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Maurud S, Lunde L, Moen A, Opheim R. Exploring the foundations of a digital health information service for patients with inflammatory bowel disease: a mixed method study in Gravitate-Health. BMC Gastroenterol 2024; 24:184. [PMID: 38789953 PMCID: PMC11127442 DOI: 10.1186/s12876-024-03272-1] [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: 09/05/2023] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Providing relevant digital health information of high quality may promote treatment adherence and self-management for patients with inflammatory bowel disease. The development of digital health services is optimised by considering end users' needs. AIM To identify key aspects required for digital promotion of inflammatory bowel disease patients' self-management by exploring their health information needs and the preferences of both patients and healthcare professionals in relation to the digital provision of inflammatory bowel disease health services. METHODS Data from an audit of 1,481 electronic health record summaries from an inflammatory bowel disease help line, 17 semi-structured interviews with inflammatory bowel disease patients and 2 focus group interviews with 11 healthcare professionals were analysed. RESULTS Patients primarily contacted the hospital due to concerns about symptoms, examinations and tests, and medicines. Their concerns appeared to vary according to diagnosis, gender, age and disease duration. The interviews identified two overarching themes: (1) the available health information and patients' health information needs, and (2) whishes, thoughts and preferences for a digital solution in IBD care with relevant and individualised information. CONCLUSIONS The findings delineate key aspects for developing a suitable digital health information service. Patients seek information from healthcare professionals about treatment; however, in a digital solution, they want access to relevant and practical information about the disease, treatment and self-management. Both patients and healthcare professionals saw opportunities for increasing health data availability to patients. However, healthcare professionals expressed concerns about adapting, maintaining and ensuring the relevance of patient health information without increasing their workload and, thus, reducing quality of care.
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Affiliation(s)
- Sigurd Maurud
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Lene Lunde
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Moen
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Randi Opheim
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, P.O. Box 1089, Blindern, Oslo, 0318, Norway
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Lee YJ, Kwak SG, Kim ES, Kim SK, Lee HS, Chung YJ, Jang BI, Kim KO, Kim J, Jo HH, Kim EY. Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn's disease. Sci Rep 2024; 14:9405. [PMID: 38658648 PMCID: PMC11043071 DOI: 10.1038/s41598-024-59914-7] [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: 07/15/2023] [Accepted: 04/16/2024] [Indexed: 04/26/2024] Open
Abstract
We aimed to determine whether Crohn's disease (CD) activity patterns assessed via a web-based symptom diary can help predict clinical outcomes in patients with newly diagnosed CD. Patients diagnosed with CD within the preceding 3 months were prospectively enrolled at four tertiary centers. All patients recorded their symptoms on a website using a smartphone at least once a week. The index outcomes were disease-related admission and surgery during follow-up. The disease activity from enrollment to outcome or last follow-up was reviewed for pattern analysis. Cox regression analysis was used to identify the predictors of disease outcomes. A total of 102 patients were enrolled. During a median follow-up period of 42 months, 25 (24.5%) and 6 (5.9%) patients required admission and surgery, respectively. Poor activity pattern was an independent predictor of disease-related hospitalization (adjusted hazard ratio [aHR], 3.96; 95% confidence interval [CI] 1.5-10.45; p = 0.005). A poor activity pattern (aHR, 19.48; 95% CI 1.86-203.95; p = 0.013) and female sex (aHR, 11.28; 95% CI 1.49-85.01; p = 0.018) were found to be independent predictors of bowel resection. CD disease activity patterns monitored through the mobile monitoring system may help predict clinical outcomes, such as disease-related hospitalization and surgery, in patients with newly diagnosed CD.
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Affiliation(s)
- Yoo Jin Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Eun Soo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, 130 Dongdeuk-ro, Jung-gu, Daegu, South Korea.
| | - Sung Kook Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, 130 Dongdeuk-ro, Jung-gu, Daegu, South Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, 130 Dongdeuk-ro, Jung-gu, Daegu, South Korea
| | - Yun Jin Chung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, 130 Dongdeuk-ro, Jung-gu, Daegu, South Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, 317‑1 Daemyung 5 Dong, Daegu, 705-703, South Korea.
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, 317‑1 Daemyung 5 Dong, Daegu, 705-703, South Korea
| | - Jeongseok Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Hyeong Ho Jo
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Eun Young Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
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Morsa M, Perrin A, David V, Rault G, Le Roux E, Alberti C, Gagnayre R, Pougheon Bertrand D. Experiences Among Patients With Cystic Fibrosis in the MucoExocet Study of Using Connected Devices for the Management of Pulmonary Exacerbations: Grounded Theory Qualitative Research. JMIR Form Res 2024; 8:e38064. [PMID: 38261372 PMCID: PMC10848132 DOI: 10.2196/38064] [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: 03/17/2022] [Revised: 10/01/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Early detection of pulmonary exacerbations (PEx) in patients with cystic fibrosis is important to quickly trigger treatment and reduce respiratory damage. An intervention was designed in the frame of the MucoExocet research study providing patients with cystic fibrosis with connected devices and educating them to detect and react to their early signs of PEx. OBJECTIVE This study aims to identify the contributions and conditions of home monitoring in relation to their care teams from the users' point of view to detect PEx early and treat it. This study focused on the patients' experiences as the first and main users of home monitoring. METHODS A qualitative study was conducted to explore patients' and professionals' experiences with the intervention. We interviewed patients who completed the 2-year study using semistructured guides and conducted focus groups with the care teams. All the interviews were recorded and transcribed verbatim. Their educational material was collected. A grounded analysis was conducted by 2 researchers. RESULTS A total of 20 patients completed the study. Three main categories emerged from the patients' verbatim transcripts and were also found in those of the professionals: (1) task technology fit, reflecting reliability, ease of use, accuracy of data, and support of the technology; (2) patient empowerment through technology, grouping patients' learnings, validation of their perception of exacerbation, assessment of treatment efficacy, awareness of healthy behaviors, and ability to react to PEx signs in relation to their care team; (3) use, reflecting a continuous or intermittent use, the perceived usefulness balanced with cumbersome measurements, routinization and personalization of the measurement process, and the way data are shared with the care team. Furthermore, 3 relationships were highlighted between the categories that reflect the necessary conditions for patient empowerment through the use of technology. CONCLUSIONS We discuss a theorization of the process of patient empowerment through the use of connected devices and call for further research to verify or amend it in the context of other technologies, illnesses, and care organizations. TRIAL REGISTRATION ClinicalTrials.gov NCT03304028; https://clinicaltrials.gov/ct2/show/results/NCT03304028.
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Affiliation(s)
- Maxime Morsa
- Adaptation, Resilience and Change Research Unit, University of Liège, Liège, Belgium
- Laboratory Health Promotion and Education (UR3412), Sorbonne Paris North University, Bobigny, France
| | - Amélie Perrin
- Paediatrics CF Centre, Nantes University Hospital, Nantes, France
| | - Valérie David
- Paediatrics CF Centre, Nantes University Hospital, Nantes, France
| | - Gilles Rault
- Laboratoire Educations et Pormotion de la santé, Université Sorbonne Paris Nord, Bobigny, France
| | - Enora Le Roux
- Institut National de la Santé et de la Recherche Médicale (UMR 1123 ECEVE), Université de Paris, Paris, France
- Unit of Clinical Epidemiology (CIC-EC 1426), Hôpital Universitaire Robert Debré, Assistance Publique des Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Corinne Alberti
- Institut National de la Santé et de la Recherche Médicale (UMR 1123 ECEVE), Université de Paris, Paris, France
- Unit of Clinical Epidemiology (CIC-EC 1426), Hôpital Universitaire Robert Debré, Assistance Publique des Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Rémi Gagnayre
- Laboratory Health Promotion and Education (UR3412), Sorbonne Paris North University, Bobigny, France
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Christen A, Benedetti FD, Händler-Schuster D. Connected health services: Health professionals' role as seen by parents of a child with inflammatory bowel disease. Digit Health 2024; 10:20552076241271772. [PMID: 39156050 PMCID: PMC11329971 DOI: 10.1177/20552076241271772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 07/02/2024] [Indexed: 08/20/2024] Open
Abstract
Objective Connected health services will change the scope of health professionals' roles. It is unclear how parents of a child with inflammatory bowel disease perceive the role of health professionals in relation to these services and what their experiences and needs are. The purpose of this study is to highlight parents' experiences with this role. Furthermore, it aims to outline the fundamental needs that parents have regarding this role, in order to promote audience-specific access to these services and derive overarching action measures. Methods Fourteen parents of children with inflammatory bowel disease from seven different clinics in Switzerland were recruited. Between August 2022 and February 2023, these parents were interviewed in semi-structured interviews. The interviews were analyzed using a structured qualitative content analysis. Results Five main categories were identified, with few parents having prior experience with the role of health professionals in this area. Parents saw health professionals in the role of gatekeepers, transferers of knowledge and in a supporting function for these services. From the parents' perspective, health professionals should recognize the limitations of these services and use them as a complement to standard treatment. Conclusion The role of health professionals in relation to connected health services needs to be adapted from the parents' perspective. To meet the needs of parents, health professionals must have access to these services. In addition to health professionals' personal engagement with these services, institutional and policy changes, as well as research on role development from the perspective of other stakeholders are needed.
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Affiliation(s)
- Aline Christen
- Institute of Nursing School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Franzisca Domeisen Benedetti
- Institute of Nursing School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Daniela Händler-Schuster
- Institute of Nursing School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Institute of Nursing Science, Department of Nursing Science and Gerontology, UMIT TIROL Private University of Health Sciences and Health Technology, Hall in Tyrol, Austria
- School of Nursing, Midwifery and Health Practice, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
- School of Public Health and Social Work, Faculty of Health at Queensland University of Technology, Brisbane, Australia
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Jannati N, Salehinejad S, Kuenzig ME, Peña-Sánchez JN. Review and content analysis of mobile apps for inflammatory bowel disease management using the mobile application rating scale (MARS): Systematic search in app stores. Int J Med Inform 2023; 180:105249. [PMID: 37857167 DOI: 10.1016/j.ijmedinf.2023.105249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND People with inflammatory bowel disease (IBD) need tools for self-management of their disease with the ultimate goal of improving medication adherence and health outcomes. Mobile apps represent a novel opportunity to provide self-management for patients with IBD. Many mobile apps have been developed for IBD self-management, but more evidence is needed about the quality of these mobile apps. OBJECTIVE This study evaluated mobile apps developed for the IBD community and rated the quality of these apps to provide a roadmap for future development. MATERIALS AND METHODS The Apple App Store and Google Play Store were systematically searched to identify IBD mobile apps for patients and physicians based on the IBD-related keywords. We included mobile apps that focus on IBD, are in the English language, and are free. The related app quality was evaluated independently by two reviewers using the Mobile Application Rating Scale (MARS). RESULTS We identified 401 mobile apps. After removing duplicates and unrelated apps, 44 apps were included in the review. Overall, the mean MARS scores were 3.5 (SD = 0.5) on a scale from 1.00 to 5.00, which was the acceptable range.; 12 apps got scores ≥ 4.00. The highest mean domain score belonged to the functionality dimension (mean = 3.9, SD = 0.6) and the lowest belonged to the engagement dimension (mean = 3.2, SD = 0.8). CONCLUSION The MARS ratings showed that the IBD mobile apps quality meet acceptable criteria. However, more attention must be paid to design features that improve user interest and engagement, especially among children and adolescents. Healthcare professional involvement is crucial for designing mobile health apps.
