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Glynn L, Mc Cann M, Mc Cabe C. Smartphone applications supporting self-management programme for adults with Chronic Obstructive Pulmonary Disease: A Scoping Review. PLOS DIGITAL HEALTH 2024; 3:e0000532. [PMID: 38870123 PMCID: PMC11175531 DOI: 10.1371/journal.pdig.0000532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Chronic Obstructive Pulmonary Disease (COPD) significantly impacts on both the quality and quantity of life for patients due to frequent exacerbations requiring hospital admissions resulting in increased morbidity and mortality. A self-management programme purpose is to increase one's knowledge, confidence, and skills to self-manage their chronic illness such as COPD. OBJECTIVE The objective of this review will therefore answer the following research question: What is the current literature pertaining to the use of a smartphone app in supporting a comprehensive self-management programme among COPD patients? A preliminary search was conducted in, Medline, Embase and CINAHL databases to ascertain index terms and keywords. Following this a rigorous search was carried out on Medline, Embase, CINAHL, Web of Science and ASSIA. The findings from this search are presented in tabular form using the PRSIMA flow diagram. RESULTS In this review, fifteen studies met the inclusion criteria. Across all studies participants engaged with the app and developed self-management skills and knowledge to manage their chronic illness. However, engagement with the app without third party involvement declined over time. Technical issues did not cause harm to participants but in some cases contributed to reduced engagement. Smartphone self-management apps empowered a cohort of COPD participants to engage in managing their chronic illness which proved useful in detecting exacerbations earlier resulting in reducing the need for hospitalisations over a three-to-six-month period. By reducing hospitalisations incurred a cost savings for health care and an improved quality and quantity of life for these participants. CONCLUSION It is evident from the literature that smartphone self-management apps may positively influence participants self-management decisions in terms of knowledge, increase physical activity, self-efficacy that may result in reduced hospitalisation and improved quality of life. It is clear that technical issues and sustained engagement over longer periods of time remains a challenge.
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Affiliation(s)
- Lisa Glynn
- School of Nursing and Midwifery, University of Galway, Ireland
| | - Margaret Mc Cann
- School of Nursing and Midwifery, Trinity College, Dublin 2, Ireland
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Abreu MIT, Santos AF, Gama JMR, Valente S, Valente MJ, Pereira H, Regateiro F, Sousa-Pinto B, Ventura MT, Bousquet J, Taborda-Barata L. Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal. Clin Interv Aging 2024; 19:971-979. [PMID: 38827238 PMCID: PMC11143487 DOI: 10.2147/cia.s448797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/01/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal. Patients and Methods In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire. Results Among the 72 sequentially recruited patients (mean age±SD 73.26±5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64±5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11±4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01-0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03-0.80; p=0.025)) than Users Group. The main reasons for not using the App were "Lack of required hardware" (n=35) and "Digital illiteracy" (n=26), but lack of interest to use the App among those who had conditions to use it was uncommon. Conclusion Most old-age asthmatics living in Beira Interior either lack a smartphone or digital skills, which are significant obstacles to implementing app-based monitoring studies.
