1
|
Shiyab W, Rolls K, Ferguson C, Halcomb E. Nurses' Use of mHealth Apps for Chronic Conditions: Cross-Sectional Survey. JMIR Nurs 2024; 7:e57668. [PMID: 38809593 PMCID: PMC11170041 DOI: 10.2196/57668] [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: 02/22/2024] [Accepted: 04/07/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) is increasingly used to support public health practice, as it has positive benefits such as enhancing self-efficacy and facilitating chronic disease management. Yet, relatively few studies have explored the use of mHealth apps among nurses, despite their important role in caring for patients with and at risk of chronic conditions. OBJECTIVE The aim of the study is to explore nurses' use of mHealth apps to support adults with or at risk of chronic conditions and understand the factors that influence technology adoption. METHODS A web-based cross-sectional survey was conducted between September 2022 and January 2023. The survey was shared via social media and professional nursing organizations to Australian nurses caring for adults with or at risk of chronic conditions. RESULTS A total of 158 responses were included in the analysis. More than two-thirds (n=108, 68.4%) of respondents reported that they personally used at least 1 mHealth app. Over half (n=83, 52.5% to n=108, 68.4%) reported they use mHealth apps at least a few times a month for clinical purposes. Logistic regression demonstrated that performance expectancy (P=.04), facilitating condition (P=.05), and personal use of mHealth apps (P=.05) were significantly associated with mHealth app recommendation. In contrast, effort expectancy (P=.09) and social influence (P=.46) did not have a significant influence on whether respondents recommended mHealth apps to patients. The inability to identify the quality of mHealth apps and the lack of access to mobile devices or internet were the most common barriers to mHealth app recommendation. CONCLUSIONS While nurses use mHealth apps personally, there is potential to increase their clinical application. Given the challenges reported in appraising and assessing mHealth apps, app regulation and upskilling nurses will help to integrate mHealth apps into usual patient care.
Collapse
Affiliation(s)
- Wa'ed Shiyab
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Kaye Rolls
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| |
Collapse
|
2
|
Campbell M, McEvoy JW, Calpin G, Concannon F, Redfern S. Perspectives of Healthcare Professionals on Clinician-Patient Communication of Cardiovascular Disease Risk. J Patient Exp 2024; 11:23743735241257386. [PMID: 38807917 PMCID: PMC11131389 DOI: 10.1177/23743735241257386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
When the consultation is predominantly verbal, existing research in clinician-patient communication indicates that many patients struggle to understand and recall medical consultations or may not understand the extent of their illness or the purpose of their treatment plan. When the clinician-patient discussion centers around the risk of a repeated cardiovascular disease (CVD) related event, qualitatively assessing what factors affect the communication of this risk may guide the creation of effective communication solutions. Semi-structured interviews were conducted with 17 clinicians treating patients at stages along the cardiac rehabilitation patients' journey. Thematic analysis identified factors that prevent patients from understanding the risk they face of experiencing a repeated cardiac event. Results indicate a clearer understanding of the cardiac rehabilitation patient journey by means of a patient journey map; an overview of how CVD risk is currently communicated; and the factors that affect communication of these risks in the form of themes and sub-themes. Findings shape the proposal of an evidence informed model of opportunities for enhanced digital media supported communication in cardiac rehabilitation.
Collapse
|
3
|
Amran MM, Bilitzky A, Bar-Yishay M, Adler L. The use of medical health applications by primary care physicians in Israel: a cross-sectional study. BMC Health Serv Res 2024; 24:410. [PMID: 38566059 PMCID: PMC10988819 DOI: 10.1186/s12913-024-10880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The use of medical health applications (mHealth apps) by patients, caregivers, and physicians is widespread. mHealth apps are often employed by physicians to quickly access professional knowledge, guide treatment, easily retrieve medical records, and monitor and manage patients. This study sought to characterize the use of mHealth apps among primary care physicians (PCPs) in Israel. The reasons for using apps and barriers to their use were also investigated. METHODS From all MHS' PCPs, we randomly selected 700 PCPs and invited them to complete a questionnaire regarding the use of mHealth apps and attitudes toward them. RESULTS From August 2020 to December 2020, 191 physicians completed the questionnaire (response rate 27.3%). 68.0% of PCPs reported using mHealth apps. Telemedicine service apps were the most frequently used. Medical calculators (used for clinical scoring) and differential diagnosis apps were the least frequently used. The most common reason for mHealth app use was accessibility, followed by time saved and a sense of information reliability. Among infrequent users of apps, the most common barriers reported were unfamiliarity with relevant apps and preference for using a computer. Concerns regarding information reliability were rarely reported by PCPs. Physician gender and seniority were not related to mHealth app use. Physician age was related to the use of mHealth apps. CONCLUSIONS mHealth apps are widely used by PCPs in this study, regardless of physician gender or seniority. Information from mHealth apps is considered reliable by PCPs. The main barrier to app use is unfamiliarity with relevant apps and preference for computer use.
Collapse
Affiliation(s)
- Menashe Meni Amran
- Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
| | - Avital Bilitzky
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Mattan Bar-Yishay
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Limor Adler
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
4
|
Clement A, Ravet M, Stanger C, Gabrielli J. Feasibility, usability, and acceptability of MobileCoach-Teen: A smartphone app-based preventative intervention for risky adolescent drinking behavior. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 159:209275. [PMID: 38110119 PMCID: PMC11027171 DOI: 10.1016/j.josat.2023.209275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/20/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Older adolescence (ages 15-18) is a critical period for experimentation with substance use, especially alcohol. Adolescent drinking poses hazards to physical and mental health, amplifies risk associated with other activities typically initiated during this life stage (e.g., driving, sexual activity), and is associated with adverse outcomes in adolescence and adulthood. Existing preventative interventions are expensive and have questionable long-term efficacy. Digital interventions may represent an accessible and personalized approach to providing preventative intervention content to youth. METHODS This study recruited 29 adolescents aged 16-18 (M = 17.24, SD = 0.74) for a pilot feasibility trial of the MobileCoach-Teen (MC-Teen) smartphone app-based intervention. The study team randomized participants to receive either the alcohol intervention (MC-Teen) or attention control pseudo-intervention (MC-Fit). MC-Teen participants received 12 weeks of content adapted from a prior Swiss-based trial of a preventative alcohol intervention. Participants provided qualitative and quantitative feedback at baseline, via six biweekly surveys during and post-intervention. RESULTS Both groups rated the application as easy to download (M = 4.31, SD = 0.93; 5-point Likert). All participants completed the baseline survey in less than the estimated time of 10 min (M = 7:42, SD = 2:15) and rated the survey as easy to complete (M = 4.69, SD = 0.60; 5-point Likert). MC-Teen participants favorably assessed application user experience, message user experience, and digital working alliance with application. Qualitative themes included a desire for increased rate/amount and diversity of content, greater representation via coach options, user interface/user experience improvements, and additional features. CONCLUSION The MC-Teen intervention is feasible and acceptable based on a pilot feasibility trial with a sample of U.S. adolescents.
