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Smit Y, Metsemakers SJJPM, Janssen JJWM, Posthuma EFM, Walraven I, Hermens RPMG, Blijlevens NMA. Measuring chronic myeloid leukaemia TKI-related toxic effects in the real world: a systematic review and critical assessment of content validity of patient-reported outcome measures. Lancet Haematol 2023; 10:e849-e859. [PMID: 37604177 DOI: 10.1016/s2352-3026(23)00173-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 08/23/2023]
Abstract
Insight into real-world treatment-related toxic effects reported by patients has the potential to improve care, benchmark trials, and fill knowledge gaps, especially in patients with chronic myeloid leukaemia, which is treated in the majority of patients continually with tyrosine-kinase inhibitors (TKIs). The aim of our systematic review was to investigate the content validity of instruments that elicit TKI-related toxic effects reported by patients with chronic myeloid leukaemia in the real world. We searched PubMed and Embase from Jan 1, 2017 to Oct 21, 2022. Studies on instruments used in or developed for patients with chronic myeloid leukaemia that assess a patient's symptoms were eligible. Content validity was assessed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN): none of the six identified instruments were rated as sufficient. Five instruments (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire for chronic myeloid leukaemia with 24 items [EORTC QLQ-CML24], EORTC symptom set, Functional Assessment of Cancer Therapy-Leukaemia [FACT-LEU], haematological malignancies patient-reported outcomes [HM-PRO], and MD Anderson Symptom Inventory for chronic myeloid leukaemia [MDASI-CML]) were rated as inconsistent due to not being evaluated by professionals post-development, having very few patients with chronic myeloid leukaemia involved, or missing key symptoms. Moderate-quality to very low-quality evidence underpinned these ratings. The two EORTC instruments were the only ones not to miss key toxic effects (eg, muscle cramps). However, their relevance was rated as inconsistent: the QLQ-CML24 includes questions on health-related quality-of-life, whereas the symptom set includes items sourced from solid cancer treatments. This Review shows the need for an instrument with sufficient content validity to measure toxic effects from TKI treatment in patients with chronic myeloid leukaemia. Until then, stakeholders can make an informed choice from currently used instruments with our assessment.
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Affiliation(s)
- Yolba Smit
- Department of Haematology, Radboud University Medical Center, Nijmegen, Netherlands.
| | | | - Jeroen J W M Janssen
- Department of Haematology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eduardus F M Posthuma
- Department of Internal Medicine, Reinier de Graaf Hospital, Delft, Netherlands; Department of Haematology, Leiden University Medical Center, Leiden, Netherlands
| | - Iris Walraven
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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Verweij L, Metsemakers SJJPM, Ector GICG, Rademaker P, Bekker CL, van Vlijmen B, van der Reijden BA, Blijlevens NMA, Hermens RPMG. Improvement, Implementation, and Evaluation of the CMyLife Digital Care Platform: Participatory Action Research Approach. J Med Internet Res 2023; 25:e45259. [PMID: 37713242 PMCID: PMC10541637 DOI: 10.2196/45259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/16/2023] [Accepted: 07/21/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The evaluation of a continuously evolving eHealth tool in terms of improvement and implementation in daily practice is unclear. The CMyLife digital care platform provides patient-centered care by empowering patients with chronic myeloid leukemia, with a focus on making medication compliance insightful, discussable, and optimal, and achieving optimal control of the biomarker BCR-ABL1. OBJECTIVE The aim of this study was to investigate to what extent the participatory action research approach is suitable for the improvement and scientific evaluation of eHealth innovations in daily clinical practice (measured by user experiences) combined with the promotion of patient empowerment. METHODS The study used iterative cycles of planning, action, and reflection, whereby participants' experiences (patients, health care providers, the CMyLife team, and app suppliers) with the platform determined next actions. Co-design workshops were the foundation of this cyclic process. Moreover, patients filled in 2 sets of questionnaires for assessing experiences with CMyLife, the actual use of the platform, and the influence of the platform after 3 and at least 6 months. Data collected during the workshops were analyzed using content analysis, which is often used for making a practical guide to action. Descriptive statistics were used to characterize the study population in terms of information related to chronic myeloid leukemia and sociodemographics, and to describe experiences with the CMyLife digital care platform and the actual use of this platform. RESULTS The co-design workshops provided insights that contributed to the improvement, implementation, and evaluation of CMyLife and empowered patients with chronic myeloid leukemia (for example, simplification of language, and improvement of the user friendliness of functionalities). The results of the questionnaires indicated that (1) the platform improved information provision on chronic myeloid leukemia in 67% (33/49) of patients, (2) the use of the medication app improved medication compliance in 42% (16/38) of patients, (3) the use of the guideline app improved guideline adherence in 44% (11/25) of patients, and (4) the use of the platform caused patients to feel more empowered. CONCLUSIONS A participatory action research approach is suited to scientifically evaluate digital care platforms in daily clinical practice in terms of improvement, implementation, and patient empowerment. Systematic iterative evaluation of users' needs and wishes is needed to keep care centered on patients and keep the innovation up-to-date and valuable for users.
