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Abdelraheem O, Salama M, Chun S. Impact of digital interventions and online health communities in patient activation: Systematic review and meta-analysis. Int J Med Inform 2024; 188:105481. [PMID: 38776718 DOI: 10.1016/j.ijmedinf.2024.105481] [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: 03/14/2024] [Revised: 05/04/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Study the efficacy of digital health interventions in enhancing patient activation and identify the distinct features of these interventions using the WHO classification system. METHODS Asystematic reviewand meta-analysis were carried out according to the PRISMA guidelines. A search was conducted in Scopus, PubMed, and ProQuest. Randomized controlled trials (RCT), quasi-randomized controlled trials, and before-and-after studies enrolling patients ≥ 18 years of age with the Patient Activation Measure (PAM) score measurement and contain digital intervention with any aspects of health education or health-related behavior were included. The Downs and Black quality assessment tool was used to assess the quality of the articles. RESULTS In the three different types of meta-analyses, implementing the intervention led to a PAM score increase (Mean Difference (M.D.)), ranging from a minimum of (MD = 0.2014, 95 % CI = 0.0871-0.3158) and a highly significant p-value 0.0006 to a maximum of (MD = 2.7882, 95 % CI = 1.5558-4.0206) and a p-value < .0001. While the M.D. score of 0.2014 may seem relatively low, it is enough to elevate the patient from one activation level to a higher one out of the four activation levels. CONCLUSION AND PRACTICE IMPLICATIONS The results suggest the effectiveness of digital health interventions on patient activation across diverse settings and contexts, implying potential generalizability. Using WHO classification, all examined digital interventions addressed the challenges of information, utilization, and efficiency in the health system, but not equity-related challenges. The study recognized online health communities (OHCs) as a subset of digital interventions that enhance patient activation through social support.
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Affiliation(s)
- Omnia Abdelraheem
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt
| | - Sungsoo Chun
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt.
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Welter S, Keinki C, Ahmadi E, Huebner J. Lay Etiology, Self-Efficacy and Patient Activation Among Cancer Patients. Cancer Invest 2021; 39:219-228. [PMID: 33475001 DOI: 10.1080/07357907.2021.1878528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND We aimed at clarifying correlations between lay etiologies, self-efficacy, and patient activation among cancer patients. METHODS Patients with different kinds of cancer answered a questionnaire on self-efficacy, lay etiology, and patient activation. RESULTS 639 patients participated. Psychological reasons/stress (43.3%) and destiny (41.6%) were the most cited causes. Lay etiology was influenced by demographics, self-efficacy, and patient activation. Men, younger people, and active patients more often described internal causes of cancer, women and religious patients more often external causes. Patients with higher scores of self-efficacy were more often convinced of external cancer causes. CONCLUSION By identifying individual disease theories, physicians may improve patient-physician communication.
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Affiliation(s)
- Saskia Welter
- Abteilung Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Keinki
- Abteilung Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Emadaldin Ahmadi
- Abteilung Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Huebner
- Abteilung Hämatologie und Internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
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Yadav UN, Lloyd J, Hosseinzadeh H, Baral KP, Bhatta N, Harris MF. Levels and determinants of health literacy and patient activation among multi-morbid COPD people in rural Nepal: Findings from a cross-sectional study. PLoS One 2020; 15:e0233488. [PMID: 32469917 PMCID: PMC7259703 DOI: 10.1371/journal.pone.0233488] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 05/06/2020] [Indexed: 01/07/2023] Open
Abstract
Background Health literacy (HL) and patient activation (PA) are necessary foundations to engage patients in self-management intervention. Each concept plays a unique role in improving access to the effective self-management of chronic disease. In this cross-sectional study, we examined the levels and determinants of HL and PA among the multi-morbid COPD patients in Nepal. Methods We conducted interviews with a simple random sample of 238 multi-morbid COPD people from July 2018 to January 2019. The questionnaire included sociodemographic profiles, five domains of the Health Literacy Questionnaire (HLQ), 13-item Patient Activation Measure (PAM) and patient’s illness perception by Brief Illness Perception Questionnaire (BIPQ). Multivariable logistic regression was used to examine the associations. Results Most people with COPD had low health levels across each of the five domains of the HLQ. The proportion of people with low literacy level across each of the domains was: (i) feeling understood and supported by healthcare providers (79.0%), (ii) having sufficient information to manage my own health (76.5%), (iii) social support for health (77.3%), (iv) ability to find the good health information (75.2%), and (v) understand the health information well enough to know what to do (74.8%), respectively. The majority of patients also reported low levels of patient activation (level 1: 81.5%; level 2: 11.8%), with only 6.7% (level 3: 5%; level 4: 1.7%) reported higher patient activation level. We found significant associations between poor HL levels in the HLQ domains and having no education, being female or from Indigenous and Dalits communities, and having a monthly family income of less than USD176. Having no education and poor illness perception were significantly associated with poor activation level on PAM scale. Conclusion A high proportion of multi-morbid COPD peoples had low levels of HL and were less activated than what would be required to self-manage COPD. These were in turn associated with socioeconomic factors and poor illness perception. The findings from this study are being used to design a COPD self—management program tailored to the low health literate population.