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Sharma M, Pal P, Gupta SK, Potdar MB, Belgamwar AV. Microglial-mediated immune mechanisms in autoimmune uveitis: Elucidating pathogenic pathways and targeted therapeutics. J Neuroimmunol 2024; 395:578433. [PMID: 39168018 DOI: 10.1016/j.jneuroim.2024.578433] [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: 12/18/2023] [Revised: 07/26/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024]
Abstract
This review offers a comprehensive examination of the role of microglia in the pathogenesis of autoimmune uveitis, an inflammatory eye disease with significant potential for vision impairment. Central to our discussion is the dual nature of microglial cells, which act as both protectors and potential perpetrators in the immune surveillance of the retina. We explore the mechanisms of microglial activation, highlighting the key signaling pathways involved, such as NF-κB, JAK/STAT, MAPK, and PI3K/Akt. The review also delves into the genetic and environmental factors influencing microglial behavior, underscoring their complex interaction in disease manifestation. Advanced imaging techniques and emerging biomarkers for microglial activation, pivotal in diagnosing and monitoring the disease, are critically assessed. Additionally, we discuss current and novel therapeutic strategies targeting microglial activity, emphasizing the shift towards more precise and personalized interventions. This article aims to provide a nuanced understanding of microglial dynamics in autoimmune uveitis, offering insights into potential avenues for effective treatment and management.
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Affiliation(s)
- Monika Sharma
- Department of Pharmacy, Banasthali Vidyapith, Rajasthan, India
| | - Pankaj Pal
- Department of Pharmacy, Banasthali Vidyapith, Rajasthan, India; IIMT College of Pharmacy, IIMT Group of Colleges, Greater Noida, Uttar Pradesh, India.
| | - Sukesh Kumar Gupta
- KIET School of Pharmacy, KIET Group of Institutions, Ghaziabad, Uttar Pradesh, India; Department of Ophthalmology, Visual and Anatomical Sciences (OVAS), School of Medicine, Wayne State University, USA.
| | - Mrugendra B Potdar
- Department of Pharmaceutics, Shri Vile Parle Kelvani Mandal's Institute of Pharmacy, Dhule, Maharashtra, India
| | - Aarti V Belgamwar
- Department of Pharmaceutics, Shri Vile Parle Kelvani Mandal's Institute of Pharmacy, Dhule, Maharashtra, India
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Pal P, Sambhakar S, Paliwal S. Revolutionizing Ophthalmic Care: A Review of Ocular Hydrogels from Pathologies to Therapeutic Applications. Curr Eye Res 2024:1-17. [PMID: 39261982 DOI: 10.1080/02713683.2024.2396385] [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: 10/08/2023] [Revised: 08/12/2024] [Accepted: 08/20/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE This comprehensive review is designed to elucidate the transformative role and multifaceted applications of ocular hydrogels in contemporary ophthalmic therapeutic strategies, with a particular emphasis on their capability to revolutionize drug delivery mechanisms and optimize patient outcomes. METHODS A systematic and structured methodology is employed, initiating with a succinct exploration of prevalent ocular pathologies and delineating the corresponding therapeutic agents. This serves as a precursor for an extensive examination of the diverse methodologies and fabrication techniques integral to the design, development, and application of hydrogels specifically tailored for ophthalmic pharmaceutical delivery. The review further scrutinizes the pivotal manufacturing processes that significantly influence hydrogel efficacy and delves into an analysis of the current spectrum of hydrogel-centric ocular formulations. RESULTS The review yields illuminating insights into the escalating prominence of ocular hydrogels within the medical community, substantiated by a plethora of ongoing clinical investigations. It reveals the dynamic and perpetually evolving nature of hydrogel research and underscores the extensive applicability and intricate progression of transposing biologics-loaded hydrogels from theoretical frameworks to practical clinical applications. CONCLUSIONS This review accentuates the immense potential and promising future of ocular hydrogels in the realm of ophthalmic care. It not only serves as a comprehensive guide but also as a catalyst for recognizing the transformative potential of hydrogels in augmenting drug delivery mechanisms and enhancing patient outcomes. Furthermore, it draws attention to the inherent challenges and considerations that necessitate careful navigation by researchers and clinicians in this progressive field.