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Affiliation(s)
- Lynn Verweij
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | | | - Peter Rademaker
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Charlotte L Bekker
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas van Vlijmen
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bert A van der Reijden
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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Geerts P, Eijsink J, Moser A, Ter Horst P, Boersma C, Postma M. Rationale and development of an e-health application to deliver patient-centered care during treatment for recently diagnosed multiple myeloma patients: pilot study of the MM E-coach. Pilot Feasibility Stud 2023; 9:85. [PMID: 37210584 DOI: 10.1186/s40814-023-01307-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/21/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Patients with multiple myeloma (MM) increasingly face complicated treatment regimens. E-health may support patients and healthcare providers in enhancing a patient-centered healthcare approach. Therefore, we aimed to develop a patient-centered multi-modality e-health application, to assess the application for usability and end-user experiences. METHODS The application was developed following an iterative "action-based" methodology using the design thinking approach. Key end users participated, and relevant stakeholders were consulted in the development process. First, the care pathway was evaluated, the focus of development was determined, and a solution ideated during recurring multidisciplinary meetings. Second, a prototype was tested and improved. Third, a subsequent prototype was evaluated during a pilot study with patients and healthcare professionals on usability, usage, and experiences. RESULTS The multi-modality application, named the "MM E-coach," consisted of a newly developed medication module, patient-reported outcome (PRO) questionnaire assessments, a messaging service, alerts, information provision, and a personal care plan. The median system usability score was 60 on a scale of 0-100. Patients appreciated the medication overview, healthcare professionals appreciated the outpatient clinic preparation module, and both appreciated the messaging service. Additional recommendations for improvement mostly revolved around the flexibility of functionalities and look and feel of the application. CONCLUSIONS The MM E-coach has the potential to provide patient-centered care by supporting patients and caregivers during MM treatment and is a promising application to be implemented in the MM care pathway. A randomized clinical trial was initiated to study its clinical effectiveness.
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Affiliation(s)
- Paul Geerts
- Department of Internal Medicine, Isala Klinieken, Zwolle, Netherlands.
- Division of Hematology, Department of Internal Medicine, Research School GROW, Maastricht University Medical Centre, Maastricht, Netherlands.
- Department of Family Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands.
| | - Job Eijsink
- Department of Clinical Pharmacy, Isala Klinieken, Zwolle, Netherlands
- Department of Health Sciences, University Medical Centre Groningen, Groningen, Netherlands
| | - Albine Moser
- Department of Family Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands
- Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Peter Ter Horst
- Department of Clinical Pharmacy, Isala Klinieken, Zwolle, Netherlands
| | - Cornelis Boersma
- Department of Health Sciences, University Medical Centre Groningen, Groningen, Netherlands
- Faculty of Management Sciences, Open University, Heerlen, Netherlands
| | - Maarten Postma
- Department of Health Sciences, University Medical Centre Groningen, Groningen, Netherlands
- Unit of Pharmacotherapy, Epidemiology & Economics, Groningen Research Institute Pharmacy, University of Groningen, Groningen, Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
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Verweij L, Ector GICG, Smit Y, van Vlijmen B, van der Reijden BA, Hermens RPMG, Blijlevens NMA. Effectiveness of digital care platform CMyLife for patients with chronic myeloid leukemia: results of a patient-preference trial. BMC Health Serv Res 2023; 23:228. [PMID: 36890512 PMCID: PMC9994406 DOI: 10.1186/s12913-023-09153-9] [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: 06/02/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Two most important factors determining treatment success in chronic myeloid leukemia (CML) are adequate medication compliance and molecular monitoring albeit still being suboptimal. The CMyLife platform is an eHealth innovation, co-created with and for CML patients, aiming to improve their care, leading to an increased quality of life and the opportunity of hospital-free care. OBJECTIVE To explore the effectiveness of CMyLife in terms of information provision, patient empowerment, medication compliance, molecular monitoring, and quality of life. METHODS Effectiveness of CMyLife was explored using a patient-preference trial. Upon completion of the baseline questionnaire, participants actively used (intervention group) or did not actively use (questionnaire group) the CMyLife platform for at least 6 months, after which they completed the post-intervention questionnaire. Scores between the intervention group and the questionnaire group were compared with regard to the within-subject change between baseline and post-measurement using Generalized Estimating Equation models. RESULTS At baseline, 33 patients were enrolled in the questionnaire group and 75 in the intervention group. Online health information knowledge improved significantly when actively using CMyLife and patients felt more empowered. No significant improvements were found regarding medication compliance and molecular monitoring, which were already outstanding. Self-reported effectiveness showed that patients experienced that using CMyLife improved their medication compliance and helped them to oversee their molecular monitoring. Patients using CMyLife reported more symptoms but were better able to manage these. CONCLUSIONS Since hospital-free care has shown to be feasible in time of the COVID-19 pandemic, eHealth-based innovations such as CMyLife could be a solution to maintain the quality of care and make current oncological health care services more sustainable. TRIAL REGISTRATION ClinicalTrials.gov NCT04595955 , 22/10/2020.