Collapse
Affiliation(s)
- Alex Clement
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL, United States of America.
| | - Mariah Ravet
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States of America
| | - Catherine Stanger
- Geisel School of Medicine, Center for Technology and Behavioral Health, Dartmouth College, Hanover, NH, United States of America
| | - Joy Gabrielli
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States of America
| |
Collapse
|
5
|
Dominiak M, Gędek A, Antosik AZ, Mierzejewski P. Mobile health for mental health support: a survey of attitudes and concerns among mental health professionals in Poland over the period 2020-2023. Front Psychiatry 2024; 15:1303878. [PMID: 38559395 PMCID: PMC10978719 DOI: 10.3389/fpsyt.2024.1303878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Mobile health (mHealth) has emerged as a dynamic sector supported by technological advances and the COVID-19 pandemic and have become increasingly applied in the field of mental health. Aim The aim of this study was to assess the attitudes, expectations, and concerns of mental health professionals, including psychiatrists, psychologists, and psychotherapists, towards mHealth, in particular mobile health self-management tools and telepsychiatry in Poland. Material and methods This was a survey conducted between 2020 and 2023. A questionnaire was administered to 148 mental health professionals, covering aspects such as telepsychiatry, mobile mental health tools, and digital devices. Results The majority of professionals expressed readiness to use telepsychiatry, with a peak in interest during the COVID-19 pandemic, followed by a gradual decline from 2022. Concerns about telepsychiatry were reported by a quarter of respondents, mainly related to difficulties in correctly assessing the patient's condition, and technical issues. Mobile health tools were positively viewed by professionals, with 86% believing they could support patients in managing mental health and 74% declaring they would recommend patients to use them. Nevertheless, 29% expressed concerns about the effectiveness and data security of such tools. Notably, the study highlighted a growing readiness among mental health professionals to use new digital technologies, reaching 84% in 2023. Conclusion These findings emphasize the importance of addressing concerns and designing evidence-based mHealth solutions to ensure long-term acceptance and effectiveness in mental healthcare. Additionally, the study highlights the need for ongoing regulatory efforts to safeguard patient data and privacy in the evolving digital health landscape.
Collapse
Affiliation(s)
- Monika Dominiak
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Gędek
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Praski Hospital, Warsaw, Poland
| | - Anna Z. Antosik
- Department of Psychiatry, Faculty of Medicine, Collegium Medicum, Cardinal Wyszynski University, Warsaw, Poland
| | - Paweł Mierzejewski
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| |
Collapse
|
6
|
Gilano G, Dekker A, Fijten R. The role of mHealth intervention to improve maternal and child health: A provider-based qualitative study in Southern Ethiopia. PLoS One 2024; 19:e0295539. [PMID: 38329947 PMCID: PMC10852240 DOI: 10.1371/journal.pone.0295539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/24/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Maternal and child mortality remained higher in developing regions such as Southern Ethiopia due to poor maternal and child health. Technologies such as mobile applications in health may be an opportunity to reduce maternal and child mortality because they can improve access to information. Therefore, the main aim of this study was to explore the role of mHealth in improving maternal and child health in Southern Ethiopia. METHODS This study employed a qualitative study design to explore the role of mHealth in improving maternal and child health among health professionals in Southern Ethiopia from December 2022 to March 2023. We conducted nine in-depth interviews, six key informants' in-depth interviews, and four focused group discussions among health professionals. This is followed by thematic analyses to synthesize the collected evidence. RESULTS The results are based on 226 quotations, 5 major themes, and 24 subthemes. The study participants discussed the possible acceptance of mHealth in terms of its fitness in the existing health system, its support to health professionals, and its importance in improving maternal and child health. The participants ascertained the importance of awareness creation before the implementation of mHealth among women, families, communities, and providers. They reported the importance of mHealth for mothers and health professionals and the effectiveness of mHealth services. The participants stated that the main challenges related to acceptance, awareness, negligence, readiness, and workload. However, they also suggested strategic solutions such as using family support, provider support, mothers' forums, and community forums. CONCLUSION The evidence generated during this analysis is important information for program implementations and can inform policy-making. The planned intervention needs to introduce mHealth in Southern Ethiopia. Planners, decision-makers, and researchers can use it in mobile technology-related interventions. For challenges identified, we recommend solution-identified-based interventions and quality studies.
Collapse
Affiliation(s)
- Girma Gilano
- Department of Public Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Andre Dekker
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology [Maastro], GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
7
|
Schroeder T, Haug M, Georgiou A, Seaman K, Gewald H. Evidence of How Physicians and Their Patients Adopt mHealth Apps in Germany: Exploratory Qualitative Study. JMIR Mhealth Uhealth 2024; 12:e48345. [PMID: 38231550 PMCID: PMC10831587 DOI: 10.2196/48345] [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: 04/20/2023] [Revised: 09/30/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The enactment of the "Act to Improve Healthcare Provision through Digitalisation and Innovation " (Digital Healthcare Act; Digitale-Versorgung-Gesetz [DVG]) in Germany has introduced a paradigm shift in medical practice, allowing physicians to prescribe mobile health (mHealth) apps alongside traditional medications. This transformation imposes a dual responsibility on physicians to acquaint themselves with qualifying apps and align them with patient diagnoses, while requiring patients to adhere to the prescribed app use, similar to pharmaceutical adherence. This transition, particularly challenging for older generations who are less skilled with technology, underscores a significant evolution in Germany's medical landscape. OBJECTIVE This study aims to investigate physicians' responses to this novel treatment option, their strategies for adapting to this form of prescription, and the willingness of patients to adhere to prescribed mHealth apps. METHODS Using an exploratory qualitative study design, we conducted semistructured interviews with 28 physicians and 30 potential patients aged 50 years and older from August 2020 to June 2021. RESULTS The findings reveal several factors influencing the adoption of mHealth apps, prompting a nuanced understanding of adoption research. Notably, both physicians and patients demonstrated a lack of information regarding mHealth apps and their positive health impacts, contributing to a deficiency in trust. Physicians' self-perceived digital competence and their evaluation of patients' digital proficiency emerge as pivotal factors influencing the prescription of mHealth apps. CONCLUSIONS Our study provides comprehensive insights into the prescription process and the fundamental factors shaping the adoption of mHealth apps in Germany. The identified information gaps on both the physicians' and patients' sides contribute to a trust deficit and hindered digital competence. This research advances the understanding of adoption dynamics regarding digital health technologies and highlights crucial considerations for the successful integration of digital health apps into medical practice.
