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Wongtanasarasin W, Nishijima DK, Wood N, DeAngelis J, Storrow A, Schimmel J, Beltre N, Sacco D, Probst MA. Factors associated with incentive redemption among participants in a multicenter prospective syncope clinical study. Acad Emerg Med 2024. [PMID: 38940329 DOI: 10.1111/acem.14979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Affiliation(s)
- Wachira Wongtanasarasin
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Daniel K Nishijima
- Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Nancy Wood
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - John DeAngelis
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Alan Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan Schimmel
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Nataly Beltre
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York City, New York, USA
| | - Dana Sacco
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York City, New York, USA
| | - Marc A Probst
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York City, New York, USA
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Oudbier SJ, Souget-Ruff SP, Chen BSJ, Ziesemer KA, Meij HJ, Smets EMA. Implementation barriers and facilitators of remote monitoring, remote consultation and digital care platforms through the eyes of healthcare professionals: a review of reviews. BMJ Open 2024; 14:e075833. [PMID: 38858155 PMCID: PMC11168143 DOI: 10.1136/bmjopen-2023-075833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/14/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES Digital transformation in healthcare is a necessity considering the steady increase in healthcare costs, the growing ageing population and rising number of people living with chronic diseases. The implementation of digital health technologies in patient care is a potential solution to these issues, however, some challenges remain. In order to navigate such complexities, the perceptions of healthcare professionals (HCPs) must be considered. The objective of this umbrella review is to identify key barriers and facilitators involved in digital health technology implementation, from the perspective of HCPs. DESIGN Systematic umbrella review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES Embase.com, PubMed and Web of Science Core Collection were searched for existing reviews dated up to 17 June 2022. Search terms included digital health technology, combined with terms related to implementation, and variations in terms encompassing HCP, such as physician, doctor and the medical discipline. ELIGIBILITY CRITERIA Quantitative and qualitative reviews evaluating digital technologies that included patient interaction were considered eligible. Three reviewers independently synthesised and assessed eligible reviews and conducted a critical appraisal. DATA EXTRACTION AND SYNTHESIS Regarding the data collection, two reviewers independently synthesised and interpreted data on barriers and facilitators. RESULTS Thirty-three reviews met the inclusion criteria. Barriers and facilitators were categorised into four levels: (1) the organisation, (2) the HCP, (3) the patient and (4) technical aspects. The main barriers and facilitators identified were (lack of) training (n=22/33), (un)familiarity with technology (n=17/33), (loss of) communication (n=13/33) and security and confidentiality issues (n=17/33). Barriers of key importance included increased workload (n=16/33), the technology undermining aspects of professional identity (n=11/33), HCP uncertainty about patients' aptitude with the technology (n=9/33), and technical issues (n=12/33). CONCLUSIONS The implementation strategy should address the key barriers highlighted by HCPs, for instance, by providing adequate training to familiarise HCPs with the technology, adapting the technology to the patient preferences and addressing technical issues. Barriers on both HCP and patient levels can be overcome by investigating the needs of the end-users. As we shift from traditional face-to-face care models towards new modes of care delivery, further research is needed to better understand the role of digital technology in the HCP-patient relationship.
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Affiliation(s)
- Susan J Oudbier
- Outpatient Division, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Digital Health, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Quality of Care, Amsterdam, The Netherlands
| | - Sylvie P Souget-Ruff
- Department of Medical Psychology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Britney S J Chen
- Department of Medical Psychology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Kirsten A Ziesemer
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans J Meij
- Outpatient Division, Amsterdam UMC, Amsterdam, The Netherlands
- National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Quality of Care, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Personalized Medicine, Amsterdam, The Netherlands
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Prieto-Moreno R, Molina-García P, Ortiz-Piña M, Mora-Traverso M, Estévez-López F, Martín-Matillas M, Ariza-Vega P. Association of the @ctivehip tele-rehabilitation with the fear of falling of older adults with hip fracture and their family caregivers: Secondary analysis of a non-randomised controlled trial. J Telemed Telecare 2024:1357633X241257972. [PMID: 38836335 DOI: 10.1177/1357633x241257972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Osteoporotic hip fracture is a major health problem. Falls, the primary cause, might lead to a persistent fear of falling (FoF) among older adults, affecting their daily activities and rehabilitation. While in-person interventions exist, limited research is available on the effects of tele-rehabilitation on the FoF after a hip fracture. Thus, this study aims to test the association of the @ctivehip tele-rehabilitation programme on reducing the levels of FoF experienced by both older adults with hip fracture and their family caregivers. METHODS A non-randomised controlled trial (ClinicalTrials.gov; Identifier: NCT02968589) that compared a webpage-based tele-rehabilitation (@ctivehip) against usual care. Fear of falling was assessed using the Short Falls Efficacy Scale-International. Patients' functional status was evaluated using the Functional Independence Measure. Physical performance was assessed by the Timed Up and Go test and Short Physical Performance Battery. We conducted a per-protocol analysis as the primary outcome, and an intention-to-treat approach as secondary analysis. RESULTS A total of 71 patients with hip fracture (78.75 ± 6.12 years, 75% women) and their family caregivers participated. Participants in the intervention showed a higher decrease in FoF in comparison to those in the usual care (0.5 Cohen's d; p = 0.042). The reduction in FoF resulting from participation in the tele-rehabilitation programme was mediated by improvements in functional status by 79%. The @ctivehip programme did not decrease FoF of family caregivers. DISCUSSION @ctivehip is associated with a reduction of the FoF in older adults with hip fractures, but not in their family caregivers, with the reduction being mostly explained by improvements in the patients' functional status. Although the intervention seems promising, it should not be applied in clinical settings until confirmed by appropriate-designed randomised clinical trials.