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Affiliation(s)
- Nazanin Jannati
- Department of Community Health & Epidemiology, College of Medicine, University Saskatchewan, Saskatoon, Canada.
| | - Simin Salehinejad
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - M Ellen Kuenzig
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada; SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Canada.
| | - Juan Nicolás Peña-Sánchez
- Department of Community Health & Epidemiology, College of Medicine, University Saskatchewan, Saskatoon, Canada.
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Zare Z, Hajizadeh E, Mahmoodi M, Nazari R, Shahmoradi L, Rezayi S. Smartphone-based application to control and prevent overweight and obesity in children: design and evaluation. BMC Med Inform Decis Mak 2023; 23:201. [PMID: 37794423 PMCID: PMC10548714 DOI: 10.1186/s12911-023-02304-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Obesity is a multifaceted condition that impacts individuals across various age, racial, and socioeconomic demographics, hence rendering them susceptible to a range of health complications and an increased risk of premature mortality. The frequency of obesity among adolescent females in Iran has exhibited an increase from 6 to 9%, while among boys, it has risen from 2 to 7%. Due to the increasing prevalence and advancements in technology, the primary objective of this study was to develop and evaluate a smartphone-based app that would serve as an educational tool for parents about the matter of childhood overweight and obesity. Additionally, the app aimed to enhance parents' capacity to effectively address and manage their children's weight-related concerns. METHODS The design of the present study is of an applied-developmental type. In the first phase, the content of related smartphone-based app was determined based on the needs identified in similar studies and the findings of a researcher-made questionnaire. The versions of the app were designed in the android studio 3 programming environment, using the Java 8 programming language and SQLite database. Then, in order to evaluate the app's usability, ease of access, and different features, the standard usability evaluation questionnaire and the user satisfaction questionnaire (QUIS) were completed by the users. RESULTS The developed app has five main sections: the main page, recommendation section (with eight parts), charts over the time, child psychology, and reminders for each user. The designed app was given to 20 people including nutritionists and parents with children under 18 years of age for conducting usability evaluation. According to the scores of participants about the usability evaluation of the app, it can be concluded that groups participating in the study could use the program, and they rated the app at a "good" level. Overall performance of the app, screen capabilities, terms and information of the program, learnability, and general features are scored higher than 7.5 out of 9. CONCLUSION By using this app, people can become familiar with the causes and symptoms of weight imbalance and manage their weight as best as possible. This app can be considered as a model for designing and creating similar broader systems and programs for the prevention, management, treatment and care of diseases, which aim to help control diseases as much as possible and increase the quality of life and reduce complications for be patients.
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Affiliation(s)
- Zahra Zare
- Department of Operating Room, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Hajizadeh
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences , Tehran, Iran
| | - Maryam Mahmoodi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Nazari
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences , Tehran, Iran
| | - Leila Shahmoradi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences , Tehran, Iran.
| | - Sorayya Rezayi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences , Tehran, Iran.
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Safarpour AR, Alireza Taghavi S, Shojaei-Zarghani S, Barati-Boldaji R. Development and Pilot Testing of an Online Calculation Tool for Relapse Risk Prediction in Ulcerative Colitis. Middle East J Dig Dis 2023; 15:162-166. [PMID: 38023459 PMCID: PMC10660315 DOI: 10.34172/mejdd.2023.338] [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: 02/02/2023] [Accepted: 06/07/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Ulcerative colitis (UC) is a relapsing gastrointestinal disease. Identifying patients at a high risk of UC relapse and initiating preventive treatment can reduce the risk of UC recurrence and its dangerous side effects. The present study was performed to design and pilot test an online calculation tool for relapse risk prediction in UC. Methods: This study is based on our previous prospective study on 157 patients with UC in-remission UC. We designed an online website rooted in our pre-developed equation to calculate relapse risk scores. Then, 280 patients with UC who were not in relapse were randomly selected from our database, and the required information was filled in on the website accordingly. Finally, the indicators were manually calculated using the formula and compared with online-calculated data. Results: The developed bilingual website is available at http://www.ucrelapserisk.com. Of the 280 patients with UC, 151 (53.9%) were male. 88 patients were at high risk of relapse in the following year. There were no differences between the manually and online calculated Seo index, UC risk score, and probability of relapse in one year. Conclusion: This online tool is now available for patients and clinicians and provides an accurate relapse risk prediction for UC patients.
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Affiliation(s)
- Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Alireza Taghavi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Shojaei-Zarghani
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Barati-Boldaji
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Noser AE, Lancaster BD, Hommel KA, Roberts CM, King JA, Alt E, Fredericks EM, Ramsey RR. Use of Behavior Change Techniques and Quality of Commercially Available Inflammatory Bowel Disease Apps. Dig Dis Sci 2023:10.1007/s10620-023-07884-7. [PMID: 36933116 DOI: 10.1007/s10620-023-07884-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Inclusion of evidence-based behavior change techniques (e.g., self-monitoring) in mobile health apps has the potential to promote adherence to inflammatory bowel disease treatment. While inflammatory bowel disease management apps exist, the extent to which they incorporate behavior change techniques remains unknown. AIMS The present study systematically evaluated the content and quality of free, commercially available inflammatory bowel disease management apps. METHODS Apps were identified using a systematic search of the Apple App and Google Play stores. Apps were evaluated using Abraham and Michie's taxonomy of 26 behavior change techniques. A literature search was conducted to identify behavior change techniques specific and relevant for people with inflammatory bowel disease. App quality was assessed using the Mobile App Rating Scale with scores ranging from 1 (Inadequate) to 5 (Excellent). RESULTS A total of 51 inflammatory bowel disease management apps were evaluated. Apps included 0-16 behavior change techniques (Mean = 4.55) and 0-10 inflammatory bowel disease management behavior change techniques (Mean = 3.43). App quality ranged from 2.03 to 4.62 (Mean = 3.39) out of 5.00. Two apps, My IBD Care: Crohn's & Colitis and MyGiHealth GI Symptom Tracker, included the highest number of overall and inflammatory bowel disease management behavior change techniques along with high-quality scores. Bezzy IBD was the only app with a high number of overall and inflammatory bowel disease management behavior change techniques with a primary focus on social support/change. CONCLUSION Most inflammatory bowel disease management apps reviewed included evidence-based inflammatory bowel disease management behavior change techniques.
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Affiliation(s)
- Amy E Noser
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN, 55414, USA.
| | - Brittany D Lancaster
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kevin A Hommel
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caroline M Roberts
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica A King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elizabeth Alt
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Güney Coşkun M, Kolay E, Basaranoglu M. Telenutrition for the management of inflammatory bowel disease: Benefits, limits, and future perspectives. World J Clin Cases 2023; 11:308-315. [PMID: 36686349 PMCID: PMC9850965 DOI: 10.12998/wjcc.v11.i2.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/24/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Patients with inflammatory bowel disease (IBD) require lifelong and personalized care by a multidisciplinary healthcare team. However, the traditional medical model is not ideal for patients who require continuous close monitoring and whose symptoms may dramatically worsen between regularly scheduled visits. Additionally, close dietary follow-up and monitoring of IBD in a traditional setting are challenging because of the disease complexity, high pressure on outpatient clinics with a small number of IBD specialist dietitians, and rising incidence. Given the significant burden of IBD, there is a need to develop effective dietary management strategies. The coronavirus disease 2019 pandemic caused an unprecedented shift from in-person care to delivering health care via technological remote devices. Traditional nutrition therapy and consultation can be provided by telenutrition through remote electronic communication applications that could greatly benefit patient care. Telenutrition might be useful, safe, and cost-effective compared with standard care. It is likely that virtual care for chronic diseases including IBD will continue in some form into the future. This review article summarizes the evidence about telenutrition applications in the management of IBD patients, and we gave an overview of the acceptance and impact of these interventions on health outcomes.
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Affiliation(s)
- Merve Güney Coşkun
- Department of Nutrition and Dietetics, Istanbul Medipol University, Faculty of Health Sciences, Istanbul 34810, Turkey
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul 34810, Turkey
| | - Ezgi Kolay
- Dietitian, Independent Researcher, Istanbul 34000, Turkey
| | - Metin Basaranoglu
- Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, Istanbul 34093, Turkey
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Gaweł K, Dąbkowski K, Zawada I, Starzyńska T. Progression risk factors of ulcerative proctitis. Scand J Gastroenterol 2022; 57:1406-1411. [PMID: 35793351 DOI: 10.1080/00365521.2022.2094726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Ulcerative colitis (UC) is an inflammatory bowel disease of unknown etiology. It is characterized by a chronic course with periods of aggravations and remissions. Among patients, 25-55% present with ulcerative proctitis (UP) at the time of diagnosis. UP is well-treated disease associated with a good prognosis. UP is characterized by a less aggressive course than the left-sided form of UC and pancolitis, with a good response to topical treatment. Moreover, UP is associated with a lower risk of severe aggravations and systemic and local complications and lower need for colectomy, hospitalization and glucocorticosteroids and immunosuppressive drugs, in comparison with more extensive forms of the disease. Thus, the key issue is to prognose the natural course of the disease in order to identify high-risk patients and apply biological or immunosuppressive treatment early to prevent the development of complications. In this review, we summarize the current knowledge about the natural course of UP and discuss risks and protective factors related to disease progression and current treatment concepts.
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Affiliation(s)
- Katarzyna Gaweł
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Dąbkowski
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Zawada
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Teresa Starzyńska
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
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Messner EM, Sturm N, Terhorst Y, Sander LB, Schultchen D, Portenhauser A, Schmidbaur S, Stach M, Klaus J, Baumeister H, Walter BM. Mobile Apps for the Management of Gastrointestinal Diseases: Systematic Search and Evaluation Within App Stores. J Med Internet Res 2022; 24:e37497. [PMID: 36197717 PMCID: PMC9582913 DOI: 10.2196/37497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/30/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Gastrointestinal diseases are associated with substantial cost in health care. In times of the COVID-19 pandemic and further digitalization of gastrointestinal tract health care, mobile health apps could complement routine health care. Many gastrointestinal health care apps are already available in the app stores, but the quality, data protection, and reliability often remain unclear. Objective This systematic review aimed to evaluate the quality characteristics as well as the privacy and security measures of mobile health apps for the management of gastrointestinal diseases. Methods A web crawler systematically searched for mobile health apps with a focus on gastrointestinal diseases. The identified mobile health apps were evaluated using the Mobile Application Rating Scale (MARS). Furthermore, app characteristics, data protection, and security measures were collected. Classic user star rating was correlated with overall mobile health app quality. Results The overall quality of the mobile health apps (N=109) was moderate (mean 2.90, SD 0.52; on a scale ranging from 1 to 5). The quality of the subscales ranged from low (mean 1.89, SD 0.66) to good (mean 4.08, SD 0.57). The security of data transfer was ensured only by 11 (10.1%) mobile health apps. None of the mobile health apps had an evidence base. The user star rating did not correlate with the MARS overall score or with the individual subdimensions of the MARS (all P>.05). Conclusions Mobile health apps might have a positive impact on diagnosis, therapy, and patient guidance in gastroenterology in the future. We conclude that, to date, data security and proof of efficacy are not yet given in currently available mobile health apps.