Collapse
Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Maximilian Haug
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Heiko Gewald
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| |
Collapse
|
8
|
Workman A, Campbell SL, Williamson GJ, Lucani C, Bowman DMJS, Cooling N, Johnston FH, Jones PJ. Understanding the perspectives and needs of multiple stakeholders: Identifying key elements of a digital health intervention to protect against environmental hazards. PLOS DIGITAL HEALTH 2024; 3:e0000444. [PMID: 38285717 PMCID: PMC10824450 DOI: 10.1371/journal.pdig.0000444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/07/2024] [Indexed: 01/31/2024]
Abstract
AirRater is a free environmental health smartphone app developed and available in Australia that collects individual health data and disseminates environmental hazard information to populations. Following previous evaluations with app users, the aim of this study was to better understand how clinicians, government agency and non-government advocacy group representatives perceive an app designed to reduce the impacts of environmental hazards on individual and public health. Nine government agency and non-government advocacy group representatives, along with 11 clinicians based in Australia participated in a semi-structured interview or focus group to explore perspectives on AirRater. Interview and focus group data were transcribed and analysed using the qualitative data analysis software NVivo. Results indicate that for clinicians, apps like AirRater can add value as an educational, patient self-management and diagnostic tool. For government and peak bodies, apps can add value by addressing environmental health literacy and monitoring and forecasting gaps, as well as supporting advocacy efforts and public health surveillance. We conclude that environmental health smartphone apps can support a range of stakeholders to achieve shared goals and priorities related to individual and public health outcomes. Further research is needed to better understand how apps could be embedded into clinical practice and policy settings.
Collapse
Affiliation(s)
- Annabelle Workman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Melbourne Climate Futures, University of Melbourne, Melbourne, Australia
| | - Sharon L. Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Chris Lucani
- School of Natural Sciences, University of Tasmania, Hobart, Australia
| | | | - Nick Cooling
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Fay H. Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Public Health Services, Department of Health, Hobart, Australia
| | - Penelope J. Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| |
Collapse
|
9
|
Guardado S, Mylonopoulou V, Rivera-Romero O, Patt N, Bansi J, Giunti G. An Exploratory Study on the Utility of Patient-Generated Health Data as a Tool for Health Care Professionals in Multiple Sclerosis Care. Methods Inf Med 2023; 62:165-173. [PMID: 37748719 PMCID: PMC10878743 DOI: 10.1055/s-0043-1775718] [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: 10/10/2022] [Accepted: 08/05/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Patient-generated health data (PGHD) are data collected through technologies such as mobile devices and health apps. The integration of PGHD into health care workflows can support the care of chronic conditions such as multiple sclerosis (MS). Patients are often willing to share data with health care professionals (HCPs) in their care team; however, the benefits of PGHD can be limited if HCPs do not find it useful, leading patients to discontinue data tracking and sharing eventually. Therefore, understanding the usefulness of mobile health (mHealth) solutions, which provide PGHD and serve as enablers of the HCPs' involvement in participatory care, could motivate them to continue using these technologies. OBJECTIVE The objective of this study is to explore the perceived utility of different types of PGHD from mHealth solutions which could serve as tools for HCPs to support participatory care in MS. METHOD A mixed-methods approach was used, combining qualitative research and participatory design. This study includes three sequential phases: data collection, assessment of PGHD utility, and design of data visualizations. In the first phase, 16 HCPs were interviewed. The second and third phases were carried out through participatory workshops, where PGHD types were conceptualized in terms of utility. RESULTS The study found that HCPs are optimistic about PGHD in MS care. The most useful types of PGHD for HCPs in MS care are patients' habits, lifestyles, and fatigue-inducing activities. Although these subjective data seem more useful for HCPs, it is more challenging to visualize them in a useful and actionable way. CONCLUSION HCPs are optimistic about mHealth and PGHD as tools to further understand their patients' needs and support care in MS. HCPs from different disciplines have different perceptions of what types of PGHD are useful; however, subjective types of PGHD seem potentially more useful for MS care.
Collapse
Affiliation(s)
- Sharon Guardado
- Empirical Software Engineering (M3S) Research Unit, Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Vasiliki Mylonopoulou
- Division of Human-Computer Interaction, Department Of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden
| | - Octavio Rivera-Romero
- Department of Electronic Technology, Universidad de Sevilla, Seville, Spain
- Instituto de Investigación en Informática, Universidad de Sevilla, Seville, Spain
- SABIEN Group, ITACA Institute, Universitat Politécnica de Valéncia, Valencia, Spain
| | - Nadine Patt
- Department of Neurology, Kliniken Valens, Rehabilitationszentrum Valens, Valens, Switzerland
| | - Jens Bansi
- Department of Neurology, Kliniken Valens, Rehabilitationszentrum Valens, Valens, Switzerland
| | - Guido Giunti
- Empirical Software Engineering (M3S) Research Unit, Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
- Health Sciences and Technology Unit, Faculty of Medicine, University of Oulu, Finland
- Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
- Clinical Medicine Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
10
|
Jiang S, Xiong M, Rao X, Liang J, Zhu X, Fu H, Chen J, Wang C. Medical Personnel Behavior Preferences for Providing mHealth Service in China: A Discrete Choice Experiment. Risk Manag Healthc Policy 2023; 16:2405-2418. [PMID: 38024491 PMCID: PMC10646158 DOI: 10.2147/rmhp.s430636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aims to investigate factors affecting medical personnel behavioral preferences for providing mHealth in China, so as to provide decision-making basis for mHealth providers and managers to encourage more doctors to participate in mHealth service delivery. Methods Typical case sampling techniques were applied in a hospital setting to conduct a discrete choice experimental questionnaire survey of doctors (n=216) concerning mHealth preferences between July and October 2022. A conditional logit model was used to assess medical personnel preferences for each attribute and level of mHealth services. Results Length of service, information security, subjects of treatment and financial compensation all have a significant effect on medical staff's preference for providing mHealth services (p < 0.05). In terms of service duration and financial compensation, medical staff preferred mHealth services that provided shorter service duration and higher financial compensation; in terms of information security, medical staff preferred mHealth services with confidentiality of diagnostic and therapeutic information compared to information disclosure; and in terms of treatment targets, medical staff preferred the general population compared to key populations, such as pregnant women, the elderly, infants and children. Conclusion The preference of medical professionals to provide mHealth services is affected by a variety of factors. By enhancing the confidentiality of information in mHealth services, providing more options for service recipients, increasing their financial compensation, and shortening the duration of the service or increasing the number of service hours that can be adjusted can guide improvement of mHealth services and promoting of its adoption among medical professionals.