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Affiliation(s)
- Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Geneviève I C G Ector
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yolba Smit
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas van Vlijmen
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bert A van der Reijden
- Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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Insight Into the Dyadic Driving Force of Theory and Big Data to Advance Cancer Care. Cancer Nurs 2023; 46:248-249. [PMID: 36888914 DOI: 10.1097/ncc.0000000000001218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Janssen L, Hopman MTE, Swaans GJA, Allard NAE, Boss M, Lobeek D, Gotthardt M, Schirris TJJ, Blijlevens NMA, Timmers S. Impact of tyrosine kinase inhibitors on glucose control and insulin regulation in patients with chronic myeloid leukemia. Am J Physiol Endocrinol Metab 2023; 324:E209-E216. [PMID: 36696600 DOI: 10.1152/ajpendo.00163.2022] [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: 01/26/2023]
Abstract
Treatment with tyrosine kinase inhibitors (TKIs), especially nilotinib, often results in hyperglycemia, which may further increase cardiovascular disease risk in patients with chronic myeloid leukemia (CML). The mechanism underlying the TKI-induced glucose dysregulation is not clear. TKIs are suggested to affect insulin secretion but also insulin sensitivity of peripheral tissue has been proposed to play a role in the pathogenesis of TKI-induced hyperglycemia. Here, we aimed to assess whether skeletal muscle glucose uptake and insulin responses are altered in nondiabetic patients with CML receiving TKI treatment. After a glycogen-depleted exercise bout, an intravenous glucose bolus (0.3 g/kg body weight) was administered to monitor 2-h glucose tolerance and insulin response in 14 patients with CML receiving nilotinib, 14 patients with CML receiving imatinib, and 14 non-CML age- and gender-matched controls. A dynamic [18F]-FDG PET scan during a hyperinsulinemic-euglycemic clamp was performed in a subgroup of 12 male patients with CML to assess m. quadriceps glucose uptake. We showed that patients with CML treated with nilotinib have an increased insulin response to intravenous glucose administration after muscle glycogen-depleted exercise. Despite the increased insulin response to glucose administration in patients with CML receiving nilotinib, glucose disappearance rates were significantly slower in nilotinib-treated patients when compared with controls in the first 15 min after glucose administration. Although [18F]-FDG uptake in m. quadriceps was not different, patients receiving nilotinib showed a trend toward decreased glucose infusion rates during euglycemic clamping when compared with patients receiving imatinib. Together, these findings indicate disturbed skeletal muscle glucose handling in patients with CML receiving nilotinib therapy.NEW & NOTEWORTHY In this study, we have shown that non-diabetic patients with CML receiving nilotinib therapy show early signs of disturbed skeletal muscle glucose handling, which was not observed in imatinib-treated patients. These observations in nilotinib users may reflect decreased muscle insulin sensitivity, which could serve as a potential target to counteract glycemic dysregulation, and is of clinical importance since these patients have an increased cardiovascular disease risk.
