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El-Tallawy SN, Pergolizzi JV, Vasiliu-Feltes I, Ahmed RS, LeQuang JK, Alzahrani T, Varrassi G, Awaleh FI, Alsubaie AT, Nagiub MS. Innovative Applications of Telemedicine and Other Digital Health Solutions in Pain Management: A Literature Review. Pain Ther 2024; 13:791-812. [PMID: 38869690 PMCID: PMC11255158 DOI: 10.1007/s40122-024-00620-7] [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: 04/24/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
Since the COVID-19 pandemic, healthcare systems are facing extraordinary challenges. Our approaches to medicine have changed and created a whole new generation of people who have chronic pain. Various medical services were postponed. The pandemic significantly impacted the bio-psychosocial model of pain and the management of chronic pain. These new challenges affected millions of patients worldwide, with more burden on patients with chronic pain. Telemedicine and digital health rather than traditional office visits have become essential tools for communications, resulting in an unmatched surge in telehealth adoption. This new approach facilitated the remote treatment and follow-up of patients who have difficulty to access the healthcare services, particularly patients with chronic pain and those who were receiving regular controlled medications. An extensive computer search was conducted, during the period (from January 2014 to March 2024), and included literature from PubMed, Scopus, MEDLINE, and Google scholar. According to preset inclusion and exclusion criteria, a total of 38 articles have been included in this review article. This literature review focuses on the innovation of telemedicine and digital health in pain management, especially in the context of the challenges posed by the COVID-19 pandemic. The manuscript provides a comprehensive overview of telemedicine and digital communications, their evolution, and their significance in healthcare. It also emphasizes the benefits, challenges, limitations, and the ethical concerns of telemedicine in pain management after the COVID-19 pandemic. Furthermore, the document explores the different modes of the telecommunications and discusses the future directions of the digital health technology.
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Affiliation(s)
- Salah N El-Tallawy
- Anesthesia and Pain Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- Anesthesia Department, Faculty of Medicine, Minia University & NCI, Cairo University, Cairo, Egypt.
| | | | | | - Rania S Ahmed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Tariq Alzahrani
- Anesthesia and Pain Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Fouad I Awaleh
- Anesthesia Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah T Alsubaie
- Anesthesia Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Wang P, Tadeo X, Chew HSJ, Sapanel Y, Ong YH, Leung NYT, Chow EKH, Ho D. N-of-1 health optimization: Digital monitoring of biomarker dynamics to gamify adherence to metabolic switching. PNAS NEXUS 2024; 3:pgae214. [PMID: 38881838 PMCID: PMC11179112 DOI: 10.1093/pnasnexus/pgae214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024]
Abstract
The digital health field is experiencing substantial growth due to its potential for sustained and longitudinal deployment. In turn, this may drive improved monitoring and intervention as catalysts for behavioral change compared to traditional point-of-care practices. In particular, the increase in incidence of population health challenges such as diabetes, heart disease, fatty liver disease, and other disorders coupled with rising healthcare costs have emphasized the importance of exploring technical, economics, and implementation considerations, among others in the decentralization of health and healthcare innovations. Both healthy individuals and patients stand to benefit from continued technical advances and studies in these domains. To address these points, this study reports a N-of-1 study comprised of sustained regimens of intermittent fasting, fitness (strength and cardiovascular training), and high protein, low carbohydrate diet and parallel monitoring. These regimens were paired with serial blood ketone, blood glucose (wearable and finger stick) and blood pressure readings, as well as body weight measurements using a collection of devices. Collectively this suite of platforms and approaches were used to monitor metabolic switching from glucose to ketones as energy sources-a process associated with potential cardio- and neuroprotective functions. In addition to longitudinal biomarker dynamics, this work discusses user perspectives on the potential role of harnessing digital devices to these dynamics as potential gamification factors, as well as considerations for the role of biomarker monitoring in health regimen development, user stratification, and potentially informing downstream population-scale studies to address metabolic disease, healthy aging and longevity, among other indications.