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Affiliation(s)
- Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Niklas Sturm
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany.,Department of Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg at Breisgau, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Alexandra Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Simone Schmidbaur
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
| | - Jochen Klaus
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Benjamin M Walter
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
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12
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Ye C, Cao C, Yang J, Shao X. Explore How Online Healthcare Can Influence Willingness to Seek Offline Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137925. [PMID: 35805579 PMCID: PMC9265923 DOI: 10.3390/ijerph19137925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/04/2022]
Abstract
With the recent development of internet healthcare, many hospitals have laid out their online platforms. However, there have been some poor service levels and low quality. The frequency of such problems has led to a decline in patient satisfaction. Therefore, it is vital to explore how hospitals can improve user satisfaction and willingness to visit them offline by setting up an online presence. Most studies conducted so far have remained limited to the single dimension of online or offline healthcare, with few studies exploring the relationship between them. While a few studies have explored the impact of online service quality on willingness to seek offline care, they also face the problem of a single perspective of analysis. Therefore, this study constructs a multidimensional model of the factors influencing online healthcare users’ willingness to seek offline care by integrating the value-based adoption model and the stimulus–organism–response model. Through a partial least squares-structural equation modelling analysis of 283 valid samples, this study found that online doctor–patient interactions and service quality positively impact user perception. This paper explores the development path of online healthcare from a new theoretical perspective. In addition, the findings provide new guidelines for hospitals to achieve economic and social benefits.
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Affiliation(s)
- Chensang Ye
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China; (C.Y.); (J.Y.)
| | - Cong Cao
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China; (C.Y.); (J.Y.)
- Correspondence:
| | - Jinjing Yang
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China; (C.Y.); (J.Y.)
| | - Xiuyan Shao
- School of Economics and Management, Southeast University, Nanjing 211189, China;
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Oancea CN, Statie RC, Gheonea DI, Ciurea T, Șerbănescu MS, Streba CT. IBD Monitor: Romanian National Mobile Application for Inflammatory Bowel Disease Personalized Treatment and Monitoring. Diagnostics (Basel) 2022; 12:diagnostics12061345. [PMID: 35741155 PMCID: PMC9221845 DOI: 10.3390/diagnostics12061345] [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: 05/11/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 02/05/2023] Open
Abstract
Background: In the last 30 years, we have seen an increase in the incidence of inflammatory bowel disease (IBD). Most cases are diagnosed in the 2nd and 3rd decades of life, a population group that is most familiar with the latest innovations in technology. Patients want to obtain more information about their disease and have complete control over the pathology, while reducing physical meetings with their doctor. Starting from these ideas, the present study aimed to develop a mobile application (app) to support IBD patients on symptoms/events reporting and on treatment administration monitoring. Methods: A multidisciplinary team was created to document and develop the app requirements and design its functionality. The app was beta-tested by several IBD patients. Their feedback was used to further refine the app. Results: We developed connected apps for both smartphones and smartwatches, with dedicated sections for event reporting and medication administration reminders/reporting. Conclusions: The development of apps dedicated to IBD patients is still in early progress. By creating this app, we aim to improve the evolution and compliance of IBD patients and to obtain new information that will have a beneficial impact on the management of these patients and open the door for personalized medicine.
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Affiliation(s)
- Carmen-Nicoleta Oancea
- Department of Analytical Chemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Răzvan-Cristian Statie
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania; (R.-C.S.); (D.-I.G.); (T.C.)
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Dan-Ionuț Gheonea
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania; (R.-C.S.); (D.-I.G.); (T.C.)
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Tudorel Ciurea
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania; (R.-C.S.); (D.-I.G.); (T.C.)
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mircea-Sebastian Șerbănescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence:
| | - Costin-Teodor Streba
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Oddsson SJ, Gunnarsdottir T, Johannsdottir LG, Amundadottir ML, Frimannsdottir A, Molander P, Ylanne AK, Islind AS, Oskarsdottir M, Thorgeirsson T. A new Digital Health Program for Patients with Inflammatory Bowel Disease: Preliminary Program Evaluation (Preprint). JMIR Form Res 2022; 7:e39331. [PMID: 37115598 PMCID: PMC10182451 DOI: 10.2196/39331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) causes chronic inflammation of the gastrointestinal tract. IBD is characterized by an unpredictable disease course that varies greatly between individuals and alternates between the periods of relapse and remission. A low energy level (fatigue) is a common symptom, whereas stress and reduced sleep quality may be the triggering factors. Therapeutic guidelines call for effective disease assessment, early intervention, and personalized care using a treat-to-target approach, which may be difficult to achieve through typical time- and resource-constrained standard care. Providing patients with a digital health program that incorporates helpful self-management features and patient support to complement standard care may be optimal for improving the disease course. OBJECTIVE This study aimed to perform a preliminary program evaluation, analyzing engagement and preliminary effectiveness and the effect on participants' energy levels (fatigue), stress, and sleep quality, of a newly developed 16-week digital health program (SK-311 and SK-321) for patients with IBD. METHODS Adults with IBD were recruited to participate in a real-world, live, digital health program via Finnish IBD patient association websites and social media. No inclusion or exclusion criteria were applied for this study. Baseline characteristics were entered by the participants upon sign-up. Platform engagement was measured by tracking the participants' event logs. The outcome measures of stress, energy levels (fatigue), and quality of sleep were reported by participants through the platform. RESULTS Of the 444 adults who registered for the digital health program, 205 (46.2%) were included in the intention-to-treat sample. The intention-to-treat participants logged events on average 41 times per week (5.9 times per day) during the weeks in which they were active on the digital platform. More women than men participated in the intervention (126/205, 88.7%). The mean age of the participants was 40.3 (SD 11.5) years, and their mean BMI was 27.9 (SD 6.0) kg/m2. In total, 80 people provided the required outcome measures during weeks 12 to 16 (completers). Treatment completion was strongly predicted by the number of active days in week 1. Analysis of the completers (80/205, 39%) showed significant improvements for stress (t79=4.57; P<.001; percentage change=-23.26%) and energy levels (t79=-2.44; P=.017; percentage change=9.48%); however, no significant improvements were observed for quality of sleep (t79=-1.32; P=.19). CONCLUSIONS These results support the feasibility of a digital health program for patients with IBD (SK-311 and SK-321) and suggest that treatment completion might have a substantial positive effect on patient-reported stress and energy levels in a real-world setting. These findings are promising and provide initial support for using the Sidekick Health digital health program to supplement standard care for patients with IBD.
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Affiliation(s)
| | | | | | | | | | - Pauliina Molander
- Abdominal Center, Gastroenterology, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
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Plevris N, Lees CW. Disease Monitoring in Inflammatory Bowel Disease: Evolving Principles and Possibilities. Gastroenterology 2022; 162:1456-1475.e1. [PMID: 35101422 DOI: 10.1053/j.gastro.2022.01.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease is a progressive and debilitating condition. Early and effective treatment using a treat-to-target approach is key to improving patient outcomes. Therefore, proactive monitoring is essential to ensure that treatment strategies are working and targets are being met. In this review we discuss the current monitoring tools available to us and how they can be used. We also discuss the importance of monitoring during key phases of the disease and propose an optimum treat-to-target monitoring strategy for Crohn's disease and ulcerative colitis. Regarding the advent of new technology, we discuss how this may improve our monitoring capabilities and how we envisage future monitoring strategies of inflammatory bowel diseases.
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Affiliation(s)
- Nikolas Plevris
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, Scotland, United Kingdom; Centre for Genomics and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital Campus, Edinburgh, Scotland, United Kingdom
| | - Charlie W Lees
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, Scotland, United Kingdom; Centre for Genomics and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital Campus, Edinburgh, Scotland, United Kingdom.
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Romero-Jimenez R, Escudero-Vilaplana V, Chamorro-De-Vega E, Ais-Larisgoitia A, Lobato Matilla ME, Herranz-Alonso A, Sanjurjo M. The Characteristics and Functionalities of Mobile Apps Aimed at Patients Diagnosed With Immune-Mediated Inflammatory Diseases: Systematic App Search. J Med Internet Res 2022; 24:e31016. [PMID: 35254286 PMCID: PMC8933793 DOI: 10.2196/31016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/03/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
Background
Immune-mediated inflammatory diseases (IMIDs) are systemic conditions associated with a high social and health impact. New treatments have changed the prognosis of IMIDs and have increased patient autonomy in disease management. Mobile apps have enormous potential to improve health outcomes in patients with IMIDs. Although a large number of IMID apps are available, the app market is not regulated, and functionality and reliability remain uncertain.
Objective
Our aims are to review available apps for patients with IMIDs or caregivers and to describe the main characteristics and functionalities of these apps.
Methods
We performed an observational, cross-sectional, descriptive study of all apps for patients with IMIDs. Between April 5 and 14, 2021, we conducted a search of the App Store (iOS) and Play Store (Android) platforms. We used the names of the different IMIDs as search terms. The inclusion criteria were as follows: content related to IMIDs, English or Spanish language, and user population consisting of patients and health care consumers, including family and caregivers. The variables analyzed were as follows: app name, type of IMID, platform (Android or iOS), country of origin, language, category of the app, cost, date of the last update, size, downloads, author affiliation, and functionalities.
Results
We identified 713 apps in the initial search, and 243 apps met the criteria and were analyzed. Of these, 37% (n=90) were on Android, 27.2% (n=66) on iOS, and 35.8% (n=87) on both platforms. The most frequent categories were health and well-being/fitness apps (n=188, 48.5%) and medicine (n=82, 37.9%). A total of 211 (82.3%) apps were free. The mean time between the date of the analysis and the date of the most recent update was 18.5 (SD 19.3) months. Health care professionals were involved in the development of 100 (41.1%) apps. We found differences between Android and iOS in the mean time since the last update (16.2, SD 14.7 months vs 30.3, SD 25.7 months) and free apps (85.6% vs 75.8%; respectively). The functionalities were as follows: general information about lifestyles, nutrition, or exercises (n=135, 55.6%); specific information about the disease or treatment (n=102, 42%); recording of symptoms or adverse events (n=51, 21%); agenda/calendar (n=44, 18.1%); reminder medication (n=41, 16.9%); and recording of patient-reported outcomes (n=41, 16.9%). A total of 147 (60.5%) apps had more than one functionality.
Conclusions
IMID-related apps are heterogeneous in terms of functionality and reliability. Apps may be a useful complement to IMID care, especially inpatient education (their most frequent functionality). However, more than half of the IMID apps had not been developed by health care professionals or updated in the last year.
