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Ruissen MM, Steyerberg EW, Huisman SD, de Graaf AA, de Koning EJP, Delgado-Lista J, Sont JK. Critical comments regarding the assessment of quality of life and the clinical impact of the POWER2DM intervention. Reply to Pouwer F, Deschênes SS [letter]. Diabetologia 2024; 67:956-957. [PMID: 38427075 DOI: 10.1007/s00125-024-06119-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Merel M Ruissen
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Sasja D Huisman
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert A de Graaf
- Netherlands Organization for Applied Scientific Research (TNO), Utrecht, the Netherlands
| | - Eelco J P de Koning
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain
| | - Jacob K Sont
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
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2
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Baillot A, Asselin M, Bernard P, Lapointe J, Bond DS, Romain AJ, Garneau PY, Biertho L, Tchernof A, Blackburn P, Langlois MF, Brunet J. Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity Before Bariatric Surgery: A Single-Case Experimental Study (Part I). Obes Surg 2024; 34:1639-1652. [PMID: 38483742 DOI: 10.1007/s11695-024-07161-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Physical activity (PA) can play an important role in optimizing metabolic/bariatric surgery (MBS) outcomes. However, many MBS patients have difficulty increasing PA, necessitating the development of theory-driven counseling interventions. This study aimed to (1) assess the feasibility and acceptability of the TELEhealth BARIatric behavioral intervention (TELE-BariACTIV) trial protocol/methods and intervention, which was designed to increase moderate-to-vigorous intensity physical activity (MVPA) in adults awaiting MBS and (2) estimate the effect of the intervention on MVPA. METHODS This trial used a repeated single-case experimental design. Twelve insufficiently active adults awaiting MBS received 6 weekly 45-min PA videoconferencing counseling sessions. Feasibility and acceptability data (i.e., refusal, recruitment, retention, attendance, and attrition rates) were tracked and collected via online surveys, and interviews. MVPA was assessed via accelerometry pre-, during, and post-intervention. RESULTS Among the 24 patients referred to the research team; five declined to participate (refusal rate = 20.8%) and seven were ineligible or unreachable. The recruitment rate was 1.2 participants per month between 2021-09 and 2022-07. One participant withdrew during the baseline phase, and one after the intervention (retention rate = 83.3%). No participant dropouts occurred during the intervention and 98.6% of sessions were completed. Participants' anticipated and retrospective acceptability of the intervention was 3.2/4 (IQR, 0.5) and 3.0/4 (IQR, 0.2), respectively. There was a statistically significant increase in MVPA [Tau-U = 0.32(0.11; 0.51)] from pre- to post-intervention. CONCLUSION Despite a low recruitment rate, which could be explained by circumstances (COVID-19 pandemic), results support feasibility, acceptability, and preliminary efficacy of the TELE-Bari-ACTIV intervention for increasing MVPA in patients awaiting MBS.
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Affiliation(s)
- Aurélie Baillot
- École Interdisciplinaire de Santé, Université du Québec en Outaouais, 283 Boul. Alexandre-Taché, Gatineau, Québec, J8X 3X7, Canada.
- Institut du Savoir Montfort, Ottawa, ON, Canada.
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services, Sociaux de L'Outaouais, Gatineau, Québec, Canada.
| | | | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec À Montréal, Montréal, Québec, Canada
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
| | - Josyanne Lapointe
- Department of Physical Activity Sciences, Université du Québec À Montréal, Montréal, Québec, Canada
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
| | - Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, USA
| | - Ahmed Jérôme Romain
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Pierre Y Garneau
- Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Laurent Biertho
- Institut Universitaire de Cardiologie et de Pneumologie de Québec et Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - André Tchernof
- Institut Universitaire de Cardiologie et de Pneumologie de Québec et École de Nutrition, Université Laval, Québec, Québec, Canada
| | - Patricia Blackburn
- Division of Kinesiology, Department of Health Sciences, Université du Québec À Chicoutimi, Chicoutimi, Québec, Canada
| | - Marie-France Langlois
- CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jennifer Brunet
- Institut du Savoir Montfort, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Scaioli G, Martella M, Moro GL, Prinzivalli A, Guastavigna L, Scacchi A, Butnaru AM, Bert F, Siliquini R. Knowledge, Attitudes, and Practices about Electronic Personal Health Records: A Cross-Sectional Study in a Region of Northern Italy. J Med Syst 2024; 48:42. [PMID: 38630322 PMCID: PMC11023976 DOI: 10.1007/s10916-024-02065-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data.
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Affiliation(s)
- Giacomo Scaioli
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
- Infection Control Unit, ASL TO3, Turin, Italy
| | - Manuela Martella
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy.
| | - Giuseppina Lo Moro
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
| | - Alessandro Prinzivalli
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
| | - Laura Guastavigna
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
| | - Alessandro Scacchi
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
| | - Andreea Mihaela Butnaru
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
- Infection Control Unit, ASL TO3, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences and Paediatrics, University of Turin, Via Santena 5bis, Turin, 10126, Italy
- AOU City of Health and Science of Turin, Turin, Italy
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Alley SJ, Schoeppe S, Moore H, To QG, van Uffelen J, Parker F, Duncan MJ, Schneiders A, Vandelanotte C. The moderating effect of social support on the effectiveness of a web-based, computer-tailored physical activity intervention for older adults. J Health Psychol 2024:13591053241241840. [PMID: 38618999 DOI: 10.1177/13591053241241840] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
This study aimed to assess the moderating effect of social support on the effectiveness of a web-based, computer-tailored physical activity intervention for older adults. In the Active for Life trial, 243 inactive adults aged 65+ years were randomised into: (1) tailoring + Fitbit (n = 78), (2) tailoring-only (n = 96) or (3) control (n = 69). For the current study, participants were categorised as having higher (n = 146) or lower (n = 97) social support based on the Duke Social Support Index (DSSI_10). Moderate-to-vigorous physical activity (MVPA) was measured through accelerometers at baseline and post-intervention. A linear mixed model analysis demonstrated that among participants with lower social support, the tailoring + Fitbit participants, but not the tailoring only participants increased their MVPA more than the control. Among participants with higher social support, no differences in MVPA changes were observed between groups. Web-based computer-tailored interventions with Fitbit integration may be more effective in older adults with lower levels of social support.
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Affiliation(s)
- Stephanie J Alley
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Stephanie Schoeppe
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Hayley Moore
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Quyen G To
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
- RMIT, Vietnam
| | | | - Felix Parker
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Mitch J Duncan
- School of Medicine & Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Australia
| | - Anthony Schneiders
- School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Corneel Vandelanotte
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
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Dilhani WNS, Mitchell S, Dale J, Toor K, Javaid M, MacArtney JI. A mixed-methods systematic review investigating the use of digital health interventions to provide palliative and end-of-life care for patients in low- and middle-income countries. Palliat Care Soc Pract 2024; 18:26323524241236965. [PMID: 38617095 PMCID: PMC11010586 DOI: 10.1177/26323524241236965] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/15/2024] [Indexed: 04/16/2024] Open
Abstract
Background The need for palliative care is rising globally with 76% of those who are in need living in low- and middle-income countries (LMICs). Digital health interventions (DHIs) have been identified as a means of making palliative care more widely accessible. This review summarizes the range and characteristics of DHIs used to deliver palliative care in LMICs and sought to identify factors that influence their implementation and utilization. Objectives This review aims to summarize the range and characteristics of DHIs used to deliver palliative care in LMICs and identify factors that influence their implementation and utilization. Design Mixed-method systematic review incorporating both quantitative and qualitative data. Data sources and methods All studies focusing on DHIs for patients who need palliative care (adults/children) and their caregivers (patient and caregiver centred) in LMICs and published in English were identified through a systematic search of MEDLINE, EMBASE, PsycINFO and CINAHL databases. Data synthesis and analysis were carried out following the convergent integrated approach based on the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews. Results Fifteen studies were included (three qualitative, four mixed-methods and eight quantitative studies). Telemedicine/mHealth was the most reported DHI utilized in LMICs in delivering palliative care. Patients and caregivers benefited from using DHIs in many ways including increased access to care with reduced discomfort, travel time and risk of health care-associated infections. Health care providers also reported that using DHI such as telemedicine enables them to provide care in a more effective and efficient way. Four factors were identified as the main barriers to implementation: resource constraints; literacy, training and skills; governance, operational and communication issues and technical issues. Conclusion DHIs, such as telemedicine, have the potential to enhance accessibility to palliative care in LMICs, particularly in rural areas. Comprehensive strategies for their use are required to address the identified barriers.
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Affiliation(s)
| | - Sarah Mitchell
- Division of Primary Care, Palliative Care and Public Health, University of Leeds, Leeds, UK
| | - Jeremy Dale
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kavanbir Toor
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Mikail Javaid
- Warwick Medical School, University of Warwick, Coventry, UK
| | - John I. MacArtney
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Medical School Building, Coventry, West Midlands CV4 7AL, UK
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Ruyssen-Witrand A, Caillet-Portillo D, Najm A, Fogel O, Baillet A, Claudepierre P, Conort O, Dernis E, Fayet F, Gossec L, Goupille P, Hudry C, Letarouilly JG, Lukas C, Marotte H, Molto A, Pouplin S, Senbel E, Sordet C, Tournadre A, Truchetet ME, Wendling D, Dougados M. Standardized Reporting for Systematic Global Evaluation of Axial Spondyloarthritis: An Evidence-Based and Consensus-Driven Initiative. Joint Bone Spine 2024:105733. [PMID: 38604594 DOI: 10.1016/j.jbspin.2024.105733] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION National and international scientific societies advocate for a regular, systematic, and standardized global evaluation of axial spondyloarthritis (axSpA) patients. However, there are no recommendations specifying the content of this global evaluation. This initiative aimed to propose a standardized reporting framework, using evidence-based and consensus approaches, to collect data on all domains of axSpA. METHODS A literature review and consensus process involved a steering committee and an expert panel of 37 rheumatologists and health professionals. The first steering committee took place in March 2022 and identified the main domains for inclusion in the standardized report. A hierarchical literature review was conducted to identify items within these domains and tools for assessment. The items and tools for assessment were discussed and consensus was reached through a vote session during an expert meeting that took place in March 2023. RESULTS The steering committee identified four main domains to include in the standardized reporting framework: disease assessment, comorbidities, lifestyle, and quality of life. Items and tools for assessment were adopted after the expert meeting. Additionally, recommendations regarding digital tools (websites, apps, social media) were provided. CONCLUSION This initiative led to a consensus, based on evidence and expertise, on a reporting framework for use during periodic systematic global evaluations of axSpa in daily practice.
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Affiliation(s)
- Adeline Ruyssen-Witrand
- Rheumatology Centre, Toulouse University Hospital, Centre d'Investigation Clinique de Toulouse CIC1436, Inserm, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS ». University of Toulouse 3, Toulouse, France.
| | - Damien Caillet-Portillo
- Rheumatology Centre, Toulouse University Hospital, University of Toulouse 3, Toulouse, France
| | - Aurélie Najm
- Institute of Infection and Immunity, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Olivier Fogel
- Department of Rheumatology, Hôpital Cochin. Assistance Publique - Hôpitaux de Paris, France
| | - Athan Baillet
- Univ. Grenoble-Alpes, TIMC - CNRS UMR5525, Grenoble, France
| | - Pascal Claudepierre
- APHP-Service de Rhumatologie, Hôpital Henri Mondor, AND Université Paris Est Créteil, EA 7379 - EpiDermE, France
| | - Orenella Conort
- Department Clinical Pharmacy, Hôpital Cochin. Assistance Publique - Hôpitaux de Paris, France
| | - Emmanuelle Dernis
- Department of Rheumatology and Clinical Immunology, General hospital Le Mans, France
| | - Françoise Fayet
- Rheumatology Centre, Clermont University Hospital, Clermont-Ferrand, France
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, AP-HP, Pitié-Salpêtrière hospital, Rheumatology department, Paris, France
| | - Philippe Goupille
- Université de Tours, EA 6295, Tours, Department of Rheumatology, University hospital of Tours, Tours, France
| | | | | | - Cédric Lukas
- Department of Rheumatology, University Hospital Montpellier, Montpellier, INSERM UA11 (IDESP), University Montpellier, Montpellier, France
| | - Hubert Marotte
- Université Jean Monnet Saint-Étienne, CHU Saint-Étienne, Service de Rhumatologie, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023 Saint-Etienne, France
| | - Anna Molto
- ECAMO team (INSERM U1153), Center of Research in Epidemiology and Statistics (CRESS) - Université Paris Cité, paris, France
| | - Sophie Pouplin
- Rheumatology centre, Rouen University Hospital, Rouen, France
| | - Eric Senbel
- Centre de rhumatologie de l'Eldorado, Marseille, France
| | - Christelle Sordet
- Rheumatology Center, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
| | - Anne Tournadre
- Rheumatology Centre, Clermont University Hospital, UNH INRAe University Clermont Auvergne, Clermont-Ferrand, France
| | - Marie-Elise Truchetet
- Department of Rheumatology, Hôpital Pellegrin, Bordeaux, France - Bordeaux University, CNRS, ImmunoConcept, UMR 5164, 33000 Bordeaux, France
| | - Daniel Wendling
- Rheumatology Centre, CHU de Besançon (University Hospital) and EA4266, Université de Franche-Comté, Besançon, France
| | - Maxime Dougados
- University of Paris-Cité, Department of Rheumatology, Hôpital Cochin. Assistance Publique - Hôpitaux de Paris -INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, France.
