: 852-3917-9883; Fax: 852-2855-9528; E-mail:
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Rhon DI, Fritz JM, Kerns RD, McGeary DD, Coleman BC, Farrokhi S, Burgess DJ, Goertz CM, Taylor SL, Hoffmann T. TIDieR-telehealth: precision in reporting of telehealth interventions used in clinical trials - unique considerations for the Template for the Intervention Description and Replication (TIDieR) checklist. BMC Med Res Methodol 2022; 22:161. [PMID: 35655144 PMCID: PMC9161193 DOI: 10.1186/s12874-022-01640-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/20/2022] [Indexed: 12/28/2022] Open
Abstract
Abstract
Background
Recent international health events have led to an increased proliferation of remotely delivered health interventions. Even with the pandemic seemingly coming under control, the experiences of the past year have fueled a growth in ideas and technology for increasing the scope of remote care delivery. Unfortunately, clinicians and health systems will have difficulty with the adoption and implementation of these interventions if ongoing and future clinical trials fail to report necessary details about execution, platforms, and infrastructure related to these interventions. The purpose was to develop guidance for reporting of telehealth interventions.
Methods
A working group from the US Pain Management Collaboratory developed guidance for complete reporting of telehealth interventions. The process went through 5-step process from conception to final checklist development with input for many stakeholders, to include all 11 primary investigators with trials in the Collaboratory.
Results
An extension focused on unique considerations relevant to telehealth interventions was developed for the Template for the Intervention Description and Replication (TIDieR) checklist.
Conclusion
The Telehealth Intervention guideline encourages use of the Template for the Intervention Description and Replication (TIDieR) checklist as a valuable tool (TIDieR-Telehealth) to improve the quality of research through a reporting guide of relevant interventions that will help maximize reproducibility and implementation.
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Freire APCF, Medina BAS, Leite MR, Lopes TO, Santos ET, Ferreira MM, Silva BSA, Cavalcante MA, Pacagnelli FL. Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study. Tob Prev Cessat 2022; 8:17. [PMID: 35601561 PMCID: PMC9074835 DOI: 10.18332/tpc/146545] [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: 10/09/2021] [Revised: 12/29/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may have changed smoking habits. For the smoking population, information regarding smoking habits and the pandemic could potentially aid COVID-19 prevention and control measures. Our study aimed to analyze the effects of the COVID-19 pandemic on tobacco consumption, nicotine dependence levels, and motivation for smoking cessation. We also collected information from smokers regarding their awareness of the consequences of tobacco use and the increased risks smokers have for severe complications from COVID-19. METHODS In the survey for this observational cross-sectional study, 122 smokers responded to an online form. The participants provided general data about their smoking history, their smoking habits in the months of April and May 2020, and the effect of the pandemic on their smoking habits. They also completed a Fagerström test and were measured by the Wisconsin Smoking Withdrawal Scale. RESULTS When compared to pre-pandemic levels, the majority of smokers reported increased tobacco consumption of between 1 and 10 cigarettes per day (37.7%). Their motivation to quit smoking (59.8%) and desire to smoke (53.2%) were unchanged by the pandemic. Most participants demonstrated an awareness of the increased risks smokers have for severe COVID-19-related complications (p<0.001). We identified the following correlations: cigarettes/day before pandemic and motivation for smoking cessation (r=0.19; p=0.030), cigarettes/day and nicotine dependence level (r=0.61; p<0.001), and load consumption and nicotine dependence level (r=0.69; p<0.001). No significant correlations were observed between load consumption and motivation to quit (r=0.13; p=0.120). CONCLUSIONS Most smokers are well aware of their increased risks for severe COVID-19-related complications. In the early stages of the COVID-19 pandemic in Brazil, most smokers reported increased cigarette consumption. In addition, motivation to quit and desire to smoke were unchanged for the majority of smokers.