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Affiliation(s)
- Rosa Romero-Jimenez
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Vicente Escudero-Vilaplana
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Esther Chamorro-De-Vega
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arantza Ais-Larisgoitia
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maria Elena Lobato Matilla
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Herranz-Alonso
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maria Sanjurjo
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Determinants of patient trust in gastroenterology televisits: Results of machine learning analysis. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.100867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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18
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Zand A, Nguyen A, Reynolds C, Khandadash A, Esrailian E, Hommes D. Patient Experience and Satisfaction with an e-Health Care Management Application for Inflammatory Bowel Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211747. [PMID: 34831502 PMCID: PMC8619840 DOI: 10.3390/ijerph182211747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
Background: Rising healthcare expenditures have been partially attributed to suboptimal management of inflammatory bowel diseases (IBD). Electronic health interventions may help improve care management for IBD patients, but there is a need to better understand patient perspectives on these emerging technologies. Aims: The primary aim was to evaluate patient satisfaction and experience with the UCLA eIBD mobile application, an integrative care management platform with disease activity monitoring tools and educational modules. The secondary objective was to capture patient feedback on how to improve the mobile application. Methods: We surveyed IBD patients treated at the UCLA Center for Inflammatory Bowel Diseases. The patient experience survey assessed the patients’ overall satisfaction with the application, perception of health outcomes after participation in the program, and feedback on educational modules as well as areas for application improvement. Results: 50 patients were included. The responses indicated that the patients were greatly satisfied with the ease of patient–provider communication within the application and appointment scheduling features (68%). A majority of respondents (54%) also reported that program participation resulted in improved perception of disease control and quality of life. Lastly, a majority of participants (79%) would recommend this application to others. Conclusions: Mobile tools such as UCLA eIBD have promising implications for integration into patients’ daily lives. This patient satisfaction study suggests the feasibility of using this mobile application by patients and providers. We further showed that UCLA eIBD and its holistic approach led to improved patient experience and satisfaction, which can provide useful recommendations for future electronic health solutions.
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Affiliation(s)
- Aria Zand
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
- Department of Digestive Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence:
| | - Audrey Nguyen
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Courtney Reynolds
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Ariela Khandadash
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Eric Esrailian
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
| | - Daniel Hommes
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; (A.N.); (C.R.); (A.K.); (E.E.); (D.H.)
- Department of Digestive Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Rüther DF, Sebode M, Lohse AW, Wernicke S, Böttinger E, Casar C, Braun F, Schramm C. Mobile app requirements for patients with rare liver diseases: A single center survey for the ERN RARE-LIVER. Clin Res Hepatol Gastroenterol 2021; 45:101760. [PMID: 34325014 DOI: 10.1016/j.clinre.2021.101760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/14/2021] [Accepted: 07/02/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND More patient data are needed to improve research on rare liver diseases. Mobile health apps enable an exhaustive data collection. Therefore, the European Reference Network on Hepatological diseases (ERN RARE-LIVER) intends to implement an app for patients with rare liver diseases communicating with a patient registry, but little is known about which features patients and their healthcare providers regard as being useful. AIMS This study aimed to investigate how an app for rare liver diseases would be accepted, and to find out which features are considered useful. METHODS An anonymous survey was conducted on adult patients with rare liver diseases at a single academic, tertiary care outpatient-service. Additionally, medical experts of the ERN working group on autoimmune hepatitis were invited to participate in an online survey. RESULTS In total, the responses from 100 patients with autoimmune (n = 90) or other rare (n = 10) liver diseases and 32 experts were analyzed. Patients were convinced to use a disease specific app (80%) and expected some benefit to their health (78%) but responses differed significantly between younger and older patients (93% vs. 62%, p < 0.001; 88% vs. 64%, p < 0.01). Comparing patients' and experts' feedback, patients more often expected a simplified healthcare pathway (e.g. 89% vs. 59% (p < 0.001) wanted access to one's own medical records), while healthcare providers saw the benefit mainly in improving compliance and treatment outcome (e.g. 93% vs. 31% (p < 0.001) and 70% vs. 21% (p < 0.001) expected the app to reduce mistakes in taking medication and improve quality of life, respectively). CONCLUSION Our results underline the great desire for disease-specific apps but also the need to involve patients and healthcare providers in the development of such apps in order to achieve long-term use and, thereby, improvements of patient care and research. The results of this study will help tremendously to implement the first cross-country app that communicates with an ERN patient registry.
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Affiliation(s)
- Darius F Rüther
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER); Digital Health Center, Hasso Plattner Institute, Potsdam, Germany.
| | - Marcial Sebode
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Ansgar W Lohse
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Sarah Wernicke
- Digital Health Center, Hasso Plattner Institute, Potsdam, Germany
| | - Erwin Böttinger
- Digital Health Center, Hasso Plattner Institute, Potsdam, Germany
| | - Christian Casar
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Felix Braun
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Christoph Schramm
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER); Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Keikavousi MR, Asadi F, Paydar S, Khounraz F. Development of Inflammatory Bowel Diseases Registry Software. Middle East J Dig Dis 2021; 13:145-152. [PMID: 34712453 PMCID: PMC8531921 DOI: 10.34172/mejdd.2021.218] [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: 08/15/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND With an increase in the prevalence and incidence of inflammatory bowel diseases (IBDs), they have become a global challenge. The IBD registry provides complete and timely data, thereby greatly contributing to the estimation of the burden of these diseases and development of control and prevention programs. We aimed to develop an IBD registry software. METHODS The present applied-developmental study had two main stages: determining user requirements, and developing the IBD registry software. The software was created using a Web-based software development technology called ASP.NET Core 2. The programming language in this framework was C#, and the SQL Server 2017 was employed to create a strong and integrated software databank in the relational form. RESULTS When determining user requirements, the data elements were classified into two main categories of patient information and visits and tests. Moreover, in this stage, registry functions, including case ascertainment, abstracting, follow-up, quality control, and reporting were identified. In the registry software development stage, the object-oriented conceptual model was designed with five use case diagrams and 59 classes. The user interface comprised the following main sections: add patient, find patient, complete source report, report, staff, and drugs. Precise user authentication and authorization were also employed to enhance the security of the developed software. CONCLUSION Development of an IBD registry which can precisely record patients and estimate the incidence, prevalence, and socioeconomic burden of these diseases can assist in planning for the control and prevention of IBD in healthcare systems.
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Affiliation(s)
- Mohammad Reza Keikavousi
- MSc in Medical Informatics, Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Asadi
- Associate Professor in Health Information Management, Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Paydar
- Assistant Professor in Health Information Management, Department of Health Information Technology, School of paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fariba Khounraz
- MSc in Medical Informatics, Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rogers CC, Moutinho TJ, Liu X, Valdez RS. Designing Consumer Health Information Technology to Support Biform and Articulation Work: A Qualitative Study of Diet and Nutrition Management as Patient Work. JMIR Hum Factors 2021; 8:e27452. [PMID: 34383664 PMCID: PMC8386363 DOI: 10.2196/27452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/18/2021] [Accepted: 07/04/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Diet and nutrition management is an integral component of Crohn disease (CD) management. This type of management is highly variable and individualized and, thus, requires personalized approaches. Consumer health information technology (CHIT) designed to support CD management has typically supported this task as everyday life work and, not necessarily, as illness work. Moreover, CHIT has rarely supported the ways in which diet and nutrition management requires coordination between multiple forms of patient work. OBJECTIVE The purpose of this study was to investigate diet and nutrition management as biform work, identify components of articulation work, and provide guidance on how to design CHIT to support this work. METHODS We performed a qualitative study in which we recruited participants from CD-related Facebook pages and groups. RESULTS Semistructured interviews with 21 individuals showed that diet and nutrition management strategies were highly individualized and variable. Four themes emerged from the data, emphasizing the interactions of diet and nutrition with physical, emotional, information, and technology-enabled management. CONCLUSIONS This study shows that the extent to which diet and nutrition management is biform work fluctuates over time and that articulation work can be continuous and unplanned. The design guidance specifies the need for patient-facing technologies to support interactions among diet and nutrition and other management activities such as medication intake, stress reduction, and information seeking, as well as to respond to the ways in which diet and nutrition management needs change over time.
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Affiliation(s)
- Courtney C Rogers
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
| | - Thomas J Moutinho
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Xiaoyue Liu
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Rupa S Valdez
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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22
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Song Y, Chen H. Evaluating Chinese Mobile Health Apps for Ankylosing Spondylitis Management: Systematic App Search. JMIR Mhealth Uhealth 2021; 9:e27234. [PMID: 34259644 PMCID: PMC8319772 DOI: 10.2196/27234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with ankylosing spondylitis (AS), a chronic systematic inflammatory disease, require long-term treatment and management. Mobile health (mHealth) apps can deliver health services through mobile devices, facilitate long-term disease management, support patient-health care provider communication, and enable patients to engage in disease management. There are some apps targeted at patients with AS, but the feature and quality of these apps have not been systematically examined. OBJECTIVE The aim of this study was to identify existing, publicly available Chinese mHealth apps for AS management and to evaluate their features and quality. METHODS We systematically searched potential apps for AS management on the Apple and Huawei App Stores, using 4 search terms: ankylosing spondylitis, spondyloarthritis, rheumatic disease, and arthritis. Apps were included if they were in the Chinese language, targeted at patients with AS, could be downloaded and run on Android and/or iOS operating systems, and incorporated elements of disease management and/or patient education. We excluded apps that were not for patient use, not relevant to AS, or had not been updated since 2018. Apps that met the inclusion criteria were downloaded for final analysis. We formulated a list of app quality measures from and consistent with international guidelines for mHealth apps and AS management to evaluate the features and quality of the included app. The user version of the Mobile App Rating Scale (uMARS) was also used to rate the apps' quality. RESULTS Of the 354 apps screened, 5 met the inclusion criteria and were included in our analysis. All apps were free, and most apps (4/5, 80%) had a privacy policy. Of the 5 apps, 1 (20%) involved medical professionals in the development process, 2 (40%) were developed by companies, and 2 (40%) were developed by medical institutions. All apps provided educational information about AS. Around half of the apps had functions like a basic information record (ie, users can input gender, age, disease history, etc) (n=3, 60%), patient-health care provider (and patient-patient) communication (n=2, 40%), symptom tracking (n=2, 40%), and information sharing (n=3, 60%). Only 1 (20%) app provided comprehensive functions that adhered to international guidelines for AS management and mHealth apps. The overall uMARS scores ranged from 2.7 to 4.2; only 1 app, with an overall uMARS score of 4.2, was considered as a high-quality app. CONCLUSIONS Most apps lacked comprehensive functions for AS management. One high-quality app provided comprehensive functions to help patients manage their conditions. This study assessed and summarized the features and quality of the apps but did not evaluate their efficacy. Future studies should evaluate the feasibility and efficacy of these apps. International guidelines and regulations for the design, development, validation, and implementation of mHealth apps are needed in the future. Meanwhile, health care providers, patients with AS, and app developers should collaborate to develop high-quality, evidence-based apps that take into account patients' needs and health care professionals' perspectives.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
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23
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Solitano V, Alfarone L, D'Amico F, Peyrin-Biroulet L, Danese S. IBD goes home: from telemedicine to self-administered advanced therapies. Expert Opin Biol Ther 2021; 22:17-29. [PMID: 34116611 DOI: 10.1080/14712598.2021.1942833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Major challenges have been posed by the coronavirus disease 2019 pandemic in the routine management of patients with inflammatory bowel disease (IBD). The need for constant monitoring of diseases activity and prompt adjustment of therapy have been balanced with the risk of contagion related to face-to-face consultations. Therefore, digital health initiatives have been pursued for safety reasons as vicarious instruments to avoid overcrowding of the IBD clinics. However, concerns and skepticism about the feasibility of digital health and telemedicine modalities limited their uptake in clinical practice in the pre-pandemic period.Areas covered: We conducted a literature overview on the current state of the art and the potential future benefits deriving from the integration of telemedicine systems, home-based laboratory tests, and self-administered drugs into IBD daily practice.Expert opinion: Digital health and telemedicine approaches at distance have been experimented as effective tools to avoid overcrowding of clinics and reduce risk from SARS-CoV2 exposure. Home-based point of care testing, such as fecal calprotectin and dried blood samples, might represent an effective method of remote monitoring of patients particularly when in-person visits are precluded. High expectations are placed on the use of self-administered advanced therapies, such as new subcutaneous formulation of biologics.