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Palakshappa JA, Hale ER, Brown JD, Kittel CA, Dressler E, Rosenthal GE, Cutrona SL, Foley KL, Haines ER, Houston Ii TK. Longitudinal Monitoring of Clinician-Patient Video Visits During the Peak of the COVID-19 Pandemic: Adoption and Sustained Challenges in an Integrated Health Care Delivery System. J Med Internet Res 2024; 26:e54008. [PMID: 38587889 PMCID: PMC11036186 DOI: 10.2196/54008] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/24/2024] [Accepted: 03/09/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Numerous prior opinion papers, administrative electronic health record data studies, and cross-sectional surveys of telehealth during the pandemic have been published, but none have combined assessments of video visit success monitoring with longitudinal assessments of perceived challenges to the rapid adoption of video visits during the pandemic. OBJECTIVE This study aims to quantify (1) the use of video visits (compared with in-person and telephone visits) over time during the pandemic, (2) video visit successful connection rates, and (3) changes in perceived video visit challenges. METHODS A web-based survey was developed for the dual purpose of monitoring and improving video visit implementation in our health care system during the COVID-19 pandemic. The survey included questions regarding rates of in-person, telephone, and video visits for clinician-patient encounters; the rate of successful connection for video visits; and perceived challenges to video visits (eg, software, hardware, bandwidth, and technology literacy). The survey was distributed via email to physicians, advanced practice professionals, and clinicians in May 2020. The survey was repeated in March 2021. Differences between the 2020 and 2021 responses were adjusted for within-respondent correlation across surveys and tested using generalized estimating equations. RESULTS A total of 1126 surveys were completed (511 surveys in 2020 and 615 surveys in 2021). In 2020, only 21.7% (73/336) of clinicians reported no difficulty connecting with patients during video visits and 28.6% (93/325) of clinicians reported no difficulty in 2021. The distribution of the percentage of successfully connected video visits ("Over the past two weeks of scheduled visits, what percentage did you successfully connect with patients by video?") was not significantly different between 2020 and 2021 (P=.74). Challenges in conducting video visits persisted over time. Poor connectivity was the most common challenge reported by clinicians. This response increased over time, with 30.5% (156/511) selecting it as a challenge in 2020 and 37.1% (228/615) in 2021 (P=.01). Patients not having access to their electronic health record portals was also a commonly reported challenge (109/511, 21.3% in 2020 and 137/615, 22.3% in 2021, P=.73). CONCLUSIONS During the pandemic, our health care delivery system rapidly adopted synchronous patient-clinician communication using video visits. As experience with video visits increased, the reported failure rate did not significantly decline, and clinicians continued to report challenges related to general network connectivity and patient access to technology.
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Affiliation(s)
- Jessica A Palakshappa
- Atrium Health Wake Forest Baptist, Winston Salem, NC, United States
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Erica R Hale
- Atrium Health Wake Forest Baptist, Winston Salem, NC, United States
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Joshua D Brown
- Atrium Health Wake Forest Baptist, Winston Salem, NC, United States
| | - Carol A Kittel
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Emily Dressler
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Gary E Rosenthal
- Atrium Health Wake Forest Baptist, Winston Salem, NC, United States
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Sarah L Cutrona
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
| | - Kristie L Foley
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Emily R Haines
- Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - Thomas K Houston Ii
- Atrium Health Wake Forest Baptist, Winston Salem, NC, United States
- Wake Forest University School of Medicine, Winston Salem, NC, United States
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Balfe M. Actor-network theory for Psychiatric and Mental Health Nursing. J Psychiatr Ment Health Nurs 2024; 31:152-157. [PMID: 37622387 DOI: 10.1111/jpm.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/18/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
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9
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Tosun AT, Isiklar C, Yildirim M, Coskunsu DK. e-Health Literacy Status of Individuals with Multiple Sclerosis in Turkey. Telemed J E Health 2024; 30:e1166-e1171. [PMID: 37851986 DOI: 10.1089/tmj.2023.0151] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: This research aims to compare e-health literacy of technology users and nonusers in people with multiple sclerosis (MS) and to investigate whether there are correlations between age, duration of MS, gender, marital status, and e-health total scores. Methods: This descriptive study was carried out with a web-based questionnaire. The questionnaire was sent to 300 patients with MS who were registered at Istanbul University-Cerrahpasa Medical Faculty Neurology Department. Results: A total of 156 people (mean age: 35.33 ± 10.47 years) participated in the survey. Smartphone 98.1% (n = 153) was the mostly used device. Rate of using Google and recommended websites about MS was 94.25% (n = 145) and 73.9% (n = 113), respectively. e-Health literacy of both the tablet and recommended websites users significantly differed from that of nonusers (p = 0.007 for both). Participants' e-health literacy total score was found to weakly, but significantly, correlate with their age, marital status, and education level (rho: -0.161, p = 0.044; rho: 0.172, p = 0.032; rho: -0.192, p = 0.016, respectively). Conclusions: With developments in digital technologies, it is important to identify the access status of people with MS to improve daily clinical management and implement further motor and cognitive rehabilitation. Therefore, determining the health literacy of individuals with MS and providing education on this subject will reduce the information pollution.
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Affiliation(s)
- Anıl Tekeoglu Tosun
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
| | - Cagdas Isiklar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Yildirim
- Department of Psychology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Dilber Karagozoglu Coskunsu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
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Kobryn M, Duplaga M. Does Health Literacy Protect Against Cyberchondria: A Cross-Sectional Study? Telemed J E Health 2024; 30:e1089-e1100. [PMID: 38016126 DOI: 10.1089/tmj.2023.0425] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
Introduction: The use of online health resources and self-diagnosis intensified during the COVID-19 pandemic, often resulting in symptoms of cyberchondria. However, little is still known about this phenomenon's real scale and determinants. The aim of the study was to examine the prevalence of cyberchondria among adult internet users in Poland. Furthermore, the study was focused on analyzing the determinants of cyberchondria, with special regard to health literacy (HL) and e-health literacy (eHL). Methods: The analysis was based on data from a computer-assisted web-based interviewing survey performed with a sample of 1,613 internet users. Uni- and multivariable linear regression models were developed for potential determinants of cyberchondria. Results: Younger respondents were more likely to have higher cyberchondria scores than older respondents. Men were more likely to have lower cyberchondria scores than women. Higher health anxiety was significantly associated with cyberchondria severity. In the multivariable regression model, the severity of cyberchondria was significantly higher among respondents with inadequate rather than sufficient HL (B = 6.24, p < 0.001). In turn, greater eHL was significantly correlated with more severe cyberchondria (B = 0.92, p < 0.001). Conclusions: Our study confirmed that HL may be perceived as a protecting factor against cyberchondria. Unexpectedly, higher eHL predicts more severe cyberchondria.
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Affiliation(s)
- Mateusz Kobryn
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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11
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Looi JCL. Psychiatric electronic health records in the era of data breaches - What are the ramifications for patients, psychiatrists and healthcare systems? Australas Psychiatry 2024; 32:121-124. [PMID: 38285964 PMCID: PMC10913320 DOI: 10.1177/10398562241230816] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To update psychiatrists and trainees on the realised risks of electronic health record data breaches. METHODS This is a selective narrative review and commentary regarding electronic health record data breaches. RESULTS Recent events such as the Medibank and Australian Clinical Labs data breaches demonstrate the realised risks for electronic health records. If stolen identity data is publicly released, patients and doctors may be subject to blackmail, fraud, identity theft and targeted scams. Medical diagnoses of psychiatric illness and substance use disorder may be released in blackmail attempts. CONCLUSIONS Psychiatrists, trainees and their patients need to understand the inevitability of electronic health record data breaches. This understanding should inform a minimised collection of personal information in the health record to avoid exposure of confidential information and identity theft. Governmental regulation of electronic health record privacy and security is needed.
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Affiliation(s)
- Jeffrey CL Looi
- Jeffrey CL Looi, Academic Unit of Psychiatry and Addiction Medicine, Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Garran, ACT 2605, Australia.
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12
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Genrich CM, Ward J, Shokar N. Telemedicine and Its Perceptions in a Border Community: A Review of How Health Care Technology Has Helped Increase Access. Telemed J E Health 2024; 30:987-993. [PMID: 37976130 DOI: 10.1089/tmj.2023.0179] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Introduction: Telemedicine is a practical way of offering medical services to remote and underserved areas. During the COVID-19 pandemic, telemedicine has provided convenient access to health care and has overcome barriers such as distance that prevent patients from receiving care. Border populations are impacted by this change in health care delivery. The goal of this study was to investigate how a border patient population perceives their experiences with telemedicine. Methods: We utilized telephone surveys of patients who had a recent telehealth visit at the Texas Tech University Health Science Center (TTUHSC) Family Medicine Center clinic in El Paso, Texas. Survey measures included patients' demographics, a quality assessment of the patients' most recent telehealth visit and their experience, a comparison of the patients' telehealth visit to past in-person visits, and a rating of their telehealth visit. Result: Over 2,000 individuals (n = 2,040), primarily Hispanic females, older than the age of 44 years were identified for potential inclusion in the study. Of these, 928 had a contact attempt, of which 1,378 could not be contacted, 592 were invited, 70 declined leading to a response rate of 67.6% (number invited/completed the survey). Most patients agreed that during their most recent telehealth visit their clinician listened well (98.7%), spent adequate time with them (98.2%), was prompt (94.5%), explained things well (98.0%), and was someone they would recommend to others (97.2%). When comparing telehealth to in-person visits, patients reported the following: less wait time, easier convenience, and similar quality between virtual and in-person visits. Patients rated both their likelihood of using telehealth again and their likelihood of recommending telehealth to others as an 8.68 out of 10, on average. Patients 65 years old or older had 3.17 times greater likelihood of satisfaction with virtual visits when compared with patients younger than 45 years old (confidence interval [95% CI], 1.24-11.11). Patients also had less satisfaction with virtual visits if they had lower educational attainment (odds ratio = 0.10; 95% CI, 0.01-0.81). Conclusions: We found that individuals in a border community had a positive experience with telehealth primary care visits. This approach may improve access to health care.