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Affiliation(s)
- Ana P. C. F. Freire
- Department of Health Sciences, Central Washington University, Ellensburg, United States
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Bruna A. S. Medina
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Marceli R. Leite
- Medicine Department, University of Western Guaruja (UNOESTE), São Paulo, Brazil
| | - Tainá O. Lopes
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Ester T. Santos
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Milena M. Ferreira
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Bruna S. A. Silva
- Exercise and Immunometabolism Research Group, Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Margaret A. Cavalcante
- Medicine Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Francis L. Pacagnelli
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
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Asayut N, Olson PS, Kanjanasilp J, Thanarat P, Senkraigul B, Sittisarn C, Suksawat S. A community pharmacist-led smoking cessation intervention using a smartphone app (PharmQuit): A randomized controlled trial. PLoS One 2022; 17:e0265483. [PMID: 35349576 PMCID: PMC8963551 DOI: 10.1371/journal.pone.0265483] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/01/2022] [Indexed: 01/10/2023] Open
Abstract
WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. As such, this study evaluated the effectiveness of smoking cessation services provided by community pharmacists using PharmQuit compared with standard care. The study was a prospective, multicenter, randomized controlled trial that included 156 participants who were 18 years or older and smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies in three provinces in Thailand. Participants were allocated to the intervention (n = 78) and control groups (n = 78). Both groups received the usual smoking cessation services with pharmacotherapy and counseling from community pharmacists for 6 months. The intervention group received PharmQuit as an additional service. Both groups were scheduled for follow-up visits on days 7, 14, 30, 60, 120, and 180. The primary outcome was continuous abstinence rate on day 180. The secondary outcomes included 7-day point abstinence rate, number of cigarettes smoked per day, exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. An analysis using the intent-to-treat principle was performed. Smoking cessation rates and the number of cigarettes smoked per day were significantly higher during the follow-up visits in both groups (p < 0.05). However, there were no statistically significant differences between the two groups. The adherence rate to the smoking cessation program was higher in the intervention group than in the control group (74 days vs. 60 days, p > 0.05). The results showed the benefits of the contribution of community pharmacists. Although the inclusion of PharmQuit did not yield better results than pharmacists' counselling alone, it may help obtain better adherence to smoking cessation programs. Trial registration: Thai Clinical Trials Registry: TCTR20200925004 on September 25, 2020 -retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841.
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Affiliation(s)
- Narong Asayut
- Doctor of Philosophy in Pharmacy Program, Faculty of Pharmacy, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Phayom Sookaneknun Olson
- The International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Juntip Kanjanasilp
- The Clinical Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Preut Thanarat
- Faculty of Informatics, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Bhattaraporn Senkraigul
- Faculty of Informatics, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Chuthathip Sittisarn
- The International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
| | - Suratsawatee Suksawat
- The International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamrieng Sub-District, Kantarawichai District, Maha Sarakham Province, Thailand
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Abstract
BACKGROUND The COVID-19 pandemic has focussed attention on models of healthcare that avoid face-to-face contacts between clinicians and patients, and teleconsultations have become the preferred mode of primary care delivery. However, the effectiveness of remote consultations in this setting remains unclear. OBJECTIVE To evaluate the impact of telephone or video consultations compared to those conducted face-to-face on key patient-relevant outcomes and healthcare utilisation in primary care, mental health and allied health services, which have had a critical role in the management of the wider and longer-term consequences of COVID-19. METHODS A systematic review of primary studies comparing telephone or video consultations versus face-to-face visits, following the PRISMA guidelines. RESULTS Overall, consultations delivered by telephone and videoconference were as effective as face-to-face in-person visits to improve clinical outcomes in adults with mental health conditions and those attending primary care services. Patient satisfaction with telephone and video consultations and the therapeutic alliance was high across the studies. However, high discontinuation rates in patients receiving teleconsultations indicate this may not be a suitable modality of healthcare delivery for all patients. Teleconsultations offer significant patient time savings in primary care, but appropriate implementation, including training of healthcare professionals and management of technical issues, is essential to ensure effective and valuable clinical interventions. CONCLUSIONS Teleconsultations via telephone or videoconference are an effective alternative to face-to-face consultations for many patients attending primary care and mental health services. Teleconsultations have the potential to deliver time-efficient and lower-cost interventions at a distance while improving access to healthcare.
