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Goldgof GM, Mishra S, Bajaj K. Efficacy of the QuitSure App for Smoking Cessation in Adult Smokers: Cross-Sectional Web Survey. JMIR Hum Factors 2024; 11:e49519. [PMID: 38709553 PMCID: PMC11106700 DOI: 10.2196/49519] [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: 05/31/2023] [Revised: 11/28/2023] [Accepted: 02/28/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Cigarette smoking remains one of the leading causes of preventable death worldwide. A worldwide study by the World Health Organization concluded that more than 8 million people die every year from smoking, tobacco consumption, and secondhand smoke. The most effective tobacco cessation programs require personalized human intervention combined with costly pharmaceutical supplementation, making them unaffordable or inaccessible to most tobacco users. Thus, digital interventions offer a promising alternative to these traditional methods. However, the leading smartphone apps available in the market today have either not been studied in a clinical setting or are unable to match the smoking cessation success rates of their expensive offline counterparts. We would like to understand whether QuitSure, a novel smoking cessation app built by Rapidkart Online Private Limited, is able to bridge this efficacy gap and deliver affordable and effective smoking cessation at scale. OBJECTIVE Our objective was to do an initial exploration into the engagement, efficacy, and safety of QuitSure based on the self-reported experiences of its users. Outcomes measured were program completion, the effect of program completion on smoking behavior, including self-reported cessation outcomes, and negative health events from using the app. METHODS All QuitSure registered users who created their accounts on the QuitSure app between April 1, 2021, and February 28, 2022, were sent an anonymized web-based survey. The survey results were added to their engagement data on the app to evaluate the feasibility and efficacy of the app as a smoking cessation intervention. The data were analyzed using descriptive statistics (frequencies and percentages) and the χ2 test of independence. RESULTS In total, 1299 users who had completed the QuitSure program submitted the survey and satisfied the inclusion criteria of the study. Of these, 1286 participants had completed the program more than 30 days before filling out the survey, and 1040 (80.1%, 95% CI 79.1%-82.6%) of them had maintained prolonged abstinence for at least 30 days after program completion. A majority of participants (770/891, 86.4%) who were still maintaining abstinence at the time of submitting the survey did not experience any severe nicotine withdrawal symptoms, while 41.9% (373/891) experienced no mild withdrawal symptoms either. Smoking quantity prior to completing the program significantly affected quit rates (P<.001), with heavy smokers (>20 cigarettes per day) having a lower 30-day prolonged abstinence rate (relative risk=0.91; 95% CI 90.0%-96.2%) compared to lighter smokers. No additional adverse events outside of known nicotine withdrawal symptoms were reported. CONCLUSIONS The nature of web-based surveys and cohort selection allows for extensive unknown biases. However, the efficacy rates of survey respondents who completed the program were high and provide a case for further investigation in the form of randomized controlled trials on the QuitSure tobacco cessation program.
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Affiliation(s)
- Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Shweta Mishra
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
| | - Kriti Bajaj
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
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González Bermúdez A, Carramiñana D, Bernardos AM, Bergesio L, Besada JA. A fusion architecture to deliver multipurpose mobile health services. Comput Biol Med 2024; 173:108344. [PMID: 38574531 DOI: 10.1016/j.compbiomed.2024.108344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.
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Affiliation(s)
- Ana González Bermúdez
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain.
| | - David Carramiñana
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Ana M Bernardos
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Luca Bergesio
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Juan A Besada
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
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Bricker JB, Santiago-Torres M, Mull KE, Sullivan BM, David SP, Schmitz J, Stotts A, Rigotti NA. Do medications increase the efficacy of digital interventions for smoking cessation? Secondary results from the iCanQuit randomized trial. Addiction 2024; 119:664-676. [PMID: 38009551 PMCID: PMC10932808 DOI: 10.1111/add.16396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS iCanQuit is a smartphone application (app) proven efficacious for smoking cessation in a Phase III randomized controlled trial (RCT). This study aimed to measure whether medications approved by the US Food and Drug Administration (FDA) for smoking cessation would further enhance the efficacy of iCanQuit, relative to its parent trial comparator-the National Cancer Institute's (NCI's) QuitGuide app. DESIGN Secondary analysis of the entire parent trial sample of a two-group (iCanQuit and QuitGuide), stratified, doubled-blind RCT. SETTING United States. PARTICIPANTS Participants who reported using an FDA-approved cessation medication on their own (n = 619) and those who reported no use of cessation medications (n = 1469). INTERVENTIONS Participants were randomized to receive iCanQuit app or NCI's QuitGuide app. MEASUREMENTS Use of FDA-approved medications was measured at 3 months post-randomization. Smoking cessation outcomes were measured at 3, 6 and 12 months. The primary outcome was 12-month self-reported 30-day point prevalence abstinence (PPA). FINDINGS The data retention rate at the 12-month follow-up was 94.0%. Participants were aged 38.5 years, 71.0% female, 36.6% minority race/ethnicity, 40.6% high school or less education, residing in all 50 US States and smoking 19.2 cigarettes/day. The 29.6% of all participants who used medications were more likely to choose nicotine replacement therapy (NRT; 78.8%) than other cessation medications (i.e. varenicline or bupropion; 18.3 and 10.5%, respectively) and use did not differ by app treatment assignment (all P > 0.05). There was a significant (P = 0.049) interaction between medication use and app treatment assignment on PPA. Specifically, 12-month quit rates were 34% for iCanQuit versus 20% for QuitGuide [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 1.59, 3.49] among participants reporting any medication use, whereas among participants reporting no medication use, quit rates were 28% for iCanQuit versus 22% for QuitGuide (OR = 1.41, 95% CI = 1.09, 1.82). Results were stronger for those using only NRT: 40% quit rates for iCanQuit versus 18% quit rates for QuitGuide (OR = 3.57, 95% CI = 2.20, 5.79). CONCLUSIONS The iCanQuit smartphone app for smoking cessation was more efficacious than the QuitGuide smartphone app, regardless of whether participants used medications to aid cessation. Smoking cessation medications, especially nicotine replacement therapy, might enhance the efficacy of the iCanQuit app.