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Affiliation(s)
| | - Adalberto Fernandes Santos
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Jorge M R Gama
- Center of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
| | - Salete Valente
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Maria Jesus Valente
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Henrique Pereira
- Psychology and Education Department, Faculty of Human and Social Sciences, University of Beira Interior, Covilhã, Portugal
- The Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Beira Interior, Covilhã, Portugal
| | - Frederico Regateiro
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Institute of Immunology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
- Centro de Neurociências e Biologia Celular, CIBB, University of Coimbra, Coimbra, Portugal
- Allergy & Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
- Institute of Science of Food Production, National Research Council (Ispa-Cnr), Bari, Italy
| | - Jean Bousquet
- Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
- Department of Pulmonology, University Hospital Montpellier, Montpellier, France
| | - Luis Taborda-Barata
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- UBIAir - Clinical & Experimental Lung Centre, UBIMedical, University of Beira Interior, Covilhã, Portugal
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
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Rafael Henriques H, Correia A, Santos T, Faria J, Sousa D, Portela J, Teixeira J. Nursing interventions to promote dyspnea self-management of complex chronic patients: An integrated review. Int J Nurs Sci 2024; 11:241-257. [PMID: 38707687 PMCID: PMC11064592 DOI: 10.1016/j.ijnss.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 05/07/2024] Open
Abstract
Objectives Chronic dyspnea, a distressing symptom in patients with complex chronic conditions, is linked to higher risks of mortality. This study aimed to identify nursing interventions that could improve self-management for complex chronic patients, thereby enhancing control over chronic dyspnea. The findings intend to guide nursing care strategies that promote self-management among this population. Methods We searched the databases Medline, Scopus, Web of Science, CINAHL, Cochrane Database of Systematic Reviews (CDSR), and Joanna Briggs Institute (JBI) databases were searched in December 2023. We included adult patients with complex chronic conditions with chronic dyspnoea. The team screened articles collaboratively, using Rayyan software. A qualitative appraisal was performed according to JBI Critical Appraisal Checklist tools. The review protocol is registered under the number CRD42023456021. Results Our review included 18 studies that explored a variety of interventions for chronic dyspnea. We identified pharmacological interventions (such as oxygen therapy and inhalation treatments) and non-pharmacological approaches (including educational programs, breathing exercises, fluid intake management, body awareness techniques, peer support, emotional intelligence training, and the use of web applications). Those interventions empower patients, improve their ability to fulfill life roles, mitigate emotional distress, and improve overall quality of life. Nursing care can be crucial in enabling individuals to achieve independence and autonomy in self-care. Conclusions Promoting self-management for chronic dyspnea in complex chronic patients requires a holistic approach, encompassing multidisciplinary interventions, individualized self-care education, peer engagement, and technological support. Current research on self-management inadequately addresses interventions targeting patient behaviour change. It highlights the need to delve deeper into the self-management process. Further research is needed to expand the evidence base and refine these interventions.
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Affiliation(s)
- Helga Rafael Henriques
- Nursing School of Lisbon, Lisbon, Portugal
- CIDNUR – Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal
| | - Andreia Correia
- Nursing School of Lisbon, Lisbon, Portugal
- Unidade de Hemodiálise de Torres Vedras – Nephrocare, Torres Vedras, Portugal
| | - Tatiana Santos
- Nursing School of Lisbon, Lisbon, Portugal
- Unidade de Cuidados Continuados na AMETIC, Torres Vedras, Portugal
| | - José Faria
- Nursing School of Lisbon, Lisbon, Portugal
- CIDNUR – Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal
- Unidade Local de Saúde São José, Cardiology Department, Lisbon, Portugal
| | - Diana Sousa
- Nursing School of Lisbon, Lisbon, Portugal
- CIDNUR – Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal
| | - Joana Portela
- Nursing School of Lisbon, Lisbon, Portugal
- CIDNUR – Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal
- Unidade Local de Saúde da Arrábida, General Surgery Department, Setúbal, Portugal
| | - Joana Teixeira
- Nursing School of Lisbon, Lisbon, Portugal
- CIDNUR – Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal
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Adida F, Pandia P, Pradana A, Tarigan AP, Ashar T, Dangana A, Listyoko AS. Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients. NARRA J 2023; 3:e412. [PMID: 38455631 PMCID: PMC10919705 DOI: 10.52225/narra.v3i3.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/11/2023] [Indexed: 03/09/2024]
Abstract
Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the "Paru Sehat" smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient's quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of "Paru Sehat" in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the "Paru Sehat" twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients' characteristics and the knowledge scores within pre- and posttreatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although "Paru Sehat" application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.