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Affiliation(s)
- Sara Carrillo de Albornoz
- Centre for Health Economics, Monash Business School, Monash University Level 5, Caulfield East, Melbourne, Australia
| | - Kah-Ling Sia
- Centre for Health Economics, Monash Business School, Monash University Level 5, Caulfield East, Melbourne, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash Business School, Monash University Level 5, Caulfield East, Melbourne, Australia
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24
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Veldhuizen S, Selby P, Wong B, Zawertailo L. Effect of COVID-19 on smoking cessation outcomes in a large primary care treatment programme: an observational study. BMJ Open 2021; 11:e053075. [PMID: 34446503 PMCID: PMC8392738 DOI: 10.1136/bmjopen-2021-053075] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has changed patterns of smoking, other substance use and other health-related behaviours, leading to a virtualisation of non-urgent medical care. In this study, we examine associated changes in outcomes of smoking-cessation treatment. DESIGN Observational study. SETTING Data are drawn from 221 physician-led primary care practices participating in a smoking cessation program in Ontario, Canada. PARTICIPANTS 43 509 patients (53% female), comprising 35 385 historical controls, 6109 people enrolled before the pandemic and followed up during it, and 1815 people enrolled after the pandemic began. INTERVENTION Nicotine-replacement therapy with counselling. PRIMARY OUTCOME MEASURE 7-day self-reported abstinence from cigarettes at a follow-up survey 6 months after entry. RESULTS For people followed up in the 6 months (6M) after the pandemic began, quit probability declined with date of enrolment. Predicted probabilities were 31.2% (95% CI 30.0% to 32.5%) for people enrolled in smoking cessation treatment 6 months prior to the emergency declaration and followed up immediately after the state of emergency was declared, and 24.1% (95% CI 22.1% to 26.2%) for those enrolled in treatment immediately before the emergency declaration and followed up 6M later (difference=-6.5%, 95% CI -9.0% to -3.9%). Seasonality and total treatment use did not explain this decline. CONCLUSION The probability of successful smoking cessation following treatment fell during the pandemic, with the decline consistent with an effect of 'exposure' to the pandemic-era environment. As many changes happened simultaneously, specific causes cannot be identified; however, the possibility that virtual care has been less effective than in-person treatment should be explored.
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Affiliation(s)
- Scott Veldhuizen
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Selby
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Wong
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Laurie Zawertailo
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
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25
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Giovenco DP, Spillane TE, Maggi RM, Lee EY, Philbin MM. Multi-level drivers of tobacco use and purchasing behaviors during COVID-19 "lockdown": A qualitative study in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103175. [PMID: 33662811 PMCID: PMC8373696 DOI: 10.1016/j.drugpo.2021.103175] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/21/2020] [Accepted: 02/11/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic and associated public health prevention measures (e.g., "stay at home" orders) may impact tobacco supply and demand among consumers. This qualitative study identified multi-level drivers of shifts in inhaled tobacco product use and access patterns during the initial COVID-19 "lockdown" period in the United States. METHODS Between April and May 2020, we conducted semi-structured telephone interviews (n = 44) with adults who use cigarettes and/or electronic nicotine delivery systems (ENDS). Transcripts were thematically analyzed using a socioecological framework. RESULTS Nearly all participants reported changes in their product use during lockdown, though patterns varied. Increased use was most common and was predominantly driven by individual-level factors: pandemic-related anxiety, boredom, and irregular routines. Decreased use was common among social users who cited fewer interpersonal interactions and fear of sharing products. At the community level, retail access impacted cigarette and ENDS use differently. While cigarettes were universally accessible, ENDS access was more limited, driving some to purchase products online. Delayed deliveries led some ENDS users to compensate with readily-available cigarettes. CONCLUSION To mitigate ways that the COVID-19 pandemic may exacerbate an existing public health crisis, multi-level policy strategies, such as expanded virtual cessation services and implementation and enforcement of smoke-free home rules, can better support population health during this critical period. Policies that facilitate access to lower risk products can help minimize harm among those who cannot or do not want to quit smoking.
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Affiliation(s)
- Daniel P Giovenco
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA
| | - Torra E Spillane
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA.
| | - Rachel M Maggi
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA
| | - Esther Y Lee
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA
| | - Morgan M Philbin
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA
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Lafont M, Morin C, Arrouy A, Rabeau A, Labouret G, Roditis L, Michelet M, Mittaine M. Pediatrician intervention impacts parental smoking in cystic fibrosis, diabetes, and bronchiolitis. Pediatr Pulmonol 2021; 56:1716-1723. [PMID: 33480170 DOI: 10.1002/ppul.25277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/26/2020] [Accepted: 01/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Child exposure to cigarette smoke is harmful. It should be reduced through parental smoking cessation interventions. The aim of our study was to determine the impact of simple advice provided by the pediatrician on the smoking habits of parents of children with cystic fibrosis (CF), diabetes mellitus (DM), and infants hospitalized for bronchiolitis. METHODS Parents were interviewed on their smoking habits. Smoking cessation advice was provided by the pediatrician. A new smoking habits assessment was done at 3 months by phone interviews. RESULTS A total of 260 parents were interviewed (91 in the CF group, 136 in the DM group, and 33 in the bronchiolitis group). A total of 70 parents were active smokers: 33% of parents of children with CF, 23.5% of parents of children with DM, and 24.2% for those with infants hospitalized for bronchiolitis (p = .42). In the CF group, smoking cessation had been significantly more frequently discussed with the medical team previously. A total of 67 smoking parents (95.7%) answered the 3-month assessment: 29.8% reported having started a smoking cessation process; 10.4% had quit smoking. The quitting rate was significantly higher in the groups of patients followed for a respiratory disorder (37.5% for bronchiolitis, 15% for CF vs. 0% for DM, p = .005). CONCLUSION This study shows the important role that information and simple advice from pediatricians can have in initiating smoking cessation in parents of patients followed in specialized clinics or who are hospitalized, with a greater efficiency in parents of patients suffering from lung disorders.