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Affiliation(s)
- Jonathan B. Bricker
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue N., Seattle, Washington, 98109, USA
- University of Washington, Department of Psychology, Box 351525, Seattle, Washington, 98195, USA
| | - Margarita Santiago-Torres
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue N., Seattle, Washington, 98109, USA
| | - Kristin E. Mull
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue N., Seattle, Washington, 98109, USA
| | - Brianna M. Sullivan
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue N., Seattle, Washington, 98109, USA
| | - Sean P. David
- NorthShore University Health System, University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA
| | - Joy Schmitz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Angela Stotts
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, 77054, USA
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Nancy A. Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Fuhrmann LM, Weisel KK, Harrer M, Kulke JK, Baumeister H, Cuijpers P, Ebert DD, Berking M. Additive effects of adjunctive app-based interventions for mental disorders - A systematic review and meta-analysis of randomised controlled trials. Internet Interv 2024; 35:100703. [PMID: 38225971 PMCID: PMC10788289 DOI: 10.1016/j.invent.2023.100703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024] Open
Abstract
Background It is uncertain whether app-based interventions add value to existing mental health care. Objective To examine the incremental effects of app-based interventions when used as adjunct to mental health interventions. Methods We searched PubMed, PsycINFO, Scopus, Web of Science, and Cochrane Library databases on September 15th, 2023, for randomised controlled trials (RCTs) on mental health interventions with an adjunct app-based intervention compared to the same intervention-only arm for adults with mental disorders or respective clinically relevant symptomatology. We conducted meta-analyses on symptoms of different mental disorders at postintervention. PROSPERO, CRD42018098545. Results We identified 46 RCTs (4869 participants). Thirty-two adjunctive app-based interventions passively or actively monitored symptoms and behaviour, and in 13 interventions, the monitored data were sent to a therapist. We found additive effects on symptoms of depression (g = 0.17; 95 % CI 0.02 to 0.33; k = 7 comparisons), anxiety (g = 0.80; 95 % CI 0.06 to 1.54; k = 3), mania (g = 0.2; 95 % CI 0.02 to 0.38; k = 4), smoking cessation (g = 0.43; 95 % CI 0.29 to 0.58; k = 10), and alcohol use (g = 0.23; 95 % CI 0.08 to 0.39; k = 7). No significant effects were found on symptoms of depression within a bipolar disorder (g = -0.07; 95 % CI -0.37 to 0.23, k = 4) and eating disorders (g = -0.02; 95 % CI -0.44 to 0.4, k = 3). Studies on depression, mania, smoking, and alcohol use had a low heterogeneity between the trials. For other mental disorders, only single studies were identified. Only ten studies had a low risk of bias, and 25 studies reported insufficient statistical power. Discussion App-based interventions may be used to enhance mental health interventions to further reduce symptoms of depression, anxiety, mania, smoking, and alcohol use. However, the effects were small, except for anxiety, and limited due to study quality. Further high-quality research with larger sample sizes is warranted to better understand how app-based interventions can be most effectively combined with established interventions to improve outcomes.
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Affiliation(s)
- Lukas M. Fuhrmann
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kiona K. Weisel
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Jennifer K. Kulke
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - David D. Ebert
- Department of Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Liu F, Song T, Yu P, Deng N, Guan Y, Yang Y, Ma Y. Efficacy of an mHealth App to Support Patients' Self-Management of Hypertension: Randomized Controlled Trial. J Med Internet Res 2023; 25:e43809. [PMID: 38113071 PMCID: PMC10762623 DOI: 10.2196/43809] [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: 10/25/2022] [Revised: 01/27/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Hypertension is a significant global disease burden. Mobile health (mHealth) offers a promising means to provide patients with hypertension with easy access to health care services. Yet, its efficacy needs to be validated, especially in lower-income areas with a high-salt diet. OBJECTIVE This study aims to assess the efficacy of an mHealth app-based intervention in supporting patients' self-management of hypertension. METHODS A 2-arm randomized controlled trial was conducted among 297 patients with hypertension at the General Hospital of Ningxia Medical University, Ningxia Hui Autonomous Region, China. Participants selected via convenience sampling were randomly allocated into intervention and control groups. Intervention group participants were trained and asked to use an mHealth app named Blood Pressure Assistant for 6 months. They could use the app to record and upload vital signs, access educational materials, and receive self-management reminders and feedback from health care providers based on the analysis of the uploaded data. Control group participants received usual care. Blood pressure (BP) and 2 questionnaire surveys about hypertension knowledge and lifestyle behavior were used to assess all participants at baseline and 6 months. Data analysis was performed with SPSS software using 2-tailed t tests and a chi-square test. RESULTS There were no significant differences in baseline characteristics and medication use between the 2 groups (all P>.05). After 6 months, although both groups show a significant pre-post improvement (P<.001 each), the BP control rate (ie, the proportion of patients with a systolic BP of <140 mm Hg and diastolic BP of <90 mm Hg) in the intervention group was better than that in the control group (100/111, 90.1% vs 75/115, 65.2%; P<.001). The mean systolic and diastolic BP were significantly reduced by 25.83 (SD 8.99) and 14.28 (SD 3.74) mm Hg in the intervention group (P<.001) and by 21.83 (SD 6.86) and 8.87 (SD 4.22) mm Hg in the control group (P<.001), respectively. The differences in systolic and diastolic BP between the 2 groups were significant (P<.001 and P=.01, respectively). Hypertension knowledge significantly improved only in the intervention group in both pre-post and intergroup comparisons (both P<.001). However, only intragroup improvement was observed for lifestyle behaviors in the intervention group (P<.001), including medication adherence (P<.001), healthy diet (P=.02), low salt intake (P<.001), and physical exercises (P=.02), and no significant difference was observed in the control group or on intergroup comparisons. CONCLUSIONS This research shows that the mHealth app-based intervention has the potential to improve patient health knowledge and support self-management among them toward a healthier lifestyle, including medication adherence, low-salt diets, and physical exercises, thereby achieving optimal BP control. Further research is still needed to verify the specific effects of these interventions. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900026437; https://www.chictr.org.cn/showproj.html?proj=38801.