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Affiliation(s)
- Lando Janssen
- Radboud Institute for Health Sciences, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Greetje J A Swaans
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Neeltje A E Allard
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marti Boss
- Radboud Institute for Health Sciences, Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daphne Lobeek
- Radboud Institute for Health Sciences, Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Radboud Institute for Health Sciences, Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom J J Schirris
- Radboud Institute for Molecular Life Sciences, Department of Pharmacology and Toxicology, Radboud Centre for Mitochondrial Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole M A Blijlevens
- Radboud Institute for Health Sciences, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Silvie Timmers
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
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Johnson AM, Brimhall AS, Johnson ET, Hodgson J, Didericksen K, Pye J, Harmon GJC, Sewell KB. A systematic review of the effectiveness of patient education through patient portals. JAMIA Open 2023; 6:ooac085. [PMID: 36686972 PMCID: PMC9847535 DOI: 10.1093/jamiaopen/ooac085] [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: 11/30/2021] [Revised: 09/01/2022] [Accepted: 10/18/2022] [Indexed: 01/19/2023] Open
Abstract
Objective The objective of this study was to systematically review all literature studying the effect of patient education on patient engagement through patient portals. Introduction Patient portals provide patients access to health records, lab results, medication refills, educational materials, secure messaging, appointment scheduling, and telehealth visits, allowing patients to take a more active role in their health care decisions and management. A debate remains around whether these additional aids actually improve patient engagement and increase their ability to manage their own health conditions. This systematic review looks specifically at the effect of educational materials included in patient portals. Materials and Methods In accordance with PRISMA guidelines, the literature search was mapped across 5 databases (PubMed, CINAHL, Scopus, PsychINFO, Embase), and implemented on June 2, 2020. Results Fifty-two studies were included in the review. Forty-six (88.5%) reported rates of patient utilization of educational resources in the patient portal. Thirty (57.9%) shared patients' perceptions of the usefulness of the education materials. Twenty-one (40.4%) reported changes in health outcomes following educational interventions through the patient portal. This review found that efforts are indeed being made to raise awareness of educational resources in patient portals, that patients are increasingly utilizing these resources, that patients are finding them useful, and that they are improving health outcomes. Conclusion It seems that patient portals are becoming a powerful tool for patient education and engagement, and show promise as a means of achieving the quadruple aim of healthcare. Moving forward, research should establish more uniform methods of measurement in order to strengthen the literature surrounding the effectiveness of patient education through patient portals.
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Affiliation(s)
- Adam M Johnson
- Corresponding Author: Adam M. Johnson, MS, Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA;
| | - Andrew S Brimhall
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Erica T Johnson
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Jennifer Hodgson
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Katharine Didericksen
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Joseph Pye
- Department of Family Medicine, ECU Health, Greenville, North Carolina, USA
| | - G J Corey Harmon
- Laupus Library, East Carolina University, Greenville, North Carolina, USA
| | - Kerry B Sewell
- Laupus Library, East Carolina University, Greenville, North Carolina, USA
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van Harlingen AOW, van de Ven LG, Hasselaar J, Thalen J, Jukema J, Vissers K, Uitdehaag M. Developing a toolkit for patients with COPD or chronic heart failure and their informal caregivers to improve person-centredness in conversations with healthcare professionals: A Design Thinking approach. PATIENT EDUCATION AND COUNSELING 2022; 105:3324-3330. [PMID: 35843846 DOI: 10.1016/j.pec.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/22/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The perspective of patients and informal caregivers is often not expressed in conversations with healthcare professionals which can have a negative impact on quality of care and quality of life. OBJECTIVE Describe the development of a toolkit for patients with COPD or chronic heart failure and their informal caregivers enabling them to explore and express their perspective in conversations with healthcare professionals. Patient involvement: Patients, informal caregivers and healthcare professionals were involved in the design process from problem definition to solution development. METHOD Design Thinking Approach using eight co-creation sessions and qualitative data-collection methods. Nineteen patients, ten informal caregivers and thirteen healthcare professionals participated in one or more co-creation sessions. Homogenous subgroups of participants were used in session 1, 2 and 4 and mixed groups were used in session 3, 5 and 6. Session 7 and 8 were used to test prototype toolkits. RESULTS Three challenges to expressing the personal perspective to healthcare professionals, four statements defining the desired situation for conversations, eleven design criteria for the toolkit and ten selection criteria for tools were identified. This information was used to develop a prototype toolkit. DISCUSSION Most patients and informal caregivers had moderate to high levels of education and all participating healthcare professionals were female with a majority of nurses and only three physicians. It is possible that this has influenced the design of the toolkit. PRACTICAL VALUE The toolkit can support patients and informal caregivers in exploring and expressing their perspective in conversations with healthcare professionals. Feasibility of the toolkit and implications for healthcare professionals will be examined in a pilot implementation study.