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Affiliation(s)
- Fiony Adida
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Prof. Chairuddin Panusunan Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Pandiaman Pandia
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Prof. Chairuddin Panusunan Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Andika Pradana
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Prof. Chairuddin Panusunan Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Amira P. Tarigan
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Division of Asthma and COPD, Department of Pulmonology and Respiratory Medicine, Prof. Chairuddin Panusunan Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Taufik Ashar
- Department of Environmental Health, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia
| | - Amos Dangana
- Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | - Aditya S. Listyoko
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
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Kouri A, Wong EKC, Sale JEM, Straus SE, Gupta S. Are older adults considered in asthma and chronic obstructive pulmonary disease mobile health research? A scoping review. Age Ageing 2023; 52:afad144. [PMID: 37742283 DOI: 10.1093/ageing/afad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) for asthma and chronic obstructive pulmonary disease (COPD) is rapidly growing and may help address the complex respiratory care needs of our ageing population. However, little is currently known about how airways mHealth is developed and used among older adults (≥65 years). OBJECTIVE To identify if and how older adults with asthma and COPD have been incorporated across the mHealth research cycle. METHODS We searched Ovid MEDLINE, EMBASE, CINAHL and the Cochrane Central Registry of Controlled Trials for studies pertaining to the development or evaluation of asthma and COPD mHealth for adults published after 2010. Study, participant and mHealth details, including any considerations of older age, were extracted, synthesised and charted. RESULTS A total of 334 studies of 191 mHealth tools were identified. Adults ≥65 years old were included in 33.3% of asthma mHealth studies and 85.3% of COPD studies. Discussions of older age focused on barriers to technology use. Methodologic and/or analytic considerations of older age were mostly absent throughout the research cycle. Among the 28 instances quantitative age-related analyses were detailed, 12 described positive mHealth use and satisfaction outcomes in older adults versus negative or equivocal outcomes. CONCLUSION We identified an overall lack of consideration for older age throughout the airways mHealth research cycle, even among COPD mHealth studies that predominantly included older adults. We also found a contrast between the perceptions of how older age might negatively influence mHealth use and available quantitative evaluations. Future airways mHealth research must better integrate the needs and concerns of older adults.
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Affiliation(s)
- Andrew Kouri
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
| | - Eric K C Wong
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Samir Gupta
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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Basch C, Lawlor ER, Yassaee A, Booth A, Westgate K, Sharp SJ, Tyrrell CSB, Aral M, Wareham NJ. Engagement With mHealth COVID-19 Digital Biomarker Measurements in a Longitudinal Cohort Study: Mixed Methods Evaluation. J Med Internet Res 2023; 25:e40602. [PMID: 36194866 PMCID: PMC9842396 DOI: 10.2196/40602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic accelerated the interest in implementing mobile health (mHealth) in population-based health studies, but evidence is lacking on engagement and adherence in studies. We conducted a fully remote study for ≥6 months tracking COVID-19 digital biomarkers and symptoms using a smartphone app nested within an existing cohort of adults. OBJECTIVE We aimed to investigate participant characteristics associated with initial and sustained engagement in digital biomarker collection from a bespoke smartphone app and if engagement changed over time or because of COVID-19 factors and explore participants' reasons for consenting to the smartphone substudy and experiences related to initial and continued engagement. METHODS Participants in the Fenland COVID-19 study were invited to the app substudy from August 2020 to October 2020 until study closure (April 30, 2021). Participants were asked to complete digital biomarker modules (oxygen saturation, body temperature, and resting heart rate [RHR]) and possible COVID-19 symptoms in the app 3 times per week. Participants manually entered the measurements, except RHR that was measured using the smartphone camera. Engagement was categorized by median weekly frequency of completing the 3 digital biomarker modules (categories: 0, 1-2, and ≥3 times per week). Sociodemographic and health characteristics of those who did or did not consent to the substudy and by engagement category were explored. Semistructured interviews were conducted with 35 participants who were purposively sampled by sex, age, educational attainment, and engagement category, and data were analyzed thematically; 63% (22/35) of the participants consented to the app substudy, and 37% (13/35) of the participants did not consent. RESULTS A total of 62.61% (2524/4031) of Fenland COVID-19 study participants consented to the app substudy. Of those, 90.21% (2277/2524) completed the app onboarding process. Median time in the app substudy was 34.5 weeks (IQR 34-37) with no change in engagement from 0 to 3 months or 3 to 6 months. Completion rates (≥1 per week) across the study between digital biomarkers were similar (RHR: 56,517/77,664, 72.77%; temperature: 56,742/77,664, 73.06%; oxygen saturation: 57,088/77,664, 73.51%). Older age groups and lower managerial and intermediate occupations were associated with higher engagement, whereas working, being a current smoker, being overweight or obese, and high perceived stress were associated with lower engagement. Continued engagement was facilitated through routine and personal motivation, and poor engagement was caused by user error and app or equipment malfunctions preventing data input. From these results, we developed key recommendations to improve engagement in population-based mHealth studies. CONCLUSIONS This mixed methods study demonstrated both high initial and sustained engagement in a large mHealth COVID-19 study over a ≥6-month period. Being nested in a known cohort study enabled the identification of participant characteristics and factors associated with engagement to inform future applications in population-based health research.