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Affiliation(s)
- Pankaj Pal
- Department of Pharmacy, Banasthali Vidyapith, Vanasthali, India
- IIMT College of Pharmacy, IIMT Group of Colleges, Greater Noida, India
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Sharma M, Pal P, Gupta SK. Deciphering the role of miRNAs in Alzheimer's disease: Predictive targeting and pathway modulation - A systematic review. Ageing Res Rev 2024; 101:102483. [PMID: 39236856 DOI: 10.1016/j.arr.2024.102483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 08/12/2024] [Accepted: 08/29/2024] [Indexed: 09/07/2024]
Abstract
Alzheimer's Disease (AD), a multifaceted neurodegenerative disorder, is increasingly understood through the regulatory lens of microRNAs (miRNAs). This review comprehensively examines the pivotal roles of miRNAs in AD pathogenesis, shedding light on their influence across various pathways. We delve into the biogenesis and mechanisms of miRNAs, emphasizing their significant roles in brain function and regulation. The review then navigates the complex landscape of AD pathogenesis, identifying key genetic, environmental, and molecular factors, with a focus on hallmark pathological features like amyloid-beta accumulation and tau protein hyperphosphorylation. Central to our discussion is the intricate involvement of miRNAs in these processes, highlighting their altered expression patterns in AD and subsequent functional implications, from amyloid-beta metabolism to tau pathology, neuroinflammation, oxidative stress, and synaptic dysfunction. The predictive analysis of miRNA targets using computational methods, complemented by experimental validations, forms a crucial part of our discourse, unraveling the contributions of specific miRNAs to AD. Moreover, we explore the therapeutic potential of miRNAs as biomarkers and in miRNA-based interventions, while addressing the challenges in translating these findings into clinical practice. This review aims to enhance understanding of miRNAs in AD, offering a foundation for future research directions and novel therapeutic strategies.
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Affiliation(s)
- Monika Sharma
- Department of Pharmacy, Banasthali Vidyapith, Rajasthan, India
| | - Pankaj Pal
- IIMT College of Pharmacy, IIMT Group of Colleges, Greater Noida, Uttar Pradesh, India.
| | - Sukesh Kumar Gupta
- KIET School of Pharmacy, KIET Group of Institutions, Ghaziabad, Uttar Pradesh, India; Department of Ophthalmology, Visual and Anatomical Sciences (OVAS), School of Medicine, Wayne State University, USA.
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Sharma M, Pal P, Gupta SK. Microglial mediators in autoimmune Uveitis: Bridging neuroprotection and neurotoxicity. Int Immunopharmacol 2024; 136:112309. [PMID: 38810304 DOI: 10.1016/j.intimp.2024.112309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/29/2024] [Accepted: 05/16/2024] [Indexed: 05/31/2024]
Abstract
Autoimmune uveitis, a severe inflammatory condition of the eye, poses significant challenges due to its complex pathophysiology and the critical balance between protective and detrimental immune responses. Central to this balance are microglia, the resident immune cells of the central nervous system, whose roles in autoimmune uveitis are multifaceted and dynamic. This review article delves into the dual nature of microglial functions, oscillating between neuroprotective and neurotoxic outcomes in the context of autoimmune uveitis. Initially, we explore the fundamental aspects of microglia, including their activation states and basic functions, setting the stage for a deeper understanding of their involvement in autoimmune uveitis. The review then navigates through the intricate mechanisms by which microglia contribute to disease onset and progression, highlighting both their protective actions in immune regulation and tissue repair, and their shift towards a pro-inflammatory, neurotoxic profile. Special emphasis is placed on the detailed pathways and cellular interactions underpinning these dual roles. Additionally, the review examines the potential of microglial markers as diagnostic and prognostic indicators, offering insights into their clinical relevance. The article culminates in discussing future research directions, and the ongoing challenges in translating these findings into effective clinical applications. By providing a comprehensive overview of microglial mechanisms in autoimmune uveitis, this review underscores the critical balance of microglial activities and its implications for disease management and therapy development.
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Affiliation(s)
- Monika Sharma
- Department of Pharmacology, Faculty of Pharmacy, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Pankaj Pal
- Department of Pharmacy, Banasthali Vidyapith, Rajasthan, India.
| | - Sukesh Kumar Gupta
- KIET School of Pharmacy, KIET Group of Institutions, Ghaziabad, Uttar Pradesh, India; Department of Ophthalmology, Visual and Anatomical Sciences (OVAS), School of Medicine, Wayne State University, USA.