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- Forum for Health Research and Development, Dharan, Nepal
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
- * E-mail: ,
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
| | | | - Kedar Prasad Baral
- School of Public Health, Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Narendra Bhatta
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Mark Fort Harris
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
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Carey SA, Tecson KM, Bass K, Felius J, Hall SA. Patient activation with respect to advanced heart failure therapy in patients over age 65 years. Heart Lung 2018; 47:285-289. [PMID: 29685331 DOI: 10.1016/j.hrtlng.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/23/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical and ethical issues persist in determining candidacy for advanced heart failure (HF) therapies in elderly patients. Selection takes many factors into account, including "activation" (engagement and ability to self-manage). OBJECTIVE To investigate effects of age, activation, and depression/anxiety on selection and 6-month survival of participants considered for therapy. METHODS Consecutive people referred for advanced HF therapy completed the Patient Activation Measure and Hospital Anxiety and Depression Scale. We analyzed data from participants by age (≥65 vs. <65 years), stratified by approval for therapy. RESULTS Among 168 referred, 109 were approved, with no difference in activation between age groups (88% highly activated). Similarly, activation was not associated with age among those not approved. Activation was related to anxiety in older, approved participants, but not to depression. CONCLUSIONS Concerns regarding reduced self-management in the elderly may not be valid. Age alone should not disqualify a candidate for advanced HF therapy.
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Affiliation(s)
- Sandra A Carey
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center, 3410 Worth Street, Suite 250, Dallas, TX 75246, USA; Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White Research Institute, 3410 Worth Street, Suite 560, Dallas, TX 75246, USA
| | - Kristen M Tecson
- Baylor Heart and Vascular Institute, Baylor Scott & White Research Institute, 621 N. Hall Street, Suite H-030, Dallas, TX 75226, USA
| | - Kyle Bass
- Soltero Cardiovascular Research Center, Baylor University Medical Center, 621 N. Hall Street, Suite 530, Dallas, TX 75226, USA.
| | - Joost Felius
- Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White Research Institute, 3410 Worth Street, Suite 560, Dallas, TX 75246, USA
| | - Shelley A Hall
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center, 3410 Worth Street, Suite 250, Dallas, TX 75246, USA; Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White Research Institute, 3410 Worth Street, Suite 560, Dallas, TX 75246, USA
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Griffiths FE, Armoiry X, Atherton H, Bryce C, Buckle A, Cave JAK, Court R, Hamilton K, Dliwayo TR, Dritsaki M, Elder P, Forjaz V, Fraser J, Goodwin R, Huxley C, Ignatowicz A, Karasouli E, Kim SW, Kimani P, Madan JJ, Matharu H, May M, Musumadi L, Paul M, Raut G, Sankaranarayanan S, Slowther AM, Sujan MA, Sutcliffe PA, Svahnstrom I, Taggart F, Uddin A, Verran A, Walker L, Sturt J. The role of digital communication in patient–clinician communication for NHS providers of specialist clinical services for young people [the Long-term conditions Young people Networked Communication (LYNC) study]: a mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundYoung people (aged 16–24 years) with long-term health conditions tend to disengage from health services, resulting in poor health outcomes. They are prolific users of digital communications. Innovative UK NHS clinicians use digital communication with these young people. The NHS plans to use digital communication with patients more widely.ObjectivesTo explore how health-care engagement can be improved using digital clinical communication (DCC); understand effects, impacts, costs and necessary safeguards; and provide critical analysis of its use, monitoring and evaluation.DesignObservational mixed-methods case studies; systematic scoping literature reviews; assessment of patient-reported outcome measures (PROMs); public and patient involvement; and consensus development through focus groups.SettingTwenty NHS specialist clinical teams from across England and Wales, providing care for 13 different long-term physical or mental health conditions.ParticipantsOne hundred and sixty-five young people aged 16–24 years living with a long-term health condition; 13 parents; 173 clinical team members; and 16 information governance specialists.InterventionsClinical teams and young people variously