A systematic review of mHealth funded R&D activities in EU: Trends, technologies and obstacles

Inconsistent Benefits From Mobile Information Communication Technology in Adults With Peripheral Arterial Disease

INTRODUCTION

Quality of evidence regarding telemedicine in adults with peripheral arterial disease has not been systematically appraised.

OBJECTIVES

To explore benefits and harms from mobile information communication technology devices and applications in peripheral arterial disease.

METHODS

Systematic rapid evidence review and appraisal with the grading of recommendations assessment, development, and evaluation working group approach.

RESULTS

Sixteen randomized controlled clinical trials (RCT) examined various self-monitoring devices, telemedicine platforms, and individualized telephone counseling. Low-quality evidence suggested that the odds of treatment failure (pooled Peto odds ratio 0.8; 95% CI, 0.4-1.7; 5 RCTs), adverse effects (pooled Peto odds ratio 0.9; 95% CI, 0.5-1.5; 2 RCTs), and physical performance (standardized mean difference in 6-minute walking test 0.2; 95% CI, -0.3-0.7; 4 RCTs) did not differ between mobile interventions and usual care. Single RCTs suggested large but inconsistent improvement in the quality of life: EuroQol5D standardized mean difference = 5.0 (95% CI, 4.4-5.7; 1 RCT) after telehealth program for promoting patient self-management and standardized mean difference = 1.4 (95% CI, 0.4-2.3; 1 RCT) after structured rehabilitation with mobile self-monitoring. Inconsistent reporting of patient-centered outcomes and small sample sizes hampered the quality of evidence.

CONCLUSIONS

Improved quality of life after specific mobile applications should be confirmed in powered RCTs and large postmarketing studies.

Pain Management Mobile Applications: A Systematic Review of Commercial and Research Efforts

Shared decision making is crucial in the pain domain. The subjective nature of pain demands solutions that can facilitate pain assessment and management. The aim of the current study is to review the current trends in both the commercial and the research domains in order to reveal the key issues and guidelines that could further help in the effective development of pain-focused apps. We searched for scientific publications and commercial apps in 22 databases and the two major app stores. Out of 3612 articles and 336 apps, 69 met the requirements for inclusion following the PRISMA guidelines. An analysis of their features (technological approach, design methodology, evaluation strategy, and others) identified critical points that have to be taken into consideration in future efforts. For example, commercial and research efforts target different types of pain, while no participatory design is followed in the majority of the cases examined. Moreover, the evaluation of the final apps remains a challenge that hinders their success. The examined domain is expected to experience a substantial increase. More research is needed towards the development of non-intrusive wearables and sensors for pain detection and assessment, along with artificial intelligence techniques and open data.

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

BACKGROUND

Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products.

OBJECTIVE

In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals.

METHODS

A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis.

RESULTS

We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure.

CONCLUSIONS

The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system's readiness for digital therapeutics.

Digital Health Innovations in the Battle against COVID-19: A Global Perspective

The COVID-19 pandemic has unleashed unprecedented challenges upon the global population, demanding rapid and innovative solutions [...].

mHealth in Sub-Saharan Africa and Europe: Context of current health, healthcare status, and demographic structure

Introduction

The advent of digital systems and global mobile phone availability presents an opportunity for better healthcare access and equity. However, the disparity in the usage and availability of mHealth systems between Europe and Sub-Saharan Africa (SSA) has not been explored in relation to current health, healthcare status, and demographics.

Objective

This study aimed to compare mHealth system availability and use in SSA and Europe in the above-mentioned context.

Methods

The study analyzed health, healthcare status, and demographics in both regions. It assessed mortality, disease burden, and universal health coverage. A systematic narrative review was conducted to thoroughly assess available data on mHealth availability and use, guiding future research in the field.

Results

SSA is on the verge of stages 2 and 3 in the demographic transition with a youthful population and high birth rate. Communicable, maternal, neonatal, and nutritional diseases contribute to high mortality and disease burden, including child mortality. Europe is on the verge of stages 4 and 5 in the demographic transition with low birth and death rates. Europe's population is old, and non-communicable diseases (NCDs) pose major health challenges. The mHealth literature adequately covers cardiovascular disease/heart failure, and cancer. However, it lacks approaches for respiratory/enteric infections, malaria, and NCDs.

Conclusions

mHealth systems in SSA are underutilized than in Europe, despite alignment with the region's demographics and major health issues. Most initiatives in SSA lack implementation depth, with only pilot tests or small-scale implementations. Europe's reported cases highlight actual implementation and acceptability, indicating a strong implementation depth of mHealth systems.

The effects of extrinsic reward that affect a user's continuous intention to use a fitness application

Fitness application service providers are offering rewards, such as points to users as incentives for service use. However, it is questionable whether this reward offering is an effective measure for persuading consumers to use fitness applications continuously. This study examines how reward affects continued use of fitness applications. An online survey was conducted on 268 people who actually used the fitness application. Respondents were divided into two groups at random, an extrinsic reward group and a non-extrinsic reward group, to check the effects of the rewards. Structural equation modeling was used for data analysis. Factors influencing a user's continuous intention to use fitness applications will vary depending on whether rewards are provided. For the extrinsic reward group, perceived enjoyment and perceived privacy protection were significant variables to continue use of a fitness application. However, for the non-extrinsic reward group, monetary value was a significant variable. For continuous use of a fitness application, if rewards are provided, it is necessary to emphasize intrinsic factors such as fun rather than extrinsic factors such as savings and cost. On the other hand, without rewards, it is necessary to highlight extrinsic factors rather than intrinsic factors.