Collapse
Affiliation(s)
- Shuai Jiang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- Institute for Hospital Management of Henan Province, Zhengzhou, Henan, People’s Republic of China
| | - Man Xiong
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Xinyi Rao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Jieting Liang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Xinghan Zhu
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Hang Fu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- Institute for Hospital Management of Henan Province, Zhengzhou, Henan, People’s Republic of China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Chengzeng Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- Institute for Hospital Management of Henan Province, Zhengzhou, Henan, People’s Republic of China
| |
Collapse
|
11
|
Tokede B, Yansane A, Ibarra-Noriega A, Mullins J, Simmons K, Skourtes N, Mehta U, Tungare S, Holmes D, White J, Walji M, Kalenderian E. Evaluating the Impact of an mHealth Platform for Managing Acute Postoperative Dental Pain: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e49677. [PMID: 37933185 PMCID: PMC10644946 DOI: 10.2196/49677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 11/08/2023] Open
Abstract
Background Postoperative dental pain is pervasive and can affect a patient's quality of life. Adopting a patient-centric approach to pain management involves having contemporaneous information about the patient's experience of pain and using it to personalize care. Objective In this study, we evaluated the use of a mobile health (mHealth) platform to collect pain-related patient-reported outcomes over 7 days after the patients underwent pain-inducing dental procedures; we then relayed the information to the dentist and determined its impact on the patient's pain experience. Methods The study used a cluster-randomized experimental study design with an intervention arm where patients were prompted to complete a series of questions relating to their pain experience after receiving automated text notifications on their smartphone on days 1, 3, 5, and 7, with the resulting information fed back to dentists, and a control arm where patients received usual care. Providers were randomized, and patients subsequently assumed the enrollment status of their providers. Providers or their staff identified eligible patients and invited them to participate in the study. Provider interviews and surveys were conducted to evaluate acceptance of the mHealth platform. Results A total of 42 providers and 1525 patients participated. For the primary outcome (pain intensity on a 1 to 10 scale, with 10 being the most painful), intervention group patients reported an average pain intensity of 4.8 (SD 2.6), while those in the control group reported an average pain intensity of 4.7 (SD 2.8). These differences were not significant. There were also no significant differences in secondary outcomes, including pain interference with activity or sleep, patient satisfaction with pain management, or opioid prescribing. Patient surveys revealed reluctance to use the app was mostly due to technological challenges, data privacy concerns, and a preference for phone calls over texting. Providers had high satisfaction with the app and suggested integrating additional features, such as an in-system camera for patients to upload pictures and videos of the procedural site, and integration with the electronic health record system. Conclusions While the mHealth platform did not have a significant impact on acute postoperative pain experience, patients and providers indicated improvement in patient-provider communication, patient-provider relationship, postoperative complication management, and ability to manage pain medication prescribing. Expanded collaboration between mHealth developers and frontline health care providers can facilitate the applicability of these platforms, further help improve its integration with the normal clinic workflow, and assist in moving toward a more patient-centric approach to pain management.
Collapse
Affiliation(s)
- Bunmi Tokede
- The University of Texas Health Science Center, HoustonTX, United States
| | - Alfa Yansane
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
| | | | | | | | | | - Urvi Mehta
- The University of Texas Health Science Center, HoustonTX, United States
| | - Sayali Tungare
- The University of Texas Health Science Center, HoustonTX, United States
| | | | - Joel White
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
| | - Muhammad Walji
- The University of Texas Health Science Center, HoustonTX, United States
| | - Elsbeth Kalenderian
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
- Harvard School of Dental Medicine, BostonMA, United States
| |
Collapse
|
12
|
Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res 2023; 25:e44886. [PMID: 37756051 PMCID: PMC10568391 DOI: 10.2196/44886] [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: 12/07/2022] [Revised: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/28/2023] Open
Abstract
Promoting online peer support beyond the informal sector to statutory health services requires ethical considerations and evidence-based knowledge about its impact on patients, health care professionals, and the wider health care system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in health care mainly focuses on apps, electronic health records, wearables, and telephone or video consultations, without necessarily covering digital social interventions, and does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.
Collapse
Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Nathan C Lea
- Department of Medical Informatics & Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Ghent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil S Coulson
- Medical School, Nottingham City Hospital, Nottingham, United Kingdom
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
13
|
Gu Y, Guan Y, Meng Z. Health Providers' Perceptions and Experiences of Using mHealth for Chronic Noncommunicable Diseases: Qualitative Systematic Review and Meta-Synthesis. J Med Internet Res 2023; 25:e45437. [PMID: 37698902 PMCID: PMC10523226 DOI: 10.2196/45437] [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: 01/01/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) technology has great potential for addressing the epidemic of chronic noncommunicable diseases (CNCDs) by assisting health providers (HPs) with managing these diseases. However, there is currently limited evidence regarding the acceptance of mHealth among HPs, which is a key prerequisite for harnessing this potential. OBJECTIVE This review aimed to investigate the perceptions and experiences of HPs regarding the barriers to and facilitators of mHealth use for CNCDs. METHODS A systematic search was conducted in MEDLINE (via Ovid), Embase, Web of Science, Google Scholar, and Cochrane Library (via Ovid) for studies that assessed the perceptions and experiences of HPs regarding the barriers to and facilitators of mHealth use for CNCDs. Qualitative studies and mixed methods studies involving qualitative methods published in English were included. Data synthesis and interpretation were performed using a thematic synthesis approach. RESULTS A total of 18,242 studies were identified, of which 24 (0.13%) met the inclusion criteria. Overall, 6 themes related to facilitators were identified, namely empowering patient self-management, increasing efficiency, improving access to care, increasing the quality of care, improving satisfaction, and improving the usability of the internet and mobile software. Furthermore, 8 themes related to barriers were identified, namely limitation due to digital literacy, personal habits, or health problems; concern about additional burden; uncertainty around the value of mHealth technology; fear of medicolegal risks; lack of comfortable design and experience; lack of resources and incentives; lack of policy guidance and regulation; and worrisome side effects resulting from the use of mHealth. CONCLUSIONS This study contributes to the understanding of the beneficial factors of and obstacles to mHealth adoption by HPs for CNCDs. The findings of this study may provide significant insights for health care workers and policy makers who seek ways to improve the adoption of mHealth by HPs for CNCDs.