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Affiliation(s)
- Maxime Lafont
- Service de Pneumologie et Allergologie pédiatrique-CRCM, CHU Toulouse, Toulouse, France
| | - Carole Morin
- Service de Diabétologie pédiatrique, CHU Toulouse, Toulouse, France
| | - Amélie Arrouy
- Service de Diabétologie pédiatrique, CHU Toulouse, Toulouse, France
| | - Audrey Rabeau
- Unité de Coordination d'Aide au Sevrage Tabagique, Hôpital Larrey, CHU Toulouse, Toulouse, France
| | - Géraldine Labouret
- Service de Pneumologie et Allergologie pédiatrique-CRCM, CHU Toulouse, Toulouse, France
| | - Léa Roditis
- Service de Pneumologie et Allergologie pédiatrique-CRCM, CHU Toulouse, Toulouse, France
| | - Marine Michelet
- Service de Pneumologie et Allergologie pédiatrique-CRCM, CHU Toulouse, Toulouse, France
| | - Marie Mittaine
- Service de Pneumologie et Allergologie pédiatrique-CRCM, CHU Toulouse, Toulouse, France
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27
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Kario K, Nomura A, Kato A, Harada N, Tanigawa T, So R, Suzuki S, Hida E, Satake K. Digital therapeutics for essential hypertension using a smartphone application: A randomized, open-label, multicenter pilot study. J Clin Hypertens (Greenwich) 2021; 23:923-934. [PMID: 33484628 PMCID: PMC8678748 DOI: 10.1111/jch.14191] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/27/2022]
Abstract
Hypertension is the most considerable but treatable risk factor for cardiovascular disease. Although physicians prescribe multiple antihypertensive drugs and promote lifestyle modifications, the real-world blood pressure (BP) control rate remains poor. To improve BP target achievement, we developed a novel digital therapeutic-the HERB software system -to manage hypertension. Here, we performed a randomized pilot study to assess the safety and efficacy of the HERB system for hypertension. We recruited 146 patients with essential hypertension from March 2018 to March 2019. We allocated eligible patients to the intervention group (HERB system + standard lifestyle modification) or control group (standard lifestyle modification alone). The primary outcome was the mean change from baseline to 24 weeks in 24-hour systolic BP (SBP) measured by ambulatory blood pressure monitoring (ABPM). The baseline characteristics in each group were well balanced; the mean age was approx. 57 years, and 67% were male. In the primary end point at 24 weeks, HERB intervention did not lower the mean change of 24-hour SBP by ABPM compared with the controls (adjusted difference: -0.66 mmHg; p = .78). In an exploratory analysis focusing on antihypertensive drug-naïve patients aged <65, the effects of the HERB intervention were significantly greater than the control for reducing 24-hour SBP by ABPM at 16 weeks (adjusted difference: -7.6 mmHg; p = .013; and morning home SBP at 24 weeks (adjusted difference - 6.0 mmHg; p = .012). Thus, the HERB intervention did not achieve a primary efficacy end point. However, we observed that antihypertensive drug-naïve adult hypertensive patients aged <65 years could be a potential HERB system-effective target for further investigations of the efficacy of the system.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineSchool of MedicineJichi Medical UniversityTochigiJapan
| | - Akihiro Nomura
- CureApp InstituteKaruizawaJapan
- Innovative Clinical Research CenterKanazawa UniversityKanazawaJapan
- Department of Cardiovascular MedicineKanazawa University Graduate School of Medical SciencesKanazawaJapan
| | - Ayaka Kato
- CureApp InstituteKaruizawaJapan
- CureApp, Inc.TokyoJapan
| | - Noriko Harada
- Division of Cardiovascular MedicineDepartment of MedicineSchool of MedicineJichi Medical UniversityTochigiJapan
| | | | - Ryuhei So
- CureApp InstituteKaruizawaJapan
- CureApp, Inc.TokyoJapan
| | | | - Eisuke Hida
- Department of Biostatistics and Data ScienceOsaka University Graduate School of MedicineOsakaJapan
| | - Kohta Satake
- CureApp InstituteKaruizawaJapan
- CureApp, Inc.TokyoJapan
- Department of Respiratory MedicineJapanese Red Cross Medical CenterTokyoJapan
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28
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Mahoney MC, Park E, Schlienz NJ, Duerr C, Hawk LW. Transitioning to Remote Clinic Visits in a Smoking Cessation Trial During the COVID-19 Pandemic: Mixed Methods Evaluation. JMIR Form Res 2021; 5:e25541. [PMID: 33878020 PMCID: PMC8092028 DOI: 10.2196/25541] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/17/2021] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Background The pandemic of SARS-CoV-2, which causes COVID-19, has caused disruptions in ongoing clinical trials and is expected to accelerate interest in conducting research studies remotely. Objective A quasi-experimental, mixed methods approach was used to examine the rates of visit completion as well as the opinions and experiences of participants enrolled in an ongoing clinical trial of smoking cessation who were required to change from in-person clinic visits to remote visits using video or telephone conferencing due to the COVID-19 pandemic. Methods For quantitative comparisons, we used a quasi-experimental design, comparing a cohort of participants followed during the pandemic (n=23, COVID-19 cohort) to a comparable cohort