scholarly journals The Use of Health IT for Chronic Disease Management: A comprehensive review of diabetes applications used for self-management of the disease (Preprint)

2019 ◽  
Author(s):  
Lorrin Robinson ◽  
Jamesa Hogges ◽  
Ingrid Brown ◽  
Kennedy Craig ◽  
Akasha Lawrence ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
The Self ◽  
Self Management ◽  
Consumer Reviews ◽  
Health Apps ◽  
Apple Ios ◽  
Mobile Health Apps

BACKGROUND Mobile health (mHealth) smartphone applications (apps) have shown promise in the self-management of chronic disease. Management of key disease variances can be performed through these applications to increase patient engagement in disease self-management. In today’s oversaturated health app market, what selection criteria do consumers employ to choose mobile health apps for disease self-management? App quality is critical in monitoring disease controls but is often linked to consumer popularity rather clinical recommendations of effectiveness in disease management. This paper provides a comprehensive review of features found in mobile health apps frequently used in the self-management of diabetes. OBJECTIVE The objective of this study was to review features of frequently used and high consumer-rated mobile health apps used in the self-management of diabetes within the Apple iOS store. These applications were cross-referenced against high consumer-rated health apps found in other online diabetes sources. This study aimed to highlight key features of consumer-favored mobile health apps used in the self-management of diabetes. METHODS A primary Apple iOS store search was conducted using the term “diabetes apps” on an Apple iPad. The top five most frequently used mobile health apps were identified and rated by the number of consumer reviews, application ratings, and the presence of key diabetes management features: dietary blood glucose, A1C, insulin, physical activity and prescription medication. A subsequent Google search was conducted using the search term “best Apple diabetes apps”. The top three search results – Healthline, Everyday Health, and Diabetes Apps, American Diabetes Association – were explored. The top five frequently used apps among those sources were examined against the same Apple iOS criteria. RESULTS Twelve mobile health apps were reviewed in total due to repetition in popularity across the four evaluated sources. Only one health app – Glucose Buddy Diabetes Tracker – appeared most frequently used within the Apple iOS store and across the other three sources. The OneTouch Reveal app ranked first on the list in the iOS store with 39,000 consumer reviews and a rating of 4.7 out of 5.0 stars while only appearing once among the other sources. Blood glucose tracking was evident across all apps, but other disease management features varied in type with at least three of the five key features being present across the 12 reviewed apps. Subscription costs and integration needs were present which could play a major role in consumer app selection. While mobile app preference was assessed and defined by the number of consumer reviews and star ratings, there were no scientific standards used in the selection and ranking of the health apps within this study. CONCLUSIONS Mobile health applications (apps) have shown promise in chronic disease management, but a surge in development of these non-regulated health solutions points to a need for standards in quality. A governing body of health information technology, clinical, policymaking, and other industry stakeholders, including patients, could be beneficial in defining health application standards for effective chronic disease management. Variabilities in features, cost, and other management inconsistencies could be diminished by regulatory uniformity and increase both patient engagement activities and disease outcomes.

scholarly journals Facilitators and Barriers to Chronic Disease Self-Management and Mobile Health Interventions for People Living With Diabetes and Hypertension in Cambodia: Qualitative Study

10.2196/13536 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e13536
Author(s):  
Lesley Steinman ◽  
Hen Heang ◽  
Maurits van Pelt ◽  
Nicole Ide ◽  
Haixia Cui ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Focus Groups ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Self Management ◽  
Facilitators And Barriers