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Affiliation(s)
- Colby M Genrich
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center-El Paso, El Paso, Texas, USA
| | - Jordan Ward
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center-El Paso, El Paso, Texas, USA
| | - Navkiran Shokar
- The University of Texas at Austin-Dell Medical School, Austin, Texas, USA
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Fernández-Rodríguez R, Zhao L, Bizzozero-Peroni B, Martínez-Vizcaíno V, Mesas AE, Wittert G, Heilbronn LK. Are e-Health Interventions Effective in Reducing Diabetes-Related Distress and Depression in Patients with Type 2 Diabetes? A Systematic Review with Meta-Analysis. Telemed J E Health 2024; 30:919-939. [PMID: 38010739 DOI: 10.1089/tmj.2023.0374] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: e-Health refers to any health care service delivered through the internet or related technologies, to improve quality of life. Despite the increasing use of e-health interventions to manage type 2 diabetes (T2D), there is a lack of evidence about the effectiveness on diabetes distress and depression, which are common issues in those living with T2D. Purpose: To synthesize and determine the effects of e-health interventions on diabetes distress and depression among patients with T2D. Methods: We systematically searched PubMed, Scopus, Cochrane CENTRAL, and Web of Science for randomized controlled trials (RCTs), non-RCTs and observational cohort studies for the effects of e-health interventions on diabetes distress and depression in patients with T2D up to September 14, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 recommendations were followed. The risk of bias was assessed according to the Risk-of-Bias 2 tool (RCTs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) (non-RCTs) and the National Institute of Health tool (observational). The standardized mean difference (SMD) and its related 95% confidence intervals (CIs) were estimated with the DerSimonian-Laird method through random-effect models. A pooled raw mean difference (MD) meta-analysis was conducted for RCTs comparing the effects of e-health versus control on diabetes distress screening to display the clinical impact. Results: A total of 41 studies (24 RCTs, 14 non-RCTs, and 3 observational) involving 8,667 individuals were included. The pooled SMD for the effect of e-health versus the control group on diabetes distress was -0.14 (95% CI = -0.24 to -0.04; I2 = 23.9%; n = 10 studies), being -0.06 (95% CI = -0.15 to 0.02; I2 = 7.8%; n = 16 studies) for depression. The pooled raw MD on diabetes distress screening showed a reduction of -0.54 points (95% CI = -0.81 to -0.27; I2 = 85.1%; n = 7 studies). Conclusion: e-Health interventions are effective in diminishing diabetes distress among adults with T2D, inducing clinically meaningful reductions.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Lijun Zhao
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Bruno Bizzozero-Peroni
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autonoma de Chile, Talca, Chile
| | - Arthur Eumann Mesas
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Gary Wittert
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Leonie K Heilbronn
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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14
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Ihaura L, Rahayu DS, Efastri SM, Nugroho FT. Tech-social synergy: nurturing community well-being. J Public Health (Oxf) 2024:fdae045. [PMID: 38556696 DOI: 10.1093/pubmed/fdae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- Lucky Ihaura
- Departement of Early Childhood Education Teacher Education, Faculty of Education and Vocational, Universitas Lancang Kuning, Riau 28266, Indonesia
| | - Dwi Sri Rahayu
- Department of Guidance and Counseling, Faculty of Training and Education, Universitas Katolik Widya Mandala Surabaya-Kampus Kota Madiun, 63131, Indonesia
| | - Sean Marta Efastri
- Departement of Early Childhood Education Teacher Education, Faculty of Education and Vocational, Universitas Lancang Kuning, Riau 28266, Indonesia
| | - Felix Trisuko Nugroho
- Department of Guidance and Counseling, Faculty of Training and Education, Universitas Katolik Widya Mandala Surabaya-Kampus Kota Madiun, 63131, Indonesia
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Hossein A, Abdessater E, Balali P, Cosneau E, Gorlier D, Rabineau J, Almorad A, Faoro V, van de Borne P. Smartphone-Derived Seismocardiography: Robust Approach for Accurate Cardiac Energy Assessment in Patients with Various Cardiovascular Conditions. Sensors (Basel) 2024; 24:2139. [PMID: 38610349 PMCID: PMC11014030 DOI: 10.3390/s24072139] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
Seismocardiography (SCG), a method for measuring heart-induced chest vibrations, is gaining attention as a non-invasive, accessible, and cost-effective approach for cardiac pathologies, diagnosis, and monitoring. This study explores the integration of SCG acquired through smartphone technology by assessing the accuracy of metrics derived from smartphone recordings and their consistency when performed by patients. Therefore, we assessed smartphone-derived SCG's reliability in computing median kinetic energy parameters per record in 220 patients with various cardiovascular conditions. The study involved three key procedures: (1) simultaneous measurements of a validated hardware device and a commercial smartphone; (2) consecutive smartphone recordings performed by both clinicians and patients; (3) patients' self-conducted home recordings over three months. Our findings indicate a moderate-to-high reliability of smartphone-acquired SCG metrics compared to those obtained from a validated device, with intraclass correlation (ICC) > 0.77. The reliability of patient-acquired SCG metrics was high (ICC > 0.83). Within the cohort, 138 patients had smartphones that met the compatibility criteria for the study, with an observed at-home compliance rate of 41.4%. This research validates the potential of smartphone-derived SCG acquisition in providing repeatable SCG metrics in telemedicine, thus laying a foundation for future studies to enhance the precision of at-home cardiac data acquisition.
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Affiliation(s)
- Amin Hossein
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus, Anderlecht, 1070 Brussels, Belgium
| | - Elza Abdessater
- Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Paniz Balali
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | | | | | - Jérémy Rabineau
- Laboratory of Physics and Physiology, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Alexandre Almorad
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1050 Brussels, Belgium
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus, Anderlecht, 1070 Brussels, Belgium
| | - Philippe van de Borne
- Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
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16
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Hofner M, Hurnaus P, DiStefano D, Philip S, Kim S, Shaw J, Waring AC. Outcomes of an Asynchronous Care Model for Chronic Conditions in a Diverse Population: 12-Month Retrospective Chart Review Study. JMIR Diabetes 2024; 9:e53835. [PMID: 38363585 DOI: 10.2196/53835] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/06/2023] [Accepted: 02/16/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Diabetes and hypertension are some of the most prevalent and costly chronic conditions in the United States. However, outcomes continue to lag behind targets, creating further risk of long-term complications, morbidity, and mortality for people living with these conditions. Furthermore, racial and ethnic disparities in glycemic and hypertension control persist. Flexible telehealth programs leveraging asynchronous care allow for increased provider access and more convenient follow-up, ultimately improving critical health outcomes across demographic groups. OBJECTIVE We aim to evaluate the 12-month clinical outcomes of participants in the 9amHealth web-based clinic for diabetes and hypertension. We hypothesized that participation in the 9amHealth program would be associated with significant improvements in glycemic and blood pressure (BP) control across a diverse group of individuals. METHODS We enrolled 95 patients in a completely web-based care clinic for diabetes and hypertension who received nutrition counseling, health coaching, and asynchronous physician consultations for medication prescribing. Patients received standard or cellular-connected glucose meters and BP cuffs in order to share data. Laboratory tests were completed either with at-home phlebotomy draws or a self-administered test kit. Patients' first and last hemoglobin A1c (HbA1c) and BP results over the 12-month period were compared, and analyses were repeated across race and ethnicity groups. RESULTS Among all 95 patients, the average HbA1c decreased by -1.0 (from 8.2% to 7.2%; P<.001) over 12 months of program participation. In those with a baseline HbA1c >8%, the average HbA1c decreased by -2.1 (from 10.2% to 8.1%; P<.001), and in those with a baseline HbA1c >9%, the average HbA1c decreased by -2.8 (from 11% to 8.2%; P<.001). Among participants who identified as a race or ethnicity other than White, the HbA1c decreased by -1.2 (from 8.6% to 7.4%, P=.001). Further examination of subgroups confirmed HbA1c lowering within each race or ethnicity group. In the overall population, the average systolic BP decreased by 17.7 mm Hg (P=.006) and the average diastolic BP decreased by 14.3 mm Hg (P=.002). Among participants self-identifying as a race or ethnicity other than White, the results similarly showed a decrease in BP (average reduction in systolic BP of 10 mm Hg and in diastolic BP of 9 mm Hg). CONCLUSIONS A fully web-based model leveraging all-asynchronous physician review and prescribing, combined with synchronous and asynchronous coaching and nutrition support, was associated with clinically meaningful improvement in HbA1c and BP control over a 12-month period among a diverse group of individuals. Further studies should prospectively evaluate the effectiveness of such models among larger populations, assess the longer-term sustainability of these outcomes, and explore financial models to make these types of programs broadly accessible.
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Affiliation(s)
| | | | | | - Shaji Philip
- Washington Permanente Medical Group, Seattle, WA, United States
| | - Sarah Kim
- Zuckerberg San Francisco General Hospital, Division of Endocrinology, Diabetes and Metabolism, University of California, San Francisco, San Francisco, CA, United States
| | - Julie Shaw
- The Ottawa Hospital and EORLA, University of Ottawa, Ottowa, ON, Canada
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Lindemann CH, Burst V, Völker LA, Brähler S, Simic D, Becker I, Hellmich M, Kurscheid C, Scholten N, Krauspe R, Leibel K, Stock S, Brinkkoetter PT. Personalized, interdisciplinary patient pathway for cross-sector care of multimorbid patients (eliPfad trial): study protocol for a randomized controlled trial. Trials 2024; 25:177. [PMID: 38468319 PMCID: PMC10926660 DOI: 10.1186/s13063-024-08026-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Multimorbid and frail elderly patients often carry a high burden of treatment. Hospitalization due to the onset of an acute illness can disrupt the fragile balance, resulting in further readmissions after hospital discharge. Current models of care in Germany do not meet the needs of this patient group. Rather lack of coordination and integration of care combined with a lack of interdisciplinary approaches result in fragmented and inadequate care and increase the burden of treatment even more. METHODS eliPfad is a randomized controlled trial conducted in 6 hospitals in Germany. Multimorbid elderly patients aged 55 or older are randomly assigned to the intervention or control group. Patients in the intervention group receive the eliPfad intervention additional to standard care. The core components of eliPfad are: Early assessment of patients' individual treatment burden and support through a specially trained case manager Involvement of the patient's general practitioner (GP) right from the beginning of the hospital stay Preparation of an individual, cross-sectoral treatment plan through the interdisciplinary hospital team with the involvement of the patient's GP Establishment of a cross-sectoral electronic patient record (e-ePA) for documentation and cross-sectoral exchange Support/Promote patient adherence Tailored early rehabilitation during the hospital stay, which is continued at home Close-tele-monitoring of medically meaningful vital parameters through the use of tablets, digital devices, and personal contacts in the home environment The intervention period begins in the hospital and continues 6 weeks after discharge. Patients in the control group will be treated according to standard clinical care and discharged according to current discharge management. The primary aim is the prevention/reduction of readmissions in the first 6 months after discharge. In addition, the impact on health-related quality of life, the burden of treatment, survival, self-management, medication prescription, health literacy, patient-centered care, cost-effectiveness, and process evaluation will be examined. Nine hundred forty-eight patients will be randomized 1:1 to intervention and control group. DISCUSSION If eliPfad leads to fewer readmissions, proves (cost-)effective, and lowers the treatment burden, it should be introduced as a new standard of care in the German healthcare system. TRIAL REGISTRATION The trial was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 08/14/2023 under the ID DRKS00031500 .
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Affiliation(s)
- Christoph Heinrich Lindemann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Linus Alexander Völker
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Sebastian Brähler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Dusan Simic
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Clarissa Kurscheid
- Research Institute for Health and System Development, EUFH University of Applied Sciences, Cologne, Germany
| | - Nadine Scholten
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair for Health Services Research, University of Cologne, Cologne, Germany
| | - Ruben Krauspe
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kerstin Leibel
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Stephanie Stock
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Paul Thomas Brinkkoetter
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany.
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Carrard VC, Roxo-Gonçalves M, Santos IDS, Romanini J, Carvalho F, Umpierre RN. Could Teledentistry Be a Solution in the Diagnosis of Oral Lesions? Telemed J E Health 2024. [PMID: 38452335 DOI: 10.1089/tmj.2023.0404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
In recent years, teledentistry has gained visibility, especially because of the COVID-19 pandemic. Concerning oral medicine, there is great expectation, particularly about its potential to promote early diagnosis of oral lesions. In southern Brazil, two initiatives have shown a positive influence on each other and have led to greater awareness of oral cancer and more access to qualified advice on diagnosing and managing oral lesions. Although the contributions of this approach are promising, there are barriers to be overcome.