of participants followed over a similar time period in the calendar years 2018 and 2019 (n=51, pre–COVID-19 cohort) to examine the rates of completion of scheduled visits and biospecimen collection. For the qualitative component, interviews were conducted with participants who experienced the transition from in-person to remote visits. Results Participants in the COVID-19 cohort completed an average of 83.6% of remote clinic visits (95% CI 73.1%-91.2%), which was not significantly different than the in-person completion rate of 89.8% in the pre–COVID-19 cohort. Participants in the COVID-19 cohort returned an average of 93.2% (95% CI 83.5%-98.1%) of saliva specimens for remote clinic visits completed, which was not significantly different than the in-person saliva specimen completion rate of 100% in the pre–COVID-19 cohort. Two broad themes emerged from the qualitative data: (1) the benefits of remote visits and (2) the challenges of remote counseling compared to in-person counseling. Despite limited experience with telehealth prior to this transition, most participants expressed a willingness to engage in remote visits in the future. Conclusions Even in the context of a rapid transition from in-person to remote visits necessitated by the COVID-19 pandemic, rates of visit completion and return of biospecimens remained high. Participants were generally accepting of the transition. Further research is needed to identify the optimal mix of in-person and remote visits beyond the pandemic context and to better understand how these changes may impact study outcomes. Trial Registration ClinicalTrials.gov NCT03262662; https://clinicaltrials.gov/ct2/show/study/NCT03262662
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Affiliation(s)
| | - Eunhee Park
- School of Nursing, University of Buffalo, Buffalo, NY, United States
| | - Nicolas J Schlienz
- Department of Psychology, University of Buffalo, Buffalo, NY, United States
| | - CeCe Duerr
- Department of Psychology, University of Buffalo, Buffalo, NY, United States
| | - Larry W Hawk
- Department of Psychology, University of Buffalo, Buffalo, NY, United States
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29
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Samples LS, Martinez J, Beru YN, Rochester MR, Geyer JR. Provider Perceptions of Telemedicine Video Visits to Home in a Veteran Population. Telemed J E Health 2021; 27:422-426. [DOI: 10.1089/tmj.2020.0045] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Laura S. Samples
- Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle, Washington, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Joseph Martinez
- Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle, Washington, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Yodit N. Beru
- Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle, Washington, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Meghan R. Rochester
- Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle, Washington, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - John R. Geyer
- Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle, Washington, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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30
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An MH, You SC, Park RW, Lee S. Using an Extended Technology Acceptance Model to Understand the Factors Influencing Telehealth Utilization After Flattening the COVID-19 Curve in South Korea: Cross-sectional Survey Study. JMIR Med Inform 2021; 9:e25435. [PMID: 33395397 PMCID: PMC7801132 DOI: 10.2196/25435] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Although telehealth is considered a key component in combating the worldwide crisis caused by COVID-19, the factors that influence its acceptance by the general population after the flattening of the COVID-19 curve remain unclear. OBJECTIVE We aimed to identify factors affecting telehealth acceptance, including anxiety related to COVID-19, after the initial rapid spread of the disease in South Korea. METHODS We proposed an extended technology acceptance model (TAM) and performed a cross-sectional survey of individuals aged ≥30 years. In total, 471 usable responses were collected. Confirmatory factor analysis was used to examine the validity of measurements, and the partial least squares (PLS) method was used to investigate factors influencing telehealth acceptance and the impacts of COVID-19. RESULTS PLS analysis showed that increased accessibility, enhanced care, and ease of telehealth use had positive effects on its perceived usefulness (P=.002, P<.001, and P<.001, respectively). Furthermore, perceived usefulness, ease, and privacy/discomfort significantly impacted the acceptance of telehealth (P<.001, P<.001, and P<.001, respectively). However, anxiety toward COVID-19 was not associated with telehealth acceptance (P=.112), and this insignificant relationship was consistent in the cluster (n=216, 46%) of respondents with chronic diseases (P=.185). CONCLUSIONS Increased accessibility, enhanced care, usefulness, ease of use, and privacy/discomfort are decisive variables affecting telehealth acceptance in the Korean general population, whereas anxiety about COVID-19 is not. This study may lead to a tailored promotion of telehealth after the pandemic subsides.