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Affiliation(s)
| | - Emma R Lawlor
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Adam Booth
- Huma Therapeutics Limited, London, United Kingdom
| | - Kate Westgate
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Carina S B Tyrrell
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Mert Aral
- Huma Therapeutics Limited, London, United Kingdom
| | - Nicholas J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Quach S, Benoit A, Oliveira A, Packham TL, Goldstein R, Brooks D. Features and characteristics of publicly available mHealth apps for self-management in chronic obstructive pulmonary disease. Digit Health 2023; 9:20552076231167007. [PMID: 37065541 PMCID: PMC10102951 DOI: 10.1177/20552076231167007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/15/2023] [Indexed: 04/18/2023] Open
Abstract
Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective To report the characteristics and features of publicly available apps for COPD self-management. Methods MHealth apps designed for patients' COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.
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Affiliation(s)
- Shirley Quach
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Shirley Quach, School of Rehabilitation
Science, McMaster University, IAHS, 1400 Main Street West Institute for Applied
Health Sciences (IAHS) Building - Room 403, Hamilton, ON L8S 1C7, Canada.
| | - Adam Benoit
- Respiratory Research, West Park Healthcare center, Toronto, Canada
| | - Ana Oliveira
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Lab3R – Respiratory Research and
Rehabilitation Laboratory, University of Aveiro
(ESSUA), Aveiro, Portugal
| | - Tara L. Packham
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Department of Medicine, University of
Toronto, Toronto, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
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A systematic review of engagement reporting in remote measurement studies for health symptom tracking. NPJ Digit Med 2022; 5:82. [PMID: 35768544 PMCID: PMC9242990 DOI: 10.1038/s41746-022-00624-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/01/2022] [Indexed: 01/25/2023] Open
Abstract
Remote Measurement Technologies (RMTs) could revolutionise management of chronic health conditions by providing real-time symptom tracking. However, the promise of RMTs relies on user engagement, which at present is variably reported in the field. This review aimed to synthesise the RMT literature to identify how and to what extent engagement is defined, measured, and reported, and to present recommendations for the standardisation of future work. Seven databases (Embase, MEDLINE and PsycINFO (via Ovid), PubMed, IEEE Xplore, Web of Science, and Cochrane Central Register of Controlled Trials) were searched in July 2020 for papers using RMT apps for symptom monitoring in adults with a health condition, prompting users to track at least three times during the study period. Data were synthesised using critical interpretive synthesis. A total of 76 papers met the inclusion criteria. Sixty five percent of papers did not include a definition of engagement. Thirty five percent included both a definition and measurement of engagement. Four synthetic constructs were developed for measuring engagement: (i) engagement with the research protocol, (ii) objective RMT engagement, (iii) subjective RMT engagement, and (iv) interactions between objective and subjective RMT engagement. The field is currently impeded by incoherent measures and a lack of consideration for engagement definitions. A process for implementing the reporting of engagement in study design is presented, alongside a framework for definition and measurement options available. Future work should consider engagement with RMTs as distinct from the wider eHealth literature, and measure objective versus subjective RMT engagement.Registration: This review has been registered on PROSPERO [CRD42020192652].
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Naranjo-Rojas A, Perula-de-Torres LÁ, Molina-Recio G. Patients, caregivers, and healthcare professionals' needs when designing the content of a mobile application for the clinical monitoring of patients with chronic obstructive pulmonary disease and home oxygen therapy: A user-centered design. Internet Interv 2022; 29:100552. [PMID: 35756891 PMCID: PMC9214792 DOI: 10.1016/j.invent.2022.100552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/06/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patients with chronic respiratory diseases require oxygen supply in a considerable amount to reduce their symptoms and increase their survival. The development of abilities for the self-management of chronic diseases has been shown to be essential to decrease exacerbation of symptoms. Therefore, the design and development of health mobile applications (apps) that aid in educating and training for disease self-management are cost-effective strategies. OBJECTIVE The purpose of this research was to describe the main characteristics that, according to final users, should be included in a mobile application for monitoring patients prescribed home oxygen therapy. METHODS A participative-qualitative design was used, involving direct participation of patients, caregivers, and healthcare professionals. Focus groups were conducted to identify the needs and perspectives related to the app. A card sorting method was used to determine the contents and basic architecture of the app. RESULTS By means of the focus groups, we could identify nine basic functions of the app for the clinical monitoring of patients under home oxygen therapy. For both profiles, the app structure was determined by identifying the most frequent contents among participants. CONCLUSIONS The implementation of a user-centered design allowed for the detection of the functions, contents, and basic architecture of the app by identifying healthcare professionals and patients' needs and preferences regarding the self-management and monitoring of home oxygen prescriptions. TRIAL REGISTRATION The study is registered in ClinicalTrials.gov: NCT04820790.