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Affiliation(s)
- Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michelle Roxo-Gonçalves
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ingrid da Silva Santos
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Romanini
- Dental Specialty/Oral Medicine Center, Porto Alegre City Hall, Porto Alegre, Brazil
| | - Fabiana Carvalho
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberto Nunes Umpierre
- TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Social Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Breivik E, Kristiansen E, Zanaboni P, Johansen MA, Øyane N, Bergmo TS. Suitability of issuing sickness certifications in remote consultations during the COVID-19 pandemic. A mixed method study of GPs' experiences. Scand J Prim Health Care 2024; 42:7-15. [PMID: 37982708 PMCID: PMC10851799 DOI: 10.1080/02813432.2023.2282587] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/07/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE To explore Norwegian GPs' experiences with and perceived suitability of issuing sickness certifications in remote consultations during the COVID-19 pandemic. DESIGN We used a mixed methods research design. An online survey with 301 respondents was combined with qualitative interviews with ten GPs. SETTING Norwegian general practice. RESULTS Most GPs agreed it was difficult to assess a patient's ability to work without physical attendance for a first-time certification in remote consultations. However, extending a certification was considered less problematic. If physical examinations were required, the GPs would ask the patient to come to the office. The most suitable diagnoses for remote certification were respiratory infections and COVID-19-related diagnoses, as well as known chronic and long-term diseases. The GPs emphasized the importance of knowing both the patient and the medical problem. The GP-patient relationship could be affected by remote consultations, and there were mixed views on the impact. Many GPs found it easier to deny a request for a sickness certification in remote consultations. The GPs expressed concern about the societal costs and an increased number of certifications if remote consultations were too easily accessible. The study was conducted during the COVID-19 pandemic, and the findings should be interpreted in that context. CONCLUSIONS Our study shows that issuing sickness certifications in remote consultations were viewed to be suitable for COVID-19 related problems, for patients the GP has met before, for the follow-up of known medical problems, and the extension of sickness certifications. Not meeting the patient face-to-face may affect the GP-patient relationship as well as make the GPs' dual role more challenging.
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Affiliation(s)
- Elin Breivik
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Eli Kristiansen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Monika A. Johansen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Nicolas Øyane
- Centre for Quality Improvement in Medical Practices, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Trine Strand Bergmo
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
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Moggia D, Lutz W, Kazantzis N, Schwartz B, Bakker D. Symptom Reduction and Engagement in a Cognitive-Behavioral Mobile Phone App: A Study of User Profiling to Determine Prognostic Indicators. Behav Ther 2024; 55:217-232. [PMID: 38418036 DOI: 10.1016/j.beth.2023.05.014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 03/01/2024]
Abstract
OBJECTIVE We investigated the presence of latent transition profiles in a sample of users of a cognitive-behavioral mental health app for the general population. Users' baseline characteristics were used as predictors of the profiles. The role of engagement with the app in the transition profiles was examined. METHOD A total of 541 users completed the Patient Health Questionnaire-9 and the General Anxiety Disorder-7 when started using the app and 30 days after. Random-Intercept Latent Transition Analysis was implemented to identify users' profiles and transition patterns as classes. The age of the users and the Emotional Self-Awareness Scale-Revised (ESAS-R) were used as predictors of class membership at baseline. The Homework Rating Scale-Mobile Application (HRS-MA; as a measure of engagement) was used as a predictor of class membership at 30 days of app use. RESULTS A 3-class solution was obtained according to the severity of symptoms (from mild to moderately severe). Age and ESAS-R predicted class membership initially; the higher the age and ESAS-R, the higher the probability of starting using the app with lower distress levels. The HRS-MA predicted class membership at 30 days of app use; the higher the engagement for more symptomatic and younger users, the higher the probability of improvement. However, older users tended to engage less. CONCLUSION Our findings underpin the relevance of easily accessible digital interventions for young adults with mild to moderate mental health problems. Further studies and developments are required to enhance these apps for older cohorts.
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Affiliation(s)
| | | | - Nikolaos Kazantzis
- Cognitive Behavior Therapy Research Unit; Beck Institute for Cognitive Behavior Therapy
| | | | - David Bakker
- Monash University; University of Tasmania; Cognitive Behavior Therapy Research Unit
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21
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Yudkin JS, Allicock MA, Atem FD, Galeener CA, Messiah SE, Barlow SE. Efficacy of a Primary Care eHealth Obesity Treatment Pilot Intervention Developed for Vulnerable Pediatric Patients. Child Obes 2024; 20:75-86. [PMID: 36893214 DOI: 10.1089/chi.2022.0185] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Background: Challenges to treat excess weight in primary care settings include time constraints during encounters and barriers to multiple visits for patient families, especially those from vulnerable backgrounds. Dynamo Kids! (DK), a bilingual (English/Spanish) e-health intervention, was created to address these system-level challenges. This pilot study assessed the effect of DK use on parent-reported healthy habits and child BMI. Methods: In this 3-month, quasi-experimental cohort design, DK was offered to parents with children aged 6-12 years with BMI ≥85th percentile in three public primary care sites in Dallas, Texas. DK included three educational modules, one tracking tool, recipes, and links to internet resources. Parents completed an online survey before and after 3 months. Pre-post changes in family nutrition and physical activity (FNPA) scores, clinic-measured child %BMIp95, and self-reported parent BMI were assessed using mixed-effects linear regression modeling. Results: A total of 73 families (mean child age = 9.3 years; 87% Hispanic, 12% non-Hispanic Black, and 77% Spanish-speaking families) completed the baseline survey (participants) and 46 (63%) used the DK site (users). Among users, pre-post changes (mean [standard deviation]) showed an increase in FNPA scores (3.0 [6.3], p = 0.01); decrease in child %BMIp95 (-1.03% [5.79], p = 0.22); and decrease in parent BMI (-0.69 [1.76], p = 0.04). Adjusted models showed -0.02% [95% confidence interval: -0.03 to -0.01] change in child %BMIp95 for each minute spent on the DK website. Conclusions: DK demonstrated a significant increase in parent FNPA scores and decrease in self-reported parent BMI. e-Health interventions may overcome barriers and require a lower dosage than in-person interventions.
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Affiliation(s)
- Joshua S Yudkin
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
| | - Marlyn A Allicock
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
| | - Folefac D Atem
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
| | - Carol A Galeener
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Campus, Dallas, TX, USA
| | - Sarah E Barlow
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children's Health, Dallas, TX, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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22
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Muehlensiepen F, Petit P, Knitza J, Welcker M, Vuillerme N. Prediction of the acceptance of telemedicine among rheumatic patients: a machine learning-powered secondary analysis of German survey data. Rheumatol Int 2024; 44:523-534. [PMID: 38206379 PMCID: PMC10866795 DOI: 10.1007/s00296-023-05518-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
Telemedicine (TM) has augmented healthcare by enabling remote consultations, diagnosis, treatment, and monitoring of patients, thereby improving healthcare access and patient outcomes. However, successful adoption of TM depends on user acceptance, which is influenced by technical, socioeconomic, and health-related factors. Leveraging machine learning (ML) to accurately predict these adoption factors can greatly contribute to the effective utilization of TM in healthcare. The objective of the study was to compare 12 ML algorithms for predicting willingness to use TM (TM try) among patients with rheumatic and musculoskeletal diseases (RMDs) and identify key contributing features. We conducted a secondary analysis of RMD patient data from a German nationwide cross-sectional survey. Twelve ML algorithms, including logistic regression, random forest, extreme gradient boosting (XGBoost), and neural network (deep learning) were tested on a subset of the dataset, with the inclusion of only RMD patients who answered "yes" or "no" to TM try. Nested cross-validation was used for each model. The best-performing model was selected based on area under the receiver operator characteristic (AUROC). For the best-performing model, a multinomial/multiclass ML approach was undertaken with the consideration of the three following classes: "yes", "no", "do not know/not answered". Both one-vs-one and one-vs-rest strategies were considered. The feature importance was investigated using Shapley additive explanation (SHAP). A total of 438 RMD patients were included, with 26.5% of them willing to try TM, 40.6% not willing, and 32.9% undecided (missing answer or "do not know answer"). This dataset was used to train and test ML models. The mean accuracy of the 12 ML models ranged from 0.69 to 0.83, while the mean AUROC ranged from 0.79 to 0.90. The XGBoost model produced better results compared with the other models, with a sensitivity of 70%, specificity of 91% and positive predictive value of 84%. The most important predictors of TM try were the possibility that TM services were offered by a rheumatologist, prior TM knowledge, age, self-reported health status, Internet access at home and type of RMD diseases. For instance, for the yes vs. no classification, not wishing that TM services were offered by a rheumatologist, self-reporting a bad health status and being aged 60-69 years directed the model toward not wanting to try TM. By contrast, having Internet access at home and wishing that TM services were offered by a rheumatologist directed toward TM try. Our findings have significant implications for primary care, in particular for healthcare professionals aiming to implement TM effectively in their clinical routine. By understanding the key factors influencing patients' acceptance of TM, such as their expressed desire for TM services provided by a rheumatologist, self-reported health status, availability of home Internet access, and age, healthcare professionals can tailor their strategies to maximize the adoption and utilization of TM, ultimately improving healthcare outcomes for RMD patients. Our findings are of high interest for both clinical and medical teaching practice to fit changing health needs caused by the growing number of complex and chronically ill patients.
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Affiliation(s)
- Felix Muehlensiepen
- Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France.
- Faculty of Health Sciences Brandenburg, Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf bei Berlin, Germany.
| | - Pascal Petit
- Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France
| | - Johannes Knitza
- Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France
- Institute for Digital Medicine, University Hospital of Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr M Welcker GmbH, Planegg, Germany
| | - Nicolas Vuillerme
- Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France
- Institut Universitaire de France, Paris, France
- LabCom Telecom4Health, Orange Labs & Univ. Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
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23
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Rosas F, Gayoso A, Tomateo D, Orellano C. Patient Perceptions on Telepsychiatry as an In-Consult Alternative During COVID-19 Pandemic: Peruvian Adaptation of the Telehealth Usability Questionnaire. Telemed J E Health 2024. [PMID: 38436234 DOI: 10.1089/tmj.2023.0428] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Objective: To identify the perceptions of the patients who received alternative care by telepsychiatry at the Cayetano Heredia Hospital (HCH). Methods: This research consisted of two phases: (1) transcultural adaptation of the Telehealth Usability Questionnaire (TUQ) with three experts and (2) application of the questionnaire in 183 patients from psychiatry in HCH. Nonparametric tests were used to determine the association between variables. Results: We applied 20 questions to 60 men and 123 women, with a median age of 45. The ease of using the virtual consultation service, the comfort with its use, and the general satisfaction had a score of 6 out of 7 and are associated with the number of devices that patients have and their degree of education. The usefulness, communication by virtual means, and the solution of technical problems had scores higher than 6, being considered acceptable by the patients. Willingness to have a teleconsultation again was high and was associated with patient satisfaction with the consultation. Conclusions: Most patients were satisfied with telepsychiatry via telemonitoring during the COVID-19 pandemic. The usage of validated tools such as TUQ might be included as part of evaluations of new telemedicine services.
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Affiliation(s)
- Fiorella Rosas
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alonso Gayoso
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Tomateo
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Orellano
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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24
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Jansen C, Bäuerle A, Jahre LM, Kocol D, Krakowczyk J, Geiger S, Dörrie N, Skoda EM, Teufel M. Needs and Demands for e-Health Interventions in Patients Attending a Psychosomatic Outpatient Clinic: A Baseline Assessment for a User-Centered Design Approach. Telemed J E Health 2024. [PMID: 38436236 DOI: 10.1089/tmj.2023.0360] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Objective: Increased utilization of e-health services can help to meet shortages of psychotherapeutic treatment. e-Health interventions can be effective if tailored according to the individual needs and demands of the target group. To gather comprehensive data for the development of a user-centered e-health intervention, a cross-sectional study was conducted among a heterogeneous cohort of 309 patients seeking treatment or consultation at psychosomatic university hospital in a densely populated region of Germany. Methods: Sociodemographic data, psychometric dimensions of mental burden, as well as needs and demands regarding an e-health intervention were assessed. A descriptive statistical analysis and a cluster analysis were performed to examine distribution of preferences and differences based on level of burden regarding needs and demands for e-health interventions. Results: Two hundred thirty-nine (N = 239) participants were included in the final data analysis. Among this primarily urban target group smartphone availability was favored by 77.8% of the participants. The cluster analysis revealed significant differences dependent on mental burden. 75.2% of participants with a high mental burden preferred longer interventions of 1-4 months compared with 49% in the low burden group, which also considered short interventions of up to 1 month (46%). Differences were also identified for content preferences and daily-life integration and were consistent irrespective of the initial reason for consultation. Conclusion: The findings of this study can provide a foundational framework for developing user-centered psychosomatic interventions. The potential relationship between individual burden and individual needs and demands highlights the crucial role of preliminary research to tailor interventions to effectively address diverse needs and preferences.
