scholarly journals Educating Patients by Providing Timely Information Using Smartphone and Tablet Apps: Systematic Review

10.2196/17342 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e17342 ◽  
Author(s):  
Thomas Timmers ◽  
Loes Janssen ◽  
Rudolf B Kool ◽  
Jan AM Kremer
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Clinical Outcomes ◽  
Treatment Adherence ◽  
Medical Information ◽  
Hospital Setting ◽  
Adherence To Treatment ◽  
Medication Usage ◽  
Tablet Apps

Background Patient education is a crucial element within health care. It is a known predictor for increased engagement in shared decision making, improved medication and treatment adherence, higher levels of satisfaction, and even better treatment outcomes. Unfortunately, often patients only remember a very limited amount of medical information. An important reason is that most patients are simply not capable of processing large amounts of new medical information in a short time. Apps for smartphones and tablets have the potential to actively educate patients by providing them with timely information through the use of push notifications. Objective The objective of this systematic review is to provide an overview of the effects of using smartphone and tablet apps to educate patients with timely education. Within this review, we focused on patients that receive their care in a hospital setting. We assessed the effects of the interventions on outcomes, such as patients’ knowledge about their illness and treatment, adherence to treatment instructions and to medication usage, and satisfaction with the care they received. Methods A comprehensive search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science was conducted. Randomized controlled trials (RCTs) published between January 2015 and November 2019 were eligible for inclusion. Two reviewers independently searched and screened articles, assessed study quality and risk of bias, and extracted the data. Due to the heterogeneity of populations, interventions, and outcomes, a meta-analysis was not deemed appropriate. Instead, a narrative synthesis is presented. Results A total of 21 RCTs with 4106 participants were included. Compared to usual care, overall effectiveness of the interventions was demonstrated in 69% of the outcomes. Effectiveness increased to 82% when the intervention had a duration shorter than one month and increased to 78% when the intervention provided at least one push notification per week. The interventions showed the highest effects on satisfaction with information, adherence to treatment instructions and to medication usage, clinical outcomes, and knowledge. Conclusions This review demonstrates that educating patients with timely medical information through their smartphones or tablets improves their levels of knowledge, medication or treatment adherence, satisfaction, and clinical outcomes, as well as having a positive effect on health care economics. These effects are most pronounced in interventions with a short duration (ie, less than a month) and with a high frequency of messages to patients (ie, once per week or more). With the knowledge that patient education is a predictor for improved outcomes and the fact that patients have obvious difficulties processing large amounts of new medical information, we suggest incorporating the delivery of timely information through smartphone and tablet apps within current medical practices.

scholarly journals Educating Patients by Providing Timely Information Using Smartphone and Tablet Apps: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Thomas Timmers ◽  
Loes Janssen ◽  
Rudolf B Kool ◽  
Jan AM Kremer
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Clinical Outcomes ◽  
Treatment Adherence ◽  
Medical Information ◽  
Hospital Setting ◽  
Adherence To Treatment ◽  
Medication Usage ◽  
Tablet Apps

BACKGROUND Patient education is a crucial element within health care. It is a known predictor for increased engagement in shared decision making, improved medication and treatment adherence, higher levels of satisfaction, and even better treatment outcomes. Unfortunately, often patients only remember a very limited amount of medical information. An important reason is that most patients are simply not capable of processing large amounts of new medical information in a short time. Apps for smartphones and tablets have the potential to actively educate patients by providing them with timely information through the use of push notifications. OBJECTIVE The objective of this systematic review is to provide an overview of the effects of using smartphone and tablet apps to educate patients with timely education. Within this review, we focused on patients that receive their care in a hospital setting. We assessed the effects of the interventions on outcomes, such as patients’ knowledge about their illness and treatment, adherence to treatment instructions and to medication usage, and satisfaction with the care they received. METHODS A comprehensive search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science was conducted. Randomized controlled trials (RCTs) published between January 2015 and November 2019 were eligible for inclusion. Two reviewers independently searched and screened articles, assessed study quality and risk of bias, and extracted the data. Due to the heterogeneity of populations, interventions, and outcomes, a meta-analysis was not deemed appropriate. Instead, a narrative synthesis is presented. RESULTS A total of 21 RCTs with 4106 participants were included. Compared to usual care, overall effectiveness of the interventions was demonstrated in 69% of the outcomes. Effectiveness increased to 82% when the intervention had a duration shorter than one month and increased to 78% when the intervention provided at least one push notification per week. The interventions showed the highest effects on satisfaction with information, adherence to treatment instructions and to medication usage, clinical outcomes, and knowledge. CONCLUSIONS This review demonstrates that educating patients with timely medical information through their smartphones or tablets improves their levels of knowledge, medication or treatment adherence, satisfaction, and clinical outcomes, as well as having a positive effect on health care economics. These effects are most pronounced in interventions with a short duration (ie, less than a month) and with a high frequency of messages to patients (ie, once per week or more). With the knowledge that patient education is a predictor for improved outcomes and the fact that patients have obvious difficulties processing large amounts of new medical information, we suggest incorporating the delivery of timely information through smartphone and tablet apps within current medical practices.