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Affiliation(s)
- Anisbed Naranjo-Rojas
- Universidad Santiago de Cali, Colombia,Universidad de Córdoba, Spain,Corresponding author at: Universidad Santiago de Cali, Colombia.
| | - Luis Ángel Perula-de-Torres
- Nursing, Pharmacology and Physiotherapy Department, University of Cordoba, Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Spain
| | - Guillermo Molina-Recio
- Multiprofessional teaching unit for Family and Community Care of the Córdoba and Guadalquivir District, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Universidad de Córdoba, Spain
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Jakob R, Harperink S, Rudolf AM, Fleisch E, Haug S, Mair JL, Salamanca-Sanabria A, Kowatsch T. Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. J Med Internet Res 2022; 24:e35371. [PMID: 35612886 PMCID: PMC9178451 DOI: 10.2196/35371] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/31/2022] [Accepted: 04/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background Mobile health (mHealth) apps show vast potential in supporting patients and health care systems with the increasing prevalence and economic costs of noncommunicable diseases (NCDs) worldwide. However, despite the availability of evidence-based mHealth apps, a substantial proportion of users do not adhere to them as intended and may consequently not receive treatment. Therefore, understanding the factors that act as barriers to or facilitators of adherence is a fundamental concern in preventing intervention dropouts and increasing the effectiveness of digital health interventions. Objective This review aimed to help stakeholders develop more effective digital health interventions by identifying factors influencing the continued use of mHealth apps targeting NCDs. We further derived quantified adherence scores for various health domains to validate the qualitative findings and explore adherence benchmarks. Methods A comprehensive systematic literature search (January 2007 to December 2020) was conducted on MEDLINE, Embase, Web of Science, Scopus, and ACM Digital Library. Data on intended use, actual use, and factors influencing adherence were extracted. Intervention-related and patient-related factors with a positive or negative influence on adherence are presented separately for the health domains of NCD self-management, mental health, substance use, nutrition, physical activity, weight loss, multicomponent lifestyle interventions, mindfulness, and other NCDs. Quantified adherence measures, calculated as the ratio between the estimated intended use and actual use, were derived for each study and compared with the qualitative findings. Results The literature search yielded 2862 potentially relevant articles, of which 99 (3.46%) were included as part of the inclusion criteria. A total of 4 intervention-related factors indicated positive effects on adherence across all health domains: personalization or tailoring of the content of mHealth apps to the individual needs of the user, reminders in the form of individualized push notifications, user-friendly and technically stable app design, and personal support complementary to the digital intervention. Social and gamification features were also identified as drivers of app adherence across several health domains. A wide variety of patient-related factors such as user characteristics or recruitment channels further affects adherence. The derived adherence scores of the included mHealth apps averaged 56.0% (SD 24.4%). Conclusions This study contributes to the scarce scientific evidence on factors that positively or negatively influence adherence to mHealth apps and is the first to quantitatively compare adherence relative to the intended use of various health domains. As underlying studies mostly have a pilot character with short study durations, research on factors influencing adherence to mHealth apps is still limited. To facilitate future research on mHealth app adherence, researchers should clearly outline and justify the app’s intended use; report objective data on actual use relative to the intended use; and, ideally, provide long-term use and retention data.
