DIGITAL HEALTH最新文献

Objectives: This study explores the influence of clinic-led onboarding and interaction processes on patient engagement within a digital health program for long COVID care, the Living with COVID Recovery (LWCR) program. We compared clinical practices and patient engagement levels across seven clinics utilising LWCR, gaining insights that could optimise digital health interventions (DHIs) for long COVID care.

Methods: Using a mixed-methods approach, we conducted qualitative interviews with clinicians from seven clinics (out of thirty five) to understand their onboarding and interaction strategies for the LWCR program. We also performed a descriptive quantitative analysis of patient and clinic usage data to rank and classify patient engagement. These rankings were then compared against qualitative insights to explore the influence of clinic-led strategies on patient engagement. Additionally, we conducted interviews with 12 patients under the care of seven clinics to complement our mixed-method analysis.

Results: Four key practices were identified in clinics with higher patient engagement: pre-assessment onboarding, proactive communication, patient education and the involvement of clinically experienced staff. Clinics that integrated these interdependent practices into a cohesive strategy demonstrated notably higher patient engagement levels.

Conclusion: This study highlights the critical role of integrating multiple, interdependent clinic-led strategies to optimise patient engagement in DHIs, particularly for long COVID care. These findings provide actionable insights for healthcare providers and policymakers, suggesting that a comprehensive approach is essential for maximising patient engagement and improving care outcomes. The study lays the groundwork for future research to explore the broader applicability of these strategies across different healthcare contexts.

Background: While anxiety disorders are one of the most prevalent mental diseases, they are often overlooked due to shortcomings of the existing diagnostic procedures, which predominantly rely on self-reporting. Due to recent technological advances, this source of information could be complemented by the so-called observable cues - indicators that are displayed spontaneously through individuals' physiological responses or behaviour and can be detected by modern devices. However, while there are several individual studies on such cues, this research area lacks a synthesis. In line with this, our scoping review aimed to identify observable cues that offer meaningful insight into individuals' anxiety and to determine how these cues can be measured.

Methods: We followed the PRISMA guidelines for scoping reviews. The search string containing terms related to anxiety and observable cues was entered into four databases (Web of Science, MEDLINE, ERIC, IEEE). While the search - limited to English peer-reviewed records published from 2012 onwards - initially yielded 2311 records, only 33 articles fit our selection criteria and were included in the final synthesis.

Results: The scoping review unravelled various categories of observable cues of anxiety, specifically those related to facial expressions, speech and language, breathing, skin, heart, cognitive control, sleep, activity and motion, location data and smartphone use. Moreover, we identified various approaches for measuring these cues, including wearable devices, and analysing smartphone usage and social media activity.

Conclusions: Our scoping review points to several physiological and behavioural cues associated with anxiety and highlights how these can be measured. These novel insights may be helpful for healthcare practitioners and fuel future research and technology development. However, as many cues were investigated only in a single study, more evidence is needed to generalise these findings and implement them into practice with greater confidence.

Persons with autism spectrum disorder (ASD) and/or intellectual disability (ID) have difficulties in planning, organising and coping with change, which impedes the learning of daily living skills (DLSs), social participation and self-management across different environmental settings. Assistive technologies (ATs) is a broad term encompassing devices and services designed to support individuals with disabilities, and if used in a self-controlled manner, they may contribute inclusion in all domains of participation. This comprehensive literature review aims to critically assess and unify existing research that investigates the use of assistive technology within the practical domain for individuals with ASD and/or ID. The 18 relevant studies included in this review highlighted the benefits of AT for social participation and independence in daily activities of individuals with ASD and/or ID. Professionals working with this target group should be knowledgeable of the speedy progress of AT products and the potential of persons with ASD and/or ID to use mainstream devices to meet their individual needs. This awareness provides an opportunity to advocate for the universal benefits of AT for everyone. Technologies such as virtual reality, mobile applications and interactive software have been shown to improve DLSs, communication and social interaction. These tools offer engaging, user-friendly platforms that address the specific needs of these individuals, enhancing their learning and independence.

Study objectives: Obesity-related health data is needed for studies and precision medicine, but existing registers, medical chart systems, and digital platforms are seldom compatible. Before creating improved ways of sharing health data, this study aimed to gather opinions, experiences, and wishes from stakeholders that may use obesity-related health data: healthcare, researchers, people with overweight or obesity, the pharmaceutical industry, and IT-specialists.

Methods: We performed semistructured interviews with 28 stakeholders and analyzed qualitative text data with inductive content analysis. We grouped the suggested parameters in categories.