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Sharma M, Pal P, Gupta SK. Advances in Alzheimer's disease: A multifaceted review of potential therapies and diagnostic techniques for early detection. Neurochem Int 2024; 177:105761. [PMID: 38723902 DOI: 10.1016/j.neuint.2024.105761] [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: 11/03/2023] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024]
Abstract
Alzheimer's disease (AD) remains one of the most formidable neurological disorders, affecting millions globally. This review provides a holistic overview of the therapeutic strategies, both conventional and novel, aimed at mitigating the impact of AD. Initially, we delve into the conventional approach, emphasizing the role of Acetylcholinesterase (AChE) inhibition, which has been a cornerstone in AD management. As our understanding of AD evolves, several novel potential approaches emerge. We discuss the promising roles of Butyrylcholinesterase (BChE) inhibition, Tau Protein inhibitors, COX-2 inhibition, PPAR-γ agonism, and FAHH inhibition, among others. The potential of the endocannabinoids (eCB) system, cholesterol-lowering drugs, metal chelators, and MMPs inhibitors are also explored, culminating in the exploration of the pivotal role of microRNA in AD progression. Parallel to these therapeutic insights, we shed light on the novel tools and methodologies revolutionizing AD research. From the quantitative analysis of gene expression by qRTPCR to the evaluation of mitochondrial function using induced pluripotent stem cells (iPSCs), the advances in diagnostic and research tools offer renewed hope. Moreover, we explore the current landscape of clinical trials, highlighting the leading drug interventions and their respective stages of development. This comprehensive review concludes with a look into the future perspectives, capturing the potential breakthroughs and innovations on the horizon. Through a synthesis of current knowledge and emerging research, this article aims to provide a consolidated resource for clinicians, researchers, and academicians in the realm of Alzheimer's disease.
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Affiliation(s)
- Monika Sharma
- Faculty of Pharmacy, Department of Pharmacology, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Pankaj Pal
- Department of Pharmacy, Banasthali Vidyapith, Rajasthan, India.
| | - Sukesh Kumar Gupta
- KIET School of Pharmacy, KIET Group of Institutions, Ghaziabad, Uttar Pradesh, India; Department of Ophthalmology, Visual and Anatomical Sciences (OVAS), School of Medicine, Wayne State University, USA.
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Saedi S, Sobhan A, Hoff M, Wang S, Muthukumarappan K. Development of Halloysite Nanotube-Infused Thermoset Soybean Bio-Resin for Advanced Medical Packaging. Polymers (Basel) 2024; 16:1616. [PMID: 38931966 PMCID: PMC11207658 DOI: 10.3390/polym16121616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The development of eco-friendly, mechanically stable, and biocompatible materials for medical packaging has gained significant attention in recent years. Halloysite nanotubes (HNTs) have emerged as a promising nanomaterial due to their unique tubular structure, high aspect ratio, and biocompatibility. We aim to develop a novel soybean oil-based thermoset bio-resin incorporating HNTs and to characterize its physical and functional properties for medical packaging. Soybean oil was epoxidized using an eco-friendly method and used as a precursor for preparing the thermoset resin (ESOR). Different amounts of HNTs (0.25, 0.50, and 1.0 wt.%) were used to prepare the ESOR/HNTs blends. Various characteristics such as transparency, tensile strength, thermal resistance, and water absorption were investigated. While incorporating HNTs improved the tensile strength and thermal properties of the ESOR, it noticeably reduced its transparency at the 1.0 wt.% level. Therefore, HNTs were modified using sodium hydroxide and (3-Aminopropyl) triethoxysilane (APTES) and ESOR/HNTs blends were made using 1.0 wt.% of modified HNTs. It was shown that modifying HNTs using NaOH improved the transparency and mechanical properties of prepared blends compared to those with the same amount of unmodified HNTs. However, modifying using (3-Aminopropyl) triethoxysilane (APTES) decreased the transparency but improved the water absorption of prepared resins. This study provides valuable insights into the design of HNT-based ESOR blends as a sustainable material for medical packaging, contributing to the advancement of eco-friendly packaging solutions in the healthcare industry.
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Affiliation(s)
- Shahab Saedi
- Department of Agricultural and Biosystems Engineering, South Dakota State University, Brookings, SD 57007, USA; (S.S.); (A.S.)
| | - Abdus Sobhan
- Department of Agricultural and Biosystems Engineering, South Dakota State University, Brookings, SD 57007, USA; (S.S.); (A.S.)