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Affiliation(s)
- Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Dilara Kocol
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Julia Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Sheila Geiger
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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25
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Mylle S, Papeleu J, Hoorens I, Verhaeghe E, Brochez L. The Value of Teledermatology Advice for Skin Toxicity in Oncology: Experience From a Pilot Study. JMIR Dermatol 2024; 7:e40053. [PMID: 38422495 PMCID: PMC10940973 DOI: 10.2196/40053] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 02/20/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Sofie Mylle
- Dermatology Department, Ghent University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Jorien Papeleu
- Dermatology Department, Ghent University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Isabelle Hoorens
- Dermatology Department, Ghent University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Evelien Verhaeghe
- Dermatology Department, Ghent University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Lieve Brochez
- Dermatology Department, Ghent University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
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van Doorn M, Nijhuis LA, Monsanto A, van Amelsvoort T, Popma A, Jaspers MWM, Noordzij ML, Öry FG, Alvarez-Jimenez M, Nieman DH. Corrigendum: Usability, feasibility, and effect of a biocueing intervention in addition to a moderated digital social therapy-platform in young people with emerging mental health problems: a mixed-method approach. Front Psychiatry 2024; 15:1364965. [PMID: 38384589 PMCID: PMC10880443 DOI: 10.3389/fpsyt.2024.1364965] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2022.871813.].
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Affiliation(s)
| | | | - Anne Monsanto
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Monique W. M. Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC-Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Matthijs L. Noordzij
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
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27
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Petretto DR, Carrogu GP, Gaviano L, Berti R, Pinna M, Petretto AD, Pili R. Telemedicine, e-Health, and Digital Health Equity: A Scoping Review. Clin Pract Epidemiol Ment Health 2024; 20:e17450179279732. [PMID: 38660571 PMCID: PMC11041391 DOI: 10.2174/0117450179279732231211110248] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 04/26/2024]
Abstract
Background With the progressive digitization of people's lives and in the specific healthcare context, the issue of equity in the healthcare domain has extended to digital environments or e-environments, assuming the connotation of "Digital Health Equity" (DHE). Telemedicine and e-Health, which represent the two main e-environments in the healthcare context, have shown great potential in the promotion of health outcomes, but there can be unintended consequences related to the risk of inequalities. In this paper, we aimed to review papers that have investigated the topic of Digital Health Equity in Telemedicine and e-Health [definition(s), advantages, barriers and risk factors, interventions]. Methods We conducted a scoping review according to the methodological framework proposed in PRISMA-ScR guidelines on the relationship between Digital Health Equity and Telemedicine and e-Health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between Digital Health Equity and Telemedicine and/or e-Health, written in English, and having no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews. Results Regarding Digital Health Equity in Telemedicine and e-Health, even if there is no unique definition, there is a general agreement on the idea that it is a complex and multidimensional phenomenon. When promoting Digital Health Equity, some people may incur some risk/s of inequities and/or they may meet some obstacles. Regarding intervention, some authors have proposed a specific field/level of intervention, while other authors have discussed multidimensional interventions based on interdependence among the different levels and the mutually reinforcing effects between all of them. Conclusion In summary, the present paper has discussed Digital Health Equity in Telemedicine and e-Health. Promoting equity of access to healthcare is a significant challenge in contemporary times and in the near future. While on the one hand, the construct "equity" applied to the health context highlights the importance of creating and sustaining the conditions to allow anyone to be able to reach (and develop) their "health potential", it also raises numerous questions on "how this can happen". An overall and integrated picture of all the variables that promote DHE is needed, taking into account the interdependence among the different levels and the mutually reinforcing effects between all of them.
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Affiliation(s)
- Donatella Rita Petretto
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Gian Pietro Carrogu
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Luca Gaviano
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Roberta Berti
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Martina Pinna
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Andrea Domenico Petretto
- Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari 09124, Italy
| | - Roberto Pili
- IERFOP Onlus, Via Platone 1/3, Cagliari 09100, Italy
- Global Community on Longevity, Italy
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28
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Taylor S, Little LM. Development and Validation of Telehealth Competency Questionnaire-Provider. Telemed J E Health 2024. [PMID: 38315744 DOI: 10.1089/tmj.2023.0472] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Background: Given the rapid increase in telehealth utilization, health care providers are being increasingly trained to deliver services virtually. However, there are limited measures available to assess the extent to which structured trainings influence competency domains associated with telehealth delivery. Methods: The authors developed the Telehealth Competency Questionnaire-Provider (TCQ-P) using a multistep process, including a literature review and expert reviewers. Using two datasets, we used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate and refine the tool, respectively. The final version contained 17 items. Model fit was evaluated using the comparative fit index (CFI) (>0.90), Tucker-Lewis index (TLI) (>0.80), standardized root mean square residual (SRMR) (<0.08) and root mean square of error of approximation (RMSEA) (<0.08). Results: Participants included n = 701 in the exploratory study and n = 721 in the confirmatory study. Two items were revised, and one item was deleted as a result of the EFA, and the CFA of 17 number of items supported a 3-factor model (i.e., Evaluation, Rapport, Troubleshooting). Model fit was good, with CFI = 0.984, TLI = 0.978, RMSEA = 0.051, and SRMR = 0.035. Discussion: The TCQ-P measures three essential domains of telehealth competency, which is essential for future health care providers. The measure may be used to assess telehealth training outcomes.
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Affiliation(s)
- Steven Taylor
- Department of Occupational Therapy, College of Health Sciences, Rush University, Chicago, Illinois, USA
| | - Lauren M Little
- Department of Occupational Therapy, College of Health Sciences, Rush University, Chicago, Illinois, USA
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29
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Nguyen L, Pozniak K, Strohm S, Havens J, Dawe-McCord C, Thomson D, Putterman C, Arafeh D, Galuppi B, Ley AVD, Doucet S, Amaria K, Kovacs AH, Marelli A, Rozenblum R, Gorter JW. Navigating meaningful engagement: lessons from partnering with youth and families in brain-based disability research. Res Involv Engagem 2024; 10:17. [PMID: 38317213 PMCID: PMC10845676 DOI: 10.1186/s40900-024-00543-9] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/17/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND While patient and family engagement in research has become a widespread practice, meaningful and authentic engagement remains a challenge. In the READYorNot™ Brain-Based Disabilities Study, we developed the MyREADY Transition™ Brain-Based Disabilities App to promote education, empowerment, and navigation for the transition from pediatric to adult care among youth with brain-based disabilities, aged 15-17 years old. Our research team created a Patient and Family Advisory Council (PFAC) to engage adolescents, young adults, and parent caregivers as partners throughout our multi-year and multi-stage project. MAIN BODY This commentary, initiated and co-authored by members of our PFAC, researchers, staff, and a trainee, describes how we corrected the course of our partnership in response to critical feedback from partners. We begin by highlighting an email testimonial from a young adult PFAC member, which constituted a "critical turning point," that unveiled feelings of unclear expectations, lack of appreciation, and imbalanced relationships among PFAC members. As a team, we reflected on our partnership experiences and reviewed documentation of PFAC activities. This process allowed us to set three intentions to create a collective goal of authentic and meaningful engagement and to chart the course to get us there: (1) offering clarity and flexibility around participation; (2) valuing and acknowledging partners and their contributions; and (3) providing choice and leveraging individual interests and strengths. Our key recommendations include: (1) charting the course with a plan to guide our work; (2) learning the ropes by developing capacity for patient-oriented research; (3) all hands on deck by building a community of engagement; and (4) making course corrections and being prepared to weather the storms by remaining open to reflection, re-evaluation, and adjustment as necessary. CONCLUSIONS We share key recommendations and lessons learned from our experiences alongside examples from the literature to offer guidance for multi-stage research projects partnering with adolescents, young adults, and family partners. We hope that by sharing challenges and lessons learned, we can help advance patient and family engagement in research.
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Affiliation(s)
- Linda Nguyen
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.
| | - Kinga Pozniak
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Sonya Strohm
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Jessica Havens
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Claire Dawe-McCord
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Donna Thomson
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Connie Putterman
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Dana Arafeh
- Patient and Family Advisory Council, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Barb Galuppi
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Alicia Via-Dufresne Ley
- The Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, QC, Canada
| | - Shelley Doucet
- Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada
| | - Khush Amaria
- CBT Associates (A CloudMD Company), Toronto, ON, Canada
| | | | - Ariane Marelli
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Ronen Rozenblum
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Centre of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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O'Connor AL, Shmelev A, Shettig A, Santucci NM, Bray J, Bazarian A, Orenstein SB, Nikolian VC. Assessing Patient-Reported Experiences for In-Person and Telemedicine-Based Preoperative Evaluations. Telemed J E Health 2024; 30:472-479. [PMID: 37624627 DOI: 10.1089/tmj.2023.0089] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Background: The COVID-19 pandemic has transformed health care delivery through the rise of telehealth solutions. Though telemedicine-based care has been identified as safe and feasible in postoperative care, data on initial surgical consultations in the preoperative setting are lacking. We sought to compare patient characteristics, anticipated downstream care utilization, and patient-reported experiences (PREs) for in-person versus telemedicine-based care conducted for initial consultation encounters at a hernia and abdominal wall center. Methods: Patients evaluated at an abdominal wall reconstruction center from August 2021 to August 2022 were prospectively surveyed. Patient characteristics, anticipated downstream care utilization, and PREs were compared. Results: Of the 176 respondents, 50.6% (n = 89) utilized telemedicine-based care and had similar demographic and disease characteristics to those receiving in-person care. Telemedicine-based care saved a median of 47 min [interquartile range 20-112.5 min] of round-trip travel time per patient, with 10.1% of encounters resulting in supplemental in-person evaluation. A large proportion of telemedicine-based and in-person encounters resulted in recommendations for operative intervention, 38.2% versus 55.2%, respectively. Indirect costs of care were significantly lower for patients utilizing telemedicine-based services. Patient satisfaction related to encounters was non-inferior to in-person care. Overall, the majority of patients responded that they preferred future care to be delivered via telemedicine-based services, if offered. Conclusions: Preoperative telemedicine-based care was associated with significant cost-savings over in-person care related with comparable patient satisfaction. Health systems should continue to dedicate resources to optimizing and expanding perioperative telemedicine capabilities.
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Affiliation(s)
- Amber L O'Connor
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Artem Shmelev
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Abigale Shettig
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Nicole M Santucci
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Jordan Bray
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Alina Bazarian
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Sean B Orenstein
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Vahagn C Nikolian
- Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
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Dahlgren C, Spånberg E, Sveréus S, Dackehag M, Wändell P, Rehnberg C. Short- and intermediate-term impact of DTC telemedicine consultations on subsequent healthcare consumption. Eur J Health Econ 2024; 25:157-176. [PMID: 36823408 PMCID: PMC9950019 DOI: 10.1007/s10198-023-01572-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
AIM The use of direct-to-consumer (DTC) telemedicine consultations in primary healthcare has increased rapidly, in Sweden and internationally. Such consultations may be a low-cost alternative to face-to-face visits, but there is limited evidence on their effects on overall healthcare consumption. The aim of this study was to assess the short- and intermediate-term impact of DTC telemedicine consultations on subsequent primary healthcare consumption, by comparing DTC telemedicine users to matched controls in a Swedish setting. METHODS We constructed a database with individual-level data on healthcare consumption, for all residents of Region Stockholm in 2018, by linking national and regional registries. The study population included all individuals who had ≥ 1 physician consultation (telemedicine or face-to-face) during the first half of 2018. DTC telemedicine users were matched 1:2 to controls who were non-users of DTC telemedicine but who had a traditional face-to-face consultation during the study period. The matching criteria were diagnosis and demographic and socioeconomic variables. An interrupted time series analysis was performed to compare the healthcare consumption of DTC telemedicine users to that of the control group. RESULTS DTC telemedicine users increased their healthcare consumption more than controls. The effect seemed to be mostly short term (within a month), but was also present at the intermediate term (2-6 months after the initial consultation). The results were robust across age and disease groups. CONCLUSION The results indicate that DTC telemedicine consultations increase the total number of physician consultations in primary healthcare. From a policy perspective, it is therefore important to further investigate for which diagnoses and treatments DTC telemedicine is suitable so that its use can be encouraged when it is most cost-efficient and limited when it is not. Given the fundamentally different models for reimbursement, there are reasons to review and possibly harmonise the incentive structures for DTC telemedicine and traditional primary healthcare.
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Affiliation(s)
- Cecilia Dahlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, LIME, 171 77, Stockholm, Sweden.