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Affiliation(s)
- Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Mariana Ortiz-Piña
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Miguel Martín-Matillas
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Ciobanu LG, Baryshnikova NV, Jawahar MC, Toben CG, Sokolenko E, Arnet VK, Addo IY, Adegboye OA, Ahinkorah BO, Alam K, Alif SM, Ameyaw EK, Anderlini D, Angell B, Ansar A, Anyasodor AE, Astell-Burt T, Atorkey P, Ayala Quintanilla BP, Ayano G, Babu AS, Bagheri N, Baune BT, Bhandari D, Bhaskar S, Boufous S, Briggs AM, Bulamu NB, Burns RA, Carvalho AF, Cerin E, Cherbuin N, Chowdhury EK, Cross M, De Leo D, Driscoll TR, Du M, Edvardsson D, Edvardsson K, Efendi F, Endalamaw A, Fauk NK, Flavel J, Franklin RC, Gill TK, Gupta B, Gupta VK, Hamiduzzaman M, Hankey GJ, Hay SI, Hebert JJ, Hendrie D, Hill CL, Huda MM, Shariful Islam SM, Kaambwa B, Kandel H, Kassie GM, Kerr JA, Khan A, Khan MN, Kulkarni V, Lalloo R, Dao Le LK, Leigh J, Liu G, Mahumud RA, Mamun AA, McGrath JJ, Meretoja A, Miller TR, Mitchell PB, Mokdad AH, Morawska L, Obamiro KO, Peden AE, Pesudovs K, Rahman A, Rahman MM, Rahman MA, Ratan ZA, Rawal L, Rumisha SF, Sachdev PS, Seidu AA, Sharma S, Shorofi SA, Siabani S, Singh A, Singh BB, Slater H, Stokes MA, Subedi N, Tadakamadla SK, Thrift AG, Ngoc Tran MT, Vandelanotte C, Wang N, Ward P, Woodward M, Xu X, Yadav L, Zaman SB, Zhang J, Clark SR. Pre-COVID life expectancy, mortality, and burden of diseases for adults 70 years and older in Australia: a systematic analysis for the Global Burden of Disease 2019 Study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101092. [PMID: 38911261 PMCID: PMC11190477 DOI: 10.1016/j.lanwpc.2024.101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/14/2024] [Accepted: 04/30/2024] [Indexed: 06/25/2024]
Abstract
Background The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices. Methods Using the standardised methodology framework and analytical strategies from GBD 2019 methodologies, we estimated mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), life expectancy at age 70 and above (LE-70), and healthy life expectancy (HALE-70) in Australia comparing them globally and with high socio-demographic index (SDI) groups. Findings DALY rates have been improving steadily over the past 30 years among Australians aged 70 and above. Decreases in DALY rates were primarily attributed to a fall in YLLs attributable to cardiovascular diseases (60%) and chronic respiratory disorders (30.2%) and transport injuries (56.9%), while the non-fatal burden remained stable from 1990 to 2019. According to the DALY rates, the top five leading causes are ischemic heart disease, Alzheimer's disease, COPD, stroke, and falls, where falls exhibited the largest increase since 1990. Interpretation This study provides an in-depth report on the main causes of mortality and disability in Australia's population aged 70 and above. It sheds light on the shifts in burden over three decades, emphasising the need for the Australian health system to enhance its readiness in addressing the escalating demands of an ageing population. These findings establish pre-COVID baseline estimates for Australia's population aged 70 and above, informing healthcare preparedness. Funding Bill & Melinda Gates Foundation.
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Schroeder T, Kamalakkannan A, Seaman K, Nguyen A, Siette J, Gewald H, Georgiou A. Perception of middle-aged and older adults towards mHealth apps: A comparative factor analysis between Australia and Germany. Int J Med Inform 2024; 189:105502. [PMID: 38815317 DOI: 10.1016/j.ijmedinf.2024.105502] [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: 07/21/2023] [Revised: 02/23/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE Although evidence of the global effectiveness and usability of mobile health (mHealth) apps as non-drug interventions is growing, older adults often demonstrate low adoption rates of these apps. This study aims to identify the perspectives of older adults on introducing and adopting mHealth apps in Australia and Germany. MATERIALS AND METHODS We conducted two online cross-sectional surveys to examine factors from contextual, technological and personal perspectives that influence older adults in mHealth app adoption. Using descriptive statistics, chi-square tests and exploratory factor analysis, we identified the differences and similarities between respondents' perspectives across two countries. RESULTS A total of 290 respondents (149, Australia; 141, Germany) completed the survey. Older adults' ability to use a mHealth app, the user-friendliness of the app, their positive self-efficacy regarding their health and resource availability for using mHealth apps were related to intended adoption. Differences between Germany and Australia were found in issues concerned with data sharing and empowerment by the doctor, while similarities were related to trust in the doctor and their treatment approaches. DISCUSSION AND CONCLUSION This study highlights participants' perspectives and attitudes towards mHealth app use, unmet needs and barriers, and the facilitating influences in the two countries. These insights can be used to inform the development and implementation of mHealth apps and to construct tailored strategies to increase the adoption rates of mHealth apps among older adults and to maximise their potential benefits.