- College of Agriculture and Applied Sciences, Alcorn State University, Lorman, MS 39096, USA
| | - Magdalene Hoff
- Department of Agricultural and Biosystems Engineering, South Dakota State University, Brookings, SD 57007, USA; (S.S.); (A.S.)
| | - Siqun Wang
- Center for Renewable Carbon, The University of Tennessee, Knoxville, TN 37996, USA;
| | - Kasiviswanathan Muthukumarappan
- Department of Agricultural and Biosystems Engineering, South Dakota State University, Brookings, SD 57007, USA; (S.S.); (A.S.)
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Kardas P. From non-adherence to adherence: Can innovative solutions resolve a longstanding problem? Eur J Intern Med 2024; 119:6-12. [PMID: 37848351 DOI: 10.1016/j.ejim.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023]
Abstract
Non-adherence to medication is a longstanding problem, profoundly affecting patient outcomes and sustainability of healthcare systems. Historically, non-adherence has been observed since the time of Hippocrates, however, when potent drugs became available in the midst of the 20th century, it became a pivotal concern. Despite numerous studies and interventions designed, medication adherence rates remain suboptimal, currently reaching about 50 % still, as described in WHO report two decades ago. What is worse, many healthcare professionals feel neither responsible nor able to change it. Enhancing adherence requires in-depth understanding of the concept, as many intuitive approaches fail to work. For example, contrary to expectations, patient education alone proves insufficient when addressing this issue. Both behavioural models and recent experience reflecting low acceptance of COVID-19 vaccinations strongly suggest that patients' decisions are driven by emotions, which often results in intentional non-adherence. Several technical innovations, such as smart inhalers and electronic pill dispensers, offer potential solutions. However, their effectiveness varies, and standardized certification procedures are lacking. Altogether, technical solutions do not eliminate the problem entirely. To move forward, social and health system innovation is equally needed. Multiple stakeholders could benefit from improved adherence, therefore their greater involvement is advisable to create an adherence-supporting environment. In conclusion, despite available evidence-based interventions, non-adherence remains a complex challenge. Technical and social innovations, combined with a shift in policy priorities, could lead to improved medication adherence and better patient outcomes. The global tide of non-communicable chronic conditions, and aging of societies urges us to take this problem seriously.
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Affiliation(s)
- Przemyslaw Kardas
- Medication Adherence Research Center, Department of Family Medicine, Medical University of Lodz, Lodz, Poland
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Luschi A. Exploring radio frequency identification (RFID) in healthcare: Promises fulfilled or forsaken? Technol Health Care 2024; 32:2847-2849. [PMID: 38306073 DOI: 10.3233/thc-231784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
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Faisal S, Samoth D, Aslam Y, Patel H, Park S, Baby B, Patel T. Key Features of Smart Medication Adherence Products: Updated Scoping Review. JMIR Aging 2023; 6:e50990. [PMID: 38113067 PMCID: PMC10762620 DOI: 10.2196/50990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/25/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Older adults often face challenges in self-managing their medication owing to physical and cognitive limitations, complex medication regimens, and packaging of medications. Emerging smart medication dispensing and adherence products (SMAPs) offer the options of automated dispensing, tracking medication intake in real time, and reminders and notifications. A 2021 review identified 51 SMAPs owing to the rapid influx of digital technology; an update to this review is required. OBJECTIVE This review aims to identify new products and summarize and compare the key features of SMAPs. METHODS Gray and published literature and videos were searched using Google, YouTube, PubMed, Embase, and Scopus. The first 10 pages of Google and the first 100 results of YouTube were screened using 4 and 5 keyword searches, respectively. SMAPs were included if they were able to store and allowed for the dispensation of medications, tracked real-time medication intake data, and could automatically analyze data. Products were excluded if they were stand-alone software applications, not marketed in English, not for in-home use, or only used in clinical trials. In total, 5 researchers independently screened and extracted the data. RESULTS This review identified 114 SMAPs, including 80 (70.2%) marketed and 34 (29.8%) prototypes, grouped into 15 types. Among the marketed products, 68% (54/80) were available for consumer purchase. Of these products, 26% (14/54) were available worldwide and 78% (42/54) were available in North America. There was variability in the hardware, software, data collection and management features, and cost of the products. Examples of hardware features include battery life, medication storage capacity, availability of types and number of alarms, locking features, and additional technology required for use of the product, whereas software features included reminder and notification capabilities and availability of manufacturer support. Data capture methods included the availability of sensors to record the use of the product and data-syncing capabilities with cloud storage with short-range communications. Data were accessible to users via mobile apps or web-based portals. Some SMAPs provided data security assurance with secure log-ins (use of personal identification numbers or facial recognition), whereas other SMAPs provided data through registered email addresses. Although some SMAPs were available at set prices or free of cost to end users, the cost of other products varied based on availability, shipping fees, and subscription fees. CONCLUSIONS An expanding market for SMAPs with features specific to at-home patient use is emerging. Health care professionals can use these features to select and suggest products that meet their patients' unique requirements.