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Affiliation(s)
- Virginia Solitano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ludovico Alfarone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ferdinando D'Amico
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IBD Center, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Silvio Danese
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IBD Center, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
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Acharya C, Sehrawat TS, McGuire DB, Shaw J, Fagan A, McGeorge S, Olofson A, White MB, Gavis E, Kamath PS, Bergstrom L, Bajaj JS. Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information Technology: Cross-sectional Multicenter Study. J Med Internet Res 2021; 23:e24639. [PMID: 33744844 PMCID: PMC8065567 DOI: 10.2196/24639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/13/2020] [Accepted: 03/21/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Health information technology (IT) interventions to decrease readmissions for cirrhosis may be limited by patient-associated factors. OBJECTIVE The aim of this study was to determine perspectives regarding adoption versus refusal of health IT interventions among patient-caregiver dyads. METHODS Inpatients with cirrhosis and their caregivers were approached to participate in a randomized health IT intervention trial requiring daily contact with research teams via the Patient Buddy app. This app focuses on ascites, medications, and hepatic encephalopathy over 30 days. Regression analyses for characteristics associated with acceptance were performed. For those who declined, a semistructured interview was performed with themes focused on caregivers, protocol, transport/logistics, technology demands, and privacy. RESULTS A total of 349 patient-caregiver dyads were approached (191 from Virginia Commonwealth University, 56 from Richmond Veterans Affairs Medical Center, and 102 from Mayo Clinic), 87 of which (25%) agreed to participate. On regression, dyads agreeing included a male patient (odds ratio [OR] 2.08, P=.01), gastrointestinal bleeding (OR 2.3, P=.006), or hepatic encephalopathy admission (OR 2.0, P=.01), whereas opioid use (OR 0.46, P=.03) and alcohol-related etiology (OR 0.54, P=.02) were associated with refusal. Race, study site, and other admission reasons did not contribute to refusing participation. Among the 262 dyads who declined randomization, caregiver reluctance (43%), perceived burden (31%), technology-related issues (14%), transportation/logistics (10%), and others (4%), but not privacy, were highlighted as major concerns. CONCLUSIONS Patients with cirrhosis admitted with hepatic encephalopathy and gastrointestinal bleeding without opioid use or alcohol-related etiologies were more likely to participate in a health IT intervention focused on preventing readmissions. Caregiver and study burden but not privacy were major reasons to decline participation. Reducing perceived patient-caregiver burden and improving communication may improve participation. TRIAL REGISTRATION ClinicalTrials.gov NCT03564626; https://www.clinicaltrials.gov/ct2/show/NCT03564626.
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Affiliation(s)
- Chathur Acharya
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Tejasav S Sehrawat
- Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States
| | - Deborah B McGuire
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Jawaid Shaw
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Andrew Fagan
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Sara McGeorge
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Amy Olofson
- Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States
| | - Melanie B White
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Edith Gavis
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
| | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States
| | - Lori Bergstrom
- Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Rochester, MN, United States
| | - Jasmohan Singh Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, United States.,McGuire VA Medical Center, Richmond, VA, United States
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25
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Zhen J, Marshall JK, Nguyen GC, Atreja A, Narula N. Impact of Digital Health Monitoring in the Management of Inflammatory Bowel Disease. J Med Syst 2021; 45:23. [PMID: 33449213 PMCID: PMC7808932 DOI: 10.1007/s10916-021-01706-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/06/2021] [Indexed: 01/12/2023]
Abstract
Technological advances now permit self-management strategies using mobile applications which could greatly benefit patient care. The purpose of this study was to investigate whether the use of the inflammatory bowel disease (IBD) digital health monitoring platform, HealthPROMISE, leads to better quality of care and improved health outcomes in IBD patients. IBD patients were recruited in gastroenterology clinics and asked to install the HealthPROMISE application onto their smartphones. Patient satisfaction, quality of care, quality of life, patient symptoms, and resource utilization metrics were collected throughout the study and sent directly to their healthcare teams. Patients with abnormal symptom/SIBDQ scores were flagged for their physicians to follow up. After one-year, patient outcome metrics were compared to baseline values. Overall, out of 59 patients enrolled in the study, 32 patients (54%) logged into the application at least once during the study period. The number of IBD-related ER visits/hospitalizations in the year of use compared to the prior year demonstrated a significant decrease from 25% of patients (8/32) to 3% (1/32) (p = 0.03). Patients also reported an increase in their understanding of the nature/causes of their condition after using the application (p = 0.026). No significant changes were observed in the number of quality indicators met (p = 0.67) or in SIBDQ scores (p = 0.48). Given the significant burden of IBD, there is a need to develop effective management strategies. This study demonstrated that digital health monitoring platforms may aid in reducing the number of ER visits and hospitalizations in IBD patients.
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Affiliation(s)
- Jamie Zhen
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - John K Marshall
- Division of Gastroenterology, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Geoffrey C Nguyen
- Mount Sinai Hospital Inflammatory Bowel Disease Centre, University of Toronto, Toronto, ON, Canada.,Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ashish Atreja
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Neeraj Narula
- Division of Gastroenterology, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
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Kalhori SRN, Hemmat M, Noori T, Heydarian S, Katigari MR. Quality Evaluation of English Mobile Applications for Gestational Diabetes: App Review using Mobile Application Rating Scale (MARS). Curr Diabetes Rev 2021; 17:161-168. [PMID: 32619173 DOI: 10.2174/1573399816666200703181438] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/06/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mobile applications and social media serve their users as convenient tools to improve and monitor diseases and conditions such as pregnancy. These tools also exert a positive impact on Gestational diabetes mellitus (GDM) self-management. INTRODUCTION Despite the expansion of mobile health apps for the management of GDM, no study has evaluated these apps using a valid tool. This study aimed to search and review the apps developed for this purpose, providing overall and specific rating scores for each aspect of MARS. METHODS Two cases of app stores (IOS and Google Play) were searched in January 2019 for apps related to GDM. Search keywords included "gestational diabetes", "pregnant diabetes", and "Health apps". Eligibility criteria include: capable of running on Android or IOS operating systems, in the English language, especially for GDM, and available in Iran. After removal of duplicates, the apps were reviewed, rated, and evaluated independently by two reviewers with Mobile App Rating Scale (MARS) tools. RESULTS Initially, 102 apps were identified after the exclusion process, five selected apps were downloaded and analyzed. All apps were classified into four categories according to contents and their interactive capabilities. In most quadrants of MARS, the Pregnant with Diabetes app received the highest scores. Also, in general, the maximum app quality mean score belonged to Pregnant with Diabetes (3.10 / 5.00). CONCLUSION Findings revealed that apps designed for GDM are small in number and poor in quality based on MARS tools. Therefore, considering pregnant women's need for using the capabilities of these apps in pregnancy management and promoting community-based care, it seems essential to develop and design a series of high-quality apps in all four specified categories (only giving comments, obtaining data and giving comments, diagnosis of GDM, and diet calculator).
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Affiliation(s)
- Sharareh R Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Hemmat
- Health Information Technology Department, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
| | - Tayebe Noori
- Health Information Technology Department, School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran
| | - Saeede Heydarian
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Rahmani Katigari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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27
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Lee YJ, Kim YH, Kim HW. Preconception Care Program for Women with Inflammatory Bowel Disease Using Intervention Mapping: A Protocol for Program Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249365. [PMID: 33327583 PMCID: PMC7765051 DOI: 10.3390/ijerph17249365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022]
Abstract
The prevalence of inflammatory bowel disease in Korea is rapidly increasing. Women with inflammatory bowel disease have a higher risk of adverse birth outcomes than healthy women, and the magnitude of this risk is related to the severity of the disease at the time of pregnancy. For a woman with inflammatory bowel disease to have a healthy pregnancy, interventions are needed to manage the disease before pregnancy—implying a need for pregnancy planning. In this study, the intervention mapping protocol was used to develop a program for this purpose. This protocol contains the following stages: needs assessment, setting of program outcomes and performance objectives, selection of methods and strategies based on theory, and development of the program and its materials. Through individual in-depth interviews and a literature review, individual and environmental determinants were assessed and six change objectives of the program were set. The methods and practical strategies were developed based on the information-motivation-behavioral skills model, self-efficacy theory, and social support theory. The final program, consisting of four sessions and the corresponding materials, was completed by making revisions based on a content validity assessment by experts and a pilot test. Follow-up studies on the implementation of this program will be conducted in the future.
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Affiliation(s)
- Young Jin Lee
- Department of Nursing, College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Yeon Hee Kim
- Department of Clinical Nursing, University of Ulsan, Seoul 05505, Korea;
| | - Hae Won Kim
- Department of Nursing, The Research Institute of Nursing Science, Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8820
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28
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Krishnaprasad K, Walsh A, Begun J, Bell S, Carter D, Grafton R, Sechi A, Sewell K, McMahon A, Connor S, Radford-Smith G, Andrews JM. Crohn's Colitis Care (CCCare): bespoke cloud-based clinical management software for inflammatory bowel disease. Scand J Gastroenterol 2020; 55:1419-1426. [PMID: 33161791 DOI: 10.1080/00365521.2020.1839960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adherence to evidence-based management is variable in inflammatory bowel disease (IBD), which leads to worse patient outcomes and higher healthcare utilization. Solutions include electronic systems to enhance care, but these have often been limited by lack of clinician design input, poor usability, and low perceived value. A cloud-based IBD-specific clinical management software - 'Crohn's Colitis Care' (CCCare) was developed by Australia and New Zealand Inflammatory Bowel Disease Consortium clinicians and software developers to improve this. METHODS CCCare captures patient-reported disease activity and medical assessment, medication monitoring, cancer screening, preventative health, and facilitates communication with the IBD team and referring doctor. De-identified longitudinal data are stored separately in a clinical quality registry for research. CCCare was tested for feasibility and usability in routine clinical settings at two large Australian hospitals. Users' experience was evaluated with System Usability Scale (SUS). Value to clinicians and patients was assessed by qualitative feedback. Security was assessed by penetration testing. RESULTS Users (n = 13; doctors, nurses, patients) reported good usability and learnability (mean SUS score 75 (range 50-95), sub-scores were 77 (50-94) and 68 (38-100), respectively). Patients reported better communication with clinical team and greater ability to track disease. Clinicians highlighted structured management plans, medication adherence, and centralised data repository as positive features. Penetration testing was passed successfully. CONCLUSIONS Initial evaluation demonstrates CCCare is usable, secure, and valued in clinical use. It is designed to measure outcomes of clinical care, including efficacy, quality, cost, and complications for individuals, and to audit these at hospital and national level.
