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Sasseville M, LeBlanc A, Tchuente J, Boucher M, Dugas M, Gisèle M, Barony R, Chouinard MC, Beaulieu M, Beaudet N, Skidmore B, Cholette P, Aspiros C, Larouche A, Chabot G, Gagnon MP. The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis. Syst Rev 2023; 12:78. [PMID: 37143171 PMCID: PMC10157597 DOI: 10.1186/s13643-023-02241-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/20/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The majority of people with a chronic disease (e.g., diabetes, hypertension, COPD) have more than one concurrent condition and are also at higher risk for developing comorbidities in mental health, including anxiety and depression. There is an urgent need for more relevant and accurate data on digital interventions in this area to prepare for an increase demand for mental health services. The aim of this study was to conduct a meta-analysis of the digital mental health interventions for people with comorbid physical and mental chronic diseases to compare the effect of technology systems and level of support. METHODS This secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods: What types of digital health interventions (according to a recognized categorization) are the most effective for the management of concomitant mental health and chronic disease conditions in adults? We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. RESULTS Seven hundred eight primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. CONCLUSIONS While our meta-analysis identifies digital intervention's characteristics are associated with better effectiveness, all technologies and levels of support could be used considering implementation context and population. TRIAL REGISTRATION The protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).
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Affiliation(s)
- Maxime Sasseville
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada.
| | - Annie LeBlanc
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Jack Tchuente
- VITAM Research Center on Sustainable Health, Quebec City, Canada
| | | | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Quebec City, Canada
| | | | | | | | | | - Nicolas Beaudet
- Université de Sherbrooke, Omnimed, Sherbrooke, Quebec, Canada
| | - Becky Skidmore
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Pascale Cholette
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale, Quebec City, Canada
| | - Christine Aspiros
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Alain Larouche
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Guylaine Chabot
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Marie-Pierre Gagnon
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
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Sasseville M, LeBlanc A, Boucher M, Dugas M, Mbemba G, Tchuente J, Chouinard MC, Beaulieu M, Beaudet N, Skidmore B, Cholette P, Aspiros C, Larouche A, Chabot G, Gagnon MP. Digital health interventions for the management of mental health in people with chronic diseases: a rapid review. BMJ Open 2021; 11:e044437. [PMID: 33820786 PMCID: PMC8030477 DOI: 10.1136/bmjopen-2020-044437] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Determine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease. DESIGN We conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively. INTERVENTIONS We included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after. MAIN OUTCOME MEASURE Reports on mental health outcomes (eg, anxiety symptoms and depression symptoms). RESULTS We included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive-behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement. CONCLUSIONS Digital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used.
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Affiliation(s)
- Maxime Sasseville
- Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
- Family medicine and emergency medicine, Université Laval, Quebec, Québec, Canada
| | - Mylène Boucher
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Gisele Mbemba
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Jack Tchuente
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | | | - Marianne Beaulieu
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Nicolas Beaudet
- Omnimed, Québec, Québec, Canada
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Becky Skidmore
- Independent information specialist, Ottawa, Ontario, Canada
| | - Pascale Cholette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec, Quebec, Canada
| | | | | | | | - Marie-Pierre Gagnon
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
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Bagayoko CO, Tchuente J, Traoré D, Moukoumbi Lipenguet G, Ondzigue Mbenga R, Koumamba AP, Ondjani MC, Ndjeli OL, Gagnon MP. Implementation of a national electronic health information system in Gabon: a survey of healthcare providers' perceptions. BMC Med Inform Decis Mak 2020; 20:202. [PMID: 32831082 PMCID: PMC7444076 DOI: 10.1186/s12911-020-01213-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/10/2019] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Health Information System (HIS) is a set of computerized tools for the collection, storage, management, and transmission of health data. The role of such tools in supporting the modernization of health systems, improving access to quality healthcare, and reducing costs in developing countries is unquestionable, but their implementation faces several challenges. In Gabon, a unique national electronic HIS has been launched. It will connect healthcare institutions and providers at all levels in the whole country. OBJECTIVE This study aims to explore and identify the factors influencing healthcare providers' perceptions of the national electronic HIS in Gabon. METHODS A 44-item questionnaire based on the Information System Success Model (ISSM) was administered between February and April 2018 among 2600 healthcare providers across the country. The questions assessed the different aspects of the HIS that could influence its perceived impact on a 5-level Likert scale (from fully agree to totally disagree). The reliability and construct validity of the questionnaire were checked using Cronbach alpha and congeneric reliability coefficients. A logistic regression was used to identify the factors influencing healthcare providers' perceptions of the system. RESULTS A total of 2327 questionnaires were completed (i.e. 89.5% response rate). The logistic regression identified five elements that significantly influenced perceived system impact: System Quality (Odds Ratio-OR = 1.70), Information Quality (OR = 1.69), Actual Use (OR = 1.41), Support Quality (OR = 1.37), and Useful Functions (OR = 1.14). The model explained 30% of the variance in providers' perception that the national HIS leads to positive impacts. DISCUSSION The results show that healthcare providers' perceptions regarding the positive impact of the national HIS in Gabon are influenced by their previous use of an HIS, the scope of their usage, and the quality of the system, information, and support provided to users. These results could inform the development of strategies to ensure adequate change of management and user experience for the implementation of the national HIS in Gabon, and eventually in other low resource environments.
