scholarly journals Context-Aware Systems for Chronic Disease Patients: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Kathleen Yin ◽  
Liliana Laranjo ◽  
Huong Ly Tong ◽  
Annie YS Lau ◽  
A Baki Kocaballi ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Conditions ◽  
Management Practices ◽  
Context Aware ◽  
Adaptive Services ◽  
Chronic Disease Patients ◽  
Health Related ◽  
Patient Work ◽  
Context Aware System ◽  
The Impact

BACKGROUND Context-aware systems, also known as context-sensitive systems, are computing applications designed to capture, interpret, and use contextual information and provide adaptive services according to the current context of use. Context-aware systems have the potential to support patients with chronic conditions; however, little is known about how such systems have been utilized to facilitate patient work. OBJECTIVE This study aimed to characterize the different tasks and contexts in which context-aware systems for patient work were used as well as to assess any existing evidence about the impact of such systems on health-related process or outcome measures. METHODS A total of 6 databases (MEDLINE, EMBASE, CINAHL, ACM Digital, Web of Science, and Scopus) were scanned using a predefined search strategy. Studies were included in the review if they focused on patients with chronic conditions, involved the use of a context-aware system to support patients’ health-related activities, and reported the evaluation of the systems by the users. Studies were screened by independent reviewers, and a narrative synthesis of included studies was conducted. RESULTS The database search retrieved 1478 citations; 6 papers were included, all published from 2009 onwards. The majority of the papers were quasi-experimental and involved pilot and usability testing with a small number of users; there were no randomized controlled trials (RCTs) to evaluate the efficacy of a context-aware system. In the included studies, context was captured using sensors or self-reports, sometimes involving both. Most studies used a combination of sensor technology and mobile apps to deliver personalized feedback. A total of 3 studies examined the impact of interventions on health-related measures, showing positive results. CONCLUSIONS The use of context-aware systems to support patient work is an emerging area of research. RCTs are needed to evaluate the effectiveness of context-aware systems in improving patient work, self-management practices, and health outcomes in chronic disease patients.

Impact of Elevated BMI and Types of Comorbid Conditions on Health-Related Quality of Life in a Nationally Representative US Sample

2021 ◽  
pp. 1-22
Author(s):  
Quang A. Le ◽  
Dimittri Delevry
Keyword(s):  
Chronic Conditions ◽  
Normal Weight ◽  
Class Iii ◽  
Comorbid Conditions ◽  
Class Iii Obesity ◽  
Related Quality ◽  
Health Related ◽  
Nationally Representative ◽  
The Impact

Abstract Objective: Elevated body mass index (BMI) is associated with multiple chronic conditions including diabetes and cardiovascular disease. Patients with overweight or obesity may also suffer from comorbidities not directly related to the pathophysiology of elevated BMI. The current study sought to determine the impact of BMI and different types of chronic conditions on health-related quality of life (HRQoL) outcomes. Design: Six weight categories by BMI were identified: Underweight, Normal weight, Overweight, Class-I obesity, Class-II obesity, and Class-III obesity. Twenty chronic conditions were considered and categorized as elevated BMI-related (concordant) or -unrelated (discordant) conditions. HRQoL outcomes were measured using Short Form-6 Dimensions (SF-6D). Multivariable regression models were performed to examine the impact of type, number of comorbid conditions, and BMI categories on SF-6D scores. Setting: Medical Expenditure Panel Survey (2013-2015). Participants: Nationally representative sample of US population; 18 years or older (n=58,960). Results: Of the sample, 1.7%, 32.9%, 34.0%, and 31.4% were classified as underweight, normal weight, overweight, and obese, respectively. The SF-6D scores were significantly decreased across all obesity classes, with the largest reduction in Class-III obesity (0.033; p < 0.001). Additionally, individuals with obesity having one or more concordant or discordant comorbidities further reduced SF-6D scores between 0.031 and 0.148 (p-values < 0.001) or between 0.080 and 0.212 (p-values < 0.001), respectively. Conclusions: Individuals with obesity had a significant reduction in HRQoL outcomes compared to those with normal BMI. Importantly, discordant comorbidity resulted in greater reduction in HRQoL outcomes compared to concordant comorbidity in subjects with elevated BMI.