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Affiliation(s)
- Fang Liu
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Ting Song
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Ning Deng
- The Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Yingping Guan
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yang Yang
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yuanji Ma
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute Of Cardiovascular Diseases, Shanghai, China
- National Clinical Research Center for International Medicine, Shanghai, China
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Brin M, Trujillo P, Jia H, Cioe P, Huang MC, Chen H, Qian X, Xu W, Schnall R. Pilot Testing of an mHealth App for Tobacco Cessation in People Living With HIV: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49558. [PMID: 37856173 PMCID: PMC10623232 DOI: 10.2196/49558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/17/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND An estimated 40% of people living with HIV smoke cigarettes. Although smoking rates in the United States have been declining in recent years, people living with HIV continue to smoke cigarettes at twice the rate of the general population. Mobile health (mHealth) technology is an effective tool for people living with a chronic illness, such as HIV, as currently 84% of households in the United States report that they have a smartphone. Although many studies have used mHealth interventions for smoking cessation, few studies have recruited people living with HIV who smoke. OBJECTIVE The objective of the pilot randomized controlled trial (RCT) is to examine the feasibility, acceptability, and preliminary efficacy of the Sense2Quit App as a tool for people living with HIV who are motivated to quit smoking. METHODS The Sense2Quit study is a 2-arm RCT for people living with HIV who smoke cigarettes (n=60). Participants are randomized to either the active intervention condition, which consists of an 8-week supply of nicotine replacement therapy, standard smoking cessation counseling, and access to the Sense2Quit mobile app and smartwatch, or the control condition, which consists of standard smoking cessation counseling and a referral to the New York State Smokers' Quitline. The Sense2Quit app is a mobile app connected through Bluetooth to a smartwatch that tracks smoking gestures and distinguishes them from other everyday hand movements. In the Sense2Quit app, participants can view their smoking trends, which are recorded through their use of the smartwatch, including how often or how much they smoke and the amount of money that they are spending on cigarettes, watch videos with quitting tips, information, and distractions, play games, set reminders, and communicate with a study team member. RESULTS Enrollment of study participants began in March 2023 and is expected to end in October 2023. All data collection is expected to be completed by the end of January 2024. This RCT will test the difference in outcomes between the control and intervention arms. The primary outcome will be the percentage of participants with biochemically verified 7-day point prevalence smoking or tobacco abstinence at their 12-week follow-up. Results from this pilot study will be disseminated to the research community following the completion of all data collection. CONCLUSIONS The Sense2Quit study leverages mHealth so that it can help smokers improve their efforts at smoking cessation. Our research has the potential to not only increase quitting rates among people living with HIV who may need a prolonged, tailored intervention but also inform further development of mHealth for people living with HIV. This mHealth study will contribute significant findings to the greater mHealth research community, providing evidence as to how mHealth should be developed and tested among the target population. TRIAL REGISTRATION ClinicalTrials.gov NCT05609032; https://clinicaltrials.gov/study/NCT05609032. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49558.
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Affiliation(s)
- Maeve Brin
- Columbia University School of Nursing, New York City, NY, United States
| | - Paul Trujillo
- Columbia University School of Nursing, New York City, NY, United States
| | - Haomiao Jia
- Columbia University School of Nursing, New York City, NY, United States
| | - Patricia Cioe
- Brown University School of Public Health, Providence, RI, United States
| | - Ming-Chun Huang
- Case Western Reserve University School of Engineering, Cleveland, OH, United States
| | - Huan Chen
- Case Western Reserve University School of Engineering, Cleveland, OH, United States
| | - Xiaoye Qian
- Case Western Reserve University School of Engineering, Cleveland, OH, United States
| | - Wenyao Xu
- Department of Computer Science and Engineering, University at Buffalo, the State University of New York, Buffalo, NY, United States
| | - Rebecca Schnall
- Columbia University School of Nursing, New York City, NY, United States
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Asan O, Choi E, Wang X. Artificial Intelligence-Based Consumer Health Informatics Application: Scoping Review. J Med Internet Res 2023; 25:e47260. [PMID: 37647122 PMCID: PMC10500367 DOI: 10.2196/47260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/02/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND There is no doubt that the recent surge in artificial intelligence (AI) research will change the trajectory of next-generation health care, making it more approachable and accessible to patients. Therefore, it is critical to research patient perceptions and outcomes because this trend will allow patients to be the primary consumers of health technology and decision makers for their own health. OBJECTIVE This study aimed to review and analyze papers on AI-based consumer health informatics (CHI) for successful future patient-centered care. METHODS We searched for all peer-reviewed papers in PubMed published in English before July 2022. Research on an AI-based CHI tool or system that reports patient outcomes or perceptions was identified for the scoping review. RESULTS We identified 20 papers that met our inclusion criteria. The eligible studies were summarized and discussed with respect to the role of the AI-based CHI system, patient outcomes, and patient perceptions. The AI-based CHI systems identified included systems in mobile health (13/20, 65%), robotics (5/20, 25%), and telemedicine (2/20, 10%). All the systems aimed to provide patients with personalized health care. Patient outcomes and perceptions across various clinical disciplines were discussed, demonstrating the potential of an AI-based CHI system to benefit patients. CONCLUSIONS This scoping review showed the trend in AI-based CHI systems and their impact on patient outcomes as well as patients' perceptions of these systems. Future studies should also explore how clinicians and health care professionals perceive these consumer-based systems and integrate them into the overall workflow.
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Affiliation(s)
- Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Euiji Choi
- Department of Computer Science, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Xiaomei Wang
- Department of Industrial Engieering, University of Louisville, Louisville, KY, United States
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8
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Fang YE, Zhang Z, Wang R, Yang B, Chen C, Nisa C, Tong X, Yan LL. Effectiveness of eHealth Smoking Cessation Interventions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e45111. [PMID: 37505802 PMCID: PMC10422176 DOI: 10.2196/45111] [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: 12/16/2022] [Revised: 04/13/2023] [Accepted: 04/24/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Rapid advancements in eHealth and mobile health (mHealth) technologies have driven researchers to design and evaluate numerous technology-based interventions to promote smoking cessation. The evolving nature of cessation interventions emphasizes a strong need for knowledge synthesis. OBJECTIVE This systematic review and meta-analysis aimed to summarize recent evidence from randomized controlled trials regarding the effectiveness of eHealth-based smoking cessation interventions in promoting abstinence and assess nonabstinence outcome indicators, such as cigarette consumption and user satisfaction, via narrative synthesis. METHODS We searched for studies published in English between 2017 and June 30, 2022, in 4 databases: PubMed (including MEDLINE), PsycINFO, Embase, and Cochrane Library. Two independent reviewers performed study screening, data extraction, and quality assessment based on the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. We pooled comparable studies based on the population, follow-up time, intervention, and control characteristics. Two researchers performed an independent meta-analysis on smoking abstinence using the Sidik-Jonkman random-effects model and log risk ratio (RR) as the effect measurement. For studies not included in the meta-analysis, the outcomes were narratively synthesized. RESULTS A total of 464 studies were identified through an initial database search after removing duplicates. Following screening and full-text assessments, we deemed 39 studies (n=37,341 participants) eligible for this review. Of these, 28 studies were shortlisted for meta-analysis. According to the meta-analysis, SMS or app text messaging can significantly increase both short-term (3 months) abstinence (log RR=0.50, 95% CI 0.25-0.75; I2=0.72%) and long-term (6 months) abstinence (log RR=0.77, 95% CI 0.49-1.04; I2=8.65%), relative to minimal cessation support. The frequency of texting did not significantly influence treatment outcomes. mHealth apps may significantly increase abstinence in the short term (log RR=0.76, 95% CI 0.09-1.42; I2=88.02%) but not in the long term (log RR=0.15, 95% CI -0.18 to 0.48; I2=80.06%), in contrast to less intensive cessation support. In addition, personalized or interactive interventions showed a moderate increase in cessation for both the short term (log RR=0.62, 95% CI 0.30-0.94; I2=66.50%) and long term (log RR=0.28, 95% CI 0.04-0.53; I2=73.42%). In contrast, studies without any personalized or interactive features had no significant impact. Finally, the treatment effect was similar between trials that used biochemically verified or self-reported abstinence. Among studies reporting outcomes besides abstinence (n=20), a total of 11 studies reported significantly improved nonabstinence outcomes in cigarette consumption (3/14, 21%) or user satisfaction (8/19, 42%). CONCLUSIONS Our review of 39 randomized controlled trials found that recent eHealth interventions might promote smoking cessation, with mHealth being the dominant approach. Despite their success, the effectiveness of such interventions may diminish with time. The design of more personalized interventions could potentially benefit future studies. TRIAL REGISTRATION PROSPERO CRD42022347104; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347104.