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Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia.
| | - Abbish Kamalakkannan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia; MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Heiko Gewald
- Institute for Digital Innovation (IDI), University of Applied Sciences Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
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6
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Chee SY. Age-related digital disparities, functional limitations, and social isolation: unraveling the grey digital divide between baby boomers and the silent generation in senior living facilities. Aging Ment Health 2024; 28:621-632. [PMID: 37424361 DOI: 10.1080/13607863.2023.2233454] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES The onset of the digital age has sparked a significant age-related digital divide, detrimentally affecting older adults. The age-related digital disparities and the gray digital divide between the Baby Boomers and the Silent Generation in senior living facilities remains an exigent issue. This study explored the lived experiences of older adults as they confront the challenges posed by age-related digital disparities inherent in the gray digital divide in senior living facilities. METHODS In-depth, semi-structured interviews and observations were conducted with 28 older adults living in six senior living facilities in three urban locations. Moustakas's transcendental phenomenology was employed, and the Modified Stevick-Colaizzi-Keen method was used to analyze the data. RESULTS This study identified six main themes: barriers to connectivity, digital literacy, generational-rooted perceptions, navigating technology with functional limitations, social isolation, and end-of-life planning. CONCLUSION The gray digital divide disproportionately affects older adults in senior living facilities. The study emphasizes the need for tailored interventions and targeted support to address the specific needs of each cohort and reduce age-related disparities. Addressing these disparities has significant implications for academics, policy-makers, senior living accommodations, and technology developers.
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Affiliation(s)
- Shi Yin Chee
- Active Ageing Impact Lab, Faculty of Social Sciences and Leisure Management, Taylor's University, Subang Jaya, Malaysia
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Bertolazzi A, Quaglia V, Bongelli R. Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review. BMC Public Health 2024; 24:506. [PMID: 38365698 PMCID: PMC10873991 DOI: 10.1186/s12889-024-18036-5] [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: 04/30/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.
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Affiliation(s)
- Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy.
| | - Valeria Quaglia
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
| | - Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
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McCarthy B, Sabharwal JK, Chawla S. Old age or cognitive decline? Examining the usability of a mobile health app for older Australians. Inform Health Soc Care 2024; 49:83-97. [PMID: 38529731 DOI: 10.1080/17538157.2024.2332691] [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: 03/27/2024]
Abstract
There is a growing literature on the role of mobile health applications (mHealth apps) in supporting older adults and the self-management of personal health. The purpose of this pilot study is to assess the usability of a government-funded mobile health app amongst older Australians and to evaluate whether cognitive function and demographic characteristics (i.e. age, gender, education) are associated with usability. A total of 28 older adults living in a regional city in Australia took part in the study. The participants were recruited using purposive sampling. Data collection instruments consisted of validated cognitive tests, task-based usability tests, and a questionnaire. The data was analyzed using non-parametric strategies. The findings of this study demonstrated that a government-funded, mHealth app was usable by older adults. Users were able to perform basic tasks in an effective and efficient manner. The hypothesis that elderly age would be significantly associated with performance on cognitive tests, as well as usability, was not supported. Performance on some cognitive tests was significantly and positively related to usability. Education and gender were not related to usability. The results suggest that traditional stereotypes surrounding aging and cognitive decline need to be reexamined.
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Affiliation(s)
- Breda McCarthy
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
- Information Technology, James Cook University, Singapore, Singapore
| | - Jagdeep Kaur Sabharwal
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
| | - Shailey Chawla
- Information Technology, James Cook University, Singapore, Singapore
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Banbury A, Taylor M, Caffery L, Der Vartanian C, Haydon H, Mendis R, Ng K, Smith A. Consumers' experiences, preferences, and perceptions of effectiveness in using telehealth for cancer care in Australia. Asia Pac J Clin Oncol 2023; 19:752-761. [PMID: 37712136 DOI: 10.1111/ajco.14002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/06/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023]
Abstract
AIM COVID-19 accelerated telehealth (video and telephone) use for cancer care to reduce disease exposure and transmission. Understanding consumers' health service delivery needs is required to sustain telehealth activity and develop new models of care. We explored consumers' experiences of telehealth in cancer care and their perspectives on improving and sustaining telehealth uptake in the future. METHODS Exploratory design mixed-methods study using the Model for Assessment of Telemedicine (MAST) framework. Consumers affected by cancer completed an online survey and semistructured interviews. Quantitative data were analyzed using descriptive statistics and chi-square. Qualitative data from the MAST consumer domain were thematically analyzed. RESULTS There were 1162 survey respondents and 18 interview participants. Video and telephone were used in cancer care with various providers. Telephone was used more frequently. Most respondents (85%) had reliable internet connections for video, however, 36% were not offered a video consultation. Video compared with telephone users were statistically significantly more likely to be satisfied with the quality of their treatment and perceived their consultation achieved as much as an in-person consultation. Telephone users (51%) compared with video users (31%) were more likely to perceive their concerns would have been better understood by their care provider if they were seen in person. Five themes emerged from the qualitative data. Consumers want modality choice, video provides superior experiences versus telephone, consultation mode preference is fluid, and consultation scheduling and administration need further consideration. CONCLUSION Consumers support telehealth in cancer care. Consumers want consultation mode choices based on their needs and purpose of consultation.