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Affiliation(s)
- Min Ho An
- So-Ahn Public Health Center, Jeon-ra-nam-do, Republic of Korea
| | - Seng Chan You
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Seongwon Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
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31
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Yatabe J, Yatabe MS, Ichihara A. The current state and future of internet technology-based hypertension management in Japan. Hypertens Res 2020; 44:276-285. [PMID: 33361825 PMCID: PMC7756130 DOI: 10.1038/s41440-020-00591-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/23/2022]
Abstract
Internet-based information and communication technology is altering our lives. Although medicine is traditionally conservative, it can benefit in many ways from adopting new technology and styles of care. Hypertension is a prime condition for the practical application of digital health management because it is prevalent and undercontrolled, and its primary index, home blood pressure, can be effectively telemonitored. Compared to other conditions that require laboratory measures or the use of drugs with frequent side effects, hypertension can be managed without actual office visits with sufficiently low risk. In this review of hypertension in Japan, we discuss the current and somewhat fragmented state of internet technology and the components and processes necessary for smooth, integrated, and multidisciplinary care in the future. Although further clinical trials are required to show the safety and efficacy of information and communication technology-based care for hypertension, the deployment of telemonitoring and telemedicine in daily practice should be expedited to solve the hypertension paradox. Challenges remain relating to cost, data integration, the redesigning of team-based care, and the improvement of user experience, but information and communication technology-based hypertension management is sure to become pivotal in improving public health.
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Affiliation(s)
- Junichi Yatabe
- General Incorporated Association TelemedEASE, Tokyo, Japan.
| | - Midori Sasaki Yatabe
- General Incorporated Association TelemedEASE, Tokyo, Japan.,Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
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Byaruhanga J, Atorkey P, McLaughlin M, Brown A, Byrnes E, Paul C, Wiggers J, Tzelepis F. Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review. J Med Internet Res 2020; 22:e18621. [PMID: 32915156 PMCID: PMC7519427 DOI: 10.2196/18621] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/18/2020] [Accepted: 07/26/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Real-time video communication technology allows virtual face-to-face interactions between the provider and the user, and can be used to modify risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. No systematic reviews have examined the effectiveness of individual real-time video counseling for addressing each of the risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. OBJECTIVE This systematic review aims to examine the effectiveness of individually delivered real-time video counseling on risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. METHODS The MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Database), PsycINFO, Cochrane Register of Controlled Trials, and Scopus databases were searched for eligible studies published up to November 21, 2019. Eligible studies were randomized or cluster randomized trials that tested the effectiveness of individual real-time video communication interventions on smoking, nutrition, alcohol, physical activity, and obesity in any population or setting; the comparator was a no-intervention control group or any other mode of support (eg, telephone); and an English-language publication. RESULTS A total of 13 studies were eligible. Four studies targeted smoking, 3 alcohol, 3 physical activity, and 3 obesity. In 2 of the physical activity studies, real-time video counseling was found to significantly increase physical activity when compared with usual care at week 9 and after 5 years. Two obesity studies found a significant change in BMI between a video counseling and a documents group, with significantly greater weight loss in the video counseling group than the in-person as well as the control groups. One study found that those in the video counseling group were significantly more likely than those in the telephone counseling group to achieve smoking cessation. The remaining studies found no significant differences between video counseling and telephone counseling or face-to-face counseling for smoking cessation, video counseling and face-to-face treatment on alcohol consumption, video counseling and no counseling for physical activity, and video counseling and face-to-face treatment on BMI. The global methodological quality rating was moderate in 1 physical activity study, whereas 12 studies had a weak global rating. CONCLUSIONS Video counseling is potentially more effective than a control group or other modes of support in addressing physical inactivity and obesity and is not less effective in modifying smoking and alcohol consumption. Further research is required to determine the relative benefits of video counseling in terms of other policy and practice decision-making factors such as costs and feasibility.