- Region Stockholm, Center for Health Economics, Informatics and Healthcare Research, Stockholm, Sweden.
| | - Emma Spånberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, LIME, 171 77, Stockholm, Sweden
- Region Dalarna, Department of Analysis, Falun, Sweden
| | - Sofia Sveréus
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, LIME, 171 77, Stockholm, Sweden
- Region Stockholm, Center for Health Economics, Informatics and Healthcare Research, Stockholm, Sweden
| | | | - Per Wändell
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Clas Rehnberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, LIME, 171 77, Stockholm, Sweden
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Stamou M, Nikolaou C, Chοiras S. Telerehabilitation in Physiotherapy Science: A Scoping Review. Cureus 2024; 16:e54396. [PMID: 38505440 PMCID: PMC10948957 DOI: 10.7759/cureus.54396] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
The advancement of computer science technologies and telemedical devices has led to an increase in the use of telerehabilitation (TR) as a therapeutic intervention. In our days, TR interventions can be considered as alternative solutions to face-to-face therapy. The primary aim of this study is to evaluate whether TR can be effective in physiotherapy. This can be adjudicated by investigating the use of the TR applications, their cost effect, and the level of effectiveness each one of them can provide. Randomized controlled trials that were published between 2003 and 2023 in the English language and used TR as the intervention were collected from online databases (MEDLINE, Physiotherapy Evidence Database (PEDro), and Cochrane) to be reviewed. Twenty of them met the criteria and were included in the study. Studies meeting the inclusion criteria were categorized by the body system investigated. Out of the 20 studies that met the inclusive criteria, five are related to the musculoskeletal system, six are related to the nervous system, two are related to proprioception and balance, one is related to the respiratory system, one is related to the cardiovascular system, two are related to pelvic floor control, and three are related to autoimmune disorders. Studies have shown that implementing TR has resulted in significant improvements in terms of functionality, muscle strength, endurance, and self-improvement. Proprioception, autoimmune diseases, and cardiovascular health have shown the most improvement. The most commonly used tools for implementing TR are gamified virtual reality (VR) and digital apps. However, there are some disadvantages, such as the lack of personal contact and the cost involved. We found that TR has the potential to positively impact various health disorders, making it a suitable form of therapy for people who can't receive in-person treatment. Nonetheless, it cannot replace traditional physiotherapy, nor does it hold the same value as it.
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Affiliation(s)
- Magdalini Stamou
- Physiotherapy Department, University of West Attica, Athens, GRC
| | | | - Savvas Chοiras
- Physiotherapy Department, University of West Attica, Athens, GRC
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Jørgensen SW, Petersen EN, Harnow S, Lee K, Nørgaard B. The meaning that people with severe mental illnesses ascribe to e-health in encounters with healthcare professionals - A repeat interview study. Int J Ment Health Nurs 2024; 33:62-72. [PMID: 37658655 DOI: 10.1111/inm.13221] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
This study sought to explore the meaning that people with severe mental illnesses attribute to e-health solutions regarding user involvement and encounters with healthcare professionals. A qualitative design with a social phenomenological approach was applied, and data were collected via repeat interviews. Using a purposive sampling strategy, eight people with severe mental illness were interviewed two times between August 2021 to May 2022, at three different treatment sites in southern Denmark. To be included, participants needed to be 18-65 years of age, diagnosed with severe mental illness (schizophrenia, bipolar disorder, or depression), and using an e-health solution in collaboration with a health professional. The interviews lasted between 20 and 70 min and were audio recorded and then transcribed. The data were analysed with Braun and Clarke's 6-step thematic analysis. Participants experienced the use of an e-health solution as helpful for structuring their everyday lives, and e-health used together with healthcare professionals was considered to have a positive impact on the collaboration. The participants experienced feeling involved and in control when e-health solutions were used, which engaged them in their treatment. Furthermore, the participants found it important to have had some in-person meetings with healthcare professionals to build trust before the e-health solutions could be implemented successfully. E-health solutions used in collaboration with a trusted healthcare professional whom the participants had met in person tended to affect treatment engagement positively.
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Affiliation(s)
| | - Esben Nedenskov Petersen
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Søren Harnow
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- University College South Denmark, Esbjerg, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Yudkin JS, Messiah SE, Allicock MA, Barlow SE. Integration of e-Health Strategies for Post-COVID-19 Pandemic Pediatric Weight Management Programs. Telemed J E Health 2024; 30:321-330. [PMID: 37552819 DOI: 10.1089/tmj.2023.0068] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Background: The COVID-19 pandemic catalyzed a renewed urgency to address the obesity pandemic and accelerated the use of technology to treat pediatric obesity. Yet, there are significant incongruities between the existing literature on technology for obesity management and the current health care system that may lead to suboptimal outcomes and increased costs. This study reviewed the types of e-health strategies currently in use, highlighted inconsistencies and overlap in terminology, and identified future research directions in e-health for childhood obesity, including gaps in implementation science. Methods: This narrative literature review synthesized seminal articles from the literature, as well as recent articles, using PubMed and Google Scholar that focused on the use of technology in treating pediatric obesity. This inclusive strategy was intended to elucidate the heterogeneity in how different disciplines are using digital health terminology in pediatric obesity research. Results: Both the prevalence of e-health interventions and its associated terminology are increasing in the peer-reviewed literature, especially since the beginning of the COVID-19 pandemic. Yet, their definitions and usage are unstandardized, leading to a lack of cohesion in the research and between disciplines. There is a gap in implementation science outcomes, including reimbursement, that may significantly impact external validity and uptake. Conclusion: A more systematic and precise approach to researching e-health that can assess specific technologies and combinations of technologies, their short-term and long-term effect sizes, and feasibility can produce the necessary data that may lead to reimbursement policies and, ultimately, improved pediatric weight management outcomes.
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Affiliation(s)
- Joshua S Yudkin
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
| | - Sarah E Messiah
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marlyn A Allicock
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Wang CC, Difede J. A Two-Phased Telehealth Model to Treat Post-Traumatic Stress Disorder in a Health Care Worker due to the COVID-19 Pandemic: A Case Report. Telemed J E Health 2024; 30:601-606. [PMID: 37585569 DOI: 10.1089/tmj.2023.0326] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Background: We report a case describing the use of a two-step telehealth intervention to treat symptoms of post-traumatic stress disorder (PTSD) that developed in a frontline health care worker (HCW) during the COVID-19 pandemic. HCWs are at increased risk of adverse psychological outcomes, including PTSD, due to the nature of their work, which has been exacerbated by the global pandemic. Methods: This case represents the first successfully completed participant in a larger ongoing trial to address psychological distress, PTSD, and comorbidities in HCWs consequent to the COVID-19 pandemic. Following a two-step intervention of self-directed narrative writing delivered entirely online followed by prolonged exposure therapy using videoconferencing, the HCW displayed significant improvement in symptoms of PTSD, depression, anxiety, and substance use. Results: The treatment model described here offers preliminary support for a two-step remote delivery approach to meet the need for scalable self-directed distance technology-based mental health interventions for HCWs. This study is registered on clinicaltrials.gov (NCT04626050).
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Affiliation(s)
- Crystal C Wang
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - JoAnn Difede
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
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Quemeneur C, Le Saché F, Ayrault C, Griscenco E, Raft J, N'Guyen P, Destruhaut G, Classaux D, Rozov R, Boussier J, Constantin JM, Bloc S. Anesthesia Teleconsultation: Quality, Medicoeconomic Interest, and Patient Satisfaction of Preoperative Assessment-A Prospective Observational Study. Telemed J E Health 2024; 30:457-463. [PMID: 37523220 DOI: 10.1089/tmj.2023.0054] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Background: Telemedicine can be defined as the use of telecommunication technology for performing medical acts remotely by health professionals. Currently in anesthesia, teleconsultation (TC) is becoming widespread, although the benefit and quality have not been well evaluated. The objective of this study was to assess the quality, the patient satisfaction, as well as the ecological and medicoeconomic impacts of the preanesthesia TC. Methods: This prospective observational multicentric study was approved by the Société Française d'Anesthésie-Réanimation ethics committee. The study took place from October 2020 to March 2021, in eight French health care institutions. Every adult patient requiring TC before elective surgery could be included. Unavailability of videoconferencing for the patient was the main exclusion criteria. Five hundred three (n) patients, scheduled for surgery, were included. Their files were analyzed for quality, 375 were successfully interviewed for the second part of the study evaluating satisfaction and medicoeconomic impact. The study's evaluation criteria were the quality of the TeleMed-Cs, the satisfaction and comprehension for the patient, and the medicoeconomic impact of a remote evaluation compared with the face-to-face consultation with the surgeon. Results: Of the 503 files, 478 (95%) were reviewed and met all the high authority of health quality criteria. The electronic format of records was associated with higher completion rate. The median satisfaction was 10.0 (IQR 8.25-10.0). The cost of a TC in anesthesia was significantly lower than that of a face-to-face surgical consultation with a median cost of 1.49€ (IQR 0.8-1.99) versus 34.81€ (IQR 14.01-91.7) p < 0.001. Conclusions: TC in anesthesia seems to be a good alternative in terms of quality, patient satisfaction, and medicoeconomic gain for our patients. By facilitating access to preoperative evaluation, it could be adopted worldwide and thus reduce surgery-related morbidity and mortality in our patients.
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Affiliation(s)
- Cyril Quemeneur
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Department of Anesthesiology, Clinique Drouot Sport, Paris, France
| | - Frédéric Le Saché
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Department of Anesthesiology, Clinique Drouot Sport, Paris, France
| | - Corentyn Ayrault
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Ecaterina Griscenco
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Julien Raft
- Department of Anesthesiology, Cancer Institut of Lorraine, Vandoeuvre-les-Nancy, France
- INSERM UMR-S 1116 Equipe 2, University of Lorraine, Nancy, France
| | - Philippe N'Guyen
- Department of Anesthesiology and Intensive Care, Hôpital Saint-Antoine and Sorbonne University, GRC 29, DMU DREAM, Assistance Publique-Hôpitaux de Paris
| | - Grégory Destruhaut
- Department of Anesthesiology, Clinique Bordeaux Merignac, Bordeaux, France
| | - Damien Classaux
- Department of Anesthesiology, Clinique Lille Sud, Ramsay Santé, Lille, France
| | - Roman Rozov
- Department of Anesthesiology, Polyclinique Saint Roch, Montpellier, France
| | - Jérémy Boussier
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-Michel Constantin
- Groupe Hospitalier La Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sébastien Bloc
- Department of Anesthesiology, Clinique Drouot Sport, Paris, France
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van 't Klooster JWJR, Rabago Mayer LM, Klaassen B, Kelders SM. Challenges and opportunities in mobile e-coaching. Front Digit Health 2024; 5:1304089. [PMID: 38351963 PMCID: PMC10863450 DOI: 10.3389/fdgth.2023.1304089] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024] Open
Abstract
Background Mobile e-health technologies have proven to provide tailored assessment, intervention, and coaching capabilities for various usage scenarios. Thanks to their spread and adoption, smartphones are one of the most important carriers for such applications. Problem However, the process of design, realization, evaluation, and implementation of these e-health solutions is wicked and challenging, requiring multiple stakeholders and expertise. Method Here, we present a tailorable intervention and interaction e-health solution that allows rapid prototyping, development, and evaluation of e-health interventions at scale. This platform allows researchers and clinicians to develop ecological momentary assessment, just-in-time adaptive interventions, ecological momentary intervention, cohort studies, and e-coaching and personalized interventions quickly, with no-code, and in a scalable way. Result The Twente Intervention and Interaction Instrument (TIIM) has been used by over 320 researchers in the last decade. We present the ecosystem and synthesize the main scientific output from clinical and research studies in different fields. Discussion The importance of mobile e-coaching for prediction, management, and prevention of adverse health outcomes is increasing. A profound e-health development strategyand strategic, technical, and operational investments are needed to prototype, develop, implement, and evaluate e-health solutions. TIIM ecosystem has proven to support these processes. This paper ends with the main research opportunities in mobile coaching, including intervention mechanisms, fine-grained monitoring, and inclusion of objective biomarker data.