scholarly journals Clustering and Healthcare Costs With Multiple Chronic Conditions in a US Cross-Sectional Study

2020 ◽  
Author(s):  
cother hajat ◽  
yakir siegal ◽  
amalia adler-waxman
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Healthcare Costs ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
The Us ◽  
Health Related ◽  
Insured Patients ◽  
The Impact ◽  
Hiv Aids

Objective To investigate healthcare costs and contributors to costs for multiple chronic conditions (MCCs), common clusters of conditions and their impact on cost and utilisation. Methods This was a cross-sectional analysis of US financial claims data representative of the US population, including Medicare, Medicaid and Commercial insurance claims in 2015. Outcome measures included healthcare costs and contributors; ranking of clusters of conditions according to frequency, strength of association and unsupervised (k-means) analysis; the impact of clustering on costs and contributors to costs. Results Of 1,878,951 patients, 931,045(49.6%) had MCCs, 56.5% weighted to the US population. Mean age was 53.0 years(SD16.7); 393,121(42.20%) were male. Mean annual healthcare spending was $12,601, ranging from $4,385 (2 conditions) to $33,874 (11 conditions), with spending increasing by 22-fold for inpatient services, 6-fold for outpatient services, 4.5-fold for generic drugs and 4.2-fold for branded drugs. Cluster ranking using the 3 methodologies yielded similar results: highest ranked clusters included metabolic syndrome(12.2% of US insured patients), age related diseases(7.7%), renal failure(5.6%), respiratory disorders(4.5%), cardiovascular disease(CVD)(4.3%), cancers(4.1-4.3%), mental health-related clusters(1.0-1.5%) and HIV/AIDS(0.2%). Highest spending was in HIV/AIDS clusters ($48,293), mental health-related clusters ($38,952-$40,637), renal disease ($38,551) and CVD ($37,155); with 89.9% of spending on outpatient and inpatient care combined, and 10.1% on medication. Conclusion and Relevance Over 57% of insured patients in the US may have MCCs. MCC Clustering is frequent and is associated with healthcare utilisation. The findings favour health system redesign towards a multiple condition approach for clusters of chronic conditions, alongside other cost-containment measures for MCCs.

A centre for the control of animal health and its management: veterinary field studies of dairy cows in Belgium

1999 ◽  
Vol 24 ◽  
pp. 193-196
Author(s):  
J. Detilleux ◽  
J. Arendt ◽  
A. Dewaele ◽  
F. Lomba ◽  
C. Doyen ◽  
...  
Keyword(s):  
Management Practices ◽  
Animal Health ◽  
International Health ◽  
Field Studies ◽  
Identification System ◽  
Animal Identification ◽  
Health Related ◽  
The Impact ◽  
Comfort Indices

AbstractIn 1998, the European Community, the Region Wallonne, and the Province du Hainaut funded the project known as the Centre for the control of animal health and its management (CESAM). This project was initiated in the Hainaut province of Belgium to answer problems encountered by cattle producers. Its overall goal is the identification of stages in the entire bovine production process where economic efficiency can be increased. A part of this project aims principally at the study of the impact of health-related problems on dairy production. For this part of the project, 32 veterinarians and 51 farmers started collecting data in the field. The methodology for data collection was based mainly on the harmony between the farmer and the veterinarian. Therefore, several procedures were implemented to ensure adequate motivation of both farmers and veterinarians. Farmers note all events of their livestock using a list, which contains disease events, preventive treatments, reasons for culling, and management practices. A veterinarian visits farms monthly to validate collected data and to discuss specific problems. During these farm visits, veterinarians collect body condition scores on adult cows. Veterinarians record also information on health problems they encounter during their normal practice using an international health data recording nomenclature. A national organization provides unique animal identification system. Production data will be recorded and feeding practices, milking procedures and barn comfort indices will be regularly investigated. All data will be collected on pre-printed documents, scanned at CESAM and centralized in a relational computer database. Criteria to evaluate the quality of the proposed methodology are presented.