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Affiliation(s)
- Annie Banbury
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Monica Taylor
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Liam Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | | | - Helen Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Roshni Mendis
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Kawai Ng
- Cancer Australia, Sydney, Australia
| | - Anthony Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
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Abazari S, Moulaei K, George M. Examining Outcomes and Challenges of Telepsychiatry in Australian Elderly: A Scoping Review. J Aging Res 2023; 2023:8864591. [PMID: 37881169 PMCID: PMC10597727 DOI: 10.1155/2023/8864591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/12/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
Methods To find relevant articles, we searched PubMed, Scopus, and Web of Science databases. We used a data extraction form to gather information from primary studies. Two researchers followed inclusion and exclusion criteria to select studies and extract data. Disagreements were resolved through discussion with all researchers. Studies needed to be in English, about telepsychiatry for Australian seniors, and use any technology type (synchronous, asynchronous, or both). We excluded nontelepsychiatry articles, books, book chapters, conference abstracts, and editor letters. Results Telepsychiatry was effectively employed to manage depression, anxiety, delirium, and cognitive impairments. Among these four disorders, telepsychiatry was mostly used for depression. Videoconference and telephone were mostly used to provide telepsychiatry services. Most telepsychiatry services for Australian seniors included "patient education on disorder control and management," "creating continuous interaction between the patient and the therapist," and "remote patients' assessment." "Reductions in symptoms of disorders," "improving patients' satisfaction with telepsychiatry," and "cost-effectiveness of telepsychiatry" were the most important positive outcomes of using telepsychiatry. We also identified four challenges in using telepsychiatry for elderly individuals in Australia. Conclusions This study is the first scoping review in Australia and provides valuable insight into telepsychiatry for elderly individuals.
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Affiliation(s)
- Sodabeh Abazari
- Older Persons Mental Health Service, West Moreton Health, Ipswich, Queensland, Australia
| | - Khadijeh Moulaei
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Manoj George
- Older Persons Mental Health Service, West Moreton Health, Ipswich, Queensland, Australia
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Jøranson N, Zechner M, Korkmaz Yaylagul N, Efthymiou A, Silva R. Experienced barriers in the use of ICT for social interaction in older adults ageing in place: a qualitative systematic review protocol (SYSR-D-22-00848). Syst Rev 2023; 12:192. [PMID: 37817279 PMCID: PMC10563227 DOI: 10.1186/s13643-023-02332-z] [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: 11/25/2022] [Accepted: 08/18/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Several information and communication technologies (ICT) have been developed to enhance social connectedness of older adults aging in place, although they are not accessible for all. Barriers in using ICT might for example relate to health issues, sensory loss, lack of technical skills, or reluctance to use technologies. Though knowledge on these barriers is crucial for the development and implementation of ICT for older adults, no systematic review was found on this subject. The proposed qualitative systematic review aims to explore barriers experienced by older adults aging in place in using ICT for social interaction. METHODS The review will be conducted in accordance with the JBI methodology. Databases for search will include MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science (ISI), among others. Included studies focus on older adults ageing in place 60 years or older. Pairs of authors will independently, by following agreed guidelines, assess the eligibility of studies, and extract data. The testing of eligibility criteria and screening of titles, abstracts, and full texts will be performed. The findings will describe for example populations, context, culture, and the phenomena of interest. Qualitative research findings will, where possible, be pooled by using JBI SUMARI for the meta-aggregation approach. DISCUSSION The mapping of published studies has the potential to identify research gaps in the existing literature, which again may inform developers and stakeholders in designing more user-friendly and adaptive ICT solutions for older people ageing in place. SYSTEMATIC REVIEW REGISTRATION CRD42022370044.
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Affiliation(s)
- Nina Jøranson
- Faculty of Health Studies, VID Specialized University, Vinderen, PO Box 184, N-3019, Oslo, Norway.
| | - Minna Zechner
- University of Helsinki, Faculty of Social Sciences, University of Helsinki, Helsinki, P.O. Box 54 (Unioninkatu 37), 00014, Finland
| | - Nilufer Korkmaz Yaylagul
- Faculty of Health Science, Gerontology Department, Akdeniz University, Dumlupınar Boulevard, 07058, Antalya, Turkey
| | - Areti Efthymiou
- Quality of Life Lab, Department of Social Work, Hellenic Mediterranean University, Estavromenos Heraklion, Crete, PC 71410, Greece
| | - Rosa Silva
- Center for Health Technology and Services Research (CINTESIS), Nursing School of Porto, 4200-072, Porto, Portugal
- Portugal Centre for Evidence Based Practice, A JBI Centre of Excellence (PCEBP), 3000-232, Coimbra, Portugal
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12
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Dillon J, Wick JY. Telehealth: Moving Older People Along the Adoption Trajectory. Sr Care Pharm 2023; 38:416-422. [PMID: 37771053 DOI: 10.4140/tcp.n.2023.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Although the concept of telehealth has been in development for many years, the global pandemic galvanized its growth and utility. In general, people adopt technological advancements at different velocities that, when plotted in a chart, resemble a bell-shaped curve. People who are quick to adopt new technologies are designated innovators, while those who are the very last to adopt new technologies are dubbed laggards. Often, older people fall into the laggard category for several reasons including physical, mental, and emotional barriers. In some cases, they lack the technology or experience with various programs that would make such programs accessible. Regardless, telehealth has proven its worth as a way to deliver care in areas distant to the health care provider when physical examination is unnecessary. It can reduce the likelihood of exposure to contagious disease. Telehealth also has the potential to reduce unnecessary emergency department visits, and long-term care facilities that have used telehealth have demonstrated cost savings. Little study has been conducted to determine how pharmacists are using telehealth, but after examining available research on telehealth, pharmacists can identify pitfalls and implement steps that reduce barriers for older people.
