scholarly journals Usability and patients attitudes after implantation of an innovative intracardiac micro-computer system for web-based real-time monitoring of heart failure (Preprint)

2020 ◽  
Author(s):  
Giuseppe D´Ancona ◽  
Monica Murero ◽  
Sebastian Feickert ◽  
Hilmi Kaplan ◽  
Alper Oener ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Technology Use ◽  
Average Score ◽  
Care Providers ◽  
Cardiac Device ◽  
Good Communication ◽  
Empirical Survey

BACKGROUND Heart failure (HF) management guided by the measurement of intracardiac and pulmonary pressure values, obtained through innovative permanent intra-cardiac micro-sensors ("embodied"), has been recently proposed as a valid strategy to individualize treatment and anticipate hemodynamic destabilization, hoping to reduce patients´ hospitalization rate and optimize their quality of life. OBJECTIVE The present manuscript has focused on the analysis and interpretation of an empirical survey evaluating usability and patients’ attitudes towards a new permanent intra-cardiac device implanted to remotely monitor left intra-atrial pressures (V-LAP™, Vectorious Medical Technologies, Tel Aviv, Israel) of chronic HF patients. METHODS The V-LAP system is a miniaturized sensor implanted totally percutaneously across the inter-atrial septum. It communicates wirelessly with a "companion device" (a wearable belt) that is placed on the patient's chest at the time of acquisition /transmission of left heart pressure measurements. At first follow-up after implantation the patients and the health care providers were asked to fill out a questionnaire on the usability of the system, the ease in performing the various required tasks (data acquisition and transmission), and overall satisfaction. Replies to the questions were mainly given using a 5-point Likert scale (1: very poor, 2: poor, 3: average, 4: good, 5: excellent). RESULTS Use and acceptance of in-body technology from the first 8 patients implanted with the V-LAP technology worldwide have been analysed. No peri-procedural morbidity/mortality was observed. Before discharge, a tailored educational session was performed after the device implantation with the participation of patients and health care providers. A pre-determined appropriate measurement position for the external measuring unit (thoracic belt) was identified before discharge to guarantee, for each patient, good communication with the internal cardiac sensor and via wireless/RF communication. At the first follow-up, the overall comfort in technology use was 3.7±1.3 with 87.5 % (7/8) of patients succeeding in applying and operating the system independently. An average score of 3.5±1.4 points was given to the ease in positioning the external measuring belt in the pre-determined measurement position. All health care providers (8/8) were able to support patients with the technology. Health care providers’ average overall ease and comfort in operating the system was 3.8± 0.8 points with 4.1±0.8 points for the ease in positioning the thoracic belt in the appropriate measuring position. CONCLUSIONS Despite the gravity of their HF pathology and the complexity of their comorbid profile, patients are comfortable in using the V-LAP technology and, in the majority of cases they can correctly and consistently acquire and transmit hemodynamic data. The overall patient/care provider satisfaction with the V-LAP system seems to be high. Patients and respective health care providers have reported a score between average to good when assessing the ease in performing simple but crucial tasks such as wearing and fastening the thoracic belt and more specifically in consistently finding its appropriate position for ideal measurements. Improvements in the external thoracic belt design have been very recently introduced and will hopefully further optimize patients´ and health care providers´ acceptance and adoption of this technology. CLINICALTRIAL NCT03775161

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

2021 ◽  
pp. 2150041
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah
Keyword(s):  
Health Care ◽  
Signal Processing ◽  
Health Care Providers ◽  
Mobile Phones ◽  
Model Parameters ◽  
Care Providers ◽  
Server Side ◽  
Respiration Signal ◽  
At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

Using ePROMs for follow-up after palliative radiotherapy: an exploratory study with patients and health care providers.

2021 ◽  
Author(s):  
Eva Oldenburger ◽  
Inge Neyens ◽  
Annemarie Coolbrandt ◽  
Sofie Isebaert ◽  
Aline Sevenants ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Exploratory Study ◽  
Palliative Radiotherapy ◽  
Care Providers

SGLT2 inhibitors: A revolution in therapeutics of a major Non-Communicable Disease

2021 ◽  
pp. 1-3
Author(s):  
Muhammad Sami Khan
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Sglt2 Inhibitors ◽  
Care Providers ◽  
Cardiovascular Outcome Trials ◽  
Non Communicable Disease

Pakistan is facing an exorbitant burden of Non-communicable diseases among which Cardiovascular diseases are the most prominent which has not only caused mortality but also posed a big threat on weakened economy and health care system of the country. Amidst of this growing crisis, Sodium glucose co-transporter 2 (SGLT2) inhibitors emerge as a ray of hope by reducing simultaneously the complication and health care expenditure associated with the management of this major mortality-bringing Non-communicable disease. SGLT2 inhibitors, including Dapagliflozin and Empagliflozin, are evidence-based standardized novel anti-diabetic agents tested in cardiovascular outcome trials namely DAPA-HF and EMPEROR-Reduced, when added to standard care in heart failure patients with reduced ejection fraction, provides breakthrough heart failure outcomes and also addresses massive health care expenditures. This novel finding provides an impetus to promote its beneficial effects among health care providers and early implementation. Continuous....