Collapse
Affiliation(s)
- Yu Gu
- Yanjing Medical College, Capital Medical University, Beijing, China
| | - Yushan Guan
- School of Nursing, Capital Medical University, Beijing, China
| | - Zhaolin Meng
- School of Nursing, Capital Medical University, Beijing, China
| |
Collapse
|
14
|
Labarta JI, Dimitri P, Keiser M, Koledova E, Rivera-Romero O. Evaluating the Usefulness and Ease of Use of a Next-Generation-Connected Drug Delivery Device for Growth Hormone Therapy: Qualitative Study of Health Care Professionals' Perceptions. JMIR Hum Factors 2023; 10:e46893. [PMID: 37531173 PMCID: PMC10433030 DOI: 10.2196/46893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Digital solutions targeting children's health have become an increasingly important element in the provision of integrated health care. For the treatment of growth hormone deficiency (GHD), a unique connected device is available to facilitate the delivery of recombinant human growth hormone (r-hGH) by automating the daily injection process and collecting injection data such that accurate adherence information is available to health care professionals (HCPs), caregivers, and patients. The adoption of such digital solutions requires a good understanding of the perspectives of HCPs as key stakeholders because they leverage data collection and prescribe these solutions to their patients. OBJECTIVE This study aimed to evaluate the third generation of the easypod device (EP3) for the delivery of r-hGH treatment from the HCP perspective, with a focus on perceived usefulness and ease of use. METHODS A qualitative study was conducted, based on a participatory workshop conducted in Zaragoza, Spain, with 10 HCPs experienced in the management of pediatric GHD from 7 reference hospitals in Spain. Several activities were designed to promote discussion among participants about predefined topics based on the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology to provide their perceptions about the new device. RESULTS Participants reported 2 key advantages of EP3 over previous easypod generations: the touch screen interface and the real-time data transmission functionality. All participants (10/10, 100%) agreed that the new device should be part of a digital health ecosystem that provides complementary functionalities including data analysis. CONCLUSIONS This study explored the perceived value of the EP3 autoinjector device for the treatment of GHD by HCPs. HCPs rated the new capabilities of the device as having substantial improvements and concluded that it was highly recommendable for clinical practice. EP3 will enhance decision-making and allow for more personalized care of patients receiving r-hGH.
Collapse
Affiliation(s)
- José I Labarta
- Unit of Endocrinology, Department of Pediatrics, Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Paul Dimitri
- Department of Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Matthew Keiser
- Ares Trading SA (an affiliate of Merck KGaA), Eysins, Switzerland
| | - Ekaterina Koledova
- Global Medical Affairs Cardiometabolic & Endocrinology, Merck Healthcare KGaA, Darmstadt, Germany
| | | |
Collapse
|
15
|
Karia J, Mohamed R, Petrushkin H. Patient-targeted mobile applications in healthcare. Br J Hosp Med (Lond) 2023; 84:1-5. [PMID: 37646550 DOI: 10.12968/hmed.2023.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
There has been an increase in the number of healthcare-related applications targeted at patients for use on mobile phones. With an increasing proportion of the population using such applications, it is important to understand the associated limitations, safety concerns and challenges of legalisation. This article explores the impact of these applications on frontline care and patient wellbeing, evaluating the literature surrounding the benefits and challenges of patient-targeted mobile applications in health care and analysing the limitations of existing research. The proclaimed benefits of such applications are not always evidence based. Furthermore, many healthcare applications are created by laypeople and not validated by healthcare authorities, creating a potential to cause patient harm. Further research is needed to identify long-term effects on both healthcare systems and individuals' psychosocial wellbeing. However, research in this field often lacks a universal perspective and may be influenced by underlying financial motives to promote use of the applications.
Collapse
Affiliation(s)
- Janvi Karia
- Division of Medicine, University College London, London, UK
| | - Ryian Mohamed
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Harry Petrushkin
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
- Department of Ophthalmology, Great Ormond Street Hospital, London, UK
| |
Collapse
|
16
|
Schroeder T, Seaman K, Nguyen A, Gewald H, Georgiou A. Enablers and inhibitors to the adoption of mHealth apps by patients - A qualitative analysis of German doctors' perspectives. PATIENT EDUCATION AND COUNSELING 2023; 114:107865. [PMID: 37356116 DOI: 10.1016/j.pec.2023.107865] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Germany is the first country that approved validated mobile health apps (called DiGA) for prescription by doctors and psychotherapists. The aim of this study is to investigate doctors' perspectives towards these mobile health apps and their intentions to prescribe them. Additionally, we investigated the influence of different roles and expectations of outcomes. METHODS We used a qualitative study design to determine doctors' viewpoints on prescribing DiGAs. We conducted 28 semi-structured interviews and used the grounded theory method for analysis. We adopted a classical conceptualist approach to gain theoretical insights. RESULTS The results show that doctors' acceptance and support of DiGAs are critical in mobile health uptake and utilisation. Although mobile health is seen to be supportive of patient management and patient education doctors nevertheless need to adopt a motivating and persuasive role in the process. CONCLUSIONS Doctors consider DiGAs complementary to their role in patient management and are predominantly positive about DiGAs. A trusted relationship with patients must be developed to ensure the appropriate support of DiGAs. PRACTICE IMPLICATIONS Our study suggests that targeted education, user-centred DiGAs, consideration of social presence and user engagement, and co-development with doctors can improve longer-term DiGA use and effectiveness.
Collapse
Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; Centre for Research on Service Sciences (CROSS), University of Applied Sciences Neu-Ulm, Neu-Ulm, Germany.
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Heiko Gewald
- Centre for Research on Service Sciences (CROSS), University of Applied Sciences Neu-Ulm, Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| |
Collapse
|
17
|
Kheirinejad S, Visuri A, Suryanarayana SA, Hosio S. Exploring mHealth applications for self-management of chronic low back pain: A survey of features and benefits. Heliyon 2023; 9:e16586. [PMID: 37346357 PMCID: PMC10279785 DOI: 10.1016/j.heliyon.2023.e16586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
The adoption of Mobile Health (mHealth) for self-management is growing. mHealth solutions are commonly used in public healthcare and health services, where they are appreciated for their ease of use, broad reach, and wide acceptance. Chronic Low Back Pain (CLBP) is one of the most common health problems and a leading cause of disability. As such, it imposes a tremendous burden on patients and society. Studies have proposed that mHealth self-management solutions, such as mobile applications, can supplement traditional care methods and benefit patients, particularly in self-managing CLBP easier. To this end, the number of available mobile applications for CLBP has increased. This paper i) provides an overview of scientific studies on mobile applications for CLBP management from three different viewpoints: researchers, health professionals, and patients, ii) uncovers the application features that were seen as beneficial in the studies, and iii) contrasts the currently available applications for CLBP in Google Play Store and Apple App Store against the discovered features. The findings show that "Personalization and customization" is the most significant feature as it is beneficial from stakeholders' viewpoint and is represented by most applications. In contrast, "Gamification" and "Artificial intelligence" are the least significant features, indicating a lack of attention from application creators and researchers in this area.