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Affiliation(s)
- Jessica Dillon
- University of Connecticut, School of Pharmacy, Storrs, Connecticut
| | - Jeannette Y Wick
- University of Connecticut, School of Pharmacy, Storrs, Connecticut
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Conway A, Ryan A, Harkin D, Mc Cauley C. "It's Another Feather in My Hat"-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia. DEMENTIA 2023; 22:1487-1513. [PMID: 37365816 PMCID: PMC10521156 DOI: 10.1177/14713012231185283] [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: 06/28/2023]
Abstract
INTRODUCTION With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia. METHODS The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis. FINDINGS The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-"That's the difficulty there even with apps or anything else." (Theme 2: Motivation)- "It makes me feel good. I feel a little with it [laughs], that its not all gone in there" (Theme 3: Fears and Concerns)- "Can somebody else get into your personal memories?" (Theme 4- Support)- "So it's important that we have that support". Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps. CONCLUSION This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of "feel good moments" and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user's information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
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14
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Wen C, Zhang Q. The role of intergenerational support in shaping oral healthcare-seeking behavior among older adults in China. Front Public Health 2023; 11:1234539. [PMID: 37744500 PMCID: PMC10512177 DOI: 10.3389/fpubh.2023.1234539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
Background This study aimed to explore how intergenerational support affects the oral healthcare or treatment-seeking behaviors of older Chinese adults and provide evidence for improving the oral health of the older adults in an aging society. Methods Data from a cross-sectional survey, the 2015 China Health and Retirement Longitudinal Study, were used to explore the relationship between oral healthcare-seeking behavior in older adults and various independent variables, such as marital status, number of children, offspring's education duration, parent-offspring interaction frequency, and financial/material support provided by children. The chi-square test and binary logistic regression were used. Results According to the results of data analysis, age, sex, marital status, cohabitation status, number of children, children's education level, and financial support from children affected older adults' oral healthcare-seeking behavior. Interviewees living with a partner and those who had 1-2 or 3-4 children showed different likelihoods of seeking oral healthcare. Moreover, interviewees whose children had higher education duration and those who received more financial/material support from their children were more likely to seek dental treatment. Conclusion Regarding the study's outcome, financial and emotional support, as well as practical assistance from family members can significantly promote oral health-seeking behavior among older adult people. Intergenerational support can serve as a crucial mechanism for promoting oral health behaviors among the older adults or act as a valuable complement to social medical assistance, warranting increased attention.
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Affiliation(s)
- Cai Wen
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of VIP Dental Service, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
| | - Qing Zhang
- Department of Nosocomial Infection Control, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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15
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Kouri A, Wong EKC, Sale JEM, Straus SE, Gupta S. Are older adults considered in asthma and chronic obstructive pulmonary disease mobile health research? A scoping review. Age Ageing 2023; 52:afad144. [PMID: 37742283 DOI: 10.1093/ageing/afad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) for asthma and chronic obstructive pulmonary disease (COPD) is rapidly growing and may help address the complex respiratory care needs of our ageing population. However, little is currently known about how airways mHealth is developed and used among older adults (≥65 years). OBJECTIVE To identify if and how older adults with asthma and COPD have been incorporated across the mHealth research cycle. METHODS We searched Ovid MEDLINE, EMBASE, CINAHL and the Cochrane Central Registry of Controlled Trials for studies pertaining to the development or evaluation of asthma and COPD mHealth for adults published after 2010. Study, participant and mHealth details, including any considerations of older age, were extracted, synthesised and charted. RESULTS A total of 334 studies of 191 mHealth tools were identified. Adults ≥65 years old were included in 33.3% of asthma mHealth studies and 85.3% of COPD studies. Discussions of older age focused on barriers to technology use. Methodologic and/or analytic considerations of older age were mostly absent throughout the research cycle. Among the 28 instances quantitative age-related analyses were detailed, 12 described positive mHealth use and satisfaction outcomes in older adults versus negative or equivocal outcomes. CONCLUSION We identified an overall lack of consideration for older age throughout the airways mHealth research cycle, even among COPD mHealth studies that predominantly included older adults. We also found a contrast between the perceptions of how older age might negatively influence mHealth use and available quantitative evaluations. Future airways mHealth research must better integrate the needs and concerns of older adults.
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Affiliation(s)
- Andrew Kouri
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
| | - Eric K C Wong
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Samir Gupta
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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16
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Kouri A, Gupta S, Straus SE, Sale JEM. Exploring the Perspectives and Experiences of Older Adults With Asthma and Chronic Obstructive Pulmonary Disease Toward Mobile Health: Qualitative Study. J Med Internet Res 2023; 25:e45955. [PMID: 37606961 PMCID: PMC10481221 DOI: 10.2196/45955] [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: 01/23/2023] [Revised: 05/23/2023] [Accepted: 06/29/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) in asthma and chronic obstructive pulmonary disease (COPD) is growing, and as the population ages, a greater number of older adults stand to benefit from mHealth-enhanced airway disease care. Though older adults are a heterogeneous population of health technology users, older age represents a potential barrier to health technology adoption, and there is currently a lack of knowledge on how older age influences mHealth use in asthma and COPD. OBJECTIVE In this qualitative study, we sought to explore the experiences and perspectives of adults who were aged 65 years and older with asthma and COPD toward mHealth use. METHODS Semistructured individual interviews were conducted with adults who were aged 65 years and older with asthma or COPD and owned a smartphone. Applying phenomenological methodology, we analyzed interview transcripts in order to develop themes and propose an essential experience of mHealth use among older adults with airway disease. We then summarized our qualitative findings and proposed strategies to leverage our results in order to guide future research and implementation efforts targeting older adults' use of airway mHealth. RESULTS Twenty participants (mean age 79.8, SD 4.4 years) were interviewed. Participants described a central tension between (1) the perception that mHealth could help maintain independence throughout aging and (2) an apprehension toward the ways in which mHealth could negatively affect established health care experiences. Several elements of these 2 themes are absent from previous research focusing on younger adults with asthma and COPD. The individual elements of these 2 themes informed potential strategies to optimize future older adults' use of asthma and COPD mHealth tools. CONCLUSIONS Focusing on the perspectives and experiences of older adults with asthma and COPD in their use of mHealth identified novel understandings of health technology use in this important demographic in need of greater care. These lessons were translated into potential strategies that will need to be objectively evaluated in future airway mHealth research, development, and implementation efforts.