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Affiliation(s)
- Annet Olde Wolsink- van Harlingen
- Saxion University of Applied Sciences, Research Group Smart Health, Enschede, Netherlands; Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands.
| | - Leontine Groen- van de Ven
- Windesheim University of Applied Sciences, Research Group Living Well With Dementia, Zwolle, Netherlands
| | - Jeroen Hasselaar
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands; Nivel Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Jos Thalen
- Saxion University of Applied Sciences, Research Group Industrial Design, Enschede, Netherlands
| | - Jan Jukema
- Saxion University of Applied Sciences, Research Group Smart Health, Enschede, Netherlands
| | - Kris Vissers
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands
| | - Madeleen Uitdehaag
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands
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Meidani Z, Moravveji A, Gohari S, Ghaffarian H, Zare S, Vaseghi F, Moosavi GA, Nickfarjam AM, Holl F. Development and Testing Requirements for an Integrated Maternal and Child Health Information System in Iran: A Design Thinking Case Study. Methods Inf Med 2022; 61:e64-e72. [PMID: 35609871 PMCID: PMC9788911 DOI: 10.1055/a-1860-8618] [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] [Indexed: 12/27/2022]
Abstract
BACKGROUND Management of child health care can be negatively affected by incomplete recording, low data quality, and lack of data integration of health management information systems to support decision making and public health program needs. Given the importance of identifying key determinants of child health via capturing and integrating accurate and high-quality information, we aim to address this gap through the development and testing requirements for an integrated child health information system. SUBJECTS AND METHODS A five-phase design thinking approach including empathizing, defining, ideation, prototyping, and testing was applied. We employed observations and interviews with the health workers at the primary health care network to identify end-users' challenges and needs using tools in human-centered design and focus group discussion. Then, a potential solution to the identified problems was developed as an integrated maternal and child health information system (IMCHIS) prototype and tested using Software Quality Requirements and Evaluation Model (SQuaRE) ISO/IEC 25000. RESULTS IMCHIS was developed as a web-based system with 74 data elements and seven maternal and child health care requirements. The requirements of "child disease" with weight (0.26), "child nutrition" with weight (0.20), and "prenatal care" with weight (0.16) acquired the maximum weight coefficient. In the testing phase, the highest score with the weight coefficient of 0.48 and 0.73 was attributed to efficiency and functionality characteristics, focusing on software capability to fulfill the tasks that meet users' needs. CONCLUSION Implementing a successful child health care system integrates both maternal and child health care information systems to track the effect of maternal conditions on child health and support managing performance and optimizing service delivery. The highest quality score of IMCHIS in efficiency and functionality characteristics confirms that it owns the capability to identify key determinants of child health.
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Affiliation(s)
- Zahra Meidani
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran,Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran,Address for correspondence Zahra Meidani, PhD Health Information Management Research Center (HIMRC)KashanIran
| | - Alireza Moravveji
- Social Determinant of Health (SDH) Research Center, Department of Community and Preventive Medicine, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shirin Gohari
- Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Sahar Zare
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran,Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Vaseghi
- Department of Public Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Gholam Abbas Moosavi
- Department of Vital Statistics and Epidemiology, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali mohammad Nickfarjam
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran,Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany,Institute for Medical Information Processing, Biometry, and Epidemiology, University of Munich, Munich, Germany
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A comprehensive eHealth implementation guide constructed on a qualitative case study on barriers and facilitators of the digital care platform CMyLife. BMC Health Serv Res 2022; 22:751. [PMID: 35668491 PMCID: PMC9169388 DOI: 10.1186/s12913-022-08020-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Substantial proliferation of eHealth has enabled a move in patient-centred cancer care from the traditional in-person care model to real-time, dynamic, and technology supported on-demand care. However, in general, the uptake of these innovations is low. Studies show that eHealth is helpful in providing patient empowerment through e.g. providing high quality and timely information, enabling self-monitoring and shared decision making, but dropout rates are high and guidance for optimal implementation is lacking. Aim To explore barriers to and facilitators for nationwide implementation and consolidation of CMyLife, a multi-component, patient-centred, digital care platform, and to construct a comprehensive implementation guide for launching digital care platforms in daily clinical practice. Methods The first qualitative case study of a digital care platform like CMyLife was performed including five focus group- and eighteen in-depth interviews with stakeholders. Data were collected using a semi-structured interview guide, based on the frameworks of Grol and Flottorp. Transcripts of the interviews were analysed and barriers and facilitators were identified and categorized according to the frameworks. An iterative process including participation of main stakeholders and using the CFIR-ERIC framework led to creating a comprehensive implementation guide for digital care platforms. Results In total, 45 barriers and 41 facilitators were identified. Main barriers were lack of connectivity between information technology systems, changing role for both health care providers and patients, insufficient time and resources, doubts about privacy and security of data, and insufficient digital skills of users. Main facilitators mentioned were motivating patients and health care providers by clarifying the added value of use of a digital care platform, clear business case with vision, demonstrating (cost) effectiveness, using an implementation guide, and educating patients and health care providers about how to use CMyLife. Based on these barriers and facilitators a clear and comprehensive implementation guide was developed for digital care platforms. Conclusion Several barriers to and facilitators for implementation were identified, a clear overview was presented, and a unique comprehensive implementation guide was developed for launching future digital care platforms in daily clinical practice. The next step is to validate the implementation guide in other (oncological) diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08020-3.