(Health-related) quality of life and psychosocial factors in adolescents with chronic disease: a systematic literature review

2017 ◽  
Vol 31 (4) ◽  
Author(s):  
Teresa Santos ◽  
Margarida Gaspar de Matos ◽  
Celeste Simões ◽  
Isabel Leal ◽  
Maria do Céu Machado
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Literature Review ◽  
Protective Factors ◽  
Psychosocial Factors ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background Research on living with a chronic disease (CD) in adolescence is increasing. However, studies on the relevance of psychosocial factors are still needed. The present review, focuses on the impact of living with a CD in adolescence on on quality of life (QoL), health-related quality of life (HRQoL) and psychosocial factors. Methods A literature review of articles identified through PubMed, PsycINFO and PsycARTICLES (these last two ones comprise the Ebsco Host platform) and original peer-reviewed research papers, published between 2010 and 2015, with no restrictions regarding the format/source of interventions, randomized controlled trials (RCTs) or types of comparisons were included. Results Eighteen papers met the inclusion criteria and contradictory results were found: the majority showed a significantly higher risk of impairment on QoL/HRQoL and psychosocial factors, whereas others reported a significantly lower risk of impairment (highlighting possible protective factors), or no significant differences. Heterogeneity in the assessment procedures and substantial difficulties in considering adolescence as a single and independent age group, were also noted. Conclusion The higher risk of impairment and the heterogeneity observed between cohorts, reinforce the need to work towards consensual procedures, which allow for more accurate comparisons among studies. Additionally, it conveys the challenge to find more effective interventions. Furthermore, it is highly suggested to routinely assess HRQoL/psychosocial factors within an individualized framework, to considerer adolescents as a single/independent group, to emphasize potential protective factors, and, to increase youth’s participation in their own adaptation process and in health promotion in general. These are possible future directions that could enable multidisciplinary responses to improve HRQoL and psychosocial care in adolescents with a CD.

scholarly journals Specializing Nurses as An Indirect Education Program for Stoma Patients

2019 ◽  
Vol 16 (13) ◽  
pp. 2272
Author(s):  
Manuel García-Goñi
Keyword(s):  
Chronic Conditions ◽  
Cost Effective ◽  
Effectiveness Analysis ◽  
Education Strategy ◽  
Related Quality ◽  
Health Related ◽  
Low Incidence ◽  
Specialist Nurses ◽  
The Impact

Education programs are beneficial for patients with different chronic conditions. Prior studies have examined direct education, where information is transferred directly to patients. In contrast, in this program, information is transferred directly to nurses who become specialists and transfer education individually to patients. Hence, this paper evaluates the impact of having specialist nurses for stoma patients at hospitals, as those nurses provide healthcare to patients but also inform and educate patients about their condition and needs. The analysis uses an observational study with ostomized patients in Spain at hospitals with and without specialist nurses, and measures health service utilization and health-related quality of life (HRQL), besides performing a cost analysis and a cost-effectiveness analysis at both types of hospitals. The results show that patients with access to specialist nurses self-manage better, present lower adverse events and a better evolution of HRQL, and significantly demand more consultations with specialist nurses and less to A&E, primary care or specialists, resulting in important savings for the health system. Consequently, specializing or hiring nurses to provide indirect education to stoma patients is cost-effective and highly beneficial for patients. This type of indirect education strategy might be considered for specific conditions with low incidence or difficulties in identifying target patients or delivering information directly to them.

The impact of a primary care e-communication intervention on the participation of chronic disease patients who had not reached guideline suggested treatment goals

2016 ◽  
Vol 99 (4) ◽  
pp. 530-541 ◽  
Author(s):  
Marie-Thérèse Lussier ◽  
Claude Richard ◽  
Emma Glaser ◽  
Denis Roberge
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Communication Intervention ◽  
Treatment Goals ◽  
Chronic Disease Patients ◽  
The Impact

Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions

2013 ◽  
Vol 19 (2) ◽  
pp. 144 ◽  
Author(s):  
Ian McRae ◽  
Laurann Yen ◽  
Yun-Hee Jeon ◽  
Pushpani M. Herath ◽  
Beverley Essue
Keyword(s):  
Chronic Disease ◽  
Chronic Conditions ◽  
Financial Burden ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Economic Consequences ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related

