scholarly journals Promise of Mobile Health Technology to Reduce Disparities in Patients With Cancer and Survivors

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Brian D. Gonzalez
Keyword(s):  
Quality Of Life ◽  
Access To Care ◽  
Mobile Health ◽  
Cancer Control ◽  
Health Technology ◽  
Self Management ◽  
Patient Access ◽  
Mobile Health Technology ◽  
Patients With Cancer

Despite recent advances in cancer control, numerous disparities exist in the areas of patient access to care, self-management, and quality of life. However, mobile health technology shows promise as a tool to reduce disparities among patients with cancer and cancer survivors by overcoming such barriers as limited access to providers, difficulty communicating with providers, and inadequate communication between patients and providers regarding symptoms. This narrative review draws on the literature in cancer and noncancer populations to identify factors that create or maintain disparities and to describe opportunities for mobile health technology to reduce disparities.

scholarly journals Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects

2017 ◽  
Vol 08 (04) ◽  
pp. 1068-1081 ◽  
Author(s):  
Mehrdad Farzandipour ◽  
Ehsan Nabovati ◽  
Reihane Sharif ◽  
Marzieh Arani ◽  
Shima Anvari
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mobile Health ◽  
Self Management ◽  
Cochrane Central Register ◽  
Patient Reported ◽  
Mobile Health Applications ◽  
Mhealth Apps ◽  
Health Applications

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.

scholarly journals Digital Self-Management Support Tools in the Care Plan of Patients With Cancer: Review of Randomized Controlled Trials

10.2196/20861 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e20861
Author(s):  
Danielle JM Adriaans ◽  
Angelique TM Dierick-van Daele ◽  
Marc Johannes Hubertus Maria van Bakel ◽  
Grard AP Nieuwenhuijzen ◽  
Joep AW Teijink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Randomized Controlled Trials ◽  
Self Management ◽  
Controlled Trials ◽  
Management Support ◽  
Patients With Cancer ◽  
Randomized Controlled ◽  
Support Tools

Background Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care. Objective The aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer. Methods Five databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively. Results A total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as high quality. Conclusions This review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.

Abstract NS1: Mobile Health Technology Is Feasible And Effective For Self-management Support Among Underserved Stroke Survivors

Stroke ◽  
2022 ◽  
Vol 53 (Suppl_1) ◽  
Author(s):  
Jane Anderson ◽  
Barbara Kimmel ◽  
Shubhada Sansgiry ◽  
Gina Evans-Hudnall ◽  
Anette Ovalle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mobile Health ◽  
Goal Attainment ◽  
Community Integration ◽  
Health Technology ◽  
Self Management ◽  
Stroke Survivors ◽  
Management Support ◽  
Mobile Health Technology ◽  
Stroke Knowledge

Background and Purpose: Self-management Support (SMS) helps stroke survivors control risk factors to prevent second stroke. Little is known about feasibility and effectiveness of using mobile health technology (MHT) for SMS among underserved stroke survivors. The investigators studied feasibility and effectiveness of using a video teleconference mobile application to deliver a SMS program to underserved, hard to reach stroke survivors. Methods: The Video teleconference Self-management TO Prevent stroke (V-STOP) program was evaluated using longitudinal design with measurements at baseline, immediately post intervention (6 weeks), intermediate (12 weeks), and at study end (18 weeks). Medically underserved stroke survivors with uncontrolled stroke risk factors were included. Feasibility was assessed as time in intervention, telehealth satisfaction, stroke knowledge and SMS effectiveness were measured as psychological (depression, PHQ-8; anxiety, GAD-7), social (community integration questionnaire), and stroke self-management (goal attainment) outcomes. Generalized estimating equations were used with site and time in intervention as covariates. Results: V-STOP was successfully delivered to 106 participants using MHT over 2 years. Mean age was 59.3 (±10.9), majority were white (82.1%), males (54.3%), not living alone (85.9%), married (52.8%), with low annual income (<$25,000) ( 58.5%), and health insurance (59.4%). Program feasibility indicated mean number of V-STOP sessions were 4.6 (±1.8), with 4.4 (±2.0) hours of total time for the intervention. Overall satisfaction at 6 weeks with V-STOP (4.8(±0.5)) and telehealth (4.7(±0.5)) was high. Stroke knowledge was high at 12 weeks (9.6(±0.7)). SMS effectiveness indicated improvement in psychological outcomes at 6, 12, and 18 weeks from baseline; depression (18 weeks - β = 0.64 (CI 0.49-0.84)) and anxiety (18 weeks - β = 0.66 (CI 0.51-0.85)). Community integration improved by 18 weeks - β = 1.08 (CI 1.01-1.16) and stroke self-management also improved long term at 12 and 18 weeks (β = 0.92 (CI 0.84-0.99). Conclusion: MHT is feasible to deliver SMS to underserved stroke survivors. It improves psycho-social and self-management goal setting and goal attainment outcomes.

scholarly journals Digital Self-Management Support Tools in the Care Plan of Patients With Cancer: Review of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Danielle JM Adriaans ◽  
Angelique TM Dierick-van Daele ◽  
Marc Johannes Hubertus Maria van Bakel ◽  
Grard AP Nieuwenhuijzen ◽  
Joep AW Teijink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Randomized Controlled Trials ◽  
Self Management ◽  
Controlled Trials ◽  
Management Support ◽  
Patients With Cancer ◽  
Randomized Controlled ◽  
Support Tools