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Affiliation(s)
- Yichen E Fang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Zhixian Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Ray Wang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Bolu Yang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Claudia Nisa
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Division of Social Sciences, Duke Kunshan University, Kunshan, China
| | - Xin Tong
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Data Science Research Center, Duke Kunshan University, Kunshan, China
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Institute for Global Health and Development, Peking University, Beijing, China
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Wynn CS, Fiks AG, Localio R, Shults J, Nekrasova E, Shone LP, Torres A, Griffith M, Unger R, Ware LA, Kelly MK, Stockwell MS. Examination of Text Message Plans and Baseline Usage of Families Enrolled in a Text Message Influenza Vaccine Reminder Trial: Survey Study. JMIR Form Res 2023; 7:e39576. [PMID: 37389945 PMCID: PMC10365607 DOI: 10.2196/39576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) is quickly expanding as a method of health promotion, but some interventions may not be familiar or comfortable for potential users. SMS text messaging has been investigated as a low-cost, accessible way to provide vaccine reminders. Most (97%) US adults own a cellphone and of those adults most use SMS text messaging. However, understanding patterns of SMS text message plan type and use in diverse primary care populations needs more investigation. OBJECTIVE We sought to use a survey to examine baseline SMS text messaging and data plan patterns among families willing to accept SMS text message vaccine reminders. METHODS As part of a National Institutes of Health (NIH)-funded national study (Flu2Text) conducted during the 2017-2018 and 2018-2019 influenza seasons, families of children needing a second seasonal influenza vaccine dose were recruited in pediatric primary care offices at the time of their first dose. Practices were from the American Academy of Pediatrics' (AAP) Pediatric Research in Office Settings (PROS) research network, the Children's Hospital of Philadelphia, and Columbia University. A survey was administered via telephone (Season 1) or electronically (Season 2) at enrollment. Standardized (adjusted) proportions for SMS text message plan type and texting frequency were calculated using logistic regression that was adjusted for child and caregiver demographics. RESULTS Responses were collected from 1439 participants (69% of enrolled). The mean caregiver age was 32 (SD 6) years, and most children (n=1355, 94.2%) were aged 6-23 months. Most (n=1357, 94.3%) families were English-speaking. Most (n=1331, 92.8%) but not all participants had an unlimited SMS text messaging plan and sent or received texts at least once daily (n=1313, 91.5%). SMS text messaging plan type and use at baseline was uniform across most but not all subgroups. However, there were some differences in the study population's SMS text messaging plan type and usage. Caregivers who wanted Spanish SMS text messages were less likely than those who chose English to have an unlimited SMS text messaging plan (n=61, 86.7% vs n=1270, 94%; risk difference -7.2%, 95% CI -27.1 to -1.8). There were no significant differences in having an unlimited plan associated with child's race, ethnicity, age, health status, insurance type, or caregiver education level. SMS text messaging use at baseline was not uniform across all subgroups. Nearly three-quarters (n=1030, 71.9%) of participants had received some form of SMS text message from their doctor's office; most common were appointment reminders (n=1014, 98.4%), prescription (n=300, 29.1%), and laboratory notifications (n=117, 11.4%). Even the majority (n=64, 61.5%) of those who did not have unlimited plans and who texted less than daily (n=72, 59%) reported receipt of these SMS text messages. CONCLUSIONS In this study, most participants had access to unlimited SMS text messaging plans and texted at least once daily. However, infrequent texting and lack of access to an unlimited SMS text messaging plan did not preclude enrolling to receive SMS text message reminders in pediatric primary care settings.
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Affiliation(s)
- Chelsea S Wynn
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Alexander G Fiks
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Russell Localio
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Justine Shults
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Ekaterina Nekrasova
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Laura P Shone
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Alessandra Torres
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Miranda Griffith
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Rebecca Unger
- Northwestern Children's Practice, Chicago, IL, United States
| | - Leigh Ann Ware
- Building Blocks Pediatrics, Pleasanton, TX, United States
| | - Mary Kate Kelly
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
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10
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Singh B, Olds T, Brinsley J, Dumuid D, Virgara R, Matricciani L, Watson A, Szeto K, Eglitis E, Miatke A, Simpson CEM, Vandelanotte C, Maher C. Systematic review and meta-analysis of the effectiveness of chatbots on lifestyle behaviours. NPJ Digit Med 2023; 6:118. [PMID: 37353578 DOI: 10.1038/s41746-023-00856-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sleep, published before 1 September 2022. Outcomes were total physical activity, steps, moderate-to-vigorous physical activity (MVPA), fruit and vegetable consumption, sleep quality and sleep duration. Standardised mean differences (SMD) were calculated to compare intervention effects. Subgroup analyses were conducted to assess chatbot type, intervention type, duration, output and use of artificial intelligence. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment tool. Nineteen trials were included. Sample sizes ranged between 25-958, and mean participant age ranged between 9-71 years. Most interventions (n = 15, 79%) targeted physical activity, and most trials had a low-quality rating (n = 14, 74%). Meta-analysis results showed significant effects (all p < 0.05) of chatbots for increasing total physical activity (SMD = 0.28 [95% CI = 0.16, 0.40]), daily steps (SMD = 0.28 [95% CI = 0.17, 0.39]), MVPA (SMD = 0.53 [95% CI = 0.24, 0.83]), fruit and vegetable consumption (SMD = 0.59 [95% CI = 0.25, 0.93]), sleep duration (SMD = 0.44 [95% CI = 0.32, 0.55]) and sleep quality (SMD = 0.50 [95% CI = 0.09, 0.90]). Subgroup analyses showed that text-based, and artificial intelligence chatbots were more efficacious than speech/voice chatbots for fruit and vegetable consumption, and multicomponent interventions were more efficacious than chatbot-only interventions for sleep duration and sleep quality (all p < 0.05). Findings from this systematic review and meta-analysis indicate that chatbot interventions are efficacious for increasing physical activity, fruit and vegetable consumption, sleep duration and sleep quality. Chatbot interventions were efficacious across a range of populations and age groups, with both short- and longer-term interventions, and chatbot only and multicomponent interventions being efficacious.