Collapse
|
18
|
Wittwer LH, Walters E, Jordan K. Improving Pediatric Asthma Care Through Asthma Apps: A Narrative Review. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
|
19
|
Alkhaldi O, McMillan B, Maddah N, Ainsworth J. Interventions Aimed at Enhancing Health Care Providers' Behavior Toward the Prescription of Mobile Health Apps: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e43561. [PMID: 36848202 PMCID: PMC10012012 DOI: 10.2196/43561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) apps have great potential to support the management of chronic conditions. Despite widespread acceptance of mHealth apps by the public, health care providers (HCPs) are reluctant to prescribe or recommend such apps to their patients. OBJECTIVE This study aimed to classify and evaluate interventions aimed at encouraging HCPs to prescribe mHealth apps. METHODS A systematic literature search was conducted to identify studies published from January 1, 2008, to August 5, 2022, using 4 electronic databases: MEDLINE, Scopus, CINAHL, and PsycINFO. We included studies that evaluated interventions encouraging HCPs to prescribe mHealth apps. Two review authors independently assessed the eligibility of the studies. The "National Institute of Health's quality assessment tool for before-and-after (pretest-posttest design) studies with no control group" and "the mixed methods appraisal tool (MMAT)" were used to assess the methodological quality. Owing to high levels of heterogeneity between interventions, measures of practice change, specialties of HCPs, and modes of delivery, we conducted a qualitative analysis. We adopted the behavior change wheel as a framework for classifying the included interventions according to intervention functions. RESULTS In total, 11 studies were included in this review. Most of the studies reported positive findings, with improvements in a number of outcomes, including increased knowledge of mHealth apps among clinicians, improved self-efficacy or confidence in prescribing, and an increased number of mHealth app prescriptions. On the basis of the behavior change wheel, 9 studies reported elements of environmental restructuring such as providing HCPs with lists of apps, technological systems, time, and resources. Furthermore, 9 studies included elements of education, particularly workshops, class lectures, individual sessions with HCPs, videos, or toolkits. Furthermore, training was incorporated in 8 studies using case studies or scenarios or app appraisal tools. Coercion and restriction were not reported in any of the interventions included. The quality of the studies was high in relation to the clarity of aims, interventions, and outcomes but weaker in terms of sample size, power calculations, and duration of follow-up. CONCLUSIONS This study identified interventions to encourage app prescriptions by HCPs. Recommendations for future research should consider previously unexplored intervention functions such as restrictions and coercion. The findings of this review can help inform mHealth providers and policy makers regarding the key intervention strategies impacting mHealth prescriptions and assist them in making informed decisions to encourage this adoption.
Collapse
Affiliation(s)
- Ohoud Alkhaldi
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, United Kingdom
| | - Noha Maddah
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Health Services and Hospitals Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - John Ainsworth
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
20
|
Arkkukangas M, Cederbom S. Movement toward an evidence-Based, digital fall prevention future-Perceptions from a physiotherapy perspective. Physiother Theory Pract 2023; 39:128-136. [PMID: 34791975 DOI: 10.1080/09593985.2021.2005198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Physiotherapy plays an important role in fall prevention, and is a science- and evidence-based profession that is constantly undergoing development. Currently, the possibility of digital fall prevention is being explored; however, the perception of physiotherapists (PTs) toward a digital approach is still a sparsely investigated topic. PURPOSE This study aimed to explore the PT's experiences with a fall prevention exercise program used in their daily work and their thoughts regarding the use of digital support in this context. METHODS Discussions were held in two focus groups with seven PTs (age: 26-48 years). A qualitative content analysis was performed. RESULTS We identified two main categories: 1) The importance of evidence-based fall prevention exercise; and 2) Transition toward a digital fall prevention exercise approach. The participants expressed that they had time- and resource-related limitations affecting evidence-based work and adherence to fall prevention exercise programs. They stated that education and management support were required. CONCLUSION There is a need for fall prevention exercise to be evidence-based and prioritized in physiotherapy. The study results provide insights into the lack of adherence to fall prevention exercise programs and highlighted the need for a transition toward working digitally in the future.
Collapse
Affiliation(s)
- Marina Arkkukangas
- Research and Development in Sörmland, Eskilstuna, Sweden.,Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Science, Dalarna University, Falun, Sweden
| | - Sara Cederbom
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo Norway
| |
Collapse
|
21
|
Paradis S, Roussel J, Bosson JL, Kern JB. Use of Smartphone Health Apps Among Patients Aged 18 to 69 Years in Primary Care: Population-Based Cross-sectional Survey. JMIR Form Res 2022; 6:e34882. [PMID: 35708744 PMCID: PMC9247815 DOI: 10.2196/34882] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background The World Health Organization has defined mobile health (mHealth) as the “use of mobile and wireless technologies to support the achievement of health objectives.” Smartphones currently represent one of the main media forms for mHealth democratization. Health apps can be an interesting tool for changing health behaviors. However, their use in France is still poorly documented. Objective The main aim of this study was to evaluate the frequency of use of health apps among patients consulting in the primary care setting in France. The secondary aims were to evaluate the use of health apps according to the sociodemographic and medical characteristics of patients and to determine their use. Methods A population-based cross-sectional survey was carried out between November 2017 and January 2018 in the Grenoble area of France among patients aged between 18 and 69 years who were consulting at 13 primary care physician offices. Patients were provided with anonymous paper self-questionnaires. The main criterion for participation was the use of a smartphone health app, defined for the purpose of this study as any app supporting patients in efforts to be healthy. Results The participation rate was 49.27% (739/1500; 95% CI 46.7%-51.8%). The smartphone use was estimated at 82.6% (597/723; 95% CI 79.6%-85.2%). Of 597 smartphone owners, 47.7% (283/595; CI 43.6%-51.6%) used at least one smartphone health app. Health apps identified in this study were mainly related to wellness, prevention, and fitness (66.1%), as well as medication, treatments, and follow-up care (50.0%). The main factors associated with health app use were: use of social networks (odds ratio [OR] 3.4, 95% CI 2.1-5.3), age under 30 years (OR 2.7, CI 1.4-4.9), city size between 5001 and 10,000 inhabitants (OR 1.8, CI 1.1-2.8), and city size more than 10,000 inhabitants (OR 2.1, CI 1.4-3.2). Conclusions In this survey, nearly one out of two patients reported the use of smartphone health apps, which are currently focused on wellness, prevention, and fitness, and are largely used by the younger population. Trial Registration ClinicalTrials.gov NCT03351491; https://clinicaltrials.gov/ct2/show/NCT03351491
Collapse
Affiliation(s)
- Sabrina Paradis
- Department of General Practice, University Grenoble Alpes, Grenoble, France
- Translational Innovation in Medicine and Complexity, National Institute of Health and Medical Research, La Tronche, France
| | - Jeremy Roussel
- Department of General Practice, University Grenoble Alpes, Grenoble, France
| | - Jean-Luc Bosson
- Translational Innovation in Medicine and Complexity, National Institute of Health and Medical Research, La Tronche, France
- Department of Public Health, University Grenoble Alpes, Grenoble, France
| | - Jean-Baptiste Kern
- Department of General Practice, University Grenoble Alpes, Grenoble, France
| |
Collapse
|
22
|
