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García-Lorenzo B, Gorostiza A, González N, Larrañaga I, Mateo-Abad M, Ortega-Gil A, Bloemeke J, Groene O, Vergara I, Mar J, Lim Choi Keung SN, Arvanitis TN, Kaye R, Dahary Halevy E, Nahir B, Arndt F, Dichmann Sorknæs A, Juul NK, Lilja M, Sherman MH, Laleci Erturkmen GB, Yuksel M, Robbins T, Kyrou I, Randeva H, Maguire R, McCann L, Miller M, Moore M, Connaghan J, Fullaondo A, Verdoy D, de Manuel Keenoy E. Assessment of the Effectiveness, Socio-Economic Impact and Implementation of a Digital Solution for Patients with Advanced Chronic Diseases: The ADLIFE Study Protocol. Int J Environ Res Public Health 2023; 20:3152. [PMID: 36833849 PMCID: PMC9966680 DOI: 10.3390/ijerph20043152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Due to population ageing and medical advances, people with advanced chronic diseases (ACD) live longer. Such patients are even more likely to face either temporary or permanent reduced functional reserve, which typically further increases their healthcare resource use and the burden of care on their caregiver(s). Accordingly, these patients and their caregiver(s) may benefit from integrated supportive care provided via digitally supported interventions. This approach may either maintain or improve their quality of life, increase their independence, and optimize the healthcare resource use from early stages. ADLIFE is an EU-funded project, aiming to improve the quality of life of older people with ACD by providing integrated personalized care via a digitally enabled toolbox. Indeed, the ADLIFE toolbox is a digital solution which provides patients, caregivers, and health professionals with digitally enabled, integrated, and personalized care, supporting clinical decisions, and encouraging independence and self-management. Here we present the protocol of the ADLIFE study, which is designed to provide robust scientific evidence on the assessment of the effectiveness, socio-economic, implementation, and technology acceptance aspects of the ADLIFE intervention compared to the current standard of care (SoC) when applied in real-life settings of seven different pilot sites across six countries. A quasi-experimental trial following a multicenter, non-randomized, non-concurrent, unblinded, and controlled design will be implemented. Patients in the intervention group will receive the ADLIFE intervention, while patients in the control group will receive SoC. The assessment of the ADLIFE intervention will be conducted using a mixed-methods approach.
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Affiliation(s)
- Borja García-Lorenzo
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | - Ania Gorostiza
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | - Nerea González
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
- Osakidetza Basque Health Service, Barrualde-Galdakao, Integrated Health Organisation, 48960 Galdakao, Spain
| | - Igor Larrañaga
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | - Maider Mateo-Abad
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
- Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014 Donostia, Basque Country, Spain
| | - Ana Ortega-Gil
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | | | - Oliver Groene
- OptiMedis, Burchardstrasse 17, 20095 Hamburg, Germany
| | - Itziar Vergara
- Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014 Donostia, Basque Country, Spain
| | - Javier Mar
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
- Unidad de Investigación AP-OSIs, Hospital Alto Deba, 20500 Arrasate-Mondragón, Gipuzkoa, Spain
- Instituto de Investigación Sanitaria Biodonostia, 20014 San Sebastián, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 48960 Galdakao, Spain
- Unidad de Gestión Sanitaria, Hospital Alto Deba, 20500 Arrasate-Mondragón, Gipuzkoa, Spain
| | - Sarah N. Lim Choi Keung
- School of Engineering, University of Birmingham, Birmingham B15 2TT, UK
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry CV4 7AL, UK
| | - Theodoros N. Arvanitis
- School of Engineering, University of Birmingham, Birmingham B15 2TT, UK
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry CV4 7AL, UK
- Digital & Data Driven Research Unit, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Rachelle Kaye
- Assuta Medical Centre Ashdod, Ashdod 7747629, Israel
| | | | - Baraka Nahir
- Assuta Medical Centre Ashdod, Ashdod 7747629, Israel
- Maccabi Healthcare Services Southern Region, Omer 8496500, Israel
| | - Fritz Arndt
- Gesunder Werra-Meißner-Kreis GmbH, 37269 Eschwege, Germany
| | - Anne Dichmann Sorknæs
- Internal Medical & Emergency Department M/FAM, OUH, Svendvorg Hospital, Baagøes Allé 15, Indgang 51, 5700 Svendborg, Denmark
| | - Natassia Kamilla Juul
- Internal Medical & Emergency Department M/FAM, OUH, Svendvorg Hospital, Baagøes Allé 15, Indgang 51, 5700 Svendborg, Denmark
| | - Mikael Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education and Development Östersund, Umeå University, 901 87 Umeå, Sweden
| | - Marie Holm Sherman
- R&D Project Office, Region Jämtland Härjedalen, 831 30 Östersund, Sweden
| | | | - Mustafa Yuksel
- SRDC, ODTU Teknokent Silikon Blok Kat: 1 No: 16 Cankaya, Ankara 06800, Turkey
| | - Tim Robbins
- Digital & Data Driven Research Unit, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Digital & Data Driven Research Unit, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Harpal Randeva
- Digital & Data Driven Research Unit, University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Roma Maguire
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Lisa McCann
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Morven Miller
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Margaret Moore
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK
| | - John Connaghan
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | - Dolores Verdoy
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
| | - Esteban de Manuel Keenoy