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Affiliation(s)
- Peter Wang
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore 117583, Singapore
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
| | - Xavier Tadeo
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yoann Sapanel
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- Singapore's Health District @ Queenstown, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
| | - Yoong Hun Ong
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
| | - Nicole Yong Ting Leung
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
| | - Edward Kai-Hua Chow
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore 117583, Singapore
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore
- NUS Centre for Cancer Research (N2CR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Dean Ho
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore 117583, Singapore
- Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- The N.1 Institute for Health (N.1), National University of Singapore, Singapore 117456, Singapore
- Singapore's Health District @ Queenstown, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- The Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
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Gao Z, Chee CS, Omar Dev RD, Gao J. Comprehensive analysis of college students' autonomous fitness behavior-a narrative review. Front Sports Act Living 2024; 6:1406810. [PMID: 38835705 PMCID: PMC11148380 DOI: 10.3389/fspor.2024.1406810] [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: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Although the physical health of college students is increasingly receiving attention, their autonomous fitness behavior has not been thoroughly investigated. This narrative review conducted a comprehensive literature search through databases such as PubMed, PsycINFO, Web of Science, and the China National Knowledge Infrastructure (CNKI), reviewing studies published up to December 2023. We explored the constructs of autonomy, fitness behavior, and agency, and discussed their integration within the autonomous fitness model. Our findings indicate a lack of comprehensive studies exploring the multifaceted factors influencing autonomous fitness behaviors. Future research should strive to deepen conceptual understanding and further explore the complex dynamics of the transition from autonomy to persistence, employing technological and interdisciplinary methodological perspectives to enhance understanding and promote sustainable fitness habits.
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Affiliation(s)
- Zhendong Gao
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Chen Soon Chee
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Jianhong Gao
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
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Charalambous A. Digital transformation in healthcare: Have we gone off the rails? Asia Pac J Oncol Nurs 2024; 11:100481. [PMID: 38774536 PMCID: PMC11107189 DOI: 10.1016/j.apjon.2024.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 05/24/2024] Open
Affiliation(s)
- Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
- Department of Nursing, University of Turku, Turku, Finland
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Mantri M, Sunder G, Kadam S, Abhyankar A. A perspective on digital health platform design and its implementation at national level. Front Digit Health 2024; 6:1260855. [PMID: 38665619 PMCID: PMC11043488 DOI: 10.3389/fdgth.2024.1260855] [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: 07/18/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Accessible and affordable health services and products including medicines, vaccines, and public health are an important health agenda of all countries. It is well understood that without digital health technologies, countries will face difficulties in tackling the needs and demands of their population. Global agencies including the World Health Organization (WHO), United Nations (UN), International Telecommunication Union (ITU), etc. have been instrumental in providing various tools, and guidance through digital health strategies in improving health and digital health maturity of the countries. The Digital Health Platform Handbook (DHPH) is a toolkit published by WHO and ITU to help countries create and implement a digital health platform (DHP) to serve as the underlying infrastructure for an interoperable and integrated national digital health system. We apply the foundational principles of DHPH and provide a perspective of DHP components in a layered, enterprise architecture of a digital health infrastructure. India has rolled out the blueprint of its National Digital Health Mission (NDHM) to address the emerging needs for digitization of healthcare in the country. In this paper, we also illustrate the design and implementation of WHO-ITU DHP components at the national level by exploring India's digital health mission implementation utilizing various digital public goods to build a digital health ecosystem in the country.
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Affiliation(s)
- Manisha Mantri
- HPC-Medical & Bioinformatics Application Group, Centre for Development of Advanced Computing (C-DAC), Pune, India
- National Supercomputing Mission, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Gaur Sunder
- HPC-Medical & Bioinformatics Application Group, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Sanjay Kadam
- National Supercomputing Mission, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Aditya Abhyankar
- Department of Technology, Savitribai Phule Pune University (SPPU), Pune, India
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Carrera A, Manetti S, Lettieri E. Rewiring care delivery through Digital Therapeutics (DTx): a machine learning-enhanced assessment and development (M-LEAD) framework. BMC Health Serv Res 2024; 24:237. [PMID: 38395905 PMCID: PMC10885456 DOI: 10.1186/s12913-024-10702-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Digital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Digital Therapeutics offer an innovative approach to disease management and treatment. Care delivery is increasingly patient-centered, data-driven, and based on real-time information. These technological innovations can lead to better patient outcomes and support for healthcare professionals, also considering resource scarcity. As these digital technologies continue to evolve, the healthcare field must be ready to integrate them into processes to take advantage of their benefits. This study aims to develop a framework for the development and assessment of Digital Therapeutics. METHODS The study was conducted relying on a mixed methodology. 338 studies about Digital Therapeutics resulting from a systematic literature review were analyzed using descriptive statistics through RStudio. Machine learning algorithms were applied to analyze variables and find patterns in the data. The results of these analytical analyses were summarized in a framework qualitatively tested and validated through expert opinion elicitation. RESULTS The research provides M-LEAD, a Machine Learning-Enhanced Assessment and Development framework that recommends best practices for developing and assessing Digital Therapeutics. The framework takes as input Digital Therapeutics characteristics, regulatory aspects, study purpose, and assessment domains. The framework produces as outputs recommendations to design the Digital Therapeutics study characteristics. CONCLUSIONS The framework constitutes the first step toward standardized guidelines for the development and assessment of Digital Therapeutics. The results may support manufacturers and inform decision-makers of the relevant results of the Digital Therapeutics assessment.