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Affiliation(s)
| | - Samir Gupta
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Sharon E Straus
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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17
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Tobis S, Piasek-Skupna J, Neumann-Podczaska A, Suwalska A, Wieczorowska-Tobis K. The Effects of Stakeholder Perceptions on the Use of Humanoid Robots in Care for Older Adults: Postinteraction Cross-Sectional Study. J Med Internet Res 2023; 25:e46617. [PMID: 37540548 PMCID: PMC10439472 DOI: 10.2196/46617] [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: 02/18/2023] [Revised: 04/10/2023] [Accepted: 06/17/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Efficient use of humanoid social robots in the care for older adults requires precise knowledge of expectations in this area. There is little research in this field that includes the interaction of stakeholders with the robot. Even fewer studies have compared the perceptions of older people (as care recipients) and professional caregivers (representing those taking care of older adults in teams with robots). OBJECTIVE The aim of this study was to analyze whether specific aspects of the perceptions about humanoid robots influence attitudes after interacting with the robot and to compare the opinions of different stakeholders (older people and their professional caregivers) on this topic. We analyzed the potential impact of the differences in perception of the robot between stakeholder groups with respect to how the robot should be designed and tailored to fit the specific needs of future users. We also attempted to define areas where targeted educational activities could bring the attitudes of the two groups of stakeholders closer to each other. METHODS The studied group was a conveniently available sample of individuals who took part in the presentation of and interaction with a humanoid social robot. Among them, there were 48 community-dwelling older adults (aged ≥60 years), who were participants of day care units (which may signal the presence of self-care needs), and 53 professional caregivers. The participants were asked to express their views after an interaction with a humanoid social robot (TIAGo) using the Users' Needs, Requirements and Abilities Questionnaire (UNRAQ) and the Godspeed Questionnaire Series (GQS). RESULTS Compared to the caregivers, older adults not only assessed the robot more positively with respect to its roles as a companion and assistant (P=.009 and P=.003, respectively) but also had higher scores on their need to increase their knowledge about the robot (P=.049). Regarding the robot's functions, the greatest differences between groups were observed for the social aspects on the UNRAQ, including decreasing the sense of loneliness (P=.003) and accompanying the user in everyday activities (P=.005). As for the GQS, the mean scores of the Animacy, Likeability, and Perceived Intelligence scales were significantly higher for older participants than for caregivers (P=.04, P<.001, and P<.001, respectively). The only parameter for which the caregivers' scores were higher than those of the older adults was the Artificial-Lifelike item from the Anthropomorphism scale of the GQS (P=.03). CONCLUSIONS The acceptance of the social functions of a humanoid robot is related to its perception in all analyzed aspects, whereas the expected usefulness of a care robot is not linked to aspects of anthropomorphism. Successful implementation of robots in the care for older people thus depends on considering not only the fears, needs, and requirements of various stakeholders but also on the perceptions of the robot. Given the differences between the stakeholders, targeted and properly structured educational and training activities for caregivers and prospective users may enable a seamless integration of robotic technologies in care provision.
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Affiliation(s)
- Slawomir Tobis
- Department of Occupational Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Piasek-Skupna
- Institute of Robotics and Machine Intelligence, Poznan University of Technology, Poznan, Poland
| | | | - Aleksandra Suwalska
- Department of Mental Health, Chair of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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18
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van Kessel R, Roman-Urrestarazu A, Anderson M, Kyriopoulos I, Field S, Monti G, Reed SD, Pavlova M, Wharton G, Mossialos E. Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review. J Med Internet Res 2023; 25:e48000. [PMID: 37490322 PMCID: PMC10410406 DOI: 10.2196/48000] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products. OBJECTIVE In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals. METHODS A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis. RESULTS We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure. CONCLUSIONS The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system's readiness for digital therapeutics.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Andres Roman-Urrestarazu
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Samantha Field
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Giovanni Monti
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Shelby D Reed
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - Milena Pavlova
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, Netherlands
| | - George Wharton
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Kissi J, Annobil C, Mensah NK, Owusu-Marfo J, Osei E, Asmah ZW. Telehealth services for global emergencies: implications for COVID-19: a scoping review based on current evidence. BMC Health Serv Res 2023; 23:567. [PMID: 37264401 DOI: 10.1186/s12913-023-09584-4] [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: 12/29/2022] [Accepted: 05/19/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION The availability of low-cost computing and digital telecommunication in the 1980s made telehealth practicable. Telehealth has the capacity to improve healthcare access and outcomes for patients while reducing healthcare costs across a wide range of health conditions and situations. OBJECTIVE This study compares the adoption, advantages, and challenges of telehealth services between high-income (HICs) and low-and-middle-income countries (LMICs) before and during the COVID-19 pandemic. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The key search terms were: "Telehealth", "Telehealth in HICs", "Telehealth in LMICs", "Telehealth before COVID-19", "Telehealth during COVID-19". We searched exhaustively ProQuest, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE databases from 2012. Booleans OR/AND were combined with key search terms to increase relevant search results. The literature search and selection process followed the Sample, Phenomena of Interest, Design, Evaluation, and Research (SPIDER) question format. RESULTS The adoption of telehealth before COVID-19 was generally low in both HICs and LMICs. The impact of COVID-19 accelerated the adoption of telehealth at the facility level but not nationwide in both high-income countries and LMICs. The rapid adoption of telehealth at the facility level in both high-income and LMICs introduced several challenges that are unique to each country and need to be addressed. CONCLUSION The lack of national policies and regulations is making the adoption of telehealth at the national level challenging in both high and low-middle-income countries. Governments and Stakeholders of healthcare must consider telehealth as a healthcare procedure that should be deployed in clinical working procedures. Primary quantitative and qualitative studies must be conducted to address challenges encountered during the pilot implementation of telehealth services in both high-income countries and LMICs before and during pandemics.