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Affiliation(s)
- Cheick Oumar Bagayoko
- Centre d'Innovation et de Santé Digitale, DigiSanté-Mali, USTTB, Bamako, Mali. .,Centre d'Expertise et de Recherche en Télémédecine et E-Santé, CERTES, Bamako, Mali.
| | - Jack Tchuente
- Research Center in Primary Care and Social Services, Quebec, Canada
| | - Diakaridia Traoré
- Centre d'Expertise et de Recherche en Télémédecine et E-Santé, CERTES, Bamako, Mali
| | - Gaetan Moukoumbi Lipenguet
- Université de Bordeaux, Bordeaux, France.,Ministère en charge de la santé, Projet eGabon-SIS, Libreville, Gabon
| | - Raymond Ondzigue Mbenga
- Ministère en charge de la santé, Projet eGabon-SIS, Libreville, Gabon.,Université de Tours, Tours, France
| | - Aimé Patrice Koumamba
- Université de Bordeaux, Bordeaux, France.,Ministère en charge de la santé, Projet eGabon-SIS, Libreville, Gabon
| | | | - Olive Lea Ndjeli
- Ministère en charge de la santé, Projet eGabon-SIS, Libreville, Gabon
| | - Marie-Pierre Gagnon
- Research Center in Primary Care and Social Services, Quebec, Canada.,Faculty of Nursing Sciences, Université Laval, Quebec, Canada
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Gagnon MP, Ndiaye MA, Larouche A, Chabot G, Chabot C, Buyl R, Fortin JP, Giguère A, Leblanc A, Légaré F, Motulsky A, Sicotte C, Witteman HO, Kavanagh É, Lépinay F, Roberge J, Hakim H, Brunet-Gauthier M, Délétroz C, Rahimi SA, Tchuente J, Sasseville M. User-Centered Design for Promoting Patient Engagement in Chronic Diseases Management: The Development of CONCERTO. Stud Health Technol Inform 2020; 270:1423-1424. [PMID: 32570690 DOI: 10.3233/shti200473] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Multimorbidity increases care needs among people with chronic diseases. In order to support communication between patients, their informal caregivers and their healthcare teams, we developed CONCERTO+, a patient portal for chronic disease management in primary care. A user-centered design comprising 3 iterations with patients and informal caregivers was performed. Clinicians were also invited to provide feedback on the feasibility of the solution. Several improvements were brought to CONCERTO+, and it is now ready to be implemented in real-life setting.
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Affiliation(s)
- Marie-Pierre Gagnon
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Faculty of Nursing, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | | | | | | | - Ronald Buyl
- Department of Public Health, Vrije Universiteit Brussel, Jette, Belgium
| | - Jean-Paul Fortin
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | - Anik Giguère
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Annie Leblanc
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - France Légaré
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Aude Motulsky
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Claude Sicotte
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Holly O Witteman
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | | | | | | | - Hina Hakim
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | | | - Carole Délétroz
- School of Health Sciences (HESAV), HES-SO, Lausanne, Switzerland
| | - Samira A Rahimi
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada
| | - Jack Tchuente
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | - Maxime Sasseville
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada
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