Most older Australians have at least one chronic health condition. The management of chronic disease is associated with potentially severe economic consequences for patients and their households, partially due to the financial burden associated with out-of-pocket costs for medical and health-related care. A questionnaire was mailed to a cross-sectional sample of older Australians in mid-2009, with 4574 responding. Multivariate logistic regression models were developed to investigate the relationships between multimorbidity and out-of-pocket spending on medical and health-related expenses, including the factors associated with severe financial stress among older Australians. We found a positive relationship between number of chronic conditions and out-of-pocket spending on health and that people with multiple chronic conditions tend to be on lower incomes. People with five or more chronic conditions spent on average five times as much on their health as those with no diagnosed chronic conditions and each additional chronic disease added 46% to the likelihood of a person facing a severe financial burden due to health costs. While health policy may minimise out-of-pocket spending for individual conditions, costs compound rapidly for patients with multiple conditions and this burden falls most heavily on those with the lowest incomes.

The Impact of 29 Chronic Conditions on Health-related Quality of Life: A General Population Survey in Finland Using 15D and EQ-5D

2006 ◽  
Vol 15 (8) ◽  
pp. 1403-1414 ◽  
Author(s):  
Samuli I. Saarni ◽  
Tommi Härkänen ◽  
Harri Sintonen ◽  
Jaana Suvisaari ◽  
Seppo Koskinen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Chronic Conditions ◽  
Population Survey ◽  
Health Related Quality ◽  
General Population Survey ◽  
Related Quality ◽  
Health Related ◽  
The Impact

The importance of considering differential item functioning in investigating the impact of chronic conditions on health-related quality of life in a multi-ethnic Asian population

2016 ◽  
Vol 26 (4) ◽  
pp. 823-834 ◽  
Author(s):  
Edimansyah Abdin ◽  
Mythily Subramaniam ◽  
Louisa Picco ◽  
Shirlene Pang ◽  
Janhavi Ajit Vaingankar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Differential Item Functioning ◽  
Chronic Conditions ◽  
Asian Population ◽  
Health Related Quality ◽  
Item Functioning ◽  
Related Quality ◽  
Health Related ◽  
The Impact

scholarly journals The impact of common chronic conditions on health-related quality of life: a general population survey in Iran using EQ-5D-5L

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ali Akbari Sari ◽  
Fereshteh Karimi ◽  
Zahra Emrani ◽  
Hojjat Zeraati ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Ordinary Least Squares ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Utility Scores

Abstract Background Diseases have undeniable effects on Health-Related Quality of Life (HRQoL). Chronic diseases, in particular, limit the productive potentials and HRQoL of individuals. EQ-5D is a very popular generic instrument, which can be used to estimate HRQoL scores in any diseases. The current study investigates mean HRQoL scores in certain chronic diseases and examines the relationship between utility scores and chronic diseases in Iran. Method This cross-sectional study was carried out among the general adult population of Tehran. 3060 individuals were chosen by a stratified probability sampling method. The EQ-5D-5L questionnaire was applied. The utility scores were estimated using the Iranian crosswalk-based value set. The effect of chronic diseases on the HRQoL scores was derived by the Ordinary Least Squares (OLS) method. Data was analyzed using Stata version 13 software. Results The mean ± standard deviation utility and EQ-VAS scores were 0.85 ± 0.14 and 76.73 ± 16.55 in the participants without any chronic conditions. The scores were 0.69 ± 0.17 and 61.14 ± 20.61 in the participants with chronic conditions. The highest and lowest mean utility scores were related to thyroid disease (0.70) and Stroke (0.54), respectively. Common chronic conditions had significant negative effects on the HRQoL scores. Stroke (0.204) and cancer (0.177) caused the most reduction in the EQ-5D-5L utility scores. Lumbar disc hernia, digestive diseases, osteoarthritis, breathing problems, and anxiety/nerves cause 0.133, 0.109, 0.108, 0.087, and 0.078 reductions, respectively, in the EQ-5D-5L utility scores. Conclusion This study provides insight into some common chronic conditions and their effects on the HRQoL. Policymakers and planners should pay attention to the effects of chronic conditions especially high prevalence one. They should adopt effective interventions to control this issue and increase health. The results of this study can also be beneficial in economic evaluation studies.

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