A Systematic Review of EU-Funded Innovative Agri-Food Projects: Potential for Transfer between Territories

This article presents a systematic review of innovative projects funded by EU Rural Development Programs that were designed and implemented in rural areas of the European Union to facilitate the territorialized production of foodstuffs and their sale through alternative networks. On the basis of the results obtained in this review, we designed a model for the transfer of knowledge to the local community in the Alpujarra Granadina (Granada, Spain) within the framework of the LifeWatch project. This study uses two consecutive methodological approaches. We began by developing a protocol for the systematic search and analysis of successful rural development projects carried out in the European Union between 2007 and 2020. After that, we created a model for the transfer of results using a participative methodological approach. The results of our analysis of the group of projects selected for review show that the main innovations were made in different aspects of the product, process, sales and distribution. These innovative ideas were implemented by rural communities with a high degree of collective initiative and intelligence and could potentially be replicated in other areas. The sample analyzed contains a wide array of novel, alternative formulas, which are transversal to the projects, so provide significant contents that could be used to activate a space for participation and debate, which could itself become fertile ground for the creation of new projects. In conclusion, this study provides the stakeholders in rural areas, in particular farmers, with a wide, systematically organized knowledge base that proposes solutions to shared challenges.

User-Centric Design Methodology for mHealth Apps. The PainApp Paradigm for Chronic Pain

The paper presents a user-centric methodology in order to design successful mobile health (mHealth) applications. In addition to the theoretical background, such an example is presented with an application targeting chronic pain. The pain domain was decided due to its significance in many aspects: its complexity, dispersion in the population, the financial burden it causes, etc. The paper presents a step-by-step plan in order to build mobile health applications. Participatory design and interdisciplinarity are only some of the critical issues towards the desired result. In the given example (development of the PainApp), a participatory design was followed with a team of seventeen stakeholders that drove the design and development phases. Three physicians, one behavioral scientist, three IT and UX experts, and ten patients collaborated together to develop the final solution. The several features implemented in the PainApp solution are presented in details. The application is threefold: it supports the management, reporting, and treatment effectiveness monitoring. The paper is giving details on the methodological approach while presenting insights on the actual plan and the steps followed for having a patient-centric solution. Key success factors and barriers to mobile health applications that support the need for such an approach are also presented.

What Factors Affect a User’s Intention to Use Fitness Applications? The Moderating Effect of Health Status: A Cross-Sectional Study

Objective

Fitness applications are becoming a tool for users who want to exercise and diet. This study examines what factors affect users’ intention to use fitness applications and how they depend on users’ health status.

Methods

An online survey was conducted on 428 potential fitness application users from South Korea. For this study, the extended unified theory of acceptance and use of technology (UTAUT2) was applied, and structural equation models were used for the data analysis.

Results

The results showed that for potential fitness application users, performance expectancy, effort expectancy, hedonic motivation, and perceived privacy protection were significant variables; however, social influence was insignificant. Factors influencing users’ intention to use fitness applications will vary depending on health status.

Conclusion

This study provides the following implications for health researchers, fitness application designers, and marketers. When trying to use fitness application, values such as performance expectancy, effort expectancy, hedonic motivation, and perceived privacy protection should be emphasized. In particular, for users with chronic diseases, the performance expectancy of fitness apps is more critical than any other factor.

Enhancing smart healthcare in dentistry: an approach to managing patients' stress

This paper presents a model of a smart healthcare service for stress management in dental patients during the interventions. The main goal is to provide dental clinics with a model that enables introducing a stress management service into everyday practice and provides patients with a better experience in a typically stressful situation. The approach is based on employing wearable sensors for monitoring physiological parameters, and a mobile application for progressive muscle relaxation therapy. Dental patients were divided into experimental and control groups. Participants from the experimental group were treated with progressive muscle relaxation through mobile health application with audio content, and patients from the control group were not exposed to any relaxation method. Heart rate was measured in both groups through three test phases: pre-intervention, intervention, and post-intervention. Evaluation of the anxiety level was performed using the STAI test. Results show that the measured heart rate in the post-intervention phase is lower than in the intervention phase in both testing groups, as well as in the pre-intervention phase. STAI scores were significantly higher in the control group through all test phases. The research found that the proposed system applied to dentist patients may relieve their anxiety symptoms and decrease stress level, which improves the patients' experience and leads to higher patients' satisfaction.

Implications of telehealth and digital care solutions during COVID-19 pandemic: a qualitative literature review

The coronavirus disease 2019 (COVID-19) pandemic has brought changes to the way medical care is delivered to keep health workers safe while simultaneously managing available resources. The well-being of patients and healthcare workers is crucial and has become a topic of debate as the world faces adjusts to the COVID-19 pandemic. Therefore, there is need to consider innovative methods of delivering medical care. Telehealth and digital health care which is the provision of medical care via Information Communication Technology (ICT) with highspeed telecommunications systems, has increasingly becoming popular in providing medical care services can be adopted to reduce infections during quarantine and social distancing practices. Specifically, by means of document and literature review this paper discusses the role of telehealth and digital care solutions, types and application of telehealth, and current policies for COVID-19. More importantly, findings from the article present the human, infrastructure, and institutional determinants that influence the adoption of telehealth and digital care solutions during the pandemic. The findings discuss how telehealth and digital care technologies can benefit the society. This study provides implications to informs medical staffs on the potential of digital technologies to provide support during and after the pandemic.