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Ector GI, Verweij L, Hermens RP, Blijlevens NM. Filling the gaps of patient information needs and information perception in chronic myeloid leukemia with the patient-physician co-produced web-based platform CMyLife. PATIENT EDUCATION AND COUNSELING 2022; 105:686-694. [PMID: 34226069 DOI: 10.1016/j.pec.2021.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND For patients with chronic myeloid leukemia, a web-based platform CMyLife was developed. Its aim is to enhance patient empowerment, by adequate information provision, among others. Before evaluating its effect, information provision and needs in current care were assessed. OBJECTIVE To assess patients' evaluation of received information and information needs before CMyLife utilization and whether this information source is used correspondingly. Additionally, we explored predicting patient factors in information perception. PATIENT INVOLVEMENT CMyLife platform was developed with active patient participation. METHODS We conducted a cross-sectional survey among 203 CML patients before launch of the CMyLife platform, using validated questionnaires on information provision and predictive factors. We focused on website utilization during the first 3 years, using Google Analytics. Regression analyses were performed to determine influence of patient factors on information perception. RESULTS Global perceived information provision was scored 42.8 (0-100). Information on other services such as rehabilitation and psychological support, and effects of treatment on sexuality showed room for improvement. One out of 3 knew where to find useful health information online. But more information was desired by 36% of them. Age ≥65 years, time since diagnosis and low education were positively associated with this need. Pages on medication and side effects were visited the most. DISCUSSION To fill the gap in perceived provision and needs, information should be adjusted more to the individual in content, manner and timing. Age, time since diagnosis, and educational level are of influence in perceived information, and specific needs within these groups should be further explored. PRACTICAL VALUE CMyLife provides reliable and up-to-date information for low eHealth literacy skilled patients concerning multiple topics indicated by patients.
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Affiliation(s)
- Geneviève Icg Ector
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Lynn Verweij
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosella Pmg Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole Ma Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
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Suleman A, Vijenthira A, Berlin A, Prica A, Rodin D. The Use of Virtual Care in Patients with Hematologic Malignancies: A Scoping Review. Curr Oncol 2022; 29:892-900. [PMID: 35200575 PMCID: PMC8871074 DOI: 10.3390/curroncol29020076] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 12/18/2022] Open
Abstract
There is increasing interest from cancer patients and their healthcare providers in the use of virtual care in routine clinical practice. In the setting of hematologic malignancy, where patients often undergo complex and immunodepleting treatments, understanding how to use virtual care safely and effectively is critically important. We aimed to describe the use of virtual care in patients with hematologic malignancies and to examine physician- and patient-reported outcomes in the form of a systematic scoping review. An electronic search of PubMed, Ovid MEDLINE, Elsevier Embase, Scopus, and EBSCO CINAHL was conducted from January 2000 to April 2021. A comprehensive search strategy was used to identify relevant articles, and data were extracted to assess the study design, population, setting, patient characteristics, virtual care platform, and study results. Studies were included if they described the use of virtual care for patients with hematologic malignancies; commentaries were excluded. Fifteen studies met the inclusion criteria after abstract and full-text review. Three studies found that app-based tools were effective in monitoring patient symptoms and triggering alerts for more urgent follow-up. Four studies described the use of phone-based interventions. Five studies found that videoconferencing, with both physicians and oncology nurses, was highly rated by patients. Emerging themes included high levels of patient satisfaction across all domains of virtual care. Provider satisfaction scores were rated lower than patient scores, with concerns about technical issues leading to challenges with virtual care. Four studies found that virtual care allowed providers to promptly respond to patient concerns, especially when patients were experiencing side-effects or had questions about their treatment. Overall, the use of virtual care in patients with hematologic malignancies appears feasible, and resulted in high patient satisfaction. Further research is needed in order to evaluate the optimal method of integrating virtual care into clinical practice.
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Affiliation(s)
- Adam Suleman
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Correspondence:
| | - Abi Vijenthira
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada; (A.V.); (A.P.)