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Affiliation(s)
- Sadaf Faisal
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Devine Samoth
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Yusra Aslam
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Hawa Patel
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - SooMin Park
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Bincy Baby
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
- Schlegel - University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
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Covid-19 Recovery and Growth: Promoting Technology Innovation in Healthcare Sector on Hygiene and Safe Medication Practices in Low-Resourced Nigerian Societies. SCIENTIFIC AFRICAN 2023; 19:e01542. [PMID: 36624773 PMCID: PMC9812470 DOI: 10.1016/j.sciaf.2023.e01542] [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: 10/03/2022] [Revised: 12/14/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Introduction Globally, the healthcare sector is primarily designated to provide timely, efficient and effective medical services. In African countries like Nigeria, the inequality in the healthcare sector is worsened by the limited coverage of healthcare delivery. This has evolved to an unprecedented effect on the provision of healthcare services in low-resource societies. In the post COVID-19 era, recovery and growth from the pandemic become more demanding with an emphasis on promoting innovative technology in the healthcare sector on hygiene and safe medication practices. Method Data was sourced from mixed research method. Questionnaires, focus group discussions, and in-depth interviews were used to deduce data from 142 healthcare providers, users, and social workers. Participants were randomly selected from three healthcare institutions in Nsukka, Enugu state. Result Findings revealed that although greater positive perception (66.7%) holds on promoting innovative technology in the healthcare sector; concerns on negative perceptions (33.3%) were; the choice of medication, cultural health behavior and non-adherence to health guidelines. Major factors militating against innovative technology in healthcare sector were corruption in healthcare system, patients' economic level and poor healthcare delivery. Findings depict that age (χ²cal= 84.0, p=0.000<0.05) and income (χ²cal= 53.7, p=0.000<0.05) of patients were found to be significant in the utilization of innovative technology in healthcare. Evidence-based interventions on innovative healthcare systems on hygiene and safe medication practices were; intensive community health education at the grass-root, implementation of health policies, and tutors' improved healthcare knowledge. Participants showed little knowledge of social workers' engagement in health institutions. Conclusion Equity in healthcare is a core concern in Sustainable Development Goals. Achieving equal distribution of health services between urban and rural societies in recovery from covid-19 pandemic and growth of the healthcare sector is pegged on promoting innovative technology in hygiene and safe medication practices. The study recommends that social workers' engagement with health providers and users in low-resourced societies could help propagate awareness and self-care management of health challenges through digital information technology in Nigeria.
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Dhamanti I, Nia IM, Nagappan K, Srikaanth BP. Smart home healthcare for chronic disease management: A scoping review. Digit Health 2023; 9:20552076231218144. [PMID: 38074339 PMCID: PMC10702417 DOI: 10.1177/20552076231218144] [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: 03/11/2023] [Accepted: 11/11/2023] [Indexed: 02/27/2024] Open
Abstract
Objective Chronic disease is the leading cause of morbidity and mortality on a global scale. Recent use of intelligent home environments for remote health monitoring has allowed patients to feel safe at home. By encouraging patient engagement and, if necessary, care delivery, smart home environments may be a useful method for managing chronic diseases at home. The purpose of this study is to synthesize the evidence on the usage of smart healthcare in the home for chronic illness management. Methods We conducted a scoping review using the Joanna Briggs Methodology and searched three databases from 2017 to 2022 for original research papers on smart healthcare, smart home technology, home-based technology, home monitoring, and physiological monitoring for chronic illness management. We did a descriptive study on the pertinent data we collected, as well as an analysis of whether the devices met its objectives. Results The final analysis included nine papers, the majority of which were randomized controlled trials. All of the studies were carried out in developed countries. The gadgets or smart healthcare in these studies are categorized based on the technology used and the outcomes measured. Respiratory, weight, and ballistocardiograph measurements, as well as changes in questionnaire ratings, hospitalization, activity monitoring, device acceptability, medication adherence, exercise capacity, and body function, were all measured. Conclusion Smart healthcare applications boost health by monitoring health and wellness, recording physical activity and rehabilitation, and improving overall quality of life. Not all smart home applications, however, served their intended purpose. As a result, more research into the efficacy of smart healthcare is needed to improve its application for chronic illness treatment.