Background In many low- and middle-income countries (LMICs), heart disease and stroke are the leading causes of death as cardiovascular risk factors such as diabetes and hypertension rapidly increase. The Cambodian nongovernmental organization, MoPoTsyo, trains local residents with diabetes to be peer educators (PEs) to deliver chronic disease self-management training and medications to 14,000 people with hypertension and/or diabetes in Cambodia. We collaborated with MoPoTsyo to develop a mobile-based messaging intervention (mobile health; mHealth) to link MoPoTsyo’s database, PEs, pharmacies, clinics, and people living with diabetes and/or hypertension to improve adherence to evidence-based treatment guidelines. Objective This study aimed to understand the facilitators and barriers to chronic disease management and the acceptability, appropriateness, and feasibility of mHealth to support chronic disease management and strengthen community-clinical linkages to existing services. Methods We conducted an exploratory qualitative study using semistructured interviews and focus groups with PEs and people living with diabetes and/or hypertension. Interviews were recorded and conducted in Khmer script, transcribed and translated into the English language, and uploaded into Atlas.ti for analysis. We used a thematic analysis to identify key facilitators and barriers to disease management and opportunities for mHealth content and format. The information-motivation-behavioral model was used to guide data collection, analysis, and message development. Results We conducted six focus groups (N=59) and 11 interviews in one urban municipality and five rural operating districts from three provinces in October 2016. PE network participants desired mHealth to address barriers to chronic disease management through reminders about medications, laboratory tests and doctor’s consultations, education on how to incorporate self-management into their daily lives, and support for obstacles to disease management. Participants preferred mobile-based voice messages to arrive at dinnertime for improved phone access and family support. They desired voice messages over texts to communicate trust and increase accessibility for persons with limited literacy, vision, and smartphone access. PEs shared similar views and perceived mHealth as acceptable and feasible for supporting their work. We developed 34 educational, supportive, and reminder mHealth messages based on these findings. Conclusions These mHealth messages are currently being tested in a cluster randomized controlled trial (#1R21TW010160) to improve diabetes and hypertension control in Cambodia. This study has implications for practice and policies in Cambodia and other LMICs and low-resource US settings that are working to engage PEs and build community-clinical linkages to facilitate chronic disease management.

scholarly journals Facilitators and Barriers to Chronic Disease Self-Management and Mobile Health Interventions for People Living With Diabetes and Hypertension in Cambodia: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Lesley Steinman ◽  
Hen Heang ◽  
Maurits van Pelt ◽  
Nicole Ide ◽  
Haixia Cui ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Focus Groups ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Self Management ◽  
Facilitators And Barriers

BACKGROUND In many low- and middle-income countries (LMICs), heart disease and stroke are the leading causes of death as cardiovascular risk factors such as diabetes and hypertension rapidly increase. The Cambodian nongovernmental organization, MoPoTsyo, trains local residents with diabetes to be peer educators (PEs) to deliver chronic disease self-management training and medications to 14,000 people with hypertension and/or diabetes in Cambodia. We collaborated with MoPoTsyo to develop a mobile-based messaging intervention (mobile health; mHealth) to link MoPoTsyo’s database, PEs, pharmacies, clinics, and people living with diabetes and/or hypertension to improve adherence to evidence-based treatment guidelines. OBJECTIVE This study aimed to understand the facilitators and barriers to chronic disease management and the acceptability, appropriateness, and feasibility of mHealth to support chronic disease management and strengthen community-clinical linkages to existing services. METHODS We conducted an exploratory qualitative study using semistructured interviews and focus groups with PEs and people living with diabetes and/or hypertension. Interviews were recorded and conducted in Khmer script, transcribed and translated into the English language, and uploaded into Atlas.ti for analysis. We used a thematic analysis to identify key facilitators and barriers to disease management and opportunities for mHealth content and format. The information-motivation-behavioral model was used to guide data collection, analysis, and message development. RESULTS We conducted six focus groups (N=59) and 11 interviews in one urban municipality and five rural operating districts from three provinces in October 2016. PE network participants desired mHealth to address barriers to chronic disease management through reminders about medications, laboratory tests and doctor’s consultations, education on how to incorporate self-management into their daily lives, and support for obstacles to disease management. Participants preferred mobile-based voice messages to arrive at dinnertime for improved phone access and family support. They desired voice messages over texts to communicate trust and increase accessibility for persons with limited literacy, vision, and smartphone access. PEs shared similar views and perceived mHealth as acceptable and feasible for supporting their work. We developed 34 educational, supportive, and reminder mHealth messages based on these findings. CONCLUSIONS These mHealth messages are currently being tested in a cluster randomized controlled trial (#1R21TW010160) to improve diabetes and hypertension control in Cambodia. This study has implications for practice and policies in Cambodia and other LMICs and low-resource US settings that are working to engage PEs and build community-clinical linkages to facilitate chronic disease management.

scholarly journals Assessing the quality of mobile applications in chronic disease management: a scoping review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Payal Agarwal ◽  
Dara Gordon ◽  
Janessa Griffith ◽  
Natasha Kithulegoda ◽  
Holly O. Witteman ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Behavior Change ◽  
Mobile Health ◽  
Scoping Review ◽  
Chronic Disease Management ◽  
Digital Health ◽  
Quality Criteria ◽  
Health Apps

