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Fung JYT, Lim H, Vongsirimas N, Klainin-Yobas P. Effectiveness of eHealth mindfulness-based interventions on cancer-related symptoms among cancer patients and survivors: A systematic review and meta-analysis. J Telemed Telecare 2024; 30:451-465. [PMID: 35212553 DOI: 10.1177/1357633x221078490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This review aimed to synthesize the best available evidence concerning the effectiveness of electronic health, mindfulness-based interventions (eHealth-MBIs) on anxiety, depression, mindfulness and quality of life (QoL) among cancer patients/survivors. METHODS Published and unpublished studies were retrieved from 10 electronic databases. Two independent authors screened and selected articles, extracted data using a standardized form and appraised the studies with the Cochrane risk of bias assessment tool. Meta-analyses were performed using a random-effect model with Review Manager (REVMAN). Standardized mean differences (SMDs) were used to determine intervention effects. Narrative syntheses were conducted for studies not suitable for meta-analyses. Heterogeneity was identified through I2 and chi-square statistics. Subgroup analyses were performed based on types of controls, age groups and gender. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess overall quality. RESULTS In total, 18 studies were included. The eHealth-MBIs improved primary outcomes of anxiety (SMD = -0.28) and depression (SMD = -0.24), among cancer patients/survivors with small effect sizes. Effects for the secondary outcomes of QoL (SMD = 0.25) and mindfulness (SMD = 0.29) were observed at short-term follow-up assessments but not at post-intervention. Overall quality was rated as low for the primary and very low for the secondary outcomes. CONCLUSION The eHealth-MBIs can be offered as a cost-effective and accessible alternative for cancer patients and survivors in healthcare settings. Future research may further explore the effectiveness of eHealth-MBIs based on different types of MBIs, cancer types, modes of delivery and other outcomes such as stress and post-traumatic growth.
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Affiliation(s)
| | | | - Nopporn Vongsirimas
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
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Esperto F, Cacciatore L, Tedesco F, Brassetti A, Testa A, Raso G, Iannuzzi A, Papalia R, Scarpa RM. Video Consensus and Radical Prostatectomy: The Way to Chase the Future? J Pers Med 2023; 13:1013. [PMID: 37374002 DOI: 10.3390/jpm13061013] [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: 04/30/2023] [Revised: 05/16/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In the age of information, new platforms are consulted by patients to acquire consciousness about medical treatments. The aim of this study was to assess the level of understanding and feasibility of video consensus (VC) administration in patients scheduled for radical prostatectomy (RP), comparing it with standard informed consensus (SIC). According to the European Association of Urology Patient Information, we set up a video content for RP that was translated in Italian and implemented with information about possible perioperative and postoperative complications, days of hospitalization etc. From 2021 to 2022, all patients undergoing RP at our institution were prospectively included in this study. Patients received an SIC and after that, a VC about RP. After two consensuses were administered, patients received a preformed Likert 10 scale and STAI questionnaires. On the RP dataset, 276 patients were selected and 552 questionnaires for both SIC and VC were evaluated. Out of these, the median age was 62 years (IQR 60-65). Patients reported a higher overall satisfaction for VC (8.8/10) compared to the traditional informed consent (6.9/10). Therefore, VC may play a role in the future of surgery, improving the consciousness and satisfaction of patients and reducing preoperative anxiety.