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Affiliation(s)
- Krupa Krishnaprasad
- Gut Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Alissa Walsh
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Jakob Begun
- Department of Gastroenterology, Mater Hospital, Brisbane, Australia
| | - Sally Bell
- Department of Gastroenterology, Monash Health, Melbourne, Australia
| | - David Carter
- Stratos Technology Partners, Christchurch, New Zealand
| | - Rachel Grafton
- Department of Gastroenterology, Royal Adelaide Hospital & University of Adelaide, Adelaide, Australia
| | - Alexandra Sechi
- Department of Gastroenterology, Liverpool Hospital, University of NSW & Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Karen Sewell
- Department of Gastroenterology, Mater Hospital, Brisbane, Australia
| | - Anna McMahon
- Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Susan Connor
- Department of Gastroenterology, Liverpool Hospital, University of NSW & Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Graham Radford-Smith
- Gut Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Australia.,University of Queensland School of Medicine, Brisbane, Australia
| | - Jane M Andrews
- Department of Gastroenterology, Royal Adelaide Hospital & University of Adelaide, Adelaide, Australia
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Towards understanding how individuals with inflammatory bowel disease use contemporary social media platforms for health-related discourse. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2020.106463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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Grainger R, Devan H, Sangelaji B, Hay-Smith J. Issues in reporting of systematic review methods in health app-focused reviews: A scoping review. Health Informatics J 2020; 26:2930-2945. [PMID: 32914696 DOI: 10.1177/1460458220952917] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
No guidelines exist for the conduct and reporting of manuscripts with systematic searches of app stores for, and then appraisal of, mobile health apps ('health app-focused reviews'). We undertook a scoping review including a systematic literature search for health app-focused reviews describing systematic app store searches and app appraisal, for apps designed for patients or clinicians. We created a data extraction template which adapted data elements from the PRISMA guidelines for systematic literature reviews to data elements operationalised for health app-focused reviews. We extracted the data from included health app-focused reviews to describe: (1) which elements of the adapted 'usual' methods of systematic review are used; (2) methods of app appraisal; and (3) reporting of clinical efficacy and recommendations for app use. From 2798 records, the 26 included health app-focused reviews showed incomplete or unclear reporting of review protocol registration; use of reporting guidelines; processes of screening apps; data extraction; and appraisal tools. Reporting of clinical efficacy of apps or recommendations for app use were infrequent. The reporting of methods in health app-focused reviews is variable and could be improved by developing a consensus reporting standard for health app-focused reviews.
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Affiliation(s)
| | - Hemakumar Devan
- Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherpay, University of Otago, Wellington, New Zealand
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31
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Kernebeck S, Busse TS, Böttcher MD, Weitz J, Ehlers J, Bork U. Impact of mobile health and medical applications on clinical practice in gastroenterology. World J Gastroenterol 2020; 26:4182-4197. [PMID: 32848328 PMCID: PMC7422538 DOI: 10.3748/wjg.v26.i29.4182] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/09/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023] Open
Abstract
Mobile health apps (MHAs) and medical apps (MAs) are becoming increasingly popular as digital interventions in a wide range of health-related applications in almost all sectors of healthcare. The surge in demand for digital medical solutions has been accelerated by the need for new diagnostic and therapeutic methods in the current coronavirus disease 2019 pandemic. This also applies to clinical practice in gastroenterology, which has, in many respects, undergone a recent digital transformation with numerous consequences that will impact patients and health care professionals in the near future. MHAs and MAs are considered to have great potential, especially for chronic diseases, as they can support the self-management of patients in many ways. Despite the great potential associated with the application of MHAs and MAs in gastroenterology and health care in general, there are numerous challenges to be met in the future, including both the ethical and legal aspects of applying this technology. The aim of this article is to provide an overview of the current status of MHA and MA use in the field of gastroenterology, describe the future perspectives in this field and point out some of the challenges that need to be addressed.
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Affiliation(s)
- Sven Kernebeck
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten 58455, Germany
| | - Theresa S Busse
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten 58455, Germany
| | - Maximilian D Böttcher
- Department of GI-, Thoracic- and Vascular Surgery, Dresden Technical University, University Hospital Dresden, Dresden 01307, Germany
| | - Jürgen Weitz
- Department of GI-, Thoracic- and Vascular Surgery, Dresden Technical University, University Hospital Dresden, Dresden 01307, Germany
| | - Jan Ehlers
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten 58455, Germany
| | - Ulrich Bork
- Department of GI-, Thoracic- and Vascular Surgery, Dresden Technical University, University Hospital Dresden, Dresden 01307, Germany
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32
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A systematic review into the assessment of medical apps: motivations, challenges, recommendations and methodological aspect. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00451-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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33
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McCombie A, Walmsley R, Barclay M, Ho C, Langlotz T, Regenbrecht H, Gray A, Visesio N, Inns S, Schultz M. A Noninferiority Randomized Clinical Trial of the Use of the Smartphone-Based Health Applications IBDsmart and IBDoc in the Care of Inflammatory Bowel Disease Patients. Inflamm Bowel Dis 2020; 26:1098-1109. [PMID: 31644793 DOI: 10.1093/ibd/izz252] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Providing timely follow-up care for patients with inflammatory bowel disease in remission is important but often difficult because of resource limitations. Using smartphones to communicate symptoms and biomarkers is a potential alternative. We aimed to compare outpatient management using 2 smartphone apps (IBDsmart for symptoms and IBDoc for fecal calprotectin monitoring) vs standard face-to-face care. We hypothesized noninferiority of quality of life and symptoms at 12 months plus a reduction in face-to-face appointments in the smartphone app group. METHODS Inflammatory bowel disease outpatients (previously seen more often than annually) were randomized to smartphone app or standard face-to-face care over 12 months. Quality of life and symptoms were measured quarterly for 12 months. Acceptability was measured for gastroenterologists and patients at 12 months. RESULTS One hundred people (73 Crohn's disease, 49 male, average age 35 years) consented and completed baseline questionnaires (50 in each group). Intention-to-treat and per-protocol analyses revealed noninferiority of quality of life and symptom scores at 12 months. Outpatient appointment numbers were reduced in smartphone app care (P < 0.001). There was no difference in number of surgical outpatient appointments or number of disease-related hospitalizations between groups. Adherence to IBDsmart (50% perfect adherence) was slightly better than adherence to IBDoc (30% perfect adherence). Good acceptability was reported among most gastroenterologists and patients. CONCLUSIONS Remote symptom and fecal calprotectin monitoring is effective and acceptable. It also reduces the need for face-to-face outpatient appointments. Patients with mild-to-moderate disease who are not new diagnoses are ideal for this system. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12615000342516.
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Affiliation(s)
| | - Russell Walmsley
- University of Auckland and Department of Gastroenterology, Waitemata District Health Board, Auckland, New Zealand
| | - Murray Barclay
- University of Otago and Department of Gastroenterology, Canterbury District Health Board, Christchurch, New Zealand
| | - Christine Ho
- Department of Gastroenterology, Southern District Health Board, Dunedin, New Zealand
| | - Tobias Langlotz
- Department of Information Science, University of Otago, Dunedin, New Zealand
| | - Holger Regenbrecht
- Department of Gastroenterology, Southern District Health Board, Dunedin, New Zealand
| | - Andrew Gray
- Centre for Biostatistics, University of Otago, Dunedin, New Zealand
| | - Nideen Visesio
- Department of Gastroenterology, Waitemata District Health Board, Auckland, New Zealand
| | - Stephen Inns
- Department of Medicine, University of Otago, Wellington, New Zealand and Department of Gastroenterology, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Michael Schultz
- Department of Medicine, University of Otago, and Department of Gastroenterology, Southern District Health Board, Dunedin, New Zealand
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Adaptation of TECCU App Based on Patients´ Perceptions for the Telemonitoring of Inflammatory Bowel Disease: A Qualitative Study Using Focus Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061871. [PMID: 32183103 PMCID: PMC7143635 DOI: 10.3390/ijerph17061871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 01/18/2023]
Abstract
Background: Despite the continuous adaptation of eHealth systems for patients with inflammatory bowel disease (IBD), a significant disconnection persists between users and developers. Since non-adherence remains high, it is necessary to better understand the patients’ perspective on telemonitoring for IBD. Accordingly, this study aimed to adapt the TECCU telemonitoring app to the preferences and needs of IBD patients. Methods: A qualitative study was carried out using successive focus groups of IBD patients. Meetings were audio-recorded and a thematic analysis was employed until data saturation was achieved. The first group included patients who had used the TECCU App in a pilot clinical trial, and subsequent meetings included patients with Crohn’s disease and ulcerative colitis recruited from the Spanish Confederation of patient associations. The information collected at each meeting guided consecutive changes to the platform. Results: Data saturation was reached after three focus groups involving a total of 18 patients. Three main themes emerged: (1) platform usability, (2) the communication process, and (3) platform content. All participants indicated that TECCU is easy to use, permitting continuous and personalized feedback. According to patients´ perspectives, the platform was adapted to foster a flexible follow-up and shared decision-making using open and safe communication networks. Many participants appreciated the educational elements and, consequently, the app was connected to reliable and continuously updated webpages. Conclusions: IBD patients valued the usability and personalized monitoring offered by the TECCU App. Improvements in the messaging system and continuously updated educational content were introduced to address patients´ needs and favor their engagement.
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Dowd AJ, Warbeck CB, Tang KT, Fung T, Culos-Reed SN. MyHealthyGut: Findings from a pilot randomized controlled trial on adherence to a gluten-free diet and quality of life among adults with celiac disease or gluten intolerance. Digit Health 2020; 6:2055207620903627. [PMID: 32071731 PMCID: PMC6997956 DOI: 10.1177/2055207620903627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/26/2019] [Indexed: 01/11/2023] Open
Abstract
Aims The purpose of this study was to assess the effectiveness of a smartphone app
(MyHealthyGut) in helping adults self-manage celiac disease or gluten
intolerance and improve their gut health. Methods Adults diagnosed with celiac disease or gluten intolerance
(N = 115) were randomized into two groups: experimental
group 1 (had access to the app for a one-month period) or wait list control
(WLC). After one month, WLC participants were given one-month access to the
app (experimental group 2). An online questionnaire was administered to
assess (a) user satisfaction with the app and (b) changes in the following
patient-reported outcomes: adherence to a gluten-free diet, quality of life
(QoL), self-regulatory efficacy, and feelings of depression and anxiety.
Generalized estimating equations were used to assess changes in the outcome
variables over time between the groups. Results Participants reported high levels of app usability, were satisfied with
features of the app, and felt that the app was best suited for people newly
diagnosed with celiac disease. Participants in the experimental groups
reported improvements in adherence, gastrointestinal symptoms (experimental
group 1 only), QoL, self-regulatory efficacy (experimental group 2 only),
anxiety (experimental group 1 only), and depression (experimental group 2
only). Experimental group 1 and the WLC group reported significantly worse
adherence after using the app based on the Celiac Dietary Adherence Test,
which was in contrast to the accidental and purposeful measures of gluten
consumption and symptoms for experimental group 1 but consistent with
reports of accidental and purposeful gluten consumption and symptoms for the
WLC group. Conclusions Based on feedback from the participants, the app may be best suited for
individuals newly diagnosed or struggling with celiac disease or gluten
intolerance. After using the MyHealthyGut app for a one-month period, adults
with celiac disease reported improvements in psychosocial outcomes. Further
iterations of the app are needed to meet the needs of this population
better. MyHealthyGut is the first evidence-based app designed to help people
with celiac disease or gluten intolerance.