scholarly journals Mobile Apps for Drug–Drug Interaction Checks in Chinese App Stores: Systematic Review and Content Analysis (Preprint)

2020 ◽  
Author(s):  
Chunying Shen ◽  
Bin Jiang ◽  
Qilian Yang ◽  
Chengnan Wang ◽  
Kevin Z Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Arithmetic Mean ◽  
Mobile App ◽  
Average Score ◽  
Care Providers ◽  
Rating Score ◽  
Average Rating ◽  
Mhealth Apps

BACKGROUND As a computerized drug–drug interaction (DDI) alert system has not been widely implemented in China, health care providers are relying on mobile health (mHealth) apps as references for checking drug information, including DDIs. OBJECTIVE The main objective of this study was to evaluate the quality and content of mHealth apps supporting DDI checking in Chinese app stores. METHODS A systematic review was carried out in November 2020 to identify mHealth apps providing DDI checking in both Chinese iOS and Android platforms. We extracted the apps’ general information (including the developer, operating system, costs, release date, size, number of downloads, and average rating), scientific or clinical basis, and accountability, based on a multidimensional framework for evaluation of apps. The quality of mHealth apps was evaluated by using the Mobile App Rating Scale (MARS). Descriptive statistics, including numbers and percentages, were calculated to describe the characteristics of the apps. For each app selected for evaluation, the section-specific MARS scores were calculated by taking the arithmetic mean, while the overall MARS score was described as the arithmetic mean of the section scores. In addition, the Cohen kappa (κ) statistic was used to evaluate the interrater agreement. RESULTS A total of 7 apps met the selection criteria, and only 3 included citations. The average rating score for Android apps was 3.5, with a minimum of 1.0 and a maximum of 4.9, while the average rating score for iOS apps was 4.7, with a minimum of 4.2 and a maximum of 4.9. The mean MARS score was 3.69 out of 5 (95% CI 3.34-4.04), with the lowest score of 1.96 for Medication Guidelines and the highest score of 4.27 for MCDEX mobile. The greatest variation was observed in the information section, which ranged from 1.41 to 4.60. The functionality section showed the highest mean score of 4.05 (95% CI 3.71-4.40), whereas the engagement section resulted in the lowest average score of 3.16 (95% CI 2.81-3.51). For the information quality section, which was the focus of this analysis, the average score was 3.42, with the MCDEX mobile app having the highest score of 4.6 and the Medication Guidelines app having the lowest score of 1.9. For the overall MARS score, the Cohen interrater κ was 0.354 (95% CI 0.236-0.473), the Fleiss κ was 0.353 (95% CI, 0.234-0.472), and the Krippendorff α was 0.356 (95% CI 0.237-0.475). CONCLUSIONS This study systematically reviewed the mHealth apps in China with a DDI check feature. The majority of investigated apps demonstrated high quality with accurate and comprehensive information on DDIs. However, a few of the apps that had a massive number of downloads in the Chinese market provided incorrect information. Given these apps might be used by health care providers for checking potential DDIs, this creates a substantial threat to patient safety.

scholarly journals Health workers' views on factors affecting caregiver engagement with bubble CPAP

2020 ◽  
Author(s):  
Sangwani Salimu ◽  
Maggie Woo Kinshella ◽  
Marianne Vidler ◽  
Mwai Banda ◽  
Laura Newberry ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Health Management ◽  
Care Providers ◽  
District Health ◽  
Severe Respiratory Distress ◽  
Good Communication ◽  
District Hospitals ◽  
Bubble Cpap

Abstract Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about caregivers' engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP.Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP.Conclusions Since caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP.

Predicting and Treating the Sexual Difficulties of Gynecologic Cancer Survivors

1996 ◽  
Vol 3 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Barbara L. Andersen
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Gynecologic Cancer ◽  
Initial Therapy ◽  
Care Providers ◽  
Cancer Treatments ◽  
Clinical Observations ◽  
Behavioral Therapies

Women treated for gynecologic cancer represent approximately 45% of cancer survivors. Many report significant sexual difficulties during follow-up, and data suggest these difficulties are direct consequences of their cancer treatments. Health care providers can identify at the time of initial therapy those women who will be at greater risk for problem development. Clinical observations are provided on the development of sexual problems for these women as they attempt to resume sexual intercourse, and the psychologic and behavioral therapies that can be used for treatment are discussed.

scholarly journals Use of the Ottawa Ankle Rules in children: a survey of physicians’ practice patterns

CJEM ◽  
2011 ◽  
Vol 13 (05) ◽  
pp. 333-338 ◽  
Author(s):  
Shawn K. Dowling ◽  
Ian Wishart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Pediatric Emergency ◽  
Ankle Fractures ◽  
Care Providers ◽  
Emergency Physicians ◽  
Ottawa Ankle Rules ◽  
Clinically Significant