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Affiliation(s)
- Jonathan Kissi
- School of Allied Health Sciences, Department of Health Information Management. University Post Office, University of Cape Coast, Cape Coast, Ghana.
| | - Caleb Annobil
- School of Allied Health Sciences, Department of Health Information Management. University Post Office, University of Cape Coast, Cape Coast, Ghana
| | - Nathan Kumasenu Mensah
- School of Allied Health Sciences, Department of Health Information Management. University Post Office, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Owusu-Marfo
- Department of Epidemiology, Biostatistics and Disease Control, University for Development Studies, Tamale, Ghana
| | - Ernest Osei
- Faculty of Health and Allied Health, Department of Public Health, Catholic University College of Ghana, Sunyani, Ghana
| | - Zenobia Wooduwa Asmah
- School of Allied Health Sciences, Department of Health Information Management. University Post Office, University of Cape Coast, Cape Coast, Ghana
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20
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Zaman SB, Evans RG, Singh R, Singh R, Singh A, Goh TY, Singh P, De Silva N, Thrift AG. Usability and acceptability of the software ‘Arogya Sahyog’ to assess non-communicable diseases in rural India. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Kim Y, Hong S, Choi M. Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2022; 24:e37753. [PMID: 36066964 PMCID: PMC9490522 DOI: 10.2196/37753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/11/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. OBJECTIVE This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. METHODS A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. RESULTS A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI -0.79 to -0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD -0.61, 95% CI -0.95 to -0.26; P<.001) than in hospital settings (SMD -0.46, 95% CI -0.85 to -0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD -0.60, 95% CI -0.95 to -0.25; P<.001) and games for both (SMD -0.73, 95% CI -1.29 to -0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. CONCLUSIONS Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. TRIAL REGISTRATION PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5.
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Affiliation(s)
- Yesol Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Soomin Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea.,Yonsei Evidence Based Nursing Centre of Korea, A JBI Affiliated Group, Seoul, Republic of Korea
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22
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Bevilacqua R, Di Rosa M, Riccardi GR, Pelliccioni G, Lattanzio F, Felici E, Margaritini A, Amabili G, Maranesi E. Design and Development of a Scale for Evaluating the Acceptance of Social Robotics for Older People: The Robot Era Inventory. Front Neurorobot 2022; 16:883106. [PMID: 35874107 PMCID: PMC9302437 DOI: 10.3389/fnbot.2022.883106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionNowadays, several robots have been developed to provide not only companionship to older adults, but also to cooperate with them during health and lifestyle activities. Despite the undeniable wealth of socially assistive robots (SARs), there is an increasing need to customize the tools used for measuring their acceptance in real-life applications.MethodsWithin the Robot-Era project, a scale was developed to understand the degree of acceptance of the robotic platform. A preliminary test with 21 participants was performed to assess the statistical validity of the Robot-Era Inventory (REI) scales.ResultsBased on the criteria observed in the literature, 41 items were developed and grouped in different scales (perceived robot personality, human–robot interaction, perceived benefit, ease of use, and perceived usefulness). The reliability of the Robot-Era Inventory scale was analyzed with Cronbach's alpha, with a mean value of 0.79 (range = 0.61–0.91). Furthermore, the preliminary validity of this scale has been tested by using the correlation analysis with a gold standard, the Unified Theory of Acceptance and Use of Technology (UTAUT) model.DiscussionThe Robot-Era Inventory represents a useful tool that can be easily personalized and included in the assessment of any SARs that cooperate with older people in real environment applications.
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Affiliation(s)
- Roberta Bevilacqua
- Scientific Direction, IRCCS INRCA, Ancona, Italy
- *Correspondence: Roberta Bevilacqua
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, Ancona, Italy
| | | | | | | | - Elisa Felici
- Scientific Direction, IRCCS INRCA, Ancona, Italy
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Islam SMS, Nourse R, Uddin R, Rawstorn JC, Maddison R. Consensus on Recommended Functions of a Smart Home System to Improve Self-Management Behaviors in People With Heart Failure: A Modified Delphi Approach. Front Cardiovasc Med 2022; 9:896249. [PMID: 35845075 PMCID: PMC9276993 DOI: 10.3389/fcvm.2022.896249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSmart home systems could enhance clinical and self-management of chronic heart failure by supporting health monitoring and remote support, but evidence to guide the design of smart home system functionalities is lacking.ObjectiveTo identify consensus-based recommendations for functions of a smart home system that could augment clinical and self-management for people living with chronic heart failure in the community.MethodsHealthcare professionals caring for people living with chronic heart failure participated in a two-round modified Delphi survey and a consensus workshop. Thirty survey items spanning eight chronic health failure categories were derived from international guidelines for the management of heart failure. In survey Round 1, participants rated the importance of all items using a 9-point Liket scale and suggested new functions to support people with chronic heart failure in their homes using a smart home system. The Likert scale scores ranged from 0 (not important) to 9 (very important) and scores were categorized into three groups: 1–3 = not important, 4–6 = important, and 7–9 = very important. Consensus agreement was defined a priori as ≥70% of respondents rating a score of ≥7 and ≤ 15% rating a score ≤ 3. In survey Round 2, panel members re-rated items where consensus was not reached, and rated the new items proposed in earlier round. Panel members were invited to an online consensus workshop to discuss items that had not reached consensus after Round 2 and agree on a set of recommendations for a smart home system.ResultsIn Round 1, 15 experts agreed 24/30 items were “very important”, and suggested six new items. In Round 2, experts agreed 2/6 original items and 6/6 new items were “very important”. During the consensus workshop, experts endorsed 2/4 remaining items. Finally, the expert panel recommended 34 items as “very important” for a smart home system including, healthy eating, body weight and fluid intake, physical activity and sedentary behavior, heart failure symptoms, tobacco cessation and alcohol reduction, medication adherence, physiological monitoring, interaction with healthcare professionals, and mental health among others.ConclusionA panel of healthcare professional experts recommended 34-item core functions in smart home systems designed to support people with chronic heart failure for self-management and clinical support. Results of this study will help researchers to co-design and protyping solutions with consumers and healthcare providers to achieve these core functions to improve self-management and clinical outcomes in people with chronic heart failure.