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Affiliation(s)
| | - Lucia M Rabago Mayer
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Bart Klaassen
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Saskia M Kelders
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
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Dehainault M, Gaillard O, Ouattara B, Peurois M, Begue C. Physical activity advice given by French general practitioners for low back pain and the role of digital e-health applications: a qualitative study. BMC Prim Care 2024; 25:44. [PMID: 38287271 PMCID: PMC10823670 DOI: 10.1186/s12875-024-02284-w] [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] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/21/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Low back pain is the fourth most common reason for consulting a general practitioner (GP) among people aged 40-50 years. Beyond the overall benefits of physical activity (PA) on health (psychological, cardiovascular, etc.), PA for low back pain seems to improve the prognosis in terms of pain, disability, and quality of life. The French National Health Insurance developed media campaigns to promote physical activity with low back pain and a smartphone application (app). Despite the known benefits and campaigns, GPs do not routinely provide advice about physical activity during low back pain consultations. To promote giving physical activity advice for low back pain, there is a need to understand how GPs currently provide this advice and whether technology could help. This study aims to explore the content of physical activity advice for low back pain that GPs provide in France, and their opinion about healthcare smartphone app provided electronically via the internet (e-health apps) as a support for this advice. METHODS This qualitative study was conducted with semi-structured individual interviews among French GPs. The verbatim was double coded using a coding tree. Thematic analysis was performed using an inductive approach. RESULTS Sixteen GPs from Maine et Loire, Sarthe, and Mayenne were included. The thematic analysis identified the following themes: GPs use a global patient-centred approach to physical activity advice for low back pain. The main goal is to enable patients to participate in their care. Advice was almost always general with little information about duration and frequency. The importance of patient-appropriate and easily achievable activities was emphasised. GPs referred patients to physiotherapists to reinforce regular physical activity, maintain motivation and improve patient adherence through supervision and follow-up. GPs knew little about e-health apps but felt they could be useful with young patients. The main barriers to their use included poor internet connection, lack of technical knowledge and no supervision meaning patients could injure themselves. CONCLUSIONS This is one of the first studies to assess the contents of physical activity advice GPs provide for low back pain. Further research is needed into the implementation of e-health apps for low back pain management. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Marion Dehainault
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France.
| | - Olivia Gaillard
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
| | - Bintou Ouattara
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
| | - Matthieu Peurois
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
- Univ Angers, CHU Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Inserm, Angers, F- 49000, France
| | - Cyril Begue
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
- Univ Angers, CHU Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Inserm, Angers, F- 49000, France
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Duplaga M. Predictors of the Use of Physician's Televisits During the COVID-19 Pandemic in Poland. Stud Health Technol Inform 2024; 310:1106-1110. [PMID: 38269986 DOI: 10.3233/shti231136] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Telemedicine-based contacts between patients and physicians were allowed in Poland only in 2016. However, using such services was not common due to the lack of a relevant reimbursement scheme. During the COVID-19 pandemic, the use of telemedicine and e-health systems increased radically. The aim of this study was the assessment of factors predicting the use of physician's televisit in the Polish general adult population. The analysis was based on data from an online survey of 2410 Internet users performed in October 2020. The logistic regression modeling revealed that both health (HL) and e-health literacy (eHL), the use of e-health services before the pandemic, the use of social media, and from sociodemographic variables, age, gender, vocational status, and marital status were significant predictors of obtaining televisit from a physician during the pandemic. Pre-pandemic experience with ehealth applications strongly predicted utilizing televisits during the pandemic. Respondents with higher levels of HL and eHL were more likely to use such telemedicine services than those with lower levels.
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Affiliation(s)
- Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Ulapane N, Wickramasinghe N, Dang TH, Thodis A, Brijnath B. Web-Based Intervention for Multilingual Family Carers of People with Dementia: Insights from the DrawCare Study. Stud Health Technol Inform 2024; 310:1416-1417. [PMID: 38269674 DOI: 10.3233/shti231222] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Addressing the needs of ethnically diverse multilingual people can be challenging in environments that are non-native to them. The consequences of this issue become more significant in healthcare contexts. Insights from the DrawCare study-an Australian study that explores the effectiveness of a web-based intervention for multilingual family carers of people with dementia-are presented illustrating the enabling role of digital health.
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Affiliation(s)
| | | | - Thu Ha Dang
- Swinburne University of Technology, Australia
- National Ageing Research Institute INC, Australia
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Paschke K, Diestelkamp S, Zapf A, Busch K, Arnaud N, Prehn-Kristensen A, Reis O, Stark M, Cloes JO, Schulz AL, Brauer H, Krömer T, Thomasius R. An app-based training for adolescents with problematic digital-media use and their parents (Res@t digital): protocol for a cluster-randomized clinical trial. Front Psychiatry 2024; 14:1245536. [PMID: 38328520 PMCID: PMC10847547 DOI: 10.3389/fpsyt.2023.1245536] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/29/2023] [Indexed: 02/09/2024] Open
Abstract
Background Digital media-use disorders (DMUD) in adolescents are a rising phenomenon associated with psychological distress, comorbid mental disorders, and high burden on affected families. Since the ICD-11 introduced criteria for gaming disorder, these can now be transferred to describe additional DMUD associated with social media platforms and streaming services. Most evidence for effective treatments comes from cognitive-behavioral therapy (CBT). However, interventions based on theoretical models for adolescents and their parents are widely missing, leading to a significant clinical gap. Methods Res@t digital (Resource-Strengthening Training for Adolescents with Problematic Digital-Media Use and their Parents) is the app-based translation of the first model-based digital intervention for adolescents with DMUD and their parents based on CBT. It comprises separate but content-related modules for adolescents (Res@t-A) and parents (Res@t-P), applying multimodal techniques. The effectiveness of Res@t will be evaluated within a multicenter cluster-randomized controlled evaluator-blinded pre-post follow-up trial with the waitlist control group (CG). In addition to the Res@t program in the intervention group, both groups will receive treatment as usual within primary child and adolescent psychiatric/psychotherapeutic healthcare. The primary outcome addresses DMUD symptom reduction after 10 weeks. Secondary outcomes are related to a reduction in psychological and family-related problems and an increase in parental self-efficacy. All outcomes will be assessed using standardized self-report measures. A total of 1,334 participating adolescent-parent dyads from a large clinical network throughout Germany are planned to be included in the primary analyses based on an intention-to-treat approach, applying linear mixed models. Discussion Assuming superiority of Res@t over the control condition, the intervention has the potential to provide evidence-based treatment for a significant number of help-seeking families, supporting local healthcare structures and resources. It is a promising program for practicable implementation and flexible use in different settings. Clinical trial registration https://drks.de, DRKS00031043.
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Affiliation(s)
- Kerstin Paschke
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Silke Diestelkamp
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Antonia Zapf
- Institute of Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Katharina Busch
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nicolas Arnaud
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Prehn-Kristensen
- Institute of Child and Adolescent Psychiatry, Center for Integrative Psychiatry, School of Medicine, Christian-Albrecht University Kiel, Kiel, Germany
| | - Olaf Reis
- Department for Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Maria Stark
- Institute of Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jan-Ole Cloes
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anna-Lena Schulz
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hannah Brauer
- Institute of Child and Adolescent Psychiatry, Center for Integrative Psychiatry, School of Medicine, Christian-Albrecht University Kiel, Kiel, Germany
| | - Thomas Krömer
- Collaborative Practice for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Hamburg, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Echarri A, Pradera C, Molina G, Gonzalez Moure C, De las Heras C, Fraga Iriso R, Ollero V, Echevarria C, Muñiz J. Implementation of a Teledermatology Electronic Consultation Program to Improve the Care of Patients with Inflammatory Bowel Disease. Telemed Rep 2024; 5:12-17. [PMID: 38469167 PMCID: PMC10927239 DOI: 10.1089/tmr.2023.0060] [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] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 03/13/2024]
Abstract
Introduction Skin lesions are a common extraintestinal manifestation associated with inflammatory bowel disease (IBD), although they may also appear as a complication of IBD treatment. Prompt referral to the dermatologist can be very helpful in practice. Teledermatology complements the traditional in-person health care modality, improving access to dermatological care. Objective To evaluate the impact of a store-and-forward teledermatology electronic consultation (e-consult) program on the care of IBD patients. Methods A retrospective study assessing the outcomes of our teledermatology program over its first 2 years of implementation. Results A total of 39 consultations involving 33 patients (69.2% women, mean age 39.6 years [12-63]) were conducted. The mean number of teleconsultations was 2.8 per month in the initial implementation stage: 33 consultations were carried out in patients with Crohn's disease and 6 in ulcerative colitis. Only 18% of the patients had an active flare-up. The most frequent reason for the e-consult was paradoxical psoriasiform lesions (n = 13, 33.3%), commonly related with anti-tumor necrosis factor agents (70% of the patients) and hidradenitis suppurativa (n = 4, 10.3%). Resolution was achieved in 87% of patients, with a mean waiting time of 4.7 days (0-14). Almost all patients (97%) were satisfied with our program, and considered the referral through the program to be appropriate (92%). Best valued features were the reduced waiting time and the coordinated approach between the two departments involved. Conclusions Dermatology e-consult is an efficient and useful means of optimizing IBD patient care.
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Affiliation(s)
- Ana Echarri
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Carmen Pradera
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Gema Molina
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | - Cristina De las Heras
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Rebeca Fraga Iriso
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Virginia Ollero
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Cristina Echevarria
- Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Javier Muñiz
- Departamento de Ciencias de la Salud e INIBIC, Universidad de A Coruña, CIBERCV, A Coruña, Spain
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Rocha HB, Carneiro BC, Vasconcelos PA, Pereira R, Quinta-Gomes AL, Nobre PJ. Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review. Healthcare (Basel) 2024; 12:253. [PMID: 38275533 PMCID: PMC10815307 DOI: 10.3390/healthcare12020253] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients' and survivors' sexual health. METHODS This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants' sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies. CONCLUSIONS Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.
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Leo DG, Proietti R. A New Player in the Game: Can Exergame Be of Support in the Management of Atrial Fibrillation? Medicina (Kaunas) 2024; 60:172. [PMID: 38256432 PMCID: PMC10819072 DOI: 10.3390/medicina60010172] [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] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia, currently affecting 2-3% of the world's population. Traditional exercise and physical activity interventions have been successfully implemented in the management of AF, with the aim of improving patients' quality of life and their exercise capacity, as well as reducing their mortality rate. Currently, new technology-mediated approaches to exercise, defined as exergame, have been shown to be successful in the delivery of exercise home-based interventions in patients with cardiovascular diseases. However, data on the effects of exergame on AF are not yet available. In this paper, we summarise the current literature on the role of traditional exercise in AF and how it affects the pathophysiology of this condition. We also review the current literature on exergame and its employment in cardiac rehabilitation and suggest its potential role in the management of AF patients. A review of the evidence suggests that traditional exercise (of light-to-moderate intensity) is beneficial in patients with AF. Additionally, exergame seems to be a promising approach for delivering exercise interventions in patients with cardiovascular diseases. Exergame may be a promising tool to improve the quality of life and exercise capacity in patients with AF, with the additional advantage of being remotely delivered, and the potential to increase patients' engagement. Proper guidelines are required to prescribe exergame interventions, considering the principles of traditional exercise prescription and applying them to this new e-health approach. Further studies are needed to validate the use of exergame in patients with AF.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L7 8TX, UK
- Liverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool L8 7TX, UK
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L7 8TX, UK
- Liverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool L8 7TX, UK
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Chatzidaki E, Chioti V, Mourtou L, Papavasileiou G, Kitani RA, Kalafatis E, Mitsis K, Athanasiou M, Zarkogianni K, Nikita K, Kanaka-Gantenbein C, Pervanidou P. Parenting Styles and Psychosocial Factors of Mother-Child Dyads Participating in the ENDORSE Digital Weight Management Program for Children and Adolescents during the COVID-19 Pandemic. Children (Basel) 2024; 11:107. [PMID: 38255420 PMCID: PMC10814028 DOI: 10.3390/children11010107] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Childhood obesity is a complex disease with multiple biological and psychosocial risk factors. Recently, novel digital programs were developed with growing evidence for their effectiveness in pediatric weight management studies. The ENDORSE platform consists of mobile applications, wearables, and serious games for the remote management of childhood obesity. The pilot studies included 50 mothers and their children aged 6-14 years and resulted in a clinically significant BMI z-score reduction over 4 to 5 months. This secondary analysis of the ENDORSE study focuses on parenting styles and psychosocial factors. METHODOLOGY Semi-structured clinical interviews were conducted with all participating mothers pre-and post-intervention. The Parenting Styles and Dimensions Questionnaire (PSDQ) evaluated the mothers' parenting styles. The psychosocial functioning of the participating children was assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). The relationship between parenting styles, psychosocial parameters, and weight outcomes was investigated using a linear regression analysis. RESULTS Weight-related stigma at school (56%), body image concerns (66%), and difficulties in family relationships (48%) were the main concerns documented during the initial psychological interviews. According to the SDQ, there was a significant decrease in children's conduct problems during the study's initial phase (pre-pilot group). A decrease in maternal demandingness (i.e., strict parenting style) was associated with a decrease in BMI z-score (beta coefficient = 0.314, p-value = 0.003). CONCLUSION Decreasing parental demandingness was associated with better weight outcomes, highlighting the importance of assessing parenting factors in pediatric weight management programs.