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Affiliation(s)
- Judith Byaruhanga
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Matthew McLaughlin
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Alison Brown
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
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Kato A, Tanigawa T, Satake K, Nomura A. Efficacy of the Ascure Smoking Cessation Program: Retrospective Study. JMIR Mhealth Uhealth 2020; 8:e17270. [PMID: 32406856 PMCID: PMC7256743 DOI: 10.2196/17270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/01/2020] [Accepted: 04/09/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Smoking cessation helps extend a healthy life span and reduces medical expenses. However, the standard 12-week smoking cessation program in Japan has several notable problems. First, only 30% of participants complete this program. Second, participants may choose not to participate unless they have a strong motivation to quit smoking, such as health problems. Third, the program does not provide enough support during the period between clinical visits and after 12 weeks. OBJECTIVE This study examined the efficacy of the 24-week ascure program to address the problems of accessibility and continuous support. The program combines online mentoring, over-the-counter pharmacotherapy, and a smartphone app. METHODS Using a retrospective study design, we investigated data for 177 adult smokers who were enrolled in the ascure smoking cessation program between August 2017 and August 2018. The primary outcomes were continuous abstinence rates (CARs) during weeks 9-12 and weeks 21-24. To confirm smoking status, we performed salivary cotinine testing at weeks 12 and 24. We also evaluated the program adherence rate. Finally, we performed exploratory analysis to determine the factors associated with continuous abstinence at weeks 21-24 to provide insights for assisting with long-term continuous abstinence. RESULTS The CARs of all participants for weeks 9-12 and weeks 21-24 were 48.6% (95% CI 41.2-56.0) and 47.5% (95% CI 40.0-54.8), respectively. Program adherence rates were relatively high throughout (72% at week 12 and 60% at week 24). In the analysis of the factors related to the CAR at weeks 21-24, the number of entries in the app's digital diary and number of educational videos watched during the first 12 weeks were significant factors. CONCLUSIONS The ascure program achieved favorable CARs, and participants showed high adherence. Proactive usage of the smartphone app may help contribute to smoking cessation success in the long-term.
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Affiliation(s)
- Ayaka Kato
- CureApp Institute, Karuizawa, Japan.,Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,CureApp Inc, Tokyo, Japan
| | | | - Kohta Satake
- CureApp Institute, Karuizawa, Japan.,CureApp Inc, Tokyo, Japan.,Japanese Red Cross Medical Center, Tokyo, Japan
| | - Akihiro Nomura
- CureApp Institute, Karuizawa, Japan.,Innovative Clinical Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Masaki K, Tateno H, Nomura A, Muto T, Suzuki S, Satake K, Hida E, Fukunaga K. A randomized controlled trial of a smoking cessation smartphone application with a carbon monoxide checker. NPJ Digit Med 2020; 3:35. [PMID: 32195370 PMCID: PMC7067789 DOI: 10.1038/s41746-020-0243-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/18/2020] [Indexed: 11/09/2022] Open
Abstract
Evidence of the long-term efficacy of digital therapies for smoking cessation that include a smartphone application (app) is limited. In this multi-center randomized controlled trial, we tested the efficacy of a novel digital therapy for smoking cessation: the "CureApp Smoking Cessation (CASC)" system, including a CASC smartphone app, a web-based patient management PC software for primary physicians, and a mobile exhaled carbon monoxide (CO) checker. A total of 584 participants with nicotine dependence were recruited from October 2017 to January 2018, and allocated 1:1 to the CASC intervention group or the control group. Both groups received a standard smoking cessation treatment with pharmacotherapy and counseling for 12 weeks. Meanwhile, the intervention group used the CASC system, and the control group used a control-app without a mobile CO checker, each for 24 weeks. The primary outcome was the biochemically validated continuous abstinence rate (CAR) from weeks 9 to 24. The main secondary outcome was an extended CAR from weeks 9 to 52. Except for 12 participants who did not download or use the apps, 285 participants were assigned to the intervention group, and 287, to the control. CAR from weeks 9 to 24 in the intervention group was significantly higher than that in the control group (63.9% vs. 50.5%; odds ratio [OR], 1.73; 95% confidence interval [CI], 1.24 to 2.42; P = 0.001). The CAR from weeks 9 to 52 was also higher in the intervention group than that in the control group (52.3% vs. 41.5%; OR, 1.55; 95% CI, 1.11 to 2.16; P = 0.010). No specific adverse events caused by the CASC system were reported. Augmenting standard face-to-face counseling and pharmacotherapy with a novel smartphone app, the CASC system significantly improved long-term CARs compared to standard treatment and a minimally supportive control app.