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Peñate GP, Parra NO, Morera JAD, Meñaca AM, Ramón ML, Menéndez SC, Marrero FL, de la Cal SG, Ghadban-Garrido C, Tolosana PR, Puentes JM, Aguayo RA, Mahdavi H, Jeanneret GB, Subías PE. Assessing the clinical benefit, safety, and patient-reported outcomes with the use of the PAHcare™ digital platform in pulmonary arterial hypertension: a pilot study. Front Public Health 2024; 12:1335072. [PMID: 38435295 PMCID: PMC10904626 DOI: 10.3389/fpubh.2024.1335072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Digital health interventions, particularly mobile health platforms, have shown promise in supporting patients with respiratory conditions, but their application in pulmonary arterial hypertension (PAH) remains limited. We aimed to assess the feasibility, acceptability, and potential clinical benefit of the novel PAHcare™ digital platform as a patient-centred intervention for PAH management through a prospective, single-arm, multicenter pilot study conducted on 53 patients diagnosed with PAH who used the platform for 6 months. Methods The primary objective was to assess the impact on Health-Related Quality of Life (HRQoL) through questionnaires. Secondary objectives included evaluating clinical outcomes, including disease progression, PAH signs and symptoms, the 6-min walking test, and the patient's symptom perception. Additionally, we assessed patient satisfaction and engagement with the PAHcare™ platform, interaction with health coaches, retention, costs and healthcare resource utilisation (HCRU), and safety through monitoring device incidents. Results Minimal changes in HRQoL and clinical outcomes were observed over 6 months. A noteworthy 92.4% of patients actively used the platform in the first month, maintaining high usage throughout the study. Patient satisfaction was substantial, with more than half of the patients expressing excellence in service quality, willingness to reuse the platform, and fulfilment of their needs. Health coach interaction was high, with 76% of patients initiating contact within the first week. User retention rates were 70%, with prevalent ongoing usage and interaction with healthcare professionals even after the study. In terms of HCRU and costs, the study showed no significant changes in PAH-related hospital admissions, clinical visits, or tests. Finally, the low number of device-related incidents indicated platform safety. Conclusion This pilot study provides compelling evidence supporting the feasibility and acceptability of the PAHcare™ digital platform to empower patients to manage their disease and significantly enhance their overall experience with PAH.
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Affiliation(s)
- Gregorio Pérez Peñate
- Unidad Multidisciplinar Vascular Pulmonar, Servicio de Neumología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Ochoa Parra
- Unidad Multidisciplinar de Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain
| | | | - Amaya Martínez Meñaca
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Marta López Ramón
- Servicios de Neumología y Cardiología, Unidad de Hipertensión Pulmonar, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Fernando León Marrero
- Unidad Multidisciplinar Vascular Pulmonar, Servicio de Neumología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Cristina Ghadban-Garrido
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | | | - Javier Martín Puentes
- Servicios de Neumología y Cardiología, Unidad de Hipertensión Pulmonar, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Hadis Mahdavi
- Digital Health & Technology, Ferrer, Barcelona, Spain
| | | | - Pilar Escribano Subías
- Unidad Multidisciplinar de Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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Carbonaro A, Marfoglia A, Nardini F, Mellone S. CONNECTED: leveraging digital twins and personal knowledge graphs in healthcare digitalization. Front Digit Health 2023; 5:1322428. [PMID: 38130576 PMCID: PMC10733505 DOI: 10.3389/fdgth.2023.1322428] [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: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Healthcare has always been a strategic domain in which innovative technologies can be applied to increase the effectiveness of services and patient care quality. Recent advancements have been made in the adoption of Digital Twins (DTs) and Personal Knowledge Graphs (PKGs) in this field. Despite this, their introduction has been hindered by the complex nature of the context itself which leads to many challenges both technical and organizational. In this article, we reviewed the literature about these technologies and their integrations, identifying the most critical requirements for clinical platforms. These latter have been used to design CONNECTED (COmpreheNsive and staNdardized hEalth-Care plaTforms to collEct and harmonize clinical Data), a conceptual framework aimed at defining guidelines to overcome the crucial issues related to the development of healthcare applications. It is structured in a multi-layer shape, in which heterogeneous data sources are first integrated, then standardized, and finally used to realize general-purpose DTs of patients backed by PKGs and accessible through dedicated APIs. These DTs will be the foundation on which smart applications can be built.
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Affiliation(s)
- Antonella Carbonaro
- Department of Computer Science and Engineering, Università di Bologna, Cesena, Italy
| | - Alberto Marfoglia
- Department of Computer Science and Engineering, Università di Bologna, Cesena, Italy
| | - Filippo Nardini
- Department of Industrial Engineering, Università di Bologna, Bologna, Italy
| | - Sabato Mellone
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, Università di Bologna, Cesena, Italy
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