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1, Torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country, Spain
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Moll C, Arndt F, Arvanitis TN, Gonzàlez N, Groene O, Ortega-Gil A, Verdoy D, Bloemeke J. "It depends on the people!" - A qualitative analysis of contextual factors, prior to the implementation of digital health innovations for chronic condition management, in a German integrated care network. Digit Health 2023; 9:20552076231222100. [PMID: 38162835 PMCID: PMC10756073 DOI: 10.1177/20552076231222100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024] Open
Abstract
Objective Integrated care and digital health technology interventions are promising approaches to coordinate services for people living with chronic conditions, across different care settings and providers. The EU-funded ADLIFE project intends to provide digitally integrated personalized care to improve and maintain patients' health with advanced chronic conditions. This study conducted a qualitative assessment of contextual factors prior to the implementation of the ADLIFE digital health platforms at the German pilot site. The results of the assessment are then used to derive recommendations for action for the subsequent implementation, and for evaluation of the other pilot sites. Methods Qualitative interviews with healthcare professionals and IT experts were conducted at the German pilot site. The interviews followed a semi-structured interview guideline, based on the HOT-fit framework, focusing on organizational, technological, and human factors. All interviews were audio recorded, transcribed, and subsequently analysed following qualitative content analysis. Results The results of the 18 interviews show the interviewees' high openness and motivation to use new innovative digital solutions, as well as an apparent willingness of cooperation between different healthcare professionals. Challenges include limited technical infrastructure and large variability of software to record health data, lacking standards and interfaces. Conclusions Considering contextual factors on different levels is critical for the success of implementing innovations in healthcare and the transfer into other settings. In our study, the HOT-fit framework proved suitable for assessing contextual factors, when implementing IT innovations in healthcare. In a next step, the methodological approach will be transferred to the six other European pilot sites, participating in the project, for a cross-national assessment of contextual factors.
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Affiliation(s)
- Clemens Moll
- Research and Innovation, OptiMedis AG, Hamburg, Germany
| | - Fritz Arndt
- Gesunder Werra-Meißner Kreis GmbH, Eschwege, Germany
| | - Theodoros N. Arvanitis
- Institute of Digital Healthcare, University of Warwick, Coventry, UK
- School of Engineering, University of Birmingham, Birmingham, UK
| | - Nerea Gonzàlez
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Oliver Groene
- Research and Innovation, OptiMedis AG, Hamburg, Germany
- Faculty of Management and Economics, University of Witten/Herdecke, Witten, Germany
| | - Ana Ortega-Gil
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Dolores Verdoy
- Kronikgune Institute for Health Service Research, Basque Country, Spain
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Ortega-Gil A, Muñoz-Barrutia A, Roca JJ, Guijarro-López L, Vaquero JJ. A radiological score for the assessment of tuberculosis progression: Validation in mouse models. Tuberculosis (Edinb) 2020; 121:101918. [PMID: 32279874 DOI: 10.1016/j.tube.2020.101918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/05/2020] [Accepted: 02/29/2020] [Indexed: 11/30/2022]
Abstract
The sensitivity of in vivo low-dose high-resolution micro-computed tomography imaging enables monitoring the lung damage caused by tuberculosis. Here, we propose a radiological score integrated in the experimental workflow that enables longitudinal monitoring for prospective efficacy studies in drug development programs. The score is based on an automatic measurement of total unaffected lung volume in vivo normalized for inter-subject comparison. It was validated on well-characterized progression of chronic tuberculosis in Erdman and H37Rv strains in C3HeB/FeJ-based models. We demonstrated that a decrease in the score value indicates increasing adverse effects and vice versa. The colony-forming units count confirmed the variability in the host response suggested by the score values. The correlation between changes in the mice's weight and the score is consistent with disease progression. The classification of disease extent by k-means clustering of the score values provided the definition of the lung damage severity according to the bacillus strain. The proposed score will reduce sources of bias and improve the statistical robustness of studies by the attrition of non-infected subjects or subjects with a weak immune response. Readily available quantifications allow for a fast assessment of the therapeutic potential in drug-resistant tuberculosis strains.
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Affiliation(s)
- Ana Ortega-Gil
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Diseases of the Developing World, Infectious Diseases-Centre for Excellence in Drug Discovery (ID CEDD), GlaxoSmithKline, Madrid, Spain
| | - Arrate Muñoz-Barrutia
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
| | - Jose Juan Roca
- Diseases of the Developing World, Infectious Diseases-Centre for Excellence in Drug Discovery (ID CEDD), GlaxoSmithKline, Madrid, Spain
| | - Laura Guijarro-López
- Diseases of the Developing World, Infectious Diseases-Centre for Excellence in Drug Discovery (ID CEDD), GlaxoSmithKline, Madrid, Spain
| | - Juan José Vaquero
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
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