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada; (A.B.); (D.R.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Anca Prica
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada; (A.V.); (A.P.)
| | - Danielle Rodin
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada; (A.B.); (D.R.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5S 1A1, Canada
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13
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Hopstaken JS, Verweij L, van Laarhoven CJHM, Blijlevens NMA, Stommel MWJ, Hermens RPMG. Effect of Digital Care Platforms on Quality of Care for Oncological Patients and Barriers and Facilitators for Their Implementation: Systematic Review. J Med Internet Res 2021; 23:e28869. [PMID: 34559057 PMCID: PMC8501408 DOI: 10.2196/28869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/17/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oncological health care services are challenged by the increasing number of cancer survivors, long-term follow-up care, and fragmentation of care. Digital care platforms are potential tools to deliver affordable, patient-centered oncological care. Previous reviews evaluated only one feature of a digital care platform or did not evaluate the effect on enhancement of information, self-efficacy, continuity of care, or patient- and health care provider-reported experiences. Additionally, they have not focused on the barriers and facilitators for implementation of a digital care platform in oncological care. OBJECTIVE The aim of this systematic review was to collect the best available evidence of the effect of a digital care platform on quality of care parameters such as enhancement of available information, self-efficacy, continuity of care, and patient- and health care provider-reported experiences. Additionally, barriers and facilitators for implementation of digital care platforms were analyzed. METHODS The PubMed (Medline), Embase, CINAHL, and Cochrane Library databases were searched for the period from January 2000 to May 2020 for studies assessing the effect of a digital care platform on the predefined outcome parameters in oncological patients and studies describing barriers and facilitators for implementation. Synthesis of the results was performed qualitatively. Barriers and facilitators were categorized according to the framework of Grol and Wensing. The Mixed Methods Appraisal Tool was used for critical appraisal of the studies. RESULTS Seventeen studies were included for final analysis, comprising 8 clinical studies on the effectiveness of the digital care platform and 13 studies describing barriers and facilitators. Usage of a digital care platform appeared to enhance the availability of information and self-efficacy. There were no data available on the effect of a digital care platform on the continuity of care. However, based on focus group interviews, digital care platforms could potentially improve continuity of care by optimizing the exchange of patient information across institutes. Patient-reported experiences such as satisfaction with the platform were considerably positive. Most barriers for implementation were identified at the professional level, such as the concern for increased workload and unattended release of medical information to patients. Most facilitators were found at the patient and innovation levels, such as improved patient-doctor communication and patient empowerment. There were few barriers and facilitators mentioned at the economic and political levels. CONCLUSIONS The use of digital care platforms is associated with better quality of care through enhancement of availability of information and increased self-efficacy for oncological patients. The numerous facilitators identified at the patient level illustrate that patients are positive toward a digital care platform. However, despite these favorable results, robust evidence concerning the effectiveness of digital care platforms, especially from high-quality studies, is still lacking. Future studies should therefore aim to further investigate the effectiveness of digital care platforms, and the barriers and facilitators to their implementation at the economic and political levels.
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Affiliation(s)
- Jana S Hopstaken
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Cees J H M van Laarhoven
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martijn W J Stommel
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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Park M, Giap TTT, Jang I, Jeong M, Kim J. Listening to patients' voices: Applying the design-thinking method for teaching person-centered care to nursing students. Nurs Forum 2021; 57:9-17. [PMID: 34405414 DOI: 10.1111/nuf.12641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/14/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Providing a person-centered care (PCC) education program to nursing students is necessary. This study aims to determine the impact of a design-thinking based education program on how nursing students perceive PCC. METHODS Five 2-h lessons were offered to 105 fourth-year nursing students in South Korea. Each randomly assigned group of eight or nine students was instructed to develop a plan to address the problems/dissatisfaction experienced by patients during hospitalization. The Individualized Care Scale-nurse's version was used to measure student's perception of PCC before and after the education program. RESULTS After the program the students exhibited significant improvements in how they viewed supporting patient individuality, with that score increasing by 0.44 (from 3.64 to 4.08; p < 0.0001), and maintaining patient individuality while providing care, with that score increasing by 0.34 (from 3.71 to 4.05; p < 0.0001). Among subdomains, the most notable change was in how the students viewed the personal life situation of patients, and its impact on patients' healthcare outcomes. CONCLUSION This education program, based on the design-thinking approach, was effective in improving the perceptions of nursing students about PCC. Expanding such PCC education programs for nursing school students should therefore be considered.