Wendrich K, Krabbenborg L. Digital Self-monitoring of Multiple Sclerosis: Interview Study With Dutch Health Care Providers on the Expected New Configuration of Roles and Responsibilities. JMIR Mhealth Uhealth 2022; 10:e30224. [PMID: 35475770 PMCID: PMC9096644 DOI: 10.2196/30224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/04/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital self-monitoring allows patients to produce and share personal health data collected at home. This creates a novel situation in which health care providers and patients must engage in a reconfiguration of roles and responsibilities. Although existing research pays considerable attention to the perceptions of patients regarding digital self-monitoring, less attention has been paid to the needs, wishes, and concerns of health care providers. As several companies and public institutions are developing and testing digital self-monitoring at the time of writing, it is timely and relevant to explore how health care providers envision using these technologies in their daily work practices. Our findings can be considered in decision-making processes concerning the further development and implementation of digital self-monitoring. Objective This study aims to explore how health care providers envisage using smartphone apps for digital self-monitoring of multiple sclerosis (MS) in their daily work practices, with a particular focus on physician-patient communication and on how health care providers respond to self-monitoring data and delegate tasks and responsibilities to patients. Methods We conducted semistructured in-depth interviews with 14 MS health care providers: 4 neurologists, 7 MS specialist nurses, and 3 rehabilitation professionals. They are affiliated with 3 different hospitals in the Netherlands that will participate in a pilot study to assess the efficiency and effectiveness of a specific smartphone app for self-monitoring. Results The interviewed health care providers seemed willing to use these smartphone apps and valued the quantitative data they produce that can complement the narratives that patients provide during medical appointments. The health care providers primarily want to use digital self-monitoring via prescription, meaning that they want a standardized smartphone app and want to act as its gatekeepers. Furthermore, they envisioned delegating particular tasks and responsibilities to patients via digital self-monitoring, such as sharing data with the health care providers or acting on the data, if necessary. The health care providers expected patients to become more proactive in the management of their disease. However, they also acknowledged that not all patients are willing or able to use digital self-monitoring apps and were concerned about the potential psychological and emotional burden on patients caused by this technology. Conclusions Our findings show that health care providers envisage a particular type of patient empowerment and personalized health care in which tensions arise between health care providers acting as gatekeepers and patient autonomy, between patient empowerment and patient disempowerment, and between the weight given to quantitative objective data and that given to patients’ subjective experiences. In future research, it would be very interesting to investigate the actual experiences of health care providers with regard to digital self-monitoring to ascertain how the tensions mentioned in this paper play out in practice.
Collapse
Affiliation(s)
- Karine Wendrich
- Institute for Science in Society, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Lotte Krabbenborg
- Institute for Science in Society, Radboud University Nijmegen, Nijmegen, Netherlands
| |
Collapse
|
23
|
Della Vecchia C, Leroy T, Bauquier C, Pannard M, Sarradon-Eck A, Darmon D, Dufour JC, Preau M. Willingness of French General Practitioners to Prescribe mHealth Apps and Devices: Quantitative Study. JMIR Mhealth Uhealth 2022; 10:e28372. [PMID: 35147508 PMCID: PMC9491832 DOI: 10.2196/28372] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/25/2021] [Accepted: 08/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background The field of mobile health (mHealth) is constantly expanding. Integrating mHealth apps and devices in clinical practice is a major and complex challenge. General practitioners (GPs) are an essential link in a patient’s care pathway. As they are patients’ preferred health care intermediaries, GPs play an important role in supporting patients’ transition to mHealth. Objective This study aims to identify the factors associated with the willingness of French GPs to prescribe mHealth apps and devices to their patients. Methods This study was part of the ApiAppS project whose overall objective was to help remove barriers GPs face when prescribing mHealth apps and devices by developing a custom-built platform to aid them. The study included GPs recruited from the general practice department of several medical faculties in France (Lyon, Nice, and Rouen) and mailing lists of academic GPs, health care professional associations, and social and professional networks. Participants were asked to complete a web-based questionnaire that collected data on various sociodemographic variables, indicators of their involvement in continued education programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, and indicators characterizing their patient population. Data on their perceptions of mHealth apps and devices were also collected. Finally, the questionnaire included items to measure GPs’ acceptability of prescribing mHealth apps and devices for several health-related dimensions. Results Of the 174 GPs, 129 (74.1%) declared their willingness to prescribe mHealth apps and devices to their patients. In multivariate analysis, involvement in continued education programs (odds ratio [OR] 6.17, 95% CI 1.52-28.72), a better patient base command of the French language (OR 1.45, 95% CI 1.13-1.88), GP-perceived benefits of mHealth apps and devices for both patients and their medical practice and GP-perceived drivers for mHealth apps and device implementation in their medical practice (OR 1.04, 95% CI 1.01-1.07), and validation of mHealth apps and devices through randomized clinical trials (OR 1.02, 95% CI 1.00-1.04) were all associated with GPs’ willingness to prescribe mHealth apps and devices. In contrast, older GPs (OR 0.95, 95% CI 0.91-0.98), female GPs (OR 0.26, 95% CI 0.09-0.69), and those who perceived risks for the patient or their medical practice (OR 0.96, 95% CI 0.94-0.99) were less inclined to prescribe mHealth apps and devices. Conclusions mHealth apps and devices were generally seen by GPs as useful in general medicine and were, for the most part, favorable to prescribing them. Their full integration in general medicine will be conditioned by the need for conclusive certification, transparency (reliable and precise data concerning mHealth app and device methods of construction and clinical validation), software aids to assist GPs prescribe them, and dedicated training programs.
Collapse
Affiliation(s)
- Claire Della Vecchia
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Tanguy Leroy
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Charlotte Bauquier
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Myriam Pannard
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Aline Sarradon-Eck
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Institut Paoli-Calmettes, CanBios, Marseille, France
| | - David Darmon
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Département d'Enseignement et de Recherche en Médecine Générale, Université Côte d'Azur, Nice, France
| | - Jean-Charles Dufour
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Service Biostatistique et Technologies de l'Information et de la Communication, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
| | - Marie Preau
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| |
Collapse
|
24
|
Gullslett MK, Strand Bergmo T. Implementation of E-prescription for Multidose Dispensed Drugs: Qualitative Study of General Practitioners' Experiences. JMIR Hum Factors 2022; 9:e27431. [PMID: 35037881 PMCID: PMC8804951 DOI: 10.2196/27431] [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: 01/25/2021] [Revised: 05/21/2021] [Accepted: 11/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Increased use of pharmaceuticals challenges both capacity and safety related to medication management for patients and changes in how general practitioners (GPs) and other health personnel interact with and follow up with patients. E-prescribing of multidose drug dispensing (eMDD) is 1 of the national measures being tested in Norway. Objective The objective of this study is to explore GPs’ experiences with the challenges and benefits of implementing eMDD in Norway. Methods Qualitative in-depth and group interviews were conducted with a total of 25 GPs between 2018 and 2020. Transcribed files were saved in NVivo to conduct a step-by-step content analysis. NVivo is a software tool for organizing, managing, and analyzing qualitative data. Results The study revealed that eMDD offers many benefits. At the same time, there are several challenges related to information, training, and initiation, as well as to the responsibility for the medication, interactions, and the risk of incorrect medication. An important activity in the start-up phase was an information meeting with pharmacies and technology suppliers, as well as exchanging information and instructions with pharmacies on how to get started. Four analytic themes emerged through the extraction of data: (1) start-up with eMDD (“Be patient”); (2) the need for training; (3) interaction, safety, and efficiency; and (4) the working day with eMDD. Conclusions There is a variation in different GPs’ needs regarding training and information, and considerable variation in competence and motivation related to the use of digital tools. There are also different degrees of understanding the everyday work of the other actors in the medication chain. In particular, the harmonization of medication lists related to the use of time, expenditures, and challenges with technological solutions in the introduction phase was emphasized as a challenge. Overall, GPs who have started using the system report great benefits; these are largely related to an increased overview of patients’ total medication lists, less time spent on prescribing prescriptions, and increased collaboration with pharmacies and nurses, both in service from providers in homes and in nursing homes.