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Affiliation(s)
- Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Aldo Brassetti
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, 00128 Rome, Italy
| | - Antonio Testa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Gianluigi Raso
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Andrea Iannuzzi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
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The Mobile Patient Information Assistant (PIA) App during the Inpatient Surgical Hospital Stay: Evaluation of Usability and Patient Approval. Healthcare (Basel) 2023; 11:healthcare11050682. [PMID: 36900686 PMCID: PMC10000762 DOI: 10.3390/healthcare11050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Mobile eHealth apps are becoming increasingly important tools in healthcare management, capable of providing education and support at any time. There is little knowledge about surgical patients' appreciation and use of these apps. The objective of this study was to develop and evaluate a user-friendly medical app (PIA; Patient Information Assistant) for providing individual patient information before and after inpatient urological surgery. Twenty-two patients aged 35 to 75 years were provided with timely information, push notifications, and personalized agendas (e.g., date of presentation, time of surgery, time of doctor's consultation, imaging appointment) via the PIA app. Of the 22 patients, 19 evaluated the PIA app in terms of usage and usability, benefits, and potential for improvement. Of the study participants, 95% did not need any assistance to use the app, 74% confirmed that the PIA app made them feel better informed and more satisfied with their hospital stay, and 89% stated that they would like to re-use the PIA app and support the general use of medical apps in healthcare. Thus, we created an innovative digital health information tool, allowing targeted support for doctor-nurse-patient communication and offering great potential for patient support before and after surgery. Our study revealed that use of an app during the surgical hospital stay is readily accepted and benefits patients by acting as an additional informative tool.
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Lee AW, Kenfield SA, Wang EY, Enriquez A, Oni-Orisan A, Steinman MA, Sim I, Breyer BN, Bauer SR. Tracking Lower Urinary Tract Symptoms and Tamsulosin Side Effects Among Older Men Using a Mobile App (PERSONAL): Feasibility and Usability Study. JMIR Form Res 2021; 5:e30762. [PMID: 34889745 PMCID: PMC8709917 DOI: 10.2196/30762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
Background Continuous α1a-blockade is the first-line treatment for lower urinary tract symptoms (LUTS) among older men with suspected benign prostatic hyperplasia. Variable efficacy and safety for individual men necessitate a more personalized, data-driven approach to prescribing and deprescribing tamsulosin for LUTS in older men.
Objective We aim to evaluate the feasibility and usability of the PERSONAL (Placebo–Controlled, Randomized, Patient-Selected Outcomes, N-of-1 Trials) mobile app for tracking daily LUTS severity and medication side effects among older men receiving chronic tamsulosin therapy.
Methods We recruited patients from the University of California, San Francisco health care system to participate in a 2-week pilot study. The primary objectives were to assess recruitment feasibility, study completion rates, frequency of symptom tracking, duration of tracking sessions, and app usability rankings measured using a follow-up survey. As secondary outcomes, we evaluated whether daily symptom tracking led to changes in LUTS severity, perceptions of tamsulosin, overall quality of life, medication adherence between baseline and follow-up surveys, and perceived app utility.
Results We enrolled 19 men within 23 days, and 100% (19/19) of the participants completed the study. Each participant selected a unique combination of symptoms to track and recorded data in the PERSONAL app, with a median daily completion rate of 79% (11/14 days). The median duration of the app session was 44 (IQR 33) seconds. On a scale of 1 (strongly disagree) to 5 (strongly agree), the participants reported that the PERSONAL app was easy to use (mean 4.3, SD 1.0), that others could learn to use it quickly (mean 4.2, SD 0.9), and that they felt confident using the app (mean 4.4, SD 0.8). LUTS severity, quality of life, and medication adherence remained unchanged after the 2-week study period. Fewer men were satisfied with tamsulosin after using the app (14/19, 74% vs 17/19, 89% at baseline), although the perceived benefit from tamsulosin remained unchanged (18/19, 95% at baseline and at follow-up). In total, 58% (11/19) of the participants agreed that the PERSONAL app could help people like them manage their urinary symptoms.
Conclusions This pilot study demonstrated the high feasibility and usability of the PERSONAL mobile app to track patient-selected urinary symptoms and medication side effects among older men taking tamsulosin to manage LUTS. We observed that daily symptom monitoring had no adverse effects on the secondary outcomes. This proof-of-concept study establishes a framework for future mobile app studies, such as digital n-of-1 trials, to collect comprehensive individual-level data for personalized LUTS management in older men.