Results: Time efficient data entering was perceived crucial. Access to health data was important to all participants. Some parameters, such as age, BMI, and sex were requested by all stakeholders. Other data were stakeholder specific, such as population-specific laboratory references, suggested by healthcare professionals only. For people with overweight or obesity, ability to share data with healthcare staff about fitness level or previous weight loss attempts, was important.

Conclusion: The results from this study can be used in the design and implementation of a national health data sharing solution that may be used for precision healthcare use and to evaluate and guide obesity treatment and preventive measures. Data parameters requested by all populations, such as BMI, sex, and age, should be prioritized when designing a data solution. Ability for individuals with overweight or obesity to share health data, may improve healthcare appointments and reduce weight stigma.

Background: The rehabilitation process for cognitive disorders is long and complex, which can lead to reduced rehabilitation outcomes and reduced quality improvement. Thus, there is a need to use new methods to boost conventional rehabilitation (e.g., drug therapy, herbal therapy, paper, and pencil tasks). Innovations such as RehaCom can be helpful to remove the obstacles to treatment, but evidence for their effectiveness is limited.

Objectives: To compare the effectiveness of RehaCom with other cognitive therapies (computer-based, non- computer) in patients with cognitive impairment (CI).

Methods: Eight bibliographic databases (PubMed, Cochran Library, Scopus, Science Direct, Web of Science, Embase, ProQuest, and google scholar) were used in this research. The initial search resulted in the extraction of 2466 articles; after the review of the title, abstract, and full text, 19 articles were selected. Quality assessment was performed using the CONSORT checklist. Then, data extraction was done using the form set by the researcher in Word 2016 software.

Results: Overall, RehaCom achieved more positive clinical effects compared to other cognitive therapies (e.g., improvement in memory, attention, and motor function) on multiple sclerosis (n = 7), schizophrenia (n = 6), stroke (n = 3), Parkinson (n = 1), mild CI (n = 1), and acquired brain damage (n = 1). In six studies, a follow-up period of some weeks to 6 months has been used. Additionally, six studies used conventional therapy plus RehaCom for intervention. Except one study, all studies used RehaCom individual training.

Conclusions: This review provides evidence for the potential effectiveness of RehaCom for the improvement of clinical outcomes in patients with CI. However, more robust Randomised Controlled Trials (RCTs) are needed to confirm the observed positive effects.

Objective: As highlighted by the COVID-19 pandemic, identifying strategies for home-based patient management is crucial. As pain is highly prevalent and imposes significant burdens, interest in its remote management is steadily increasing. Transcranial Direct Current Stimulation (tDCS) seems promising in this context.

Methods: This systematic review and meta-analysis aimed to determine the effectiveness of home-based tDCS in pain management (PROSPERO, CRD42023452899). The extracted data included clinical conditions, interventions, comparators, outcome measures, adverse effects, and risk of bias; the Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment was carried out.

Results: 12 records (9 randomized controlled trials [RCTs], 446 participants, 266 undergoing tDCS) were included in the systematic review. The meta-analysis showed that home-based tDCS might produce large and clinically relevant improvement in chronic pain intensity at the end of the intervention (standard mean difference [SMD] -0.95, 95% CI -1.34 to -0.56; p < 0.01; 404 participants, low certainty), as well as small clinically unimportant improvement at short-term follow-up (SMD -0.50, 95% CI -0.82 to -0.19; p < 0.01; 160 participants, moderate certainty). A subgroup analysis showed that it might clinically improve the chronic pain related to fibromyalgia and knee osteoarthritis. Moreover, home-based tDCS seems to modulate pressure pain threshold, heat pain threshold, and heat and cold tolerance at the end of the intervention. Notably, tDCS appeared to be generally safe, well-accepted and easily applied at home.

Conclusions: Low to moderate certainty evidence suggests that home-based self-administered tDCS is a safe and effective tool for managing various types of chronic pain. Further well-designed, large-scale RCTs are warranted.

Objective: The main aim of this review was to systematically collect and summarize the available evidence on health information-seeking behavior among people living with the two common types of chronic diseases in LMICs.

Methods: For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, Google Scholar, and forward and backward citations from included studies. The preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) procedure were followed to develop and report the review. The pooled effect size and the effect's 95% confidence interval were calculated using a random-effect model meta-analysis for each research. A sub-group analysis was done to investigate potential sources of heterogeneity. To identify publication bias, Egger-weighted regression tests were employed.