used mobile phone calls, text messages, e-mail and voice over internet protocol.Main outcome measuresEmpirical work – thematic and ethical analysis of qualitative data; annual direct costs; did not attend, accident and emergency attendance and hospital admission rates plus clinic-specific clinical outcomes. Scoping reviews–patient, health professional and service delivery outcomes and technical problems. PROMs: scale validity, relevance and credibility.Data sourcesObservation, interview, structured survey, routinely collected data, focus groups and peer-reviewed publications.ResultsDigital communication enables access for young people to the right clinician when it makes a difference for managing their health condition. This is valued as additional to traditional clinic appointments. This access challenges the nature and boundaries of therapeutic relationships, but can improve them, increase patient empowerment and enhance activation. Risks include increased dependence on clinicians, inadvertent disclosure of confidential information and communication failures, but clinicians and young people mitigate these risks. Workload increases and the main cost is staff time. Clinical teams had not evaluated the impact of their intervention and analysis of routinely collected data did not identify any impact. There are no currently used generic outcome measures, but the Patient Activation Measure and the Physicians’ Humanistic Behaviours Questionnaire are promising. Scoping reviews suggest DCC is acceptable to young people, but with no clear evidence of benefit except for mental health.LimitationsQualitative data were mostly from clinician enthusiasts. No interviews were achieved with young people who do not attend clinics. Clinicians struggled to estimate workload. Only eight full sets of routine data were available.ConclusionsTimely DCC is perceived as making a difference to health care and health outcomes for young people with long-term conditions, but this is not supported by evidence that measures health outcomes. Such communication is challenging and costly to provide, but valued by young people.Future workFuture development should distinguish digital communication replacing traditional clinic appointments and additional timely communication. Evaluation is needed that uses relevant generic outcomes.Study registrationTwo of the reviews in this study are registered as PROSPERO CRD42016035467 and CRD42016038792.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
| | - Xavier Armoiry
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Helen Atherton
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Carol Bryce
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Abigail Buckle
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Rachel Court
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Kathryn Hamilton
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Thandiwe R Dliwayo
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | | | - Patrick Elder
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Vera Forjaz
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Joe Fraser
- Patient and public involvement representative, London, UK
| | - Richard Goodwin
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | | | | | | | - Sung Wook Kim
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Kimani
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jason J Madan
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Harjit Matharu
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Mike May
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Moli Paul
- Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Gyanu Raut
- King’s College Hospital NHS Foundation Trust, London, UK
| | | | | | - Mark A Sujan
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | | | - Ayesha Uddin
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Alice Verran
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Leigh Walker
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
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Ngooi BX, Packer TL, Kephart G, Warner G, Koh KWL, Wong RCC, Lim SP. Validation of the Patient Activation Measure (PAM-13) among adults with cardiac conditions in Singapore. Qual Life Res 2016; 26:1071-1080. [PMID: 27645458 DOI: 10.1007/s11136-016-1412-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE The Patient Activation Measure (PAM-13) measures patients' knowledge, skill, and confidence in chronic condition self-management. The purpose of this study was to assess the validity of PAM-13 (English version) among English-speaking adults with cardiac conditions in Singapore. METHODS A cross-sectional study was conducted in a convenient sample of 270 heart clinic patients. Using the unitary concept of validity, evidence of (1) internal structure via data quality, unidimensionality, differential item functioning, and internal consistency, (2) response process through item difficulty and item fit using Rasch modeling, and (3) relationship to other variables via correlations with depression and self-efficacy were examined. RESULTS The item response was high with only one missing answer. All items had a small floor effect, but nine out of 13 items had a ceiling effect larger than 15 %. Cronbach's α was 0.86, and average inter-item correlations was 0.324. Results suggested unidimensionality; however, differences in item difficulty ranking were found. A low, negative correlation was found with depression, while a moderate, positive correlation was found with self-efficacy. CONCLUSION Evidence in all three areas of validity were mixed. Caution should be exercised when using categorical activation "level" to inform clinical decisions.