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

Adherence to treatment in psychiatry

2020 ◽  
pp. 193-204
Author(s):  
Amy Chan ◽  
Rob Horne
Keyword(s):  
Health Care ◽  
Treatment Adherence ◽  
Health Care Providers ◽  
Patient Perspective ◽  
Good Health ◽  
Active Role ◽  
Care Providers ◽  
Adherence To Treatment ◽  
Factors Influencing ◽  
Adherence Support

Adherence to treatment in psychiatry is pivotal for achieving and maintaining good health outcomes. Yet, despite the vast amount of research into adherence, treatment adherence remains suboptimal. There is a need for everyone to take an active role in addressing non-adherence if we are to realize the full benefits of available treatments. This chapter introduces the concept of adherence and discusses the factors influencing adherence in psychiatry. The adherence literature is then reviewed, and results from past adherence interventions summarized to explain why non-adherence occurs from an individual patient perspective. A perceptions and practicalities approach to adherence is then presented to help guide the design and delivery of patient-centred adherence support. This chapter serves as a practical guide to adherence for health care providers and others interested in supporting adherence to treatment in psychiatry.

Links Between Perceptions and Practices in Patient Education: A Systematic Review

2019 ◽  
Vol 46 (6) ◽  
pp. 1001-1011 ◽  
Author(s):  
Sandrine Roussel ◽  
Mariane Frenay
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Quality Criteria ◽  
World Health ◽  
Health Organization ◽  
The Individual ◽  
Meta Analyses

Background. Two decades after “patient education” was defined by the World Health Organization, its integration in health care practices remains a challenge. Perceptions might shed light on these implementation difficulties. This systematic review aims to investigate links between perceptions and patient education practices among health care professionals, paying particular attention to the quality of practices in order to highlight any associated perception. Method. PubMed, PsycINFO, and Scopus were searched using the following search terms: “perceptions,” “patient education,” “health care professionals,” and “professional practices.” PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used. Results. Twenty studies were included. Overall findings supported the existence of links between some perceptions and practices. Links were either correlational or “causal” (generally in a single direction: perceptions affecting practices). Four types of perceptions (perceptions of the task including patient education, perceptions about the patient, perceptions of oneself as a health care professional, and perceptions of the context) were identified as being linked with educational practices. Links can although be mediated by other factors. Results concerning links should, however, be considered with caution as practices were mostly assessed by prevalence measurements, were self-reported and concerned exclusively individual education. When analyzing the quality of practices, the two retained studies highlighted their changing nature and the central role of perceptions with respect to the individual patient. Conclusions. This literature review led us to specify the quality criteria for further research: covering the entire spectrum of patient education, operationalizing variables, exploring specific practices, measuring the quality of practices, developing designs that facilitate causation findings, and considering a bidirectional perspective.

scholarly journals Treatment adherence

2007 ◽  
Vol 13 (2) ◽  
pp. 5 ◽  
Author(s):  
M Y H Moosa ◽  
F Y Jeenah ◽  
N Kazadi
Keyword(s):  
Health Care ◽  
Treatment Adherence ◽  
Pill Count ◽  
Self Report ◽  
Adherence To Treatment ◽  
Unfavourable Outcome ◽  
Related Factors ◽  
Psychiatric Illnesses ◽  
Adequate Care ◽  
Physical Disorders

<p>Patients with psychiatric illnesses show a greater degree of non-adherence than those with physical disorders. Adherence to treatment may be assessed using biological measurements, clinician ratings, patient self-report, pill count, caregiver reports and side-effects of medication. Reasons cited for non-adherence include factors related to the treatment, patient-related factors, health care, and socio-economic circumstances. It is important not to make prejudicial predictions of non-adherence based on these factors, or the use non-adherence as an excuse to blame the patient for an unfavourable outcome. Rather, non-adherence should be seen not only as the patient’s inability to follow treatment recommendations but also as the health system's failure to provide adequate care and to meet the patient’s needs.</p>

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Jobbe PL Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

BACKGROUND Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. OBJECTIVE The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. METHODS A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. RESULTS In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. CONCLUSIONS Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

scholarly journals Teaching through telemedicine: A systematic review of education-focused asthma interventions (Preprint)

2019 ◽  
Author(s):  
Nathan Culmer ◽  
Todd Smith ◽  
Catanya Stager ◽  
Andrea Wright ◽  
Karen Burgess ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Video Streaming ◽  
Symptom Burden ◽  
Self Management ◽  
School Based ◽  
Methodological Rigor