AbstractWhile there has been a rapid growth of digital health apps to support chronic diseases, clear standards on how to best evaluate the quality of these evolving tools are absent. This scoping review aims to synthesize the emerging field of mobile health app quality assessment by reviewing criteria used by previous studies to assess the quality of mobile apps for chronic disease management. A literature review was conducted in September 2017 for published studies that use a set of quality criteria to directly evaluate two or more patient-facing apps supporting promote chronic disease management. This resulted in 8182 citations which were reviewed by research team members, resulting in 65 articles for inclusion. An inductive coding schema to synthesize the quality criteria utilized by included articles was developed, with 40 unique quality criteria identified. Of the 43 (66%) articles that reported resources used to support criteria selection, 19 (29%) used clinical guidelines, and 10 (15%) used behavior change theory. The most commonly used criteria included the presence of user engagement or behavior change functions (97%, n = 63) and technical features of the app such as customizability (20%, n = 13, while Usability was assessed by 24 studies (36.9%). This study highlights the significant variation in quality criteria employed for the assessment of mobile health apps. Future methods for app evaluation will benefit from approaches that leverage the best evidence regarding the clinical impact and behavior change mechanisms while more directly reflecting patient needs when evaluating the quality of apps.

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

10.2196/15927 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15927
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

Abstract 13206: Blood Pressure Apps: Do They Educate the Lay Public About Risk Factors?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arunima Vijay ◽  
Gloria Wu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Mobile Health ◽  
Health Apps ◽  
Hypertension Risk ◽  
Apple Ios ◽  
Mobile Health Apps ◽  
Google Play ◽  
Lay Public ◽  
Mood Depression

Introduction: Hypertension affects 108 million Americans. To help track and manage hypertension, there are many free and popular mobile health apps that track BP. Hypothesis: BP tracking mobile health apps have many downloads but do not fully educate the public about hypertension risk factors. Methods: “Blood Pressure” as a search term was used in the Google Play and Apple iOS stores to identify the most popular, free BP tracking apps aimed at the lay public. The top 10 most popular, free apps on each store were evaluated for educating the lay public on hypertension risk factors. Inclusion criteria: top 10 free blood pressure (BP) apps, by highest number of downloads on Google Play and highest rating (out of five stars) on Apple iOS Store (no available data on iOS downloads). Exclusion criteria: non-English, requiring a wearable device, primary purpose other BP tracking. Results: Of top 20 apps: BP log: 19/20, BP ranges: 13/20, height: 5/20, weight: 8/20, BMI: 3/20, race: 1/20, gender: 4/20, age: 6/20, diet: 1/20, exercise: 1/20, medication: 4/20, diabetes: 1/20, FBS: 1/20, goals: 3/20, mood/depression: 1/20. 2 apps mentioned the American Heart Association (AHA). None of the apps had information on cvriskcalculator.com, family history, cholesterol, LDL, triglycerides, HbA1c, and alcohol use. Conclusion: Most free and popular BP apps monitor BP but largely ignore hypertension risk factors such as cholesterol, LDL, triglycerides, alcohol intake, mood/depression, race, and gender. Furthermore, 7/20 apps do not uniformly educate patients that a normal BP is <120/<80, in accordance with the AHA and ACC guidelines. More collaboration may be needed between physicians and software developers to educate and meet the needs of our hypertensive patients in America.

scholarly journals Development of a Personalized Apps to Inculcate Dietary Self-Management for Maintenance Hemodialysis Patients: A Need Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1325-1325
Author(s):  
Jun Hao Lim ◽  
Cordelia Kheng May Lim ◽  
Imliya Ibrahim ◽  
Jazlina Shahrul ◽  
Mohd Hazli Mohd Zabil ◽  
...  
Keyword(s):  
Mobile Health ◽  
Online Survey ◽  
Self Management ◽  
Maintenance Hemodialysis ◽  
Health Apps ◽  
Funding Sources ◽  
Need Analysis ◽  
Renal Diet ◽  
Poor Treatment ◽  
Mobile Health Apps