Collapse
Affiliation(s)
| | - Trine Strand Bergmo
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
| |
Collapse
|
25
|
Breil B, Salewski C, Apolinário-Hagen J. Comparing the Acceptance of Mobile Hypertension Apps for Disease Management Among Patients Versus Clinical Use Among Physicians: Cross-sectional Survey. JMIR Cardio 2022; 6:e31617. [PMID: 34989683 PMCID: PMC8778565 DOI: 10.2196/31617] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/11/2021] [Accepted: 11/27/2021] [Indexed: 02/06/2023] Open
Abstract
Background High blood pressure or hypertension is a vastly prevalent chronic condition among adults that can, if not appropriately treated, contribute to several life-threatening secondary diseases and events, such as stroke. In addition to first-line medication, self-management in daily life is crucial for tertiary prevention and can be supported by mobile health apps, including medication reminders. However, the prescription of medical apps is a relatively novel approach. There is limited information regarding the determinants of acceptance of such mobile health (mHealth) apps among patients as potential users and physicians as impending prescribers in direct comparison. Objective The present study aims to investigate the determinants of the acceptance of health apps (in terms of intention to use) among patients for personal use and physicians for clinical use in German-speaking countries. Moreover, we assessed patients’ preferences regarding different delivery modes for self-care service (face-to-face services, apps, etc). Methods Based on an extended model of the unified theory of acceptance and use of technology (UTAUT2), we performed a web-based cross-sectional survey to explore the acceptance of mHealth apps for self-management of hypertension among patients and physicians in Germany. In addition to UTAUT2 variables, we measured self-reported self-efficacy, eHealth literacy, previous experiences with health apps, perceived threat to privacy, and protection motivation as additional determinants of mHealth acceptance. Data from 163 patients and 46 physicians were analyzed using hierarchical regression and mediation analyses. Results As expected, a significant influence of the unified theory of acceptance and use of technology (UTAUT) predictors on intentions to use hypertension apps was confirmed, especially for performance expectancy. Intention to use was moderate in patients (mean 3.5; SD 1.1; range 1-5) and physicians (mean 3.4, SD 0.9), and did not differ between both groups. Among patients, a higher degree of self-reported self-efficacy and protection motivation contributed to an increased explained variance in acceptance with R2=0.09, whereas eHealth literacy was identified as exerting a positive influence on physicians (increased R2=0.10). Furthermore, our findings indicated mediating effects of performance expectancy on the acceptance among patients but not among physicians. Conclusions In summary, this study has identified performance expectancy as the most important determinant of the acceptance of mHealth apps for self-management of hypertension among patients and physicians. Concerning patients, we also identified mediating effects of performance expectancy on the relationships between effort expectancy and social influence and the acceptance of apps. Self-efficacy and protection motivation also contributed to an increase in the explained variance in app acceptance among patients, whereas eHealth literacy was a predictor in physicians. Our findings on additional determinants of the acceptance of health apps may help tailor educational material and self-management interventions to the needs and preferences of prospective users of hypertension apps in future research.
Collapse
Affiliation(s)
- Bernhard Breil
- Faculty of Health Care, Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
26
|
Zhou S, Li K, Ogihara A, Wang X. Perceptions of traditional Chinese medicine doctors about using wearable devices and traditional Chinese medicine diagnostic instruments: A mixed-methodology study. Digit Health 2022; 8:20552076221102246. [PMID: 35646381 PMCID: PMC9134401 DOI: 10.1177/20552076221102246] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/05/2022] [Indexed: 02/06/2023] Open
Abstract
Objective This study aimed to investigate the perceptions of traditional Chinese
medicine doctors about wearable devices and diagnostic instruments and
explore the factors that influence them. Methods Data on the perceptions of the traditional Chinese medicine doctors in
Hangzhou, China, about wearable devices and diagnostic instruments were
collected through face-to-face semi-structured interviews. The author coded
the interview responses using grounded theory. A cross-sectional survey was
conducted in four traditional Chinese medicine hospitals in Hangzhou, China.
The responses of 385 traditional Chinese medicine doctors were considered
valid. Descriptive statistics and binary logistic regression models were
used for analysis. Results This study categorized the perceptions of traditional Chinese medicine about
wearable devices and traditional Chinese medicine diagnostic instruments
under convenience, reliability, suitable population, machine usage scenario,
and the integration of traditional Chinese medicine and information
communication technology. Convenience encompassed portability and the
convenience of carrying instruments or wearing the devices and operating
them and the human–device interface. Reliability encompassed the underlying
principles, accuracy, durability, and reference to diagnosis. Suitability
for people encompassed age distinction and disease differentiation. Machine
usage scenarios included use in daily life, educational institutions, and
primary medical institutions. The combination of traditional Chinese
medicine and information communication technology encompassed the
integration of traditional Chinese medicine and wearable functions and
diagnostic interpretation. The perceptions of traditional Chinese medicine
doctors were affected by age, title, type of hospital, and specialty. Conclusions The use of wearable devices and traditional Chinese medicine diagnostic
instruments has gradually been accepted by traditional Chinese medicine
doctors. Traditional Chinese medicine doctors need to improve their
knowledge and skills for information communication technology integration,
and their standardized training should incorporate information communication
technology and digital health.
Collapse
Affiliation(s)
- Siyu Zhou
- School of Public health, Hangzhou Normal University, Hangzhou, China
| | - Kai Li
- School of Medical technology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Astushi Ogihara
- Department of Health Sciences and Social Welfare, Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Xiaohe Wang
- School of Public health, Hangzhou Normal University, Hangzhou, China
| |
Collapse
|