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Affiliation(s)
- Bi Xia Ngooi
- Department of Rehabilitation, National University Hospital, 5 Lower Kent Ridge Road, Main Building 1, Level 1, Singapore, 119074, Singapore. .,School of Occupational Therapy, Dalhousie University, Room 214 Forrest Building, 5869 University Ave, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Tanya L Packer
- School of Occupational Therapy, Dalhousie University, Room 214 Forrest Building, 5869 University Ave, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, Room 416, 5790 University Ave, Halifax, NS, B3H 1V7, Canada
| | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Room 214 Forrest Building, 5869 University Ave, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Karen Wei Ling Koh
- Department of Nursing, National University Hospital, 5 Lower Kent Ridge Wing, Singapore, 119074, Singapore
| | - Raymond Ching Chiew Wong
- Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Wing, Singapore, 119074, Singapore
| | - Serene Peiying Lim
- Department of Rehabilitation, National University Hospital, 5 Lower Kent Ridge Road, Main Building 1, Level 1, Singapore, 119074, Singapore
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Koley M, Saha S, Ghosh S, Nag G, Kundu M, Mondal R, Purkait R, Patra S, Ali SS. Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital. J Tradit Complement Med 2016; 6:72-7. [PMID: 26933640 PMCID: PMC4765762 DOI: 10.1016/j.jtcme.2014.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/29/2014] [Accepted: 09/09/2014] [Indexed: 11/02/2022] Open
Abstract
Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM) has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC)-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility) was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC) 0.57-0.75; positive to strong positive correlations; p < 0.0001] for all domains and the total score, strong internal consistency (Cronbach's α = 0.86 overall and 0.65-0.82 for individual subscales), and large responsiveness (1.11). The overall mean score percentage seemed to be moderate at 69.5 ± 8.8%. Gender and presence of chronic conditions did not seem to vary significantly with PACIC-20 subscale scores (p > 0.05); however, monthly household income had a significant influence (p < 0.05) on the subscales except for "delivery system or practice design." Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital.
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Affiliation(s)
- Munmun Koley
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Government of India, Gokhel Road, Arabindapally, Siliguri 734006, Darjeeling, West Bengal, India
| | - Subhranil Saha
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Government of India, Gokhel Road, Arabindapally, Siliguri 734006, Darjeeling, West Bengal, India
| | - Shubhamoy Ghosh
- Department of Pathology and Microbiology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
| | - Goutam Nag
- Department of Forensic Medicine and Toxicology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
| | - Monojit Kundu
- Private Practice, Ramrajatala, Muchipara Road, GIP Colony, Howrah 711112, West Bengal, India
| | - Ramkumar Mondal
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
| | - Rajib Purkait
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
| | - Supratim Patra
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
| | - Seikh Swaif Ali
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Drainage Canal Road, Doomurjala, Howrah 711104, West Bengal, India
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Dusek JA, Abrams DI, Roberts R, Griffin KH, Trebesch D, Dolor RJ, Wolever RQ, McKee MD, Kligler B. Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER) of the BraveNet practice-based research network: study protocol. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:53. [PMID: 26846166 PMCID: PMC4743108 DOI: 10.1186/s12906-016-1025-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/27/2016] [Indexed: 11/25/2022]
Abstract
Background Integrative medicine (IM) provides patient-centered care and addresses the full range of physical, emotional, mental, social, spiritual, and environmental influences that affect a person’s health. IM is a “whole systems” approach that employs multiple modalities as opposed to an isolated complementary therapy. Thus, studying outcomes of IM is more challenging than evaluating an isolated intervention. Practice-based research networks (PBRNs) allow for clinicians/investigators at multiple diverse sites using common methodology to pool their data, increase participant sample size and increase generalizability of results. To conduct real-world, practice-based research, the Bravewell Collaborative founded BraveNet in 2007 as the first national integrative medicine PBRN. Methods and design Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER) is a prospective, non-randomized, observational evaluation conducted at fourteen clinical sites. Participants receive a non-standardized, personalized, multimodal IM approach for various medical conditions. Using the REDCap electronic platform, an anticipated 10,000 study participants will complete patient-reported outcome measures including Patient Reported Outcomes Measurement Information System (PROMIS)-29, Perceived Stress Scale-4, and the Patient Activation Measure at baseline, 2, 4, 6, 12, 18 and 24 months. Extractions from participants’ electronic health records include IM services received, as well as ICD diagnostic codes, and CPT billing codes associated with each IM visit. Repeated-measures analyses will be performed on data to assess change from baseline through 24 months with planned subgroup analyses to include specific clinical population and specific IM intervention or combinations. Discussion As the PRIMIER registry grows, we anticipate that our results would provide an indication of the promise of PBRN research efforts in IM. Analyses will incorporate a large sample of participants and an expected 10-year observation period and will provide the ability to evaluate the effect of IM on outcomes for specific clinical populations and specific IM interventions or combinations. As such, PRIMIER will serve as a national platform for future evaluations of IM best practices. Trial registration Clinical Trials.gov NCT01754038 Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1025-0) contains supplementary material, which is available to authorized users.