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Affiliation(s)
- Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tateno
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Saitama City Hospital, Saitama, Japan
| | - Akihiro Nomura
- CureApp Institute, Karuizawa, Nagano, Japan
- Innovative Clinical Research Center, Kanazawa University (iCREK), Kanazawa, Ishikawa, Japan
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Tomoyasu Muto
- CureApp Institute, Karuizawa, Nagano, Japan
- CureApp, Inc, Tokyo, Japan
| | | | - Kohta Satake
- CureApp Institute, Karuizawa, Nagano, Japan
- CureApp, Inc, Tokyo, Japan
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Tzelepis F, Paul CL, Williams CM, Gilligan C, Regan T, Daly J, Hodder RK, Byrnes E, Byaruhanga J, McFadyen T, Wiggers J. Real-time video counselling for smoking cessation. Cochrane Database Syst Rev 2019; 2019:CD012659. [PMID: 31684699 PMCID: PMC6818086 DOI: 10.1002/14651858.cd012659.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Real-time video communication software such as Skype and FaceTime transmits live video and audio over the Internet, allowing counsellors to provide support to help people quit smoking. There are more than four billion Internet users worldwide, and Internet users can download free video communication software, rendering a video counselling approach both feasible and scalable for helping people to quit smoking. OBJECTIVES To assess the effectiveness of real-time video counselling delivered individually or to a group in increasing smoking cessation, quit attempts, intervention adherence, satisfaction and therapeutic alliance, and to provide an economic evaluation regarding real-time video counselling. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, CENTRAL, MEDLINE, PubMed, PsycINFO and Embase to identify eligible studies on 13 August 2019. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov to identify ongoing trials registered by 13 August 2019. We checked the reference lists of included articles and contacted smoking cessation researchers for any additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), randomised trials, cluster RCTs or cluster randomised trials of real-time video counselling for current tobacco smokers from any setting that measured smoking cessation at least six months following baseline. The real-time video counselling intervention could be compared with a no intervention control group or another smoking cessation intervention, or both. DATA COLLECTION AND ANALYSIS Two authors independently extracted data from included trials, assessed the risk of bias and rated the certainty of the evidence using the GRADE approach. We performed a random-effects meta-analysis for the primary outcome of smoking cessation, using the most stringent measure of smoking cessation measured at the longest follow-up. Analysis was based on the intention-to-treat principle. We considered participants with missing data at follow-up for the primary outcome of smoking cessation to be smokers. MAIN RESULTS We included two randomised trials with 615 participants. Both studies delivered real-time video counselling for smoking cessation individually, compared with telephone counselling. We judged one study at unclear risk of bias and one study at high risk of bias. There was no statistically significant treatment effect for smoking cessation (using the strictest definition and longest follow-up) across the two included studies when real-time video counselling was compared to telephone counselling (risk ratio (RR) 2.15, 95% confidence interval (CI) 0.38 to 12.04; 2 studies, 608 participants; I2 = 66%). We judged the overall certainty of the evidence for smoking cessation as very low due to methodological limitations, imprecision in the effect estimate reflected by the wide 95% CIs and inconsistency of cessation rates. There were no significant differences between real-time video counselling and telephone counselling reported for number of quit attempts among people who continued to smoke (mean difference (MD) 0.50, 95% CI -0.60 to 1.60; 1 study, 499 participants), mean number of counselling sessions completed (MD -0.20, 95% CI -0.45 to 0.05; 1 study, 566 participants), completion of all sessions (RR 1.13, 95% CI 0.71 to 1.79; 1 study, 43 participants) or therapeutic alliance (MD 1.13, 95% CI -0.24 to 2.50; 1 study, 398 participants). Participants in the video counselling arm were more likely than their telephone counselling counterparts to recommend the programme to a friend or family member (RR 1.06, 95% CI 1.01 to 1.11; 1 study, 398 participants); however, there were no between-group differences on satisfaction score (MD 0.70, 95% CI -1.16 to 2.56; 1 study, 29 participants). AUTHORS' CONCLUSIONS There is very little evidence about the effectiveness of real-time video counselling for smoking cessation. The existing research does not suggest a difference between video counselling and telephone counselling for assisting people to quit smoking. However, given the very low GRADE rating due to methodological limitations in the design, imprecision of the effect estimate and inconsistency of cessation rates, the smoking cessation results should be interpreted cautiously. High-quality randomised trials comparing real-time video counselling to telephone counselling are needed to increase the confidence of the effect estimate. Furthermore, there is currently no evidence comparing real-time video counselling to a control group. Such research is needed to determine whether video counselling increases smoking cessation.
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Affiliation(s)
- Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Christine L Paul
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Conor Gilligan
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
| | - Tim Regan
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Justine Daly
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Emma Byrnes
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Judith Byaruhanga
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
| | - Tameka McFadyen
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthUniversity DriveCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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