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Affiliation(s)
- Robert Jakob
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
| | - Samira Harperink
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Aaron Maria Rudolf
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Elgar Fleisch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, Zurich University, Zurich, Switzerland
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
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Pépin JL, Degano B, Tamisier R, Viglino D. Remote Monitoring for Prediction and Management of Acute Exacerbations in Chronic Obstructive Pulmonary Disease (AECOPD). Life (Basel) 2022; 12:life12040499. [PMID: 35454991 PMCID: PMC9028268 DOI: 10.3390/life12040499] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/14/2022] [Accepted: 03/27/2022] [Indexed: 11/21/2022] Open
Abstract
The progression of chronic obstructive pulmonary disease (COPD) is characterized by episodes of acute exacerbation (AECOPD) of symptoms, decline in respiratory function, and reduction in quality-of-life increasing morbi-mortality and often requiring hospitalization. Exacerbations can be triggered by environmental exposures, changes in lifestyle, and/or physiological and psychological factors to greater or lesser extents depending on the individual’s COPD phenotype. The prediction and early detection of an exacerbation might allow patients and physicians to better manage the acute phase. We summarize the recent scientific data on remote telemonitoring (TM) for the prediction and management of acute exacerbations in COPD patients. We discuss the components of remote monitoring platforms, including the integration of environmental monitoring data; patient reported outcomes collected via interactive Smartphone apps, with data from wearable devices that monitor physical activity, heart rate, etc.; and data from medical devices such as connected non-invasive ventilators. We consider how telemonitoring and the deluge of data it potentially generates could be combined with electronic health records to provide personalized care and multi-disease management for COPD patients.
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Affiliation(s)
- Jean-Louis Pépin
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300, 38000 Grenoble, France; (B.D.); (R.T.); (D.V.)
- EFCR Laboratory, Thorax and Vessels Division, University Hospital of Grenoble Alpes, 38043 Grenoble, France
- Correspondence:
| | - Bruno Degano
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300, 38000 Grenoble, France; (B.D.); (R.T.); (D.V.)
- EFCR Laboratory, Thorax and Vessels Division, University Hospital of Grenoble Alpes, 38043 Grenoble, France
| | - Renaud Tamisier
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300, 38000 Grenoble, France; (B.D.); (R.T.); (D.V.)
- EFCR Laboratory, Thorax and Vessels Division, University Hospital of Grenoble Alpes, 38043 Grenoble, France
| | - Damien Viglino
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300, 38000 Grenoble, France; (B.D.); (R.T.); (D.V.)
- Emergency Department, University Hospital of Grenoble Alpes, 38043 Grenoble, France
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12
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Taralunga DD, Florea BC. A Blockchain-Enabled Framework for mHealth Systems. SENSORS (BASEL, SWITZERLAND) 2021; 21:2828. [PMID: 33923842 PMCID: PMC8073055 DOI: 10.3390/s21082828] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 11/27/2022]
Abstract
Presently modern technology makes a significant contribution to the transition from traditional healthcare to smart healthcare systems. Mobile health (mHealth) uses advances in wearable sensors, telecommunications and the Internet of Things (IoT) to propose a new healthcare concept centered on the patient. Patients' real-time remote continuous health monitoring, remote diagnosis, treatment, and therapy is possible in an mHealth system. However, major limitations include the transparency, security, and privacy of health data. One possible solution to this is the use of blockchain technologies, which have found numerous applications in the healthcare domain mainly due to theirs features such as decentralization (no central authority is needed), immutability, traceability, and transparency. We propose an mHealth system that uses a private blockchain based on the Ethereum platform, where wearable sensors can communicate with a smart device (a smartphone or smart tablet) that uses a peer-to-peer hypermedia protocol, the InterPlanetary File System (IPFS), for the distributed storage of health-related data. Smart contracts are used to create data queries, to access patient data by healthcare providers, to record diagnostic, treatment, and therapy, and to send alerts to patients and medical professionals.