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Affiliation(s)
- Ben Singh
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia.
| | - Timothy Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Jacinta Brinsley
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Dot Dumuid
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Rosa Virgara
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Lisa Matricciani
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Amanda Watson
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Kimberley Szeto
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Emily Eglitis
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Aaron Miatke
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Catherine E M Simpson
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Carol Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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11
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Aggarwal A, Tam CC, Wu D, Li X, Qiao S. Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. J Med Internet Res 2023; 25:e40789. [PMID: 36826990 PMCID: PMC10007007 DOI: 10.2196/40789] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI)-based chatbots can offer personalized, engaging, and on-demand health promotion interventions. OBJECTIVE The aim of this systematic review was to evaluate the feasibility, efficacy, and intervention characteristics of AI chatbots for promoting health behavior change. METHODS A comprehensive search was conducted in 7 bibliographic databases (PubMed, IEEE Xplore, ACM Digital Library, PsycINFO, Web of Science, Embase, and JMIR publications) for empirical articles published from 1980 to 2022 that evaluated the feasibility or efficacy of AI chatbots for behavior change. The screening, extraction, and analysis of the identified articles were performed by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Of the 15 included studies, several demonstrated the high efficacy of AI chatbots in promoting healthy lifestyles (n=6, 40%), smoking cessation (n=4, 27%), treatment or medication adherence (n=2, 13%), and reduction in substance misuse (n=1, 7%). However, there were mixed results regarding feasibility, acceptability, and usability. Selected behavior change theories and expert consultation were used to develop the behavior change strategies of AI chatbots, including goal setting, monitoring, real-time reinforcement or feedback, and on-demand support. Real-time user-chatbot interaction data, such as user preferences and behavioral performance, were collected on the chatbot platform to identify ways of providing personalized services. The AI chatbots demonstrated potential for scalability by deployment through accessible devices and platforms (eg, smartphones and Facebook Messenger). The participants also reported that AI chatbots offered a nonjudgmental space for communicating sensitive information. However, the reported results need to be interpreted with caution because of the moderate to high risk of internal validity, insufficient description of AI techniques, and limitation for generalizability. CONCLUSIONS AI chatbots have demonstrated the efficacy of health behavior change interventions among large and diverse populations; however, future studies need to adopt robust randomized control trials to establish definitive conclusions.
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Affiliation(s)
- Abhishek Aggarwal
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- SC SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC, United States
| | - Cheuk Chi Tam
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- SC SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC, United States
| | - Dezhi Wu
- UofSC Big Data Health Science Center (BDHSC), University of South Carolina, Columbia, SC, United States
- Department of Integrated Information Technology, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- SC SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC, United States
- UofSC Big Data Health Science Center (BDHSC), University of South Carolina, Columbia, SC, United States
| | - Shan Qiao
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- SC SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC, United States
- UofSC Big Data Health Science Center (BDHSC), University of South Carolina, Columbia, SC, United States
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Sha L, Yang X, Deng R, Wang W, Tao Y, Cao H, Ma Q, Wang H, Nie Y, Leng S, Lv Q, Li X, Wang H, Meng Y, Xu J, Greenshaw AJ, Li T, Guo WJ. Automated Digital Interventions and Smoking Cessation: Systematic Review and Meta-analysis Relating Efficiency to a Psychological Theory of Intervention Perspective. J Med Internet Res 2022; 24:e38206. [DOI: 10.2196/38206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/13/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background
Smoking remains a highly significant preventable global public health problem. In this context, digital interventions offer great advantages in terms of a lack of biological side effects, possibility of automatic delivery, and consequent human resource savings relative to traditional interventions. Such interventions have been studied in randomized controlled trials (RCTs) but have not been systematically reviewed with the inclusion of text-based and multiplatform-based interventions. In addition, this area has not been evaluated from the perspective of the psychological theoretical basis of intervention.
Objective
The aim of this paper is to assess the efficiency of digital interventions in RCT studies of smoking cessation and to evaluate the effectiveness of the strategies used for digital interventions.
Methods
An electronic search of RCTs was conducted using PubMed, Embase, and the Cochrane Library by June 30, 2021. Eligible studies had to compare automated digital intervention (ADI) to the use of a self-help guideline or no intervention. Participants were current smokers (aged 16 years or older). As the main outcome, abstinence after endpoint was extracted from the studies. Systematic review and meta-analysis were conducted to assess the efficiency of ADIs. Metaregressions were conducted to assess the relationship between intervention theory and effectiveness.
Results
A total of 19 trials (15,472 participants) were included in the analysis. The overall abstinence rate (95% CI) at the endpoint was 17.8% (17.0-18.7). The overall risk ratio of the intervention group compared to the controls at the endpoint was 17.8% (17.0-18.7). Cochrane risk-of-bias tool for randomized trials (ROB 2) suggested that most of the studies had a low risk of bias (56.3%). Psychological theory–related constructs or predictors, which refer to other theory-based concepts (rather than only behavioral theory) such as craving or anxiety, are associated with effectiveness.
Conclusions
This study found that ADI had a clear positive effect compared to self-help guidelines or to no intervention, and effectiveness was associated with theory-related constructs or predictors. ADIs should be promoted by policy makers and clinical practitioners to address the huge gap between the need for smoking cessation and availability of traditional treatment resources. Possible increases in ADI efficiency may be achieved by optimally integrating psychotherapeutic theories and techniques.