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Affiliation(s)
- Inge Dhamanti
- Department of Health Policy and Administration, Universitas Airlangga, Surabaya, Indonesia
- Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Department of Networking And Communications, College of Engineering & Technology, SRM Institute and Technology, Kattankulathur, Chennai, India
| | - Ika M Nia
- Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia
| | - Krishnaraj Nagappan
- Department of Networking And Communications, College of Engineering & Technology, SRM Institute and Technology, Kattankulathur, Chennai, India
| | - Balaji P Srikaanth
- Department of Networking And Communications, College of Engineering & Technology, SRM Institute and Technology, Kattankulathur, Chennai, India
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Wells J, Wang C, Dolgin K, Kayyali R. SPUR: A Patient-Reported Medication Adherence Model as a Predictor of Admission and Early Readmission in Patients Living with Type 2 Diabetes. Patient Prefer Adherence 2023; 17:441-455. [PMID: 36844798 PMCID: PMC9948632 DOI: 10.2147/ppa.s397424] [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: 11/21/2022] [Accepted: 01/14/2023] [Indexed: 02/20/2023] Open
Abstract
PURPOSE Poor medication adherence (MA) is linked to an increased likelihood of hospital admission. Early interventions to address MA may reduce this risk and associated health-care costs. This study aimed to evaluate a holistic Patient Reported Outcome Measure (PROM) of MA, known as SPUR, as a predictor of general admission and early readmission in patients living with Type 2 Diabetes. PATIENTS AND METHODS An observational study design was used to assess data collected over a 12-month period including 6-month retrospective and 6-month prospective monitoring of the number of admissions and early readmissions (admissions occurring within 30 days of discharge) across the cohort. Patients (n = 200) were recruited from a large South London NHS Trust. Covariates of interest included: age, ethnicity, gender, level of education, income, the number of medicines and medical conditions, and a Covid-19 diagnosis. A Poisson or negative binomial model was employed for count outcomes, with the exponentiated coefficient indicating incident ratios (IR) [95% CI]. For binary outcomes (Coefficient, [95% CI]), a logistic regression model was developed. RESULTS Higher SPUR scores (increased adherence) were significantly associated with a lower number of admissions (IR = 0.98, [0.96, 1.00]). The number of medical conditions (IR = 1.07, [1.01, 1.13]), age ≥80 years (IR = 5.18, [1.01, 26.55]), a positive Covid-19 diagnosis during follow-up (IR = 1.83, [1.11, 3.02]) and GCSE education (IR = 2.11, [1.15,3.87]) were factors associated with a greater risk of admission. When modelled as a binary variable, only the SPUR score (-0.051, [-0.094, -0.007]) was significantly predictive of an early readmission, with patients reporting higher SPUR scores being less likely to experience an early readmission. CONCLUSION Higher levels of MA, as determined by SPUR, were significantly associated with a lower risk of general admissions and early readmissions among patients living with Type 2 Diabetes.
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Affiliation(s)
- Joshua Wells
- Department of Pharmacy, Kingston University, Kingston upon Thames, KT1 2EE, UK
| | - Chao Wang
- Faculty of Health, Science, Social Care and Education, Kingston University, Kingston upon Thames, KT2 7LB, UK
| | - Kevin Dolgin
- Behavioural Science Department, Observia, Paris, 75015, France
| | - Reem Kayyali
- Department of Pharmacy, Kingston University, Kingston upon Thames, KT1 2EE, UK
- Correspondence: Reem Kayyali, Department of Pharmacy, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK, Tel/Fax +44 208 417 2561, Email
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Liu S, Ye Z. Intelligent medicine: leading the new development of human health. GLOBAL HEALTH JOURNAL 2021. [DOI: 10.1016/j.glohj.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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