Abstract Objectives Dietary non-adherence is highly prevalent among maintenance hemodialysis (HD) patients resulting in multitudes health complications and poor treatment outcomes. Given high penetration of smartphone, well-designed mobile health apps emerged as a potential tool to empower HD patients with dietary self-management skills. This need analysis study determined the perception and expectation of patients and dietitians on the features and the use of apps in dialysis care to foster development of evidence-based renal diet apps. Methods This was a mixed-method study with concurrent triangulation design. The quantitative arm involved HD patients (n = 184) through face-to-face interview and dietitians (n = 120) via anonymous online survey. While the qualitative arm consisted of 10 in-depth interviews (HD patients) and 8 email interviews (dietitians). Descriptive and thematic analyses were used, and the results were compared. Results A total of 69.6% of HD patients owned a smartphone. More than half (53.9%) of the smartphone users had the experience of searching health information especially nutrition-related topics (91.3%). Majority of them (78.9%) perceived renal diet apps as very important and were willing to use (80.5%). They agreed that renal diet apps can help them in preventing nutrition complications (82.0%), planning menu (78.9%) and monitoring nutrient intakes (82.8%). In the context of practising dietitians, 60.8% aware of the existence of renal diet apps but only 38.3% of them would recommend existing renal diet apps to their patients due to lack of local content (42.5%) and unsure credibility (37.5%). Most of them (88.3%) perceived that local-based renal diet app is needed and agreed that it can enhance dietetics care in HD population (90.8%). Top features anticipated by both patients and dietitians included plan or order, tailored assistance, usability and tracker. Conclusions Dietary self-management via mobile health apps seems to be feasible in the dialysis population given the high smartphone penetration, strong desire to use and positive perceptions from patients and dietitians. Features valued by patients and dietitians will be integrated into the design of the apps to promote acceptance and usage. Funding Sources This project is funded by the internal grant of Universiti Putra Malaysia (Inisiatif Putra Muda).

Chronic disease management and dementia: a qualitative study of knowledge and needs of staff

2019 ◽  
Vol 25 (4) ◽  
pp. 359 ◽  
Author(s):  
Chelsea Baird ◽  
Marta H. Woolford ◽  
Carmel Young ◽  
Margaret Winbolt ◽  
Joseph Ibrahim
Keyword(s):  
Cognitive Impairment ◽  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Cognitive Abilities ◽  
Chronic Disease Management ◽  
Self Management ◽  
Semistructured Interviews ◽  
Management Approaches

Effective self-management is the cornerstone of chronic disease self-management. However, self-management of chronic disease in patients with comorbid dementia is particularly challenging. It is vital that clinicians, patients and carers work collaboratively to tailor self-management programs to each patient with dementia. This study aimed to identify barriers and facilitators of successful self-management in the context of cognitive impairment in order to optimise the capacity for self-management for persons with dementia (PWD). A qualitative study based on semistructured interviews was conducted in Victoria, Australia. Interviews were conducted with 12 people (employed in the ambulatory and dementia care sectors), representing six health services. Participants identified a healthcare system that is complex, not dementia friendly and not accommodating the needs of PWD who have comorbidities. Individual and systemic barriers contributed to ineffective self-management. Chronic disease support programs do not routinely undertake cognitive assessment or have guidelines for modified management approaches for those with cognitive impairment. Support needs to be long-term and requires a specialised skillset that recognises not only chronic disease management, but also the effect of cognition on self-management. Although formal guidelines are needed, care also needs to be tailored to individual cognitive abilities and deficits.

Development and Psychometric Evaluation of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) in Low-Literacy Patients With Chronic Disease

2007 ◽  
Vol 15 (3) ◽  
pp. 203-219 ◽  
Author(s):  
Jessica Risser ◽  
Terry A. Jacobson ◽  
Sunil Kripalani
Keyword(s):  
Chronic Disease ◽  
Medication Adherence ◽  
Disease Management ◽  
Internal Consistency ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Medication Use ◽  
Literacy Skills ◽  
The Self ◽  
Low Literacy

Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one’s ability to perform a given task such as taking one’s medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this construct. This study sought to develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills. The Self-efficacy for Appropriate Medication Use (SEAMS) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. Its psychometric properties were evaluated among 436 patients with coronary heart disease and other comorbid conditions. Reliability was evaluated by measuring internal consistency and test-retest reliability. Principal component factor analysis was performed to evaluate the validity of the SEAMS. Reliability and validity analyses were also performed separately among patients with low and higher literacy levels. The final 13-item scale had good internal consistency reliability (Cronbach’s α = 0.89). A two-factor solution was found, explaining 52.3% of the scale’s variance. The scale performed similarly across literacy levels. The SEAMS is a reliable and valid instrument that may provide a valuable assessment of medication self-efficacy in chronic disease management, and appears appropriate for use in patients with low literacy skills.

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