Trial Registration
PROSPERO CRD42021256593; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256593
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13
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Escrivá-Martínez T, Vara MD, Czeraniuk N, Denis M, Núñez-Benjumea FJ, Fernández-Luque L, Jiménez-Díaz A, Traver V, Llull JJ, Martínez-Millana A, Garcés-Ferrer J, Miragall M, Herrero R, Enríquez A, Schaefer V, Cervera-Torres S, Villasanti C, Cabral CV, Fernández I, Baños RM. mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial. PLoS One 2022; 17:e0273290. [PMID: 36346807 PMCID: PMC9642890 DOI: 10.1371/journal.pone.0273290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04659746.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Mª Dolores Vara
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Nadia Czeraniuk
- Centro de Investigación y Documentación, Universidad Autónoma de Encarnación, Encarnación, Paraguay
| | - Matías Denis
- Centro de Investigación y Documentación, Universidad Autónoma de Encarnación, Encarnación, Paraguay
| | | | | | - Alba Jiménez-Díaz
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicente Traver
- ITACA Institute, Polytechnic University of Valencia, Valencia, Spain
| | - Juan José Llull
- ITACA Institute, Polytechnic University of Valencia, Valencia, Spain
| | | | | | - Marta Miragall
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
- Adhera Health, Inc, Palo Alto, CA, United States of America
| | - Rocío Herrero
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
| | - Analía Enríquez
- Centro de Investigación y Documentación, Universidad Autónoma de Encarnación, Encarnación, Paraguay
| | - Verena Schaefer
- Instituto Superior de Educación Divina Esperanza, Encarnación, Paraguay
| | | | - Cecilia Villasanti
- Centro de Investigación y Documentación, Universidad Autónoma de Encarnación, Encarnación, Paraguay
| | | | - Irene Fernández
- Department of Methodology for the Behavioral Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa Mª Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
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14
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Guo YQ, Chen Y, Dabbs AD, Wu Y. The effectiveness of smartphone application-based interventions for assisting smoking cessation: A systematic review and meta-analysis (Preprint). J Med Internet Res 2022; 25:e43242. [PMID: 37079352 PMCID: PMC10160935 DOI: 10.2196/43242] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/07/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Smoking is a leading cause of premature death globally. Quitting smoking reduces the risk of all-cause mortality by 11%-34%. Smartphone app-based smoking cessation (SASC) interventions have been developed and are widely used. However, the evidence for the effectiveness of smartphone-based interventions for smoking cessation is currently equivocal. OBJECTIVE The purpose of this study was to synthesize the evidence for the effectiveness of smartphone app-based interventions for smoking cessation. METHODS We conducted a systematic review and meta-analysis of the effectiveness of smartphone interventions for smoking cessation based on the Cochrane methodology. An electronic literature search was performed using the Cochrane Library, Web of Science, PubMed, Embase, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases to identify published papers in English or Chinese (there was no time limit regarding the publication date). The outcome was the smoking abstinence rate, which was either a 7-day point prevalence abstinence rate or a continuous abstinence rate. RESULTS A total of 9 randomized controlled trials involving 12,967 adults were selected for the final analysis. The selected studies from 6 countries (the United States, Spain, France, Switzerland, Canada, and Japan) were included in the meta-analysis between 2018 and 2022. Pooled effect sizes (across all follow-up time points) revealed no difference between the smartphone app group and the comparators (standard care, SMS text messaging intervention, web-based intervention, smoking cessation counseling, or apps as placebos without real function; odds ratio [OR] 1.25, 95% CI 0.99-1.56, P=.06, I2=73.6%). Based on the subanalyses, 6 trials comparing smartphone app interventions to comparator interventions reported no significant differences in effectiveness (OR 1.03, 95% CI 0.85-1.26, P=.74, I2=57.1%). However, the 3 trials that evaluated the combination of smartphone interventions combined with pharmacotherapy compared to pharmacotherapy alone found higher smoking abstinence rates in the combined intervention (OR 1.79, 95% CI 1.38-2.33, P=.74, I2=7.4%). All SASC interventions with higher levels of adherence were significantly more effective (OR 1.48, 95% CI 1.20-1.84, P<.001, I2=24.5%). CONCLUSIONS This systematic review and meta-analysis did not support the effectiveness of delivering smartphone-based interventions alone to achieve higher smoking abstinence rates. However, the efficacy of smartphone-based interventions increased when combined with pharmacotherapy-based smoking cessation approaches. TRIAL REGISTRATION PROSPERO CRD42021267615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=267615.
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Affiliation(s)
- Yi-Qiang Guo
- School of Nursing, Capital Medical University, Beijing, China
| | - Yuling Chen
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | | | - Ying Wu
- School of Nursing, Capital Medical University, Beijing, China
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15
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da Silva Teixeira R, Garcia de Siqueira Galil A, Cupertino AP, Cartujano-Barrera F, Basile Colugnati FA. Effectiveness of a smoking cessation decision-making electronic tool ( Pare de Fumar Conosco): A randomized clinical trial. Health Informatics J 2022; 28:14604582221105450. [DOI: 10.1177/14604582221105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an underutilization of smoking cessation treatment among patients with chronic conditions, which indicates a need for new strategies to engage them. Web-based smoking cessation decision-making tools can be beneficial. This study assessed the effectiveness of the Pare de Fumar Conosco software at increasing engagement to smoking cessation counseling groups among Brazilian smokers with chronic conditions. Clinical trial participants were randomized to Pare de Fumar Conosco or standard of care. Engagement in the smoking cessation counseling group was the primary outcome. Secondary outcomes included motivation level, cessation rate, completion, and treatment adherence. The t-tests and Chi-square analyzed baseline differences between groups and the Poisson models, the effects of the intervention. Engagement rates were higher in the Pare de Fumar Conosco (IR=2.22; 95% CI: 1.06 - 4.63) concerning the standard of care. Pare de Fumar Conosco group was more adherent to treatment over time (6.4% versus 4.2% in the final week). Cessation rate was 26.3% in standard care and 23.1% in Pare de Fumar Conosco. Both interventions maintained significant motivation levels to quit smoking. The Pare de Fumar Conosco intervention effectively increases the engagement in the smoking cessation counseling groups. There is a need to improve the smoking cessation rate.
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Affiliation(s)
| | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, USA
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Takeuchi H, Suwa K, Kishi A, Nakamura T, Yoshiuchi K, Yamamoto Y. The Effects of Objective Push-type Sleep Feedback on Habitual Sleep Behavior and Momentary Symptoms in Daily Life: Mobile Health Intervention Trial using a Healthcare IoT System (Preprint). JMIR Mhealth Uhealth 2022; 10:e39150. [PMID: 36201383 PMCID: PMC9585447 DOI: 10.2196/39150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/12/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background Sleep is beneficial for physical and mental health. Several mobile and wearable sleep-tracking devices have been developed, and personalized sleep feedback is the most common functionality among these devices. To date, no study has implemented an objective push-type feedback message and investigated the characteristics of habitual sleep behavior and diurnal symptoms when receiving sleep feedback. Objective We conducted a mobile health intervention trial to examine whether sending objective push-type sleep feedback changes the self-reported mood, physical symptoms, and sleep behavior of Japanese office workers. Methods In total, 31 office workers (mean age 42.3, SD 7.9 years; male-to-female ratio 21:10) participated in a 2-arm intervention trial from November 30 to December 19, 2020. The participants were instructed to indicate their momentary mood and physical symptoms (depressive mood, anxiety, stress, sleepiness, fatigue, and neck and shoulder stiffness) 5 times a day using a smartphone app. In addition, daily work performance was rated once a day after work. They were randomly assigned to either a feedback or control group, wherein they did or did not receive messages about their sleep status on the app every morning, respectively. All participants wore activity monitors on their nondominant wrists, through which objective sleep data were registered on the web on a server. On the basis of the estimated sleep data on the server, personalized sleep feedback messages were generated and sent to the participants in the feedback group using the app. These processes were fully automated. Results Using hierarchical statistical models, we examined the differences in the statistical properties of sleep variables (sleep duration and midpoint of sleep) and daily work performance over the trial period. Group differences in the diurnal slopes for mood and physical symptoms were examined using a linear mixed effect model. We found a significant group difference among within-individual residuals at the midpoint of sleep (expected a posteriori for the difference: −15, 95% credible interval −26 to −4 min), suggesting more stable sleep timing in the feedback group. However, there were no significant group differences in daily work performance. We also found significant group differences in the diurnal slopes for sleepiness (P<.001), fatigue (P=.002), and neck and shoulder stiffness (P<.001), which was largely due to better scores in the feedback group at wake-up time relative to those in the control group. Conclusions This is the first mobile health study to demonstrate that objective push-type sleep feedback improves sleep timing of and physical symptoms in healthy office workers. Future research should incorporate specific behavioral instructions intended to improve sleep habits and examine the effectiveness of these instructions.