Results: A total of 4281 articles were retrieved, with ten studies meeting the eligibility criteria for qualitative synthesis and only seven studies were eligible for the meta-analysis. The pooled extent of health information-seeking behavior among chronic disease patients was 50.5% (95% CI: 35.36-65.70, p = 0.00), with high heterogeneity (I²= 98.25). Based on the sub-group analysis, it was found that 55% (95% CI: 29.9-79.4) of cancer patients and 40% (95% CI: 36.9%-43.9%) of DM patients sought out health-related information. In studies conducted before 2015, the level of health information seeking was 49%, increasing to 52% (95% CI: 41.0%-62.2%) after 2015.

Conclusion: The overall health information seeking behavior among diabetes and cancer patients has increased over time, but remains relatively low, with only nearly half actively seeking information. The findings also emphasize that patients require health-related information on various topics.. Health educators and health professionals should consider this diversity when developing interventions and educational materials to provide patients with the most comprehensive information and education regarding their healthcare issues.

Protocol registration number: CRD42023433169.

Objective: Rapid digitisation of health occurred during the COVID-19 pandemic worldwide. In October 2020, we conducted a survey on digital health technology use in Germany. This study aimed to conduct a second survey to investigate in more detail the internet use in health context and digital technology use for health promotion and disease prevention in Germany.

Methods: A cross-sectional, nationwide telephone survey was conducted in November 2022. Anonymous data on internet and digital technology use, digital health literacy, and sociodemographic characteristics were analysed using descriptive statistics and binary logistic regressions.

Results: The 1020 participants were aged 18-92 years, 53% were male, 62% completed primary or secondary education, 71% resided in large cities, and 45% reported a country-average net household income. Overall, 61% reported internet use in health context via 1-4 devices. Among those, more than 50% used the internet and apps to obtain general health information and less than 50% used digital technologies for physical activity promotion or cancer prevention. Overall, 34% were confident in using the internet for health decisions and 71% preferred to receive health information non-digitally (e.g. on paper). Internet, app, and digital technology use were associated with higher digital health literacy and income, and residence in larger cities. Digital technologies were used for physical activity promotion by younger and for cancer prevention by older participants.

Conclusion: The internet and digital technologies were predominantly used to obtain health information, but less often for health promotion and disease prevention in 2022 in Germany. While health app and digital technology use for physical activity promotion increased, the confidence in using online information for health decisions decreased in 2022 relative to 2020. Factors that promote confidence in online health information and digital technology use for health promotion and disease prevention need to be investigated in future studies.

Background: Patients with chronic pain often struggle to engage in physical activity despite its health benefits. The eVISualisation of physical activity and pain intervention (eVIS) was developed to support adherence to physical activity plans in Interdisciplinary Pain Rehabilitation Programs (IPRPs) by visualising activity, pain levels, pain interference, and pharmacological use. This pilot study assesses the feasibility and acceptability of trial design and trial conduct of a registry-based randomised clinical trial (R-RCT).

Method: This randomised clinical pilot study included the first 10% (n = 39, mean age 43.5, 74.4% females) of the R-RCT sample (n≈400). Participants with non-cancer chronic pain from six IPRP units were randomly assigned to either the intervention group (IPRP + eVIS, n = 19) or the control group (IPRP, n = 20). Feasibility and acceptability were evaluated using pre-defined criteria on recruitment- and data collection procedures (e.g., inclusion rates, representativeness, adverse events), physiotherapists' ratings of trial design and conduct (e.g., acceptability, feasibility), and outcome data characteristics and completeness (e.g., adherence, data accessibility).

Results: Recruitment was largely feasible, though attrition differences and the need for refined eligibility screening were noted. Physiotherapists cited time and implementation challenges. Both groups had satisfactory data completeness, but the control group showed lower adherence to daily reporting in the final third of the study. The intervention group had greater improvements in physical health, with 19.5% more participants achieving the minimum clinically important difference (≥3) on the physical component summary scale (PCS). No adverse events occurred.

Conclusion: With minor adjustments, the R-RCT design is mostly feasible, though some challenges to feasibility were identified and addressed.

Access to timely oral healthcare services is paramount for any oral healthcare system, as good oral health contributes to overall quality of life and wellbeing. Despite several initiatives' efforts, there are still persistent deficiencies in accessing oral healthcare. As a result, teledentistry is recognized as a promising and cost-effective intervention to reduce oral health inequalities, enhance patients' outcomes and experiences, improve oral healthcare providers' wellbeing, reduce costs, and contribute to environmental sustainability in dentistry. However, there is confusion in its terminology with many interchangeably used terms referring to this concept. Therefore, based on our research on systematic reviews on teledentistry, we define teledentistry as the use of technology for remote oral healthcare delivery between patients and oral healthcare providers or between healthcare providers. Its goals are to facilitate access to care, reduce oral health inequalities, mitigate the economic impact of oral diseases and treatment, and foster interprofessional collaboration.