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Koley M, Saha S, Arya JS, Choubey G, Ghosh S, Chattopadhyay R, Das KD, Ghosh A, Hait H, Mukherjee R, Banerjee T. Knowledge, Attitude, and Practice Related to Diabetes Mellitus Among Diabetics and Nondiabetics Visiting Homeopathic Hospitals in West Bengal, India. J Evid Based Complementary Altern Med 2015; 21:39-47. [PMID: 26156145 DOI: 10.1177/2156587215593656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/04/2015] [Indexed: 11/15/2022] Open
Abstract
High prevalence of undiagnosed cases of diabetes mellitus and poor knowledge, awareness, and practice has increased premature death, costly complications, and financial burden. A cross-sectional survey was conducted in November 2014 on 273 diabetics and 355 nondiabetics in 3 government homeopathic hospitals in West Bengal, India. A self-administered questionnaire assessing knowledge, awareness, and practice related to diabetes was used. A total of 17.5% to 29.3% of the participants were aware of the normal blood sugar level. Lack of insulin, frequent urination, hypertension, and poor wound healing were identified most frequently as the cause, symptom, association, and complications. A total of 35.5% to 46.5% said that diabetes was preventable; 14.1% to 31.9% knew that diabetes was controllable rather than curable. Consumption of planned diet, avoiding sugar, and testing blood sugar were the most frequently identified components of healthy lifestyle, diabetic diet, and diagnostic domain. Diabetics had higher knowledge and awareness than nondiabetics (P < .0001); still the latter need to be made aware and knowledgeable to curtail the ever-increasing burden of diabetes.
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Affiliation(s)
- Munmun Koley
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Siliguri, West Bengal, India
| | - Subhranil Saha
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Siliguri, West Bengal, India
| | - Jogendra Singh Arya
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Siliguri, West Bengal, India
| | - Gurudev Choubey
- Clinical Research Unit (Homeopathy), Central Council for Research in Homeopathy, Siliguri, West Bengal, India
| | - Shubhamoy Ghosh
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Rajat Chattopadhyay
- Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Kaushik Deb Das
- Midnapore Homoeopathic Medical College and Hospital, Midnapore, India
| | - Aloke Ghosh
- Midnapore Homoeopathic Medical College and Hospital, Midnapore, India
| | - Himangsu Hait
- The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
| | - Rajarshi Mukherjee
- The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
| | - Tanapa Banerjee
- Nitai Charan Chakroborty Homoeopathic Medical College and Hospital, Howrah, West Bengal, India
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Do V, Young L, Barnason S, Tran H. Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals. F1000Res 2015. [PMID: 26213616 PMCID: PMC4505779 DOI: 10.12688/f1000research.6557.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate heart failure knowledge (p=.005), low self-efficacy (p<.001) and low engagement in heart failure self-management behaviors (p<.001) after discharge from hospital.
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Affiliation(s)
- Van Do
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Lufei Young
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Sue Barnason
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Hoang Tran
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
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Saha S, Koley M, Arya JS, Choubey G, Upadhyaya S, Rasaily BN, Datta S, Roy A, Mukherjee S, Mundle M. Patient preference for integrating homeopathy (PPIH) and attitude and satisfaction following integration within mainstream healthcare settings in West Bengal, India: the part 2 (PPIH-2) study. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/fct.12177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Subhranil Saha
- Clinical Research Unit (Homeopathy), Siliguri; Under Central Council for Research in Homeopathy; Gokhel Road Arabindapally Siliguri 734006 India
| | - Munmun Koley
- Clinical Research Unit (Homeopathy), Siliguri; Under Central Council for Research in Homeopathy; Gokhel Road Arabindapally Siliguri 734006 India
| | - Jogendra S Arya
- Clinical Research Unit (Homeopathy), Siliguri; Under Central Council for Research in Homeopathy; Gokhel Road Arabindapally Siliguri 734006 India
| | - Gurudev Choubey
- Clinical Research Unit (Homeopathy), Siliguri; Under Central Council for Research in Homeopathy; Gokhel Road Arabindapally Siliguri 734006 India
| | - Shailaja Upadhyaya
- Sonapur Primary Health Center; Dalua Block Primary Health Center; Uttar Dinajpur West Bengal India
| | | | - Somnath Datta
- Debidanga Health Subcenter; Debidanga Champasari Darjeeling West Bengal India
| | - Aparna Roy
- Homeopathy Specialty Clinic; Balurghat District Hospital; Beltala Park Dakshin Dinajpur West Bengal India
| | - Sudeshna Mukherjee
- Birpara State Homeopathic Dispensary; Madhya Rangali Bazna Primary Health Center; Madaria Block Alipurduar West Bengal India
| | - Malay Mundle
- Swasthya Bhawan; Salt Lake City Kolkata West Bengal India
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