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Affiliation(s)
- Dragos Daniel Taralunga
- Faculty of Electronics, Telecommunications and Information Technology, Politehnica University of Bucharest, 060042 Bucharest, Romania;
- Faculty of Medical Engineering, Politehnica University of Bucharest, 060042 Bucharest, Romania
| | - Bogdan Cristian Florea
- Faculty of Electronics, Telecommunications and Information Technology, Politehnica University of Bucharest, 060042 Bucharest, Romania;
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The role of smart monitoring digital health care system based on smartphone application and personal health record platform for patients diagnosed with coronavirus disease 2019. BMC Infect Dis 2021; 21:229. [PMID: 33639861 PMCID: PMC7910795 DOI: 10.1186/s12879-021-05898-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 02/12/2021] [Indexed: 01/10/2023] Open
Abstract
Background The massive outbreak of the novel coronavirus disease 2019 (COVID-19) in Daegu city and Gyeongsangbuk-do, Republic of Korea (ROK), caused the exponential increase in new cases exceeding 5000 within 6 weeks. Therefore, the community treatment center (CTC) with a digital health care monitoring system based on the smartphone application and personal health record platform (PHR) was implemented. Thus, we report our experience in one of the CTCs to investigate the role of CTC and the feasibility of the digital health care monitoring system in the COVID-19 pandemic. Methods The Gyeongbuk-Daegu 2 CTC was set up at the private residential facility. Admission criteria were 1) patients < 65 years with COVID-19, 2) patients without underlying medical comorbidities, and 3) COVID-19 disease severity of mild class. Admitted patients were placed under monitoring of vital signs and symptoms. Clinical information was collected using the smartphone application or telephone communication. Collected information was displayed on the PHR platform in a real-time fashion for close monitoring. Results From Mar 3, 2020, to Mar 26, 2020, there was a total of 290 patients admitted to the facility. Males were 104 (35.9%). The median age was 37 years. The median time between the COVID-19 diagnosis and admission was 7 days. Five patients were identified and were transferred to the designed COVID-19 treatment hospital for their urgent medical needs. The smartphone application usage to report vital signs and symptoms was noted in 96% of the patients. There were no deaths of the patients. Conclusions Our results suggest that implementation of the CTC using a commercial residence facility and digital health care technology may offer valuable solutions to the challenges posed by the COVID-19 outbreak.
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Rodríguez Hermosa JL, Fuster Gomila A, Puente Maestu L, Amado Diago CA, Callejas González FJ, Malo De Molina Ruiz R, Fuentes Ferrer ME, Alvarez-Sala JL, Calle Rubio M. Assessing the Usefulness of the Prevexair Smartphone Application in the Follow-Up High-Risk Patients with COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:53-65. [PMID: 33447026 PMCID: PMC7802911 DOI: 10.2147/copd.s279394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/11/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction This manuscript analyzes the exacerbations recorded by the Prevexair application through the daily analysis of symptoms in high-risk patients with COPD and explores its usefulness in assessing clinical stability with respect to that reported in visits. Patients and Methods This study is a multi-centre cohort of COPD patients with the exacerbator phenotype who were monitored over 6 months. The Prevexair application was installed on the patients' smartphones. Patients used the app to record symptom changes, use of medication and use of healthcare resources. It is not established a recommended action plan when worsening of symptoms. At their clinical visit during the follow-up period, patients were asked about exacerbations suffered during these 6 months of monitoring. The investigators who conducted the visit were blinded about the Prevexair app records. Results The patients experienced a total of 185 exacerbations according to daily records in the app whereas only 64 exacerbations were recalled during medical visits. Perception became more accurate for severe exacerbations (kappa 0.6577), although we found no factors that predicted poor recall. The proportion of 72.5% patients were classified as unstable if the exacerbations captured by Prevexair were used to define stability, versus 47.8% if the exacerbations recall in visit was used. Two-thirds of the exacerbations recorded in the Prevexair application were not reported to doctors during their clinical visits. Almost half were treated with oral corticosteroids and/or antibiotics and more than one-quarter of the exacerbations treated did not seek medical attention. Conclusion The findings of this cohort study confirm that patients do not always remember the exacerbations suffered during their medical visit. The prevexair application is useful in monitoring COPD patients at high risk, in order to a better assessment of exacerbations of COPD during medical visits. Further research must be carried out to evaluate this strategy in clinical practice.
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Affiliation(s)
- Juan Luis Rodríguez Hermosa
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Antonia Fuster Gomila
- Pulmonology Department, Hospital U. Son Llátzer, Palma De Mallorca, Balearic Islands, Spain
| | | | - Carlos Antonio Amado Diago
- Pulmonology Department, Hospital U. Marqués de Valdecilla, Santander, Cantabria, Spain.,Department of Medicine, Universidad de Cantabria, Santander, Spain
| | | | | | - Manuel E Fuentes Ferrer
- Department of Medicine Preventive, San Carlos Health Research Institute (IdISSC), Madrid, Spain.,Department of Medicine, Universidad Alfonso X El Sabio, Madrid, Spain
| | - Jose Luis Alvarez-Sala
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Myriam Calle Rubio
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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