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Affiliation(s)
- Evi Chatzidaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Vassiliki Chioti
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Lidia Mourtou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Georgia Papavasileiou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Rosa-Anna Kitani
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Eleftherios Kalafatis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Kostas Mitsis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Maria Athanasiou
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Konstantia Zarkogianni
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
- Department of Advanced Computing Sciences, Faculty of Sciences and Engineering, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Panagiota Pervanidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
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Mailuhu AK, Verhagen EA, van Ochten J, Bindels PJ, Bierma-Zeinstra SM, van Middelkoop M. E-health intervention for preventing recurrent ankle sprains: a randomised controlled trial in general practice. Br J Gen Pract 2024; 74:e56-e62. [PMID: 38154933 PMCID: PMC10755994 DOI: 10.3399/bjgp.2022.0465] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 08/10/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet. AIM To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice. DESIGN AND SETTING Randomised controlled trial with 1-year follow-up among patients (14-65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury. METHOD The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport. RESULTS In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82). CONCLUSION The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.
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Affiliation(s)
- Adinda Ke Mailuhu
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Evert Alm Verhagen
- Department of Health Sciences & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - John van Ochten
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Patrick Je Bindels
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Sita Ma Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
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Tomás AS, Dias RM, Cabido H, Nunes C, Lemos P. Online Group Consultation on Labor Analgesia for Pregnant Women: Is It Feasible? Cureus 2024; 16:e51687. [PMID: 38313986 PMCID: PMC10838392 DOI: 10.7759/cureus.51687] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
INTRODUCTION Our department of anesthesiology has been conducting weekly, for several years, a group consultation to educate childbearing people about labor analgesia. The emergence of the COVID-19 pandemic forced an adaptation to a virtual consultation format. Since there are no studies about online group consultation on labor analgesia in order to understand its role, an anonymous questionnaire was created and applied. The objective was to evaluate this new consultation format, namely the ease of access, usefulness of the content provided, and its impact on the satisfaction and experience of childbirth. MATERIALS AND METHODS An observational prospective study was conducted. A questionnaire was sent by e-mail after childbirth to all childbearing people participating in the online consultation from January 20, 2021, to March 2, 2022. SPSS Statistics version 28.0 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp) was used for statistical analysis. Internal consistency was analyzed using Cronbach's alpha. RESULTS A total of 563 participants were eligible, and 404 (71.8%) completed questionnaires were analyzed. A few technical problems were reported. The participants considered their privacy respected, and more than 90% were satisfied with the content of the online consultation, the opportunity to pose questions, and the help managing expectations. Considering face-to-face consultation, 89.6% of patients considered the online format an effective alternative, 63.2% believed it could replace the old model, and 96.3% would recommend it. CONCLUSIONS Our study demonstrates that online consultation on labor analgesia was a good strategy during the COVID-19 pandemic and has the potential to be used in this format in the future.
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Affiliation(s)
- Ana Sofia Tomás
- Department of Anaesthesiology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Raquel M Dias
- Department of Anaesthesiology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Hermina Cabido
- Department of Anaesthesiology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Catarina Nunes
- Department of Science and Technology, Universidade Aberta, Lisboa, PRT
| | - Paulo Lemos
- Department of Anaesthesiology, Centro Hospitalar Universitário de Santo António, Porto, PRT
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Zain E, Rahman N, Khan SA, Farook MS, Khan E, Jubapu AS, Talreja N, Chan BH, Ng ALW. Patients' Readiness Towards Teledentistry in the Malaysian Urban Population Attending an Undergraduate Teaching University. Telemed J E Health 2024; 30:214-222. [PMID: 37358591 DOI: 10.1089/tmj.2023.0075] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Introduction: COVID-19 disease has resulted in suspension of all nonurgent routine dental treatments. In view of COVID-19 situation, social distancing, movement restriction orders, and affected health care systems, there is an urgent need to resume and deliver oral health care remotely. Hence, alternative means of dental care should be available for both patients and dentists. Therefore, this study aims to assess patients' readiness for teledentistry in Malaysian urban population attending an undergraduate teaching university. Methods: A cross-sectional study was conducted among 631 adult patients visiting the Faculty of Dentistry, SEGi University, from January 2020 to May 2021 in Selangor, Malaysia. A validated, self-administered, 5-point Likert scale online questionnaire comprising five domains was administered. (1) Patients' demographics and dental history, (2) patients' access to teledentistry, (3) patients' understanding towards teledentistry, (4) patients' willingness, and (5) barriers in using teledentistry were used to collect the required information. Results: Six hundred and thirty-one (n = 631) participants responded to the questionnaire. Ninety percent of patients were able to connect to Wi-Fi services independently and 77% participants were comfortable using online communication platforms. Seventy-one percent of the participants agreed that video and telephone clinics can reduce chances of infection rather than face-to-face consultation during the pandemic. Fifty-five percent of patients felt that virtual clinics would save time and 60% thought it could reduce travelling costs. Fifty-one percent showed their willingness to use video or telephone clinics when implemented at onsite clinics. Conclusion: Our study shows the readiness of patients to accept teledentistry as an alternative method of oral care if appropriate training and education are provided. The results of this study have prompted an increase in patients' education and shown a need to train clinicians and patients to integrate this technology at SEGi University. This might facilitate unhindered dental consultation and care in all situations.
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Affiliation(s)
- Erum Zain
- Department of Restorative Dentistry, Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - Naomi Rahman
- Consultant in Oral Surgery, University College London Hospital, London, United Kingdom
| | - Saad Ahmad Khan
- Department of Health Sciences, Dadabhoy Institute of Higher Education, Karachi, Pakistan
| | - Mohideen Salihu Farook
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala lumpur, Malaysia
| | - Erum Khan
- Department of Oral Basic and Clinical Sciences, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
| | - Ayesha Shaziya Jubapu
- Department of Prosthodontics, Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - Nidhi Talreja
- Department of Paediatric and Preventive Dentistry, Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - Bing Hong Chan
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - Aaron Long Wai Ng
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
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de Gier M, Beckerman H, Twisk JWR, Knoop H, de Groot V. Effectiveness of a blended booster programme for the long-term outcome of cognitive behavioural therapy for MS-related fatigue: A randomized controlled trial. Mult Scler 2024; 30:71-79. [PMID: 38018811 PMCID: PMC10782645 DOI: 10.1177/13524585231213258] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) reduces MS-related fatigue. However, studies on the long-term effects show inconsistent findings. OBJECTIVE To evaluate whether a blended booster programme improves the outcome of CBT for MS-related fatigue on fatigue severity at 1-year follow-up. METHOD A multicentre randomized clinical trial in which 126 patients with MS were allocated to either a booster programme or no booster programme (control), after following 20-week tailored CBT for MS-related fatigue. Primary outcome was fatigue severity assessed with the Checklist Individual Strength fatigue subscale 1 year after start of treatment (T52). Mixed model analysis was performed by a statistician blinded for treatment-allocation to determine between-group differences in fatigue severity. RESULTS Fatigue severity at 1-year follow-up did not differ significantly between the booster (N = 62) and control condition (N = 64) (B = -2.01, 95% confidence interval (CI) = -4.76 to 0.75). No significant increase in fatigue severity was found at T52 compared with directly post-treatment (T20) in both conditions (B = 0.44, 95% CI = -0.97 to 1.85). CONCLUSION Effects of CBT were sustained up to 1 year in both conditions. The booster programme did not significantly improve the long-term outcome of CBT for MS-related fatigue. TRIAL REGISTRATION Dutch Trial Register (NTR6966), registered 18 January 2018 https://www.trialregister.nl/trial/6782.
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Affiliation(s)
- Marieke de Gier
- Department of Medical Psychology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Heleen Beckerman
- Department of Rehabilitation Medicine, MS Center, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jos WR Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, location Vrije Universiteit Amsterdam and location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, MS Center, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
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Pronk M, Feenstra-Kikken V, Smits C, Besser J, Lissenberg-Witte BI, Polleunis C, Timmer BH, Kramer SE. Feasibility of the HEAR-aware App for Hearing Loss Self-Management: A Nonrandomized Intervention Study to Examine Intervention Acceptability and the Stages-of-Change Concept. Ear Hear 2024; 45:186-197. [PMID: 37677943 PMCID: PMC10718215 DOI: 10.1097/aud.0000000000001414] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/17/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES The HEAR-aware project targets adults ≥50 years who were recently diagnosed with hearing loss and declined hearing aids, but were open for support via a smartphone app on different target behaviors (TBs). The HEAR-aware app, based on Ecological Momentary Assessment and Ecological Momentary Intervention (EMA, EMI), contains educational materials ("snippets") tailored partly to the user's experienced listening situations. The app aims to increase adults' TB-specific readiness to take action on hearing problems. The present study focused on examining feasibility regarding three novel aspects: (1) the app's acceptability, mainly regarding its EMA and EMI elements (compliance, usability, usefulness, satisfaction), (2) psychometric properties of 10 new TB-specific stages-of-change (SoC) measures (test-retest reliability, construct validity), and (3) the potential of tailoring snippets on a person's SoC. DESIGN A nonrandomized intervention study including four measurements with 2-week intervals (T0-T3). (1) The intervention period lasted 4 weeks. App usage data were collected throughout (T1-T3). Usability, usefulness, and satisfaction were measured at T3 (n = 26). (2) Reliability concerned T0 and T1 data, in between which no intervention occurred. Intraclass correlation coefficients (ICCs) were calculated (n = 29). Construct validity was examined by calculating correlations between the different TB-specific scales (at T0), and also between each of them and self-reported hearing disability (n = 29). (3) Person-tailoring by SoC was examined using T0 and T1 data. Linear mixed models were applied to test whether users rated snippets corresponding to their SoC as more interesting and useful than noncorresponding snippets (n = 25). RESULTS (1) The percentage of participants that complied with the intended usage varied across the five predefined compliance criteria (lowest: 8%; highest: 85%). Median snippet satisfaction scores were reasonably positive (3.5 to 4.0 of 5). Usability was good (System Usability Score, mean = 72.4, SD = 14.3) and usefulness satisfactory (Intrinsic Motivation Inventory, mean = 4.4, SD = 1.4), but showed large variance. (2) The 10 TB-specific scales showed fair-to-excellent reliabilities (range ICCs = 0.51 to 0.80). Correlations between the TB-specific scales ranged between -0.17 ( p > 0.05) and 0.74 ( p < 0.001), supporting only partly overlap between their underlying constructs. Only the correlation between TB-specific readiness for hearing aid uptake and self-reported hearing disability was significant. (3) Correspondence of a snippet's SoC with the person's SoC significantly related to "interesting" ratings ( p = 0.006). Unexpectedly, for snippets with a lower SoC than the participant's, further deviation of the snippet's SoC from the participant's SoC, increased the participant's interest in the snippet. The relationship with "usefulness" was borderline significant. CONCLUSIONS (1) Overall usability, usefulness, and satisfaction scores indicated sufficient app acceptability. The high variance and fairly low compliance showed room for improving the app's EMA/EMI parts for part of the participants. (2) The 10 new TB-specific SoC measures showed sufficient reliability, supporting that they measured different types of readiness to take action on hearing problems (construct validity). (3) The unexpected findings regarding tailoring educational app materials to individuals' SoC deserve further study.
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Affiliation(s)
- Marieke Pronk
- Otolaryngology—Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Vanessa Feenstra-Kikken
- Otolaryngology—Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Cas Smits
- Otolaryngology—Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | | | - Birgit I. Lissenberg-Witte
- Epidemiology & Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Conny Polleunis
- Sonova Audiological Care Nederland BV (Schoonenberg HoorSupport), Rotterdam, the Netherlands
| | - Barbra H.B. Timmer
- Sonova AG, Stäfa, Switzerland
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Brisbane, Australia
| | - Sophia E. Kramer
- Otolaryngology—Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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