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Affiliation(s)
| | | | | | - Tak Fung
- Research Computing Services, Information Technologies, University of Calgary, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Canada
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Sleurs K, Seys SF, Bousquet J, Fokkens WJ, Gorris S, Pugin B, Hellings PW. Mobile health tools for the management of chronic respiratory diseases. Allergy 2019; 74:1292-1306. [PMID: 30644567 DOI: 10.1111/all.13720] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The market of mobile health (mHealth) technology is rapidly evolving, making new mobile technologies potentially available for healthcare systems. Patient empowerment through self-monitoring of symptoms, shared decision making with the physician, and easily accessible education are important features extending the reach of mHealth technology beyond traditional care. METHODS Two digital distribution platforms (Apple App Store and Google Play Store) were searched for currently available mobile applications (apps) for patients with chronic respiratory diseases (CRDs). A new index (score ranging from 0 to 10) was developed to assess the potential of apps as a tool to empower patients through mobile technology (based on self-monitoring, personalized feedback, and patient education app features). RESULTS One hundred and twelve apps were retained for analysis and could be classified in 5 categories: Asthma (n = 71), COPD (n = 15), Asthma and COPD (n = 15), Rhinitis and Asthma (n = 5), and Rhinosinusitis (n = 6). Eighty percent were developed by medical technology companies compared to 18% by medical doctors and 2% by pharmaceutical companies. Two-thirds of apps allow disease self-monitoring, whereas over half of apps provide patient feedback through graphs. Sixty percent of apps contain easily accessible patient education material. Only three percent of apps reach a score of ≥7 on the newly designed patient empowerment index. CONCLUSIONS A variety of apps are available for patients with CRDs of which only few were developed by or jointly with medical doctors. The majority of these apps include self-monitoring tools, but only few also provide personalized feedback, which is needed to adopt these apps into daily care.
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Affiliation(s)
- Kristien Sleurs
- Department of Otorhinolaryngology University Hospitals Leuven KU Leuven Leuven Belgium
| | - Sven F. Seys
- Allergy and Clinical Immunology Research Group Department of Microbiology Immunology and Transplantation KU Leuven Leuven Belgium
- EUFOREA European Forum for Research and Education in Allergy and Airway Diseases Brussels Belgium
| | - Jean Bousquet
- Department of Respiratory Disease University Hospital Arnaud de Villeneuve Montpellier France
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Academic Medical Center Amsterdam The Netherlands
| | - Senne Gorris
- Department of Otorhinolaryngology University Hospitals Leuven KU Leuven Leuven Belgium
| | - Benoit Pugin
- Allergy and Clinical Immunology Research Group Department of Microbiology Immunology and Transplantation KU Leuven Leuven Belgium
- EUFOREA European Forum for Research and Education in Allergy and Airway Diseases Brussels Belgium
| | - Peter W. Hellings
- Department of Otorhinolaryngology University Hospitals Leuven KU Leuven Leuven Belgium
- Allergy and Clinical Immunology Research Group Department of Microbiology Immunology and Transplantation KU Leuven Leuven Belgium
- Department of Otorhinolaryngology Academic Medical Center Amsterdam The Netherlands
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Echarri A, Vera I, Ollero V, Arajol C, Riestra S, Robledo P, Calvo M, Gallego F, Ceballos D, Castro B, Aguas M, García-López S, Marín-Jiménez I, Chaparro M, Mesonero P, Guerra I, Guardiola J, Nos P, Muñiz J. The Harvey-Bradshaw Index Adapted to a Mobile Application Compared with In-Clinic Assessment: The MediCrohn Study. Telemed J E Health 2019; 26:80-88. [PMID: 30848700 PMCID: PMC6948001 DOI: 10.1089/tmj.2018.0264] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objectives: Mobile apps are useful tools in e-health and self-management strategies in disease monitoring. We evaluated the Harvey–Bradshaw index (HBI) mobile app self-administered by the patient to see if its results agreed with HBI in-clinic assessed by a physician. Methods: Patients were enrolled in a 4-month prospective study with clinical assessments at months 1 and 4. Patients completed mobile app HBI and within 48 h, HBI was performed by a physician (gold standard). HBI scores characterized Crohn's disease (CD) as remission <5 or active ≥5. We determined agreement per item and total HBI score and intraclass correlation coefficients (ICCs). Bland–Altman plot was performed. HBI changes in disease activity from month 1 to month 4 were determined. Results: A total of 219 patients were enrolled. All scheduled assessments (385 pairs of the HBI questionnaire) showed a high percentage of agreement for remission/activity (92.4%, κ = 0.796), positive predictive value (PPV) for remission of 98.2%, and negative predictive value of 76.7%. High agreement was also found at month 1 (93.15%, κ = 0.82) and month 4 (91.5%, κ = 0.75). Bland–Altman plot was more uniform when the HBI mean values were <5 (remission). ICC values were 0.82, 0.897, and 0.879 in all scheduled assessments, 1 and 4 months, respectively. Conclusions: We found a high percentage of agreement between patients' self-administered mobile app HBI and in-clinic physician assessment to detect CD activity with a remarkably high PPV for remission. The mobile app HBI might allow a strict control of inflammation by remote monitoring and flexible follow-up of CD patients. Reduction of sanitary costs could be possible.
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Affiliation(s)
- Ana Echarri
- Gastroenterology Department, University Hospital, Ferrol, Spain
| | - Isabel Vera
- Gastroenterology Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Virginia Ollero
- Gastroenterology Department, University Hospital, Ferrol, Spain
| | - Claudia Arajol
- Gastroenterology Department, Bellvitge University Hospital; IDIBELL Barcelona University, Barcelona, Spain
| | - Sabino Riestra
- Gastroenterology Department, Central University Hospital, Oviedo, Spain
| | - Pilar Robledo
- Gastroenterology Department, San Pedro de Alacantara University Hospital, Cáceres, Spain
| | - Marta Calvo
- Gastroenterology Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Franscisco Gallego
- Gastroenterology Department, Poniente University Hospital, Almeria, Spain
| | - Daniel Ceballos
- Gastroenterology Department, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Beatriz Castro
- Gastroenterology Department, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Mariam Aguas
- Gastroenterology Department, La Fe University Hospital, Valencia, Spain
| | | | | | - María Chaparro
- Gastroenterology Department, Instituto de Investigación Sanitaria Princesa and CIBERehd, La Princesa University Hospital, Madrid, Spain
| | - Paco Mesonero
- Gastroenterology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Iván Guerra
- Gastroenterology Department, Fuenlabrada University Hospital, Madrid, Spain
| | - Jordi Guardiola
- Gastroenterology Department, Bellvitge University Hospital; IDIBELL Barcelona University, Barcelona, Spain
| | - Pilar Nos
- Gastroenterology Department, La Fe University Hospital, Valencia, Spain
| | - Javier Muñiz
- Instituto Universitario de Ciencias de La Salud e INIBIC, La Coruña University, La Coruña, Spain
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Zhao YE, Zhu XQ. Continuous care education for patients with inflammatory bowel disease. Shijie Huaren Xiaohua Zazhi 2019; 27:197-202. [DOI: 10.11569/wcjd.v27.i3.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Continuous nursing education for patients with inflammatory bowel disease (IBD) has positive influence in reducing clinical visits and medical costs, alleviating psychological stress, and improving their quality of life. This article reviews the forms and contents of continuing nursing education for patients with IBD.
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Affiliation(s)
- Yu-E Zhao
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xiu-Qin Zhu
- Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Park H, Park MS. Capturing the trend of mHealth research using text mining. Mhealth 2019; 5:48. [PMID: 31728383 PMCID: PMC6851422 DOI: 10.21037/mhealth.2019.09.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/30/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND With the increasing development and use of mobile technologies, an increasing amount of research on mobile health is being conducted. The purpose of the study was to capture the trends in mHealth research by mining terms related to medical conditions, interventions, study populations, and the relationships between these terms. METHODS This study analyzed 5,600 journal articles published in Web of Science from 2008 to 2018. Using text mining techniques, a total of 39,292 terms extracted from the titles and abstracts of the journal articles were independently reviewed to identify meaningful terms related to medical conditions, interventions, and study populations. RESULTS A total of 48 different types of medical conditions were identified in the dataset. Mood disorders appeared to be the most frequently identified medical condition in mHealth research. Thirty interventions were identified. Cell phone-, SMS-, and Internet-based interventions appeared to be the most prominent types, and "female" appeared to be the most frequently identified term related to the studied population. Females appeared to have been studied in the widest range of medical conditions, including pregnancy issues, overnutrition, neoplasms, and AIDS. Older adults were the least studied population in mHealth. CONCLUSIONS Knowledge gaps that have not been explored in previous studies in mHealth research were identified, which should be addressed by researchers.
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Affiliation(s)
- Hyejin Park
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Min Sook Park
- School of Information Studies, University of Wisconsin Milwaukee, Milwaukee, WI, USA
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40
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MacKenzie-Smith L, Marchi P, Thorne H, Timeus S, Young R, Le Calvé P. Patient Preference and Physician Perceptions of Patient Preference for Oral Pharmaceutical Formulations: Results from a Real-Life Survey. Inflamm Intest Dis 2018; 3:43-51. [PMID: 30505842 DOI: 10.1159/000493346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Pharmaceutical treatment prescribed according to patient preference for a formulation may have a positive impact on adherence to treatment and consequently on treatment outcomes. AIM This study aimed at understanding patient preference for pharmaceutical formulations and attributes that trigger patient preference and physician perception of patient preference. METHODS Between August and September 2017, gastroenterologists and patients with mild to moderate ulcerative colitis from France, Germany, Spain, and the UK participated in an online survey. The investigation was exploratory in nature, and descriptive results are presented. RESULTS Patient (n = 380) preference appears to be driven by the appearance (format, shape, size, and color - 44%), number of units per administration (39%), and number of administrations per day (17%). Gastroenterologist (n = 159) preference is instead driven by the number of administrations per day (55%), number of units per day (26%), and tablet size (19%). Overall, 254 (67%) patients preferred a tablet formulation, 111 (29%) preferred granules, and 15 (4%) other formulations. According to gastroenterologist perception of patient preference, only 49% of patients prefer tablets, 38% prefer granules, and 13% have no preference. After switching from granules to tablets, 25% patients expressed negative feelings for granules. However, after switching from tablets to granules, 44% of patients still have positive perceptions of tablets. Among patients receiving tablets (n = 255), 18 (7%) perceived their treatment to be not at all effective versus 16 (13%) patients receiving granules (n = 125). A similar proportion of patients in the two groups perceived their treatment as extremely effective (48 vs. 46%, respectively). CONCLUSIONS Patients generally prefer tablets. Patient and gastroenterologist perception of patient preference for different oral drug formulations is triggered by the same attributes but with inverse importance. To improve adherence, patients should be involved in the choice of the treatment formulation.
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Egberg MD, Kappelman MD, Gulati AS. Improving Care in Pediatric Inflammatory Bowel Disease. Gastroenterol Clin North Am 2018; 47:909-919. [PMID: 30337040 DOI: 10.1016/j.gtc.2018.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Pediatric patients with inflammatory bowel disease (IBD) stand to benefit from quality improvement (QI) due to the chronic nature of the disease, frequent interaction with the health care system, and exposure to high-risk treatments. The use of QI in health care has led to significant improvements in quality and reliability of care. Despite these advances, significant deficits in providing high-quality pediatric IBD care persist. This article describes a brief history of health care QI, identifies gaps and challenges in delivery of quality pediatric IBD care, highlights several IBD QI initiatives, and concludes with future directions for improving pediatric IBD outcomes.