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Affiliation(s)
- Austin W Lee
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Stacey A Kenfield
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Elizabeth Y Wang
- Columbia University Vagelos College of Physicians and Surgeons, New York City, CA, United States
| | - Anthony Enriquez
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Akinyemi Oni-Orisan
- Department of Clinical Pharmacy and Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, United States
| | - Michael A Steinman
- Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States.,Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Ida Sim
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin N Breyer
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Scott R Bauer
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States.,Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States.,Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021. [PMID: 34469671 PMCID: PMC8486450 DOI: 10.1590/s1677-5538.ibju.2021.0211.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Wang G, Wu B, Chen J, Yu G, Lin D, Wang G, Bai Z. A novel mHealth App (RyPros) for prostate cancer management: an accessibility and acceptability study. Transl Androl Urol 2021; 10:3723-3736. [PMID: 34804816 PMCID: PMC8575583 DOI: 10.21037/tau-21-459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022] Open
Abstract
Background Over the past decade, there has been a significant increase in research on the use of mobile health (mHealth) apps as disease management tools. However, very few apps are currently available for prostate cancer (PCa) patient management, and the available apps do not combine the needs of physicians with the requirements of patients. This study aimed to describe the development of a mHealth application for PCa survivors called RyPros, which includes dynamic visualization, intelligent reminders, and instant messaging to support decision-making regarding treatment and follow-up and test the initial accessibility and acceptability application. Methods The application was developed through a three-step procedure: logical structure design, application programming, and testing. Dynamic visualization, intelligent reminders, and instant messaging were the core functions of RyPros. Twenty-eight participants who had PCa were enrolled in four weeks of follow-up using the RyPros App. We initially evaluated participants' acceptance of RyPros based on their use of the app (login data, questionnaire completion) and a satisfaction survey. Results We successfully designed and tested the application. A total of 32 participants were enrolled, of whom 28 completed the 4-week follow-up, yielding a participation rate of 87.5%. Each participant logged on an average of 2.82 times and achieved an average of 0.89 questionnaires per week over the four weeks. Most participants (64%) liked the app, and most participants (71%) were satisfied, giving the RyPros app a rating of 4 or 5. More than half of the participants (61%) intended to use the RyPros app regularly, and the majority of participants agreed that the three core functionalities of RyPros were helpful (20/28, 71% for instant messaging; 16/28, 57% for visualization; and 18/28, 64% for reminders and assessments). Conclusions The mHealth application we developed for PCa survivor management provided dynamic visualization, reminders, assessments, and instant messaging to support decision-making based on multidisciplinary collaboration. PCa survivors showed high acceptance of the RyPros app.
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Affiliation(s)
- Gang Wang
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Bing Wu
- ChronoCloud Medical Information (Hainan) Co., Ltd, Haikou, China
| | - Jing Chen
- Department of Radiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Gang Yu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Danni Lin
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Guoren Wang
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Zhiming Bai
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021; 47:1195-1197. [PMID: 34469665 PMCID: PMC8486462 DOI: 10.1590/s1677-5538.ibju.2021.06.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K M Moromizato
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Lucia S Ribeiro
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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Hameed BZ, Shah M, Naik N, Reddy SJ, Somani BK. Use of ureteric stent related mobile phone application (UROSTENTZ App) in COVID-19 for improving patient communication and safety: a prospective pilot study from a university hospital. Cent European J Urol 2021; 74:51-56. [PMID: 33976916 PMCID: PMC8097645 DOI: 10.5173/ceju.2021.0328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction During the COVID-19 led lockdown, a reliable system to monitor ureteral stent insertion and timely removal became an important facet of their use. This study looks at the use of ‘Urostentz’ smartphone application (app) for stent procedures and whether it improved patient communication and safety during the lockdown. Material and methods The ‘Urostentz’ app was used for patients who underwent ureteric stent after ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL) procedure. It is a smartphone app developed to improve patient safety, facilitate data collection, and provide an efficient interface to simplify ureteral stent tracking and patient communication. It also helps clinicians track stent-related symptoms (SRS) and provide digital remote assistance. Results A total of 33 patients registered with a mean age of 47.8 years (range:18–80) and a male: female ratio of 4.5:1. Of these, 29 (87.9%) used the Urostentz app, and 55.2% had SRS. The number of effective communication episodes ranged from 1–7/patient. Based on the symptoms and communication, stent was removed during lockdown (n = 2), within 1 week of lockdown lifted (n = 24) and within 2 weeks of lockdown lifted (n = 5). None of the patients suffered any stent-related complications and there were no cases of forgotten stents or readmissions despite the lockdown and lack of communication using standard practices. Conclusions The Urostentz app proved to an effective medium of communication to provide guidance and personalized digital remote healthcare. It also allowed prompt removal of stents avoiding prolonged stent symptoms or forgotten stents. Such apps can have a much wider application in the post-COVID-19-era to reduce unnecessary post-procedural visits and reduce health care costs.