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Affiliation(s)
- Myonghwa Park
- College of Nursing, Chungnam National University, Education and Research Center for Evidence-Based Nursing Knowledge, Daejeon, South Korea
| | - Thi-Thanh-Tinh Giap
- College of Nursing, Chungnam National University, Education and Research Center for Evidence-Based Nursing Knowledge, Daejeon, South Korea
| | - Insook Jang
- Department of Infection Control, Chungnam National University Hospital, Daejeon, South Korea
| | - Miri Jeong
- Department of Nursing, Joongbu University, Geumsan, South Korea
| | - Jahyeon Kim
- College of Nursing, Chungnam National University, Education and Research Center for Evidence-Based Nursing Knowledge, Daejeon, South Korea
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Efficace F, Iurlo A, Patriarca A, Stagno F, Bee PC, Ector G, Capodanno I, Elena C, Bonifacio M, Blijlevens NMA, Caocci G, Wan C, Abruzzese E, Breccia M, Cottone F, Okumura I, Oerlemans S, Cascavilla N, Albano F, Kota V, Sztankay M, Miggiano MC, Saussele S, Di Renzo N, Sorà F, Castagnetti F, Baccarani M, Vignetti M, Rosti G. Validation and reference values of the EORTC QLQ-CML24 questionnaire to assess health-related quality of life in patients with chronic myeloid leukemia. Leuk Lymphoma 2020; 62:669-678. [DOI: 10.1080/10428194.2020.1838509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Patriarca
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Fabio Stagno
- Hematology Section with BMT Unit, AOU Policlinico – V. Emanuele, Catania, Italy
| | - Ping-Chong Bee
- Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Geneviève Ector
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Chiara Elena
- Division of Hematology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | | | | | - Giovanni Caocci
- Dipartimento Scienze Mediche e Sanità Pubblica, Università di Cagliari, Ospedale Businco, Cagliari, Italy
| | - Chonghua Wan
- School of Humanities and Management, Research center for quality of life and applied psychology, Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Guangdong Medical University, Dongguan, China
| | - Elisabetta Abruzzese
- Division of Hematology, Ospedale S. Eugenio, Tor Vergata University, ASL Roma 2, Roma, Italy
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Iris Okumura
- Unidade de Hematologia, Hemoterapia e Oncologia (UHHO), Serviço de Transplante de Medula Óssea (STMO), Complexo Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | - Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Nicola Cascavilla
- Department of Hematology and Stem Cell Transplant Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Francesco Albano
- Department of Emergency and Transplantation, Hematology Section, University of Bari Medical School, Bari, Italy
| | - Vamsi Kota
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Monika Sztankay
- Medical University of Innsbruck, University Hospital Innsbruck, Psychiatry II, Innsbruck, Austria
| | | | - Susanne Saussele
- III. Med. Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany
| | | | - Federica Sorà
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Institute of Hematology “L. & A. Seràgnoli”, “Sant'Orsola-Malpighi” University Hospital, University of Bologna, Bologna, Italy
| | - Michele Baccarani
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Institute of Hematology “L. & A. Seràgnoli”, “Sant'Orsola-Malpighi” University Hospital, University of Bologna, Bologna, Italy
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Gianantonio Rosti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Institute of Hematology “L. & A. Seràgnoli”, “Sant'Orsola-Malpighi” University Hospital, University of Bologna, Bologna, Italy
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16
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Ector GICG, Huijskens EGW, Blijlevens NMA, Westerweel PE. Prevalence of COVID-19 diagnosis in Dutch CML patients during the 2020 SARS-CoV2 pandemic. A prospective cohort study. Leukemia 2020; 34:2533-2535. [PMID: 32641732 PMCID: PMC7341464 DOI: 10.1038/s41375-020-0964-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/27/2023]
Affiliation(s)
- Geneviève I C G Ector
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | | | - Nicole M A Blijlevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Peter E Westerweel
- Department of Haematology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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17
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Ector GICG, Hermens RPMG, Blijlevens NMA. Filling the gaps of patient information and comprehension. Curr Opin Oncol 2020; 32:262-268. [PMID: 32541311 DOI: 10.1097/cco.0000000000000633] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review describes the gaps in cancer patient information and comprehension and provides examples of interventions aimed at filling the gaps. RECENT FINDINGS Despite the technologically advanced era, unmet information needs remain a challenge in current cancer care, even though the beneficial effects of adequate information provision are well described.It starts with the basics of patient-physician communication and information exchange. Barriers are described both patient and physician-specific. For patients to comprehend and recall information correctly, information provision should be tailored to the specific patient in content, as well as in readability level. Tailored content based on bidirectional and iterative information exchange (i.e., patients reported outcomes, followed by specific/personalized feedback) is of focus in the current development of interventions aimed at meeting the gaps. However, the effects of such interventions are not overwhelming and the explanation could be multifactorial. SUMMARY Unmet informational needs are still a gap in current cancer care. The effect of eHealth interventions is not yet well established. Key is to educate patients and (future) healthcare professionals in eHealth. Future research should focus on identifying what kind of interventions are able to fill the gaps.
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Affiliation(s)
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
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