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Affiliation(s)
- Matthew D Egberg
- Department of Pediatrics, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Bioinformatics Building, CB# 7229, Chapel Hill, NC 27599, USA.
| | - Michael D Kappelman
- Department of Pediatrics, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Bioinformatics Building, CB# 7229, Chapel Hill, NC 27599, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Bioinformatics Building, CB# 7229, Chapel Hill, NC 27599, USA
| | - Ajay S Gulati
- Department of Pediatrics, University of North Carolina at Chapel Hill, 230 MacNider, CB# 7229, Chapel Hill, NC 27599, USA; Department of Pathology, University of North Carolina at Chapel Hill, 230 MacNider, CB# 7229, Chapel Hill, NC 27599, USA
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Jackson BD, Con D, De Cruz P. Design considerations for an eHealth decision support tool in inflammatory bowel disease self-management. Intern Med J 2018; 48:674-681. [PMID: 29136332 DOI: 10.1111/imj.13677] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/07/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Electronic health (eHealth) decision support tools have the potential to: facilitate inflammatory bowel disease (IBD) self-management, reduce health care utilisation and alleviate the pressure on overburdened outpatient clinics. The purpose of this study was to explore the perspectives of key stakeholders on the potential use of a decision support tool for IBD patients. METHODS A qualitative study using focus group methodology was conducted at a tertiary IBD centre in Melbourne, Australia in February 2015. Key stakeholders, including physicians, nurses and patients, were included in the study. Two independent reviewers undertook inductive coding and generated themes. RESULTS In total, 31 participants were included in the study (including 16 males; 11 physicians; 6 nurses). An eHealth decision support tool was thought to be beneficial to facilitate IBD self-management. Four themes emerged: (i) Framework for the decision support tool - the tool should be an adjunct to current models of care and facilitate shared decision-making and patient engagement; (ii) Target population - stable patients with mild to moderate disease; (iii) Functionalities of the intervention - a web-based platform encompassing patient-reported outcomes, objective markers of disease and clinical algorithms based on international guidelines; and (iv) Design and Implementation - patients should be involved in the design. CONCLUSIONS eHealth interventions are thought to be an important strategy to facilitate self-management for patients with IBD. A multi-stage iterative approach should be adopted in the design and implementation process of eHealth interventions. Patient perspectives need to be sought prior to and throughout the development of an eHealth decision support tools for IBD.
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Affiliation(s)
- Belinda D Jackson
- Department of Gastroenterology, The Austin Hospital, Melbourne, Victoria, Australia.,Department of Medicine, Austin Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia
| | - Danny Con
- Department of Gastroenterology, The Austin Hospital, Melbourne, Victoria, Australia
| | - Peter De Cruz
- Department of Gastroenterology, The Austin Hospital, Melbourne, Victoria, Australia.,Department of Medicine, Austin Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia
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Cohen AB, Mathews SC. The Digital Outcome Measure. Digit Biomark 2018; 2:94-105. [PMID: 32095761 PMCID: PMC7015352 DOI: 10.1159/000492396] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/23/2018] [Indexed: 01/04/2023] Open
Abstract
Improving clinical outcomes remains the gold standard in advancing healthcare. Focusing on outcomes holds the potential to unite all clinical stakeholders including payers, industry, providers, and patients. Yet, the dominant ways in which outcomes are captured, provider-collected or patient-reported, have significant limitations. The emerging field of biosensors and wearables, which aims to capture many types of health data, holds promise to specifically capture outcomes while complementing existing outcome collection methods. A digital outcome measure, unlike a traditional provider-collected or patient-reported outcome measure, depends less on active patient or provider participation. Thus, digital outcome measures may be more amenable to standardization as well as greater collection consistency, frequency, and accuracy.
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Affiliation(s)
- Adam B. Cohen
- The Johns Hopkins University Applied Physics Lab, Health Technologies, National Health Mission Area, Laurel, Maryland, USA
- Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Simon C. Mathews
- Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, USA
- Division of Gastroenterology, Department of Internal Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA
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Hamilton MJ. The Use of Mobile Applications in the Management of Patients With Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y) 2018; 14:529-531. [PMID: 30364254 PMCID: PMC6194659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Matthew J Hamilton
- Assistant Professor of Medicine, Harvard Medical School Division of Gastroenterology, Hepatology, and Endoscopy Brigham and Women's Hospital Boston, Massachusetts
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Walsh A, Travis S. What's app? Electronic health technology in inflammatory bowel disease. Intest Res 2018; 16:366-373. [PMID: 30090035 PMCID: PMC6077306 DOI: 10.5217/ir.2018.16.3.366] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 12/30/2022] Open
Abstract
Electronic health (eHealth) data collection is increasingly used in many chronic illnesses, to track pattern of disease. eHealth systems have the potential to revolutionize care. Inflammatory bowel disease (IBD) is a paradigm for such an approach: this is a chronic disease that usually affects young and technologically literate patient population, who are motivated to be involved in their own care. A range of eHealth technologies are available for IBD. This review considers the strengths and weaknesses of 7 platforms that focus on patient-provider interaction. These have been developed in Denmark, United States, the Netherlands, and the United Kingdom, demonstrating an international interest in this form of technology and interaction. Not only do these technologies aim to improve care but they also have the potential to collect large amounts of information. Information includes demographics and patient reported outcomes (symptoms, quality of life), quality of care (steroid use, among other metrics) and outcomes such as hospitalization. These data could inform quality improvement programmes to improve their focus. eHealth technology is also open to machine learning to analyze large data sets, through which personalized algorithms may be developed.
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Affiliation(s)
- Alissa Walsh
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Simon Travis
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
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Nimkar S, Gilles EE. Improving Global Health With Smartphone Technology. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2018. [DOI: 10.4018/ijehmc.2018070101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The widespread use of smartphones makes them a popular platform for healthcare applications. This article reveals the global trends and overarching goals of mHealth initiatives that seek to enhance healthcare quality, increase access to health services, and improve global health communication. Three main themes emerged from this study: a) the impact of mHealth on international public health, b) overcoming mhealth barriers, and c) emerging mHealth technologies. The costs of developing mHealth apps and handling related data security concerns are the key barriers which need to be addressed to successfully implement global mHealth campaigns. Future directions of mHealth research are discussed, including the integration of new technologies, development of innovative healthcare systems, and overall improvement of global healthcare.
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Kelso M, Feagins LA. Can Smartphones Help Deliver Smarter Care for Patients With Inflammatory Bowel Disease? Inflamm Bowel Dis 2018; 24:1453-1459. [PMID: 29868764 DOI: 10.1093/ibd/izy162] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Indexed: 12/16/2022]
Abstract
The addition of smartphone applications to the armamentarium of tools to help manage patients with inflammatory bowel disease (IBD) has the potential to improve care in multiple ways, including enhanced disease understanding, improved adherence to medications, accessible support networks, and earlier interventions by medical professionals when problems arise. However, at present, for patients with IBD, the development of such mobile applications is still in its infancy. We conducted a review of the literature and online resources including phone application stores (Apple and Android app stores) to assess the current availability of mobile health applications for IBD patients and opportunities to increase patient engagement. We also addressed the limitations and challenges of patient and provider adoption of mobile-based technologies for IBD self-management and remote monitoring.
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Affiliation(s)
- Michael Kelso
- Department of Medicine, VA North Texas Healthcare System, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Linda A Feagins
- Department of Medicine, VA North Texas Healthcare System, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
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Foster KR, Callans DJ. Smartphone Apps Meet Evidence-Based Medicine: The Future of Medicine May (Or May Not) Be in Your Smartphone. IEEE Pulse 2018; 8:34-39. [PMID: 29155376 DOI: 10.1109/mpul.2017.2750783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
"The future of medicine is in your smartphone," proclaimed an eminent medical researcher in a 2015 Wall Street Journal essay. In a sense, that future has already arrived, judging from the proliferation of apps and medical devices now connected to smartphones. One 2015 industry study identified more than 165,000 health-related smartphone apps available from the Google Play Store and Apple iTunes. But to what extent does this technology lead to improved patient outcomes? That question is one for evidence-based medicine, to be answered by clinical trials and systematic reviews by medical experts.
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Dalton JA, Rodger D, Wilmore M, Humphreys S, Skuse A, Roberts CT, Clifton VL. The Health-e Babies App for antenatal education: Feasibility for socially disadvantaged women. PLoS One 2018; 13:e0194337. [PMID: 29768407 PMCID: PMC5955503 DOI: 10.1371/journal.pone.0194337] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 03/01/2018] [Indexed: 11/18/2022] Open
Abstract
Background The use of mobile technology such as phone applications (apps) has been proposed as an efficient means of providing health and clinical information in a variety of healthcare settings. We developed the Health-e Babies app as an Android smart phone application for pregnant women attending a tertiary hospital in a low socio-economic community, with the objective of providing health information about early pregnancy that would increase maternal confidence and reduce anxiety. Based on our earlier research, this form of health communication was viewed as a preferred source of information for women of reproductive age. However, the pilot study had a poor participation rate with 76% (n = 94) not completing the study requirements. These initial findings raised some very important issues in relation to the difficulties of engaging women with a pregnancy app. This paper analyses the characteristics of the participants who did not complete the study requirements in an attempt to identify potential barriers associated with the implementation of a pregnancy app. Methods This retrospective review of quantitative and qualitative data collected at the commencement of the Health-e Babies App trial, related to the participant’s communication technology use, confidence in knowing where to seek help and mental health status, maternal-fetal attachment and parenting confidence. Engagement and use of the Health-e Babies App was measured by the completion of a questionnaire about the app and downloaded data from participant’s phones. Mental health status, confidence and self-efficacy were measured by questionnaires. Results All women were similar in terms of age, race, marital status and level of education. Of the 94 women (76%) who did not complete the trial, they were significantly more anxious as indicated by State Trait Anxiety Inventory (p = 0.001 Student T-test) and more likely to be unemployed (50% vs 31%, p = 0.012 Student T-Test). Conclusion This study provides important information about the challenges associated with the implementation of a pregnancy app in a socially disadvantaged community. The data suggests that factors including social and mental health issues, financial constraints and technological ability can affect women’s engagement with a mobile phone app.
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Affiliation(s)
- Julia A. Dalton
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Dianne Rodger
- Department of Anthropology and Development Studies, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Wilmore
- Department of Media Studies, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Faculty of Health, Arts and Design, Swinburne University, Hawthorn, Victoria, Australia
| | - Sal Humphreys
- Department of Media Studies, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew Skuse
- Department of Anthropology and Development Studies, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Claire T. Roberts
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Vicki L. Clifton
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
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Can existing mobile apps support healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change theory and user quality integration. Public Health Nutr 2017; 21:288-298. [PMID: 29081322 DOI: 10.1017/s1368980017002889] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps. DESIGN Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour. SETTING Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components. SUBJECTS A sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality. RESULTS The quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation. CONCLUSIONS Existing mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.
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