Personalized and Self-Management: Systematic Search and Evaluation Quality Factors and User Preference of Drug Reference Apps in Taiwan

Background: Drug reference apps promote self-management and improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. This study aimed to describe a systematic and stepwise process to identify drug reference apps in Taiwan, assess the quality of these apps, and analyze the influential factors for user ratings. Methods: A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. Results: A total of 23 drug reference apps in Taiwan were identified and analyzed. Generally, these drug reference apps were evaluated as acceptable quality with an average MARS score of 3.23. Higher user engagement, more functionality, better aesthetics, and more information associated with higher user ratings. Navigation is the most influential factor on higher user ratings (AME: 13.15%) followed by performance (AME: 11.03%), visual appeal (AME: 10.87%), credibility (AME: 10.67%), and quantity of information (AME: 10.42%). Conclusions: User experience and information clearly affect user ratings of drug reference apps. Five key factors should be considered when designing drug reference apps.

Assessing Quality Factors and User Preference of Drug Reference Apps in Taiwan: Systematic Search and Evaluation (Preprint)

BACKGROUND Drug reference apps play various distinct and vital roles through the medication use process. A drug reference app that carried out comprehensive localized drug information would greatly improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. OBJECTIVE This current study aimed to describe a systematic and stepwise process to identify drug reference apps with localized drug information in Taiwan. Moreover, we assessed the quality of these apps by using a reliable quality assessment tool and further analyzing the influential factors for user ratings. METHODS A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Apps were divided into two groups: higher user ratings and lower user ratings. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted, and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. A p-value< 0.05 was considered statistically significant. RESULTS A total of 23 drug reference apps in Taiwan had been identified and analyzed. Ten apps had higher user star ratings (>=4 stars), and 13 apps had lower user star ratings ( < 4 stars). These drug reference apps had acceptable quality with an average MARS score of 3.23. Apps with higher user star ratings had higher MARS scores than the lowers (engagement (2.70 v.s. 2.50, P= .005), functionality (3.85 v.s. 3.49, P= .003), aesthetics (3.39 v.s. 2.98, P < .001), and information (3.55 v.s. 3.25, P= .005)). The regression model showed five influential factors for higher user ratings (navigation, AME, 13.15%; performance, AME, 11.03%; visual appeal, AME, 10.87%; credibility, AME, 10.67%; quantity of information, AME, 10.42%). CONCLUSIONS The proposed KESS algorithm could be a valuable and unbiased framework for systematic search for app. While the higher engagement, more functionality, better aesthetics, and more information associated with higher user ratings, there are five most influential factors, navigation, performance, visual appeal, credibility, and quantity of information among the four elements.

Marine Exopolysaccharide Complexed With Scandium Aimed as Theranostic Agents

(1) Background: Exopolysaccharide (EPS) derivatives, produced by Alteromonas infernus bacterium, showed anti-metastatic properties. They may represent a new class of ligands to be combined with theranostic radionuclides, such as 47Sc/44Sc. The goal of this work was to investigate the feasibility of such coupling. (2) Methods: EPSs, as well as heparin used as a drug reference, were characterized in terms of molar mass and dispersity using Asymmetrical Flow Field-Flow Fractionation coupled to Multi-Angle Light Scattering (AF4-MALS). The intrinsic viscosity of EPSs at different ionic strengths were measured in order to establish the conformation. To determine the stability constants of Sc with EPS and heparin, a Free-ion selective radiotracer extraction (FISRE) method has been used. (3) Results: AF4-MALS showed that radical depolymerization produces monodisperse EPSs, suitable for therapeutic use. EPS conformation exhibited a lower hydrodynamic volume for the highest ionic strengths. The resulting random-coiled conformation could affect the complexation with metal for high concentration. The LogK of Sc-EPS complexes have been determined and showing that they are comparable to the Sc-Hep. (4) Conclusions: EPSs are very promising to be coupled with the theranostic pair of scandium for Nuclear Medicine.

Optimization of the Synthesis of Diclofenac Derivatives with Hydrazone Structure and In Vitro Evaluation of the Anti-Inflammatory Potential

The aim of the study was to optimize the synthesis of diclofenac derivative with hydrazones structure in order to obtain higher yields and purity by variation of different parameters such as: ratio between reactants, solvent, catalyst, temperature, time of reaction and method used. The anti-inflammatory effects of diclofenac derivatives were evaluated using in vitro assays: albumin denaturation and erythrocyte membrane stability. The obtained results showed that the effect of the tested derivatives is increasing with the concentration, the best results being obtained at the concentration of 125 �g/mL (albumin denaturation assay), respectively 111.11 �g/mL (erythrocyte membrane stability assay). The most active compound was 4d which showed the highest inhibition effect on albumin denaturation and an appreciable effect on erythrocyte membrane stability, in comparation with diclofenac, used as drug reference.

Usage of smart devices amongst medical practitioners in Universitas Academic Hospital

Background: There has been a rapid rise in the use of smart devices amongst medical practitioners throughout the world. This study aimed to identify how smart devices were being used by medical practitioners at the Universitas Academic Hospital (UAH), Bloemfontein, and the associated factors thereof. We also identified the views of medical practitioners regarding the usage of smart devices at their workplace.Methods: A prospective cross-sectional study was conducted. Anonymous questionnaires were distributed to medical practitioners working at UAH during weekly departmental meetings or monthly morbidity and mortality meetings. The following largest departments were included: Surgery, Anaesthetics, Paediatrics, Internal Medicine, Family Medicine, and Obstetrics and Gynaecology.Results: The response rate was 82.7% of those attending the meetings. All the respondents owned a smart device and brought it to their workplace. The most common applications used on these smart devices were that for drug references (65.9%), medical textbooks (63.6%) and medical calculators (58.1%). Significantly larger percentages of doctors aged 21–39 years compared with those aged 40–65 years used drug reference applications and medical calculators. A quarter (24.8%) of respondents communicated with patients through a smart device, 21.7% used an online storage platform to backup patient data, whilst 56.6% used their devices to store and view patient information. More than one-third (36.7%) agreed that smart devices threatened patient confidentiality, but the majority (58.8%) did not agree that these devices hinder patient communication. The majority felt that these devices improved both personal performance (69.2%) and patient care (79.0%).Conclusion: Smart devices usage is common in this setting. Hence, integration of such usage in medical curricula, discussion on professionalism, ethics and confidentiality in this context, and guidance from institutions and professional bodies become necessary.