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Gallegos-Rejas VM, Thomas EE, Kelly JT, Smith AC. A multi-stakeholder approach is needed to reduce the digital divide and encourage equitable access to telehealth. J Telemed Telecare 2022; 29:73-78. [PMID: 35733379 DOI: 10.1177/1357633x221107995] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since the COVID-19 pandemic onset, there has been exponential growth in the uptake of telehealth, globally. However, evidence suggests that people living in lower socioeconomic areas, cultural and linguistically diverse communities, people with disabilities, and with low health literacy are less likely to receive telehealth services. These population groups have disproportionately higher health needs and face additional barriers to healthcare access. Barriers that reduce access to telehealth further exacerbate existing gaps in care delivery. To improve equity of access to telehealth, we need to reduce the digital divide through a multi-stakeholder approach. This article proposes practical steps to reduce the digital divide and encourage equitable access to telehealth. Enabling more equitable access to telehealth requires improvements in digital health literacy, workforce training in clinical telehealth, co-design of new telehealth-enabled models of care, change management, advocacy for culturally appropriate services, and sustainable funding models.
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Affiliation(s)
- Victor M Gallegos-Rejas
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Emma E Thomas
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia.,Centre for Innovative Medical Technology, 6174University of Southern Denmark, Odense, Denmark
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Altunkalem Seydi K, Ates Bulut E, Yavuz I, Kavak H, Kaya D, Isik AT. E-mail-based health care in patients with dementia during the pandemic. Front Psychiatry 2022; 13:863923. [PMID: 36003979 PMCID: PMC9393299 DOI: 10.3389/fpsyt.2022.863923] [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: 01/27/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION/AIM Frail and cognitively impaired older patients are particularly vulnerable groups during the pandemic. Lockdowns, social isolation, and physical inactivity considerably affect physical and mental wellbeing. During the pandemic process, routine medical checks and acute medical care services may be disrupted. The study aimed to demonstrate the feasibility and effectiveness of telemedicine in the delivery of healthcare services to elderly patients during the pandemic. MATERIALS AND METHODS E-mails sent to the e-mail address of the department of geriatrics, which has been actively used for 4 years, between April 2020 and June 2021, were retrospectively evaluated. The time and reason for each application, referral to the patients, demographic data of the patients, and chronic diseases were recorded. E-mail frequencies were considered monthly time series, and time series charts for e-mail frequencies from patients were produced. RESULTS A total of 374 e-mails that 213 patients sent were assessed. A vast majority, 97.6% of the e-mails, were sent by proxies. The mean age of patients was 78.7 ± 8.1 years, and 59.2% were women. Hypertension and dementia were the most common comorbidities. The applications mostly occurred in April-May and October-November 2020. The most common complaint in dementia was behavioral disturbances (13.6%). Geriatric outpatient appointments were arranged for 29.9% of the applicants, 14.2% were referred to the emergency department, and 23.0% were offered medical treatment. Outpatient examination and treatment were completed in 15% of the patients and 10.4% of them were hospitalized. The time series charts showed that e-mails were sent more frequently by patients with dementia than the others (p = 0.03). CONCLUSIONS Telemedicine, which enables many problems of patients to be solved in geriatric practice without face-to-face appointments, can also prevent infections and unnecessary hospitalizations, especially during these unusual pandemic days.
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Affiliation(s)
- Kubra Altunkalem Seydi
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.,Geriatric Science Association, Izmir, Turkey
| | - Esra Ates Bulut
- Geriatric Science Association, Izmir, Turkey.,Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, Turkey
| | - Idil Yavuz
- Department of Statistics, Faculty of Science, Dokuz Eylul University, Izmir, Turkey
| | - Hemrin Kavak
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.,Geriatric Science Association, Izmir, Turkey
| | - Derya Kaya
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.,Geriatric Science Association, Izmir, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.,Geriatric Science Association, Izmir, Turkey
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Islam SMS, Mishra V, Siddiqui MU, Moses JC, Adibi S, Nguyen L, Wickramasinghe N. Smartphone Apps for Diabetes Medication Adherence: A Systematic Review (Preprint). JMIR Diabetes 2021; 7:e33264. [PMID: 35727613 PMCID: PMC9257622 DOI: 10.2196/33264] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/24/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
| | - Vinaytosh Mishra
- College of Healthcare Management and Economics, Gulf Medical University, Ajman, United Arab Emirates
| | - Muhammad Umer Siddiqui
- Department of Internal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | | | - Sasan Adibi
- School of Information Technology, Deakin University, Burwood, Australia
| | - Lemai Nguyen
- School of Information Technology, Deakin University, Burwood, Australia
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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