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Affiliation(s)
- Bm Zeeshan Hameed
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India.,KMC Innovation Centre, Manipal Academy of Higher Education, Karnataka, India.,International Training and Research in Uro-Oncology and Endourology (i-TRUE), Manipal, Karnataka, India
| | - Milap Shah
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India.,International Training and Research in Uro-Oncology and Endourology (i-TRUE), Manipal, Karnataka, India
| | - Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Karnataka, India.,International Training and Research in Uro-Oncology and Endourology (i-TRUE), Manipal, Karnataka, India
| | - Suraj Jayadeva Reddy
- KMC Innovation Centre, Manipal Academy of Higher Education, Karnataka, India.,International Training and Research in Uro-Oncology and Endourology (i-TRUE), Manipal, Karnataka, India
| | - Bhaskar K Somani
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India.,Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.,International Training and Research in Uro-Oncology and Endourology (i-TRUE), Manipal, Karnataka, India
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Birkhäuser FD, Moltzahn F, Huber PM, Zehnder JL, Flückiger S, Hasler D, Mitra AP, Zehnder P. Intensified and Standardized Digital Communication with Cystectomy Patients as a Potentially Simple and Effective Modality for Early Detection of Postoperative Complications: Results from a Pilot Study. EUR UROL SUPPL 2020; 22:3-8. [PMID: 34337472 PMCID: PMC8317797 DOI: 10.1016/j.euros.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Postoperative readmission rates following radical cystectomy remain significant. Early identification of emerging complications could potentially allow for immediate institution of therapy. OBJECTIVE To intensify postoperative patient-physician communication via a cellphone-based health care application (CHA) and to evaluate its potential for early detection of complications. DESIGN SETTING AND PARTICIPANTS This was a pilot study involving 18 radical cystectomy patients. During the first 30 d, patients received a push cellphone notification twice a week requesting data input into the CHA. This was reduced to once a week from day 31 to day 90. De-identified recorded data were reviewed by the surgeon involved. If deemed necessary, patients were contacted by the surgeon via telephone to obtain more detailed clinical information. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Descriptive statistics were used. RESULTS AND LIMITATIONS Of the 18 patients enrolled, all completed the 90-d reporting period. On two occasions, interventions were necessary on the basis of data recorded on the CHA. One neobladder patient was given antibiotic therapy for pyelonephritis. Another patient reported weight loss and nausea with clinical suspicion of metabolic acidosis, and his sodium bicarbonate and fluid intake were increased. Limitations include the small number of cases from a single low-volume center. CONCLUSIONS CHA-based monitoring of clinical parameters within the crucial 90-d postoperative period following radical cystectomy provides meaningful information. In this pilot study, two potential readmissions were possibly avoided on the basis of recorded basic vital signs and early intervention. PATIENT SUMMARY Besides regular clinic follow-up visits after radical cystectomy, additional aids such as a cellphone-based health care application can provide treating physicians with relevant clinical information and may help to identify imminent deviations from normal postoperative recovery at an early stage.
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Affiliation(s)
| | | | | | | | | | | | - Anirban P. Mitra
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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