BACKGROUND Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care. OBJECTIVE The aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer. METHODS Five databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively. RESULTS A total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as <i>high quality</i>. CONCLUSIONS This review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.

scholarly journals Self-Management education for adults with poorly controlled epILEpsy [SMILE (UK)]: a randomised controlled trial

2018 ◽  
Vol 22 (21) ◽  
pp. 1-142 ◽  
Author(s):  
Leone Ridsdale ◽  
Alison McKinlay ◽  
Gabriella Wojewodka ◽  
Emily J Robinson ◽  
Iris Mosweu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Management Education ◽  
Controlled Trial ◽  
Health Technology ◽  
Self Management ◽  
Depression Symptoms ◽  
Randomised Controlled

BackgroundEpilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting.ObjectivesTo determine the effectiveness and cost-effectiveness of Self-Management education for people with poorly controlled epILEpsy [SMILE (UK)].DesignA parallel pragmatic randomised controlled trial.SettingParticipants were recruited from eight hospitals in London and south-east England.ParticipantsAdults aged ≥ 16 years with epilepsy and two or more epileptic seizures in the past year, who were currently being prescribed antiepileptic drugs.InterventionA 2-day group self-management course alongside treatment as usual (TAU). The control group received TAU.Main outcome measuresThe primary outcome is QoL in people with epilepsy at 12-month follow-up using the Quality Of Life In Epilepsy 31-P (QOLIE-31-P) scale. Other outcomes were seizure control, impact of epilepsy, medication adverse effects, psychological distress, perceived stigma, self-mastery and medication adherence. Cost-effectiveness analyses and a process evaluation were undertaken.RandomisationA 1 : 1 ratio between trial arms using fixed block sizes of two.BlindingParticipants were not blinded to their group allocation because of the nature of the study. Researchers involved in data collection and analysis remained blinded throughout.ResultsThe trial completed successfully. A total of 404 participants were enrolled in the study [SMILE (UK),n = 205; TAU,n = 199] with 331 completing the final follow-up at 12 months [SMILE (UK),n = 163; TAU,n = 168]. In the intervention group, 61.5% completed all sessions of the course. No adverse events were found to be related to the intervention. At baseline, participants had a mean age of 41.7 years [standard deviation (SD) 14.1 years], and had epilepsy for a median of 18 years. The mean QOLIE-31-P score for the whole group at baseline was 66.0 out of 100.0 (SD 14.2). Clinically relevant levels of anxiety symptoms were reported in 53.6% of the group and depression symptoms in 28.0%. The results following an intention-to-treat analysis showed no change in any measures at the 12-month follow-up [QOLIE-31-P: SMILE (UK) mean: 67.4, SD 13.5; TAU mean: 69.5, SD 14.8]. The cost-effectiveness study showed that SMILE (UK) was possibly cost-effective but was also associated with lower QoL. The process evaluation with 20 participants revealed that a group course increased confidence by sharing with others and improved self-management behaviours.ConclusionsFor people with epilepsy and persistent seizures, a 2-day self-management education course is cost-saving, but does not improve QoL after 12-months or reduce anxiety or depression symptoms. A psychological intervention may help with anxiety and depression. Interviewed participants reported attending a group course increased their confidence and helped them improve their self-management.Future workMore research is needed on self-management courses, with psychological components and integration with routine monitoring.Trial registrationCurrent Controlled Trials ISRCTN57937389.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 21. See the NIHR Journals Library website for further project information.

A mobile health application to support self-management in patients with chronic obstructive pulmonary disease: a randomised controlled trial

2020 ◽  
pp. 026921552094693
Author(s):  
LianHong Wang ◽  
YunMei Guo ◽  
Meili Wang ◽  
Yan Zhao
Keyword(s):  
Quality Of Life ◽  
Mobile Health ◽  
Intervention Group ◽  
Smartphone Application ◽  
Self Management ◽  
Control Group ◽  
Chronic Obstructive ◽  
Copd Assessment Test ◽  
Management Behaviour

Objective: To investigate the effects of a mobile health smartphone application to support self-management programmes on quality of life, self-management behaviour and exercise and smoking cessation behaviour in patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled, single-blind trial, was carried out from November 2017 to February 2019, which included 78 participants admitted with COPD to the Affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention ( n = 39) and control groups ( n = 39). Methods: Participants in the intervention group undertook a mobile medical application-based programme in addition to routine care, and participants in the control group received only routine care. The outcome measures were health-related quality of life evaluated by the COPD Assessment-Test, self-management behaviour using the COPD Self-Management Scale and physical activity and smoking behaviour were measured using a self-designed questionnaire. Data collection was conducted at baseline, third month, sixth month and 12th months. Results: Thirty-five participants in the intervention group and 33 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant improvement in the COPD -Assessment -Test scores ( P < 0.01) and in all domains of the COPD Self-Management Scale scores ( P < 0.01) at 12th 12 months. Improvements in the COPD -Assessment -Test scores by 4.3 and 0.3 units, and in the total scores of the COPD Self-Management Scale total score by 23.01 and 2.28 units, respectively, were observed in the intervention and control groups, respectively over the 12-month study period. Meanwhile, the mobile health application programme also improved participants’ exercise and smoking cessation behaviour. Conclusions: The mobile health smartphone application to support self-management programmes was effective in improving health-related quality of life and self-management behaviour in patients with COPD. Trial registration: This study was registered in Chinese clinicaltrials.gov

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