ABSTRACT: Introduction: A number of studies have assessed the diagnostic accuracy of the Ottawa Ankle Rules (OAR) in children; however, the role of the OAR in guiding physician radiograph use is unclear. Objectives: The primary purpose of this study was to determine the extent to which Canadian pediatric emergency physicians report using the OAR. Secondary goals included determining current diagnostic and management strategies for Salter-Harris 1 (SH-1) injuries of the ankle and which fractures physicians deem to be clinically significant. Methods: A self-administered piloted survey was distributed by mail to 215 Canadian pediatric emergency physicians using a modified Dillman technique. Participants were selected through Pediatric Emergency Research Canada (PERC), a national network of health care professionals with an interest in pediatric emergency medicine research. Results: Of 209 surveys, 144 were returned, for a response rate of 68.9%. Of those, 87.5% (126 of 144) reported applying the OAR in children to determine the need for radiographs in acute ankle or midfoot injuries. Of those, 65.1% reported using the OAR always or usually, and 64.5% (93 of 144) of physicians stated that they believe all ankle fractures are clinically significant. Although physicians report that they most commonly order the radiographs, 36.2% of participants indicated that radiographs were requisitioned by nurses or other health care providers at their facilities. SH-1 fractures were reported to be most commonly managed by immobilization (83.3%; 120 of 144), with most patients going on to follow-up with an orthopedic surgeon. Conclusions: The majority of Canadian pediatric emergency physicians indicate that they use the OAR when assessing children with acute ankle and midfoot injuries. Most physicians believe that all ankle fractures, including SH-1, are clinically significant and have a management preference for immobilization and orthopedic follow-up.

scholarly journals Naive Expectations to Resignation

2018 ◽  
Vol 5 (3) ◽  
pp. 219-224
Author(s):  
Michael M Evans ◽  
Judith E Hupcey ◽  
Lisa Kitko ◽  
Windy Alonso
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Longitudinal Study ◽  
Health Care Providers ◽  
Secondary Analysis ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Life Activity ◽  
Chronic Group ◽  
Stage D

Purpose: This study examined life descriptions of persons with stage D heart failure (HF) comparing those newly diagnosed to those with chronic HF. Methods: A secondary analysis of interviews from 75 participants followed in a longitudinal study of persons with stage D HF was thematically analyzed. There were 24 participants who were recently diagnosed with stage D HF (less than 2 years) and 51 participants with HF longer than 2 years. Results: Both groups shared life descriptions along a continuum, where recently diagnosed participants described naive expectations with hope for improvement, while the chronic group appeared resigned to their fate and the reality of the limitations of living with HF. Four themes illustrated differences between the groups: outlook on life, activity adjustments, understanding of HF, and mood. Conclusions: Although persons with stage D HF share the same life descriptions, they have differing perspectives of life with HF. Findings from this study can help health-care providers tailor interventions based on the length of time from diagnosis.

scholarly journals Effect of Health Care Providers’ Focused Discussion and Proactive Education About Relapse Management on Patient Reporting of Multiple Sclerosis Relapse

2021 ◽  
Author(s):  
Royce W. Waltrip ◽  
Nancy Mahler ◽  
Alina Ahsan ◽  
Leslie B. Herbert
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Online Survey ◽  
Care Providers ◽  
Patient Reporting ◽  
Multiple Sclerosis Relapse ◽  
The Past ◽  
Disease Modifying Therapy

Abstract Background: Treatments for multiple sclerosis (MS) relapse include intravenous corticosteroids and repository corticotropin injection. Despite available treatment, in the Multiple Sclerosis in America 2017 survey, only 47% of patients reported always/often contacting their MS health care provider (HCP) during relapse. In this study, the Multiple Sclerosis in America 2017 survey participants who received intravenous corticosteroids or repository corticotropin injection for treatment of past relapses completed a follow-up survey to understand how patients characterize relapse severity and to explore predictors of patients contacting their HCP during a relapse. Methods: Patients were18 years and older, diagnosed as having MS by an HCP, and currently using disease-modifying therapy. Patients completed an online survey assessing relapse characteristics and interactions with the HCP treating the patient’s MS. Regression analysis identified predictors of patients contacting their HCP during relapse. Results: Mean age of the 126 respondents was 49.2 years, 81.0% were female, and most (80.2%) had one or more relapses in the past 2 years. Patients estimated that 38.3% of their relapses were mild; 45.1%, moderate; and 16.6%, severe. Number and frequency of symptoms increased with relapse severity. Less than half (46.0%) reported they were extremely likely to contact their HCP during a relapse. The best predictors of being likely to contact the HCP during relapse were the HCP having previously discussed the importance of immediately communicating a relapse and patients’ willingness to accept the HCP’s recommendation for relapse treatment. Conclusions: Findings highlight the importance of HCPs’ advance discussions with patients with MS regarding relapse management to increase the likelihood patients will contact their HCP during relapse.

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