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Affiliation(s)
- Hiroki Takeuchi
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Kaori Suwa
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Akifumi Kishi
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Precursory Research for Embryonic Science and Technology, Japan Science and Technology Agency, Saitama, Japan
| | - Toru Nakamura
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
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Barbosa MT, Sousa CS, Morais-Almeida M. Telemedicine in the Management of Chronic Obstructive Respiratory Diseases: An Overview. Digit Health 2022. [DOI: 10.36255/exon-publications-digital-health-respiratory-diseases] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Applying Collective Intelligence in Health Recommender Systems for Smoking Cessation: A Comparison Trial. ELECTRONICS 2022. [DOI: 10.3390/electronics11081219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Health recommender systems (HRSs) are intelligent systems that can be used to tailor digital health interventions. We compared two HRSs to assess their impact providing smoking cessation support messages. Methods: Smokers who downloaded a mobile app to support smoking abstinence were randomly assigned to two interventions. They received personalized, ratable motivational messages on the app. The first intervention had a knowledge-based HRS (n = 181): it selected random messages from a subset matching the users’ demographics and smoking habits. The second intervention had a hybrid HRS using collective intelligence (n = 190): it selected messages applying the knowledge-based filter first, and then chose the ones with higher ratings provided by other similar users in the system. Both interventions were compared on: (a) message appreciation, (b) engagement with the system, and (c) one’s own self-reported smoking cessation status, as indicated by the last seven-day point prevalence report in different time intervals during a period of six months. Results: Both interventions had similar message appreciation, number of rated messages, and abstinence results. The knowledge-based HRS achieved a significantly higher number of active days, number of abstinence reports, and better abstinence results. The hybrid algorithm led to more quitting attempts in participants who completed their user profiles.
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Davids J, Ashrafian H. AIM and mHealth, Smartphones and Apps. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hartmann-Boyce J, Theodoulou A, Farley A, Hajek P, Lycett D, Jones LL, Kudlek L, Heath L, Hajizadeh A, Schenkels M, Aveyard P. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev 2021; 10:CD006219. [PMID: 34611902 PMCID: PMC8493442 DOI: 10.1002/14651858.cd006219.pub4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Most people who stop smoking gain weight. This can discourage some people from making a quit attempt and risks offsetting some, but not all, of the health advantages of quitting. Interventions to prevent weight gain could improve health outcomes, but there is a concern that they may undermine quitting. OBJECTIVES To systematically review the effects of: (1) interventions targeting post-cessation weight gain on weight change and smoking cessation (referred to as 'Part 1') and (2) interventions designed to aid smoking cessation that plausibly affect post-cessation weight gain (referred to as 'Part 2'). SEARCH METHODS Part 1 - We searched the Cochrane Tobacco Addiction Group's Specialized Register and CENTRAL; latest search 16 October 2020. Part 2 - We searched included studies in the following 'parent' Cochrane reviews: nicotine replacement therapy (NRT), antidepressants, nicotine receptor partial agonists, e-cigarettes, and exercise interventions for smoking cessation published in Issue 10, 2020 of the Cochrane Library. We updated register searches for the review of nicotine receptor partial agonists. SELECTION CRITERIA Part 1 - trials of interventions that targeted post-cessation weight gain and had measured weight at any follow-up point or smoking cessation, or both, six or more months after quit day. Part 2 - trials included in the selected parent Cochrane reviews reporting weight change at any time point. DATA COLLECTION AND ANALYSIS Screening and data extraction followed standard Cochrane methods. Change in weight was expressed as difference in weight change from baseline to follow-up between trial arms and was reported only in people abstinent from smoking. Abstinence from smoking was expressed as a risk ratio (RR). Where appropriate, we performed meta-analysis using the inverse variance method for weight, and Mantel-Haenszel method for smoking. MAIN RESULTS Part 1: We include 37 completed studies; 21 are new to this update. We judged five studies to be at low risk of bias, 17 to be at unclear risk and the remainder at high risk. An intermittent very low calorie diet (VLCD) comprising full meal replacement provided free of charge and accompanied by intensive dietitian support significantly reduced weight gain at end of treatment compared with education on how to avoid weight gain (mean difference (MD) -3.70 kg, 95% confidence interval (CI) -4.82 to -2.58; 1 study, 121 participants), but there was no evidence of benefit at 12 months (MD -1.30 kg, 95% CI -3.49 to 0.89; 1 study, 62 participants). The VLCD increased the chances of abstinence at 12 months (RR 1.73, 95% CI 1.10 to 2.73; 1 study, 287 participants). However, a second study found that no-one completed the VLCD intervention or achieved abstinence. Interventions aimed at increasing acceptance of weight gain reported mixed effects at end of treatment, 6 months and 12 months with confidence intervals including both increases and decreases in weight gain compared with no advice or health education. Due to high heterogeneity, we did not combine the data. These interventions increased quit rates at 6 months (RR 1.42, 95% CI 1.03 to 1.96; 4 studies, 619 participants; I2 = 21%), but there was no evidence at 12 months (RR 1.25, 95% CI 0.76 to 2.06; 2 studies, 496 participants; I2 = 26%). Some pharmacological interventions tested for limiting post-cessation weight gain (PCWG) reduced weight gain at the end of treatment (dexfenfluramine, phenylpropanolamine, naltrexone). The effects of ephedrine and caffeine combined, lorcaserin, and chromium were too imprecise to give useful estimates of treatment effects. There was very low-certainty evidence that personalized weight management support reduced weight gain at end of treatment (MD -1.11 kg, 95% CI -1.93 to -0.29; 3 studies, 121 participants; I2 = 0%), but no evidence in the longer-term 12 months (MD -0.44 kg, 95% CI -2.34 to 1.46; 4 studies, 530 participants; I2 = 41%). There was low to very low-certainty evidence that detailed weight management education without personalized assessment, planning and feedback did not reduce weight gain and may have reduced smoking cessation rates (12 months: MD -0.21 kg, 95% CI -2.28 to 1.86; 2 studies, 61 participants; I2 = 0%; RR for smoking cessation 0.66, 95% CI 0.48 to 0.90; 2 studies, 522 participants; I2 = 0%). Part 2: We include 83 completed studies, 27 of which are new to this update. There was low certainty that exercise interventions led to minimal or no weight reduction compared with standard care at end of treatment (MD -0.25 kg, 95% CI -0.78 to 0.29; 4 studies, 404 participants; I2 = 0%). However, weight was reduced at 12 months (MD -2.07 kg, 95% CI -3.78 to -0.36; 3 studies, 182 participants; I2 = 0%). Both bupropion and fluoxetine limited weight gain at end of treatment (bupropion MD -1.01 kg, 95% CI -1.35 to -0.67; 10 studies, 1098 participants; I2 = 3%); (fluoxetine MD -1.01 kg, 95% CI -1.49 to -0.53; 2 studies, 144 participants; I2 = 38%; low- and very low-certainty evidence, respectively). There was no evidence of benefit at 12 months for bupropion, but estimates were imprecise (bupropion MD -0.26 kg, 95% CI -1.31 to 0.78; 7 studies, 471 participants; I2 = 0%). No studies of fluoxetine provided data at 12 months. There was moderate-certainty that NRT reduced weight at end of treatment (MD -0.52 kg, 95% CI -0.99 to -0.05; 21 studies, 2784 participants; I2 = 81%) and moderate-certainty that the effect may be similar at 12 months (MD -0.37 kg, 95% CI -0.86 to 0.11; 17 studies, 1463 participants; I2 = 0%), although the estimates are too imprecise to assess long-term benefit. There was mixed evidence of the effect of varenicline on weight, with high-certainty evidence that weight change was very modestly lower at the end of treatment (MD -0.23 kg, 95% CI -0.53 to 0.06; 14 studies, 2566 participants; I2 = 32%); a low-certainty estimate gave an imprecise estimate of higher weight at 12 months (MD 1.05 kg, 95% CI -0.58 to 2.69; 3 studies, 237 participants; I2 = 0%). AUTHORS' CONCLUSIONS Overall, there is no intervention for which there is moderate certainty of a clinically useful effect on long-term weight gain. There is also no moderate- or high-certainty evidence that interventions designed to limit weight gain reduce the chances of people achieving abstinence from smoking.