BACKGROUND Asthma affects nearly six million children in the United States, with annual school absences totaling 13.8 million days and additional health expenses of $800/year. With limited access to health care in remote locations and underserved communities, telemedicine in a school-based setting involving partnerships between an asthmatic child and health care provider can provide patients with the opportunity to better manage chronic conditions, communicate among partners, and collaborate for solutions. OBJECTIVE The aim of this systematic review is to examine the findings from partnerships involving school-based telemedicine studies using live video streaming to support clinical and educational outcomes for patient-centered care. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched the peer-reviewed literature with terms related to asthma, education and pediatrics and found 408 unduplicated, relevant articles. A determination to include or exclude each abstract was independently made through reviews by at least two researchers. All conflicts were resolved through a consensus by the two lead authors, resulting in five articles. We then methodically extracted data from these five articles related to a) participant background, b) research methods and purpose, and (c) outcomes (educational, self-management, clinical, quality of life (QOL), and satisfaction). We also used the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool to better understand the methodological rigor of each study. RESULTS Our results support telemedicine in a school-based setting as an effective means of empowering asthmatic children and their families to better manage their asthma and thereby improve quality of life. All projects utilized telemedicine technology and live two-way video streaming. We found a variety of educational and curricular tools used to deliver the sessions, with each study reporting generally positive results in terms of clinical outcomes (such as symptom-free days [SFDs] and health care utilization), learning, self-management of asthma, satisfaction with the intervention, and certain aspects of QOL, but not in terms of self-efficacy. Regarding the methodological rigor of the five studies, we rated two articles as strong, two as moderate, and one as weak. CONCLUSIONS After a review of these five studies, we believe that real-time telemedically delivered asthma education has great potential to improve QOL, enhance symptom management ability, and reduce symptom burden on asthma patients, though the results were mixed across the studies. In terms of clinical outcomes, most, but not all, studies found statistically significant improvements in terms of SFDs, symptom control, peak flow rates, and visits to physicians or an ED. Additionally, we found promising results that patient education can, under proper circumstances, positively influence symptom burden. However, further validation of the methods and tools used for these interventions is both merited and prudent.

scholarly journals Tools to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Gerlinde Lenaerts ◽  
Geertruida E Bekkering ◽  
Martine Goossens ◽  
Leen De Coninck ◽  
Nicolas Delvaux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Medical Information ◽  
Point Of Care ◽  
Reliability And Validity ◽  
Website Design ◽  
Evidence Based ◽  
Related Information ◽  
Care Information ◽  
Website Interactivity

BACKGROUND User-friendly information at the point of care should be well structured, rapidly accessible, and comprehensive. Also, this information should be trustworthy, as it will be used by health care practitioners to practice evidence-based medicine. Therefore, a standard, validated tool to evaluate the trustworthiness of such point-of-care information resources is needed. OBJECTIVE This systematic review sought to search for tools to assess the trustworthiness of point-of-care resources and to describe and analyze the content of these tools. METHODS A systematic search was performed on three sources: (1) we searched online for initiatives that worked off of the trustworthiness of medical information; (2) we searched Medline (PubMed) until June 2019 for relevant literature; and (3) we scanned reference lists and lists of citing papers via Web of Science for each retrieved paper. We included all studies, reports, websites, or methodologies that reported on tools that assessed the trustworthiness of medical information for professionals. From the selected studies, we extracted information on the general characteristics of the tools. As no standard, risk-of-bias assessment instruments are available for these types of studies, we described how each tool was developed, including any assessments on reliability and validity. We analyzed the criteria used in the different tools and divided them into five categories: (1) author-related information; (2) evidence-based methodology; (3) website quality; (4) website design and usability; and (5) website interactivity. The percentage of tools in compliance with these categories and the different criteria were calculated. RESULTS Included in this review was a total of 17 tools, all published between 1997 and 2018. The tools were developed for different purposes, from a general quality assessment of medical information to very detailed analyses, all specifically for point-of-care resources. However, the development process of the tools was poorly described. Overall, seven tools had a scoring system implemented, two were assessed for reliability only, and two other tools were assessed for both validity and reliability. The content analysis showed that all the tools assessed criteria related to an evidence-based methodology: 82% of the tools assessed author-related information, 71% assessed criteria related to website quality, 71% assessed criteria related to website design and usability, and 47% of the tools assessed criteria related to website interactivity. There was significant variability in criteria used, as some were very detailed while others were more broadly defined. CONCLUSIONS The 17 included tools encompass a variety of items important for the assessment of the trustworthiness of point-of-care information. Overall, two tools were assessed for both reliability and validity, but they lacked some essential criteria for the assessment of the trustworthiness of medical information for use at the point-of-care. Currently, a standard, validated tool does not exist. The results of this review may contribute to the development of such an instrument, which may enhance the quality of point-of-care information in the long term.

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