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Affiliation(s)
- Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amanda Farley
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Deborah Lycett
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Laura L Jones
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Laura Kudlek
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Heath
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anisa Hajizadeh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Davids J, Ashrafian H. AIM and mHealth, Smartphones and Apps. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Illustration of tailored digital health and potential new avenues. Digit Health 2021. [DOI: 10.1016/b978-0-12-820077-3.00009-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Valencia S, Callinan L, Shic F, Smith M. Evaluation of the MoMba Live Long Remote Smoking Detection System During and After Pregnancy: Development and Usability Study. JMIR Mhealth Uhealth 2020; 8:e18809. [PMID: 33231550 PMCID: PMC7723738 DOI: 10.2196/18809] [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: 03/23/2020] [Revised: 08/07/2020] [Accepted: 09/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background The smoking relapse rate during the first 12 months after pregnancy is around 80% in the United States. Delivering remote smoking cessation interventions to women in the postpartum period can reduce the burden associated with frequent office visits and can enable remote communication and support. Developing reliable, remote, smoking measuring instruments is a crucial step in achieving this vision. Objective The study presents the evaluation of the MoMba Live Long system, a smartphone-based breath carbon monoxide (CO) meter and a custom iOS smartphone app. We report on how our smoking detection system worked in a controlled office environment and in an out-of-office environment to examine its potential to deliver a remote contingency management intervention. Methods In-office breath tests were completed using both the MoMba Live Long system and a commercial monitor, the piCO+ Smokerlyzer. In addition, each participant provided a urine test for smoking status validation through cotinine. We used in-office test data to verify the validity of the MoMba Live Long smoking detection system. We also collected out-of-office tests to assess how the system worked remotely and enabled user verification. Pregnant adult women in their second or third trimester participated in the study for a period of 12 weeks. This study was carried out in the United States. Results Analyses of in-office tests included 143 breath tests contributed from 10 participants. CO readings between the MoMba Live Long system and the piCO+ were highly correlated (r=.94). In addition, the MoMba Live Long system accurately distinguished smokers from nonsmokers with a sensitivity of 0.91 and a specificity of 0.94 when the piCO+ was used as a gold standard, and a sensitivity of 0.81 and specificity of 1.0 when cotinine in urine was used to confirm smoking status. All participants indicated that the system was easy to use. Conclusions Relatively inexpensive portable and internet-connected CO monitors can enable remote smoking status detection in a wide variety of nonclinical settings with reliable and valid measures comparable to a commercially available CO monitor. Trial Registration ClinicalTrials.gov NCT02237898; https://clinicaltrials.gov/ct2/show/NCT02237898
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Affiliation(s)
- Stephanie Valencia
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States.,Carnegie Mellon University, Pittsburgh, PA, United States
| | - Laura Callinan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Frederick Shic
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States.,Seattle's Children's Research Institute, University of Washington School of Medicine, Seattle, WA, United States
| | - Megan Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Abstract
COPD is a major cause of morbidity and mortality worldwide and carries a huge and growing economic and social burden. Telemedicine might allow the care of patients with limited access to health services and improve their self-management. During the COVID-19 pandemic, patient's safety represents one of the main reasons why we might use these tools to manage our patients. The authors conducted a literature search in MEDLINE database. The retrieval form of the Medical Subject Headings (Mesh) was ((Telemedicine OR Tele-rehabilitation OR Telemonitoring OR mHealth OR Ehealth OR Telehealth) AND COPD). We only included systematic reviews, reviews, meta-analysis, clinical trials and randomized-control trials, in the English language, with the selected search items in title or abstract, and published from January 1st 2015 to 31st May 2020 (n = 56). There was a positive tendency toward benefits in tele-rehabilitation, health-education and self-management, early detection of COPD exacerbations, psychosocial support and smoking cessation, but the heterogeneity of clinical trials and reviews limits the extent to which this value can be understood. Telemonitoring interventions and cost-effectiveness had contradictory results. The literature on teleconsultation was scarce during this period. The non-inferiority tendency of telemedicine programmes comparing to conventional COPD management seems an opportunity to deliver quality healthcare to COPD patients, with a guarantee of patient's safety, especially during the COVID-19 outbreak.
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Affiliation(s)
- Miguel T Barbosa
- Pulmonology Department, Hospital Centre of Barreiro-Montijo, Barreiro, Portugal.,Allergy Centre, CUF Descobertas Hospital, Lisboa, Portugal
| | - Cláudia S Sousa
- Allergy Centre, CUF Descobertas Hospital, Lisboa, Portugal.,Pulmonology Department, Central Hospital of Funchal, Portugal
| | | | - Maria J Simões
- Pulmonology Department, Hospital Centre of Barreiro-Montijo, Barreiro, Portugal
| | - Pedro Mendes
- Pulmonology Department, Central Hospital of Funchal, Portugal
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