Optimizing Training Programs and Opportunities for Professional Development in the Era of Digital Pain Interventions: A Unique Opportunity for Collaboration (Preprint)

2020 ◽  
Author(s):  
Amara Nasir ◽  
Syed Hazique Mahmood
Keyword(s):  
Digital Health ◽  
Grey Literature ◽  
Health Interventions ◽  
Optimal Care ◽  
Medical Specialties ◽  
Health Technologies ◽  
Learning Techniques ◽  
Pain Intervention ◽  
Pain Patients ◽  
Patient Centric

UNSTRUCTURED Introduction: New digital health technologies provide accessible adjuncts to alleviating pain in the general population. The advent novel digital pain interventions have resulted in a rapidly evolving learning environment. Improving knowledge and understanding of these digital patient-centric approaches to treating pain is vital for our current practitioners and new cadre of trainees. The objective of this manuscript is to initiate a discussion about digital pain intervention educational needs of residents as well as attendings in PM&R, anesthesia and neurology. Methodology: After reviewing Accreditation Council Graduate Medical Education (ACGME) and relevant American Board of Medical Specialties policies and best available evidence, including grey literature, we interviewed a group of practicing physicians in physiatry, anesthesiology and neurology, including program directors, to provide expert opinion, guidance and formulate recommendations on educational requirements, research endeavors, and learning techniques and opportunities in utilizing digital health interventions for management of pain. IRB approval was not required. Conclusions: We hope that this manuscript will serve as the basis of designing a comprehensive educational program and outlining opportunities for research that prioritizes optimal care for pain patients and leverages the unique and complementary knowledge base within our fields.

Optimizing training programs and opportunities for professional development in the era of digital pain interventions: A unique opportunity for collaboration

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Syed H, Mahmood ◽  
Amara Nasir
Keyword(s):  
Professional Development ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Training Programs ◽  
Digital Health ◽  
Grey Literature ◽  
Medical Specialties ◽  
Accreditation Council ◽  
Health Technologies ◽  
Graduate Medical

Introduction: New digital health technologies provide accessible adjuncts to alleviating pain in the general population. The advent novel digital pain interventions have resulted in a rapidly evolving learning environment. Improving knowledge and understanding of these digital patient-centric approaches to treating pain is vital for our current practitioners and new cadre of trainees. The objective of this manuscript is to initiate a discussion about digital pain intervention educational needs of residents as well as attendings in PM&R, anesthesia and neurology. Methodology: After reviewing Accreditation Council Graduate Medical Education (ACGME) and relevant American Board of Medical Specialties policies and best available evidence, including grey literature, we interviewed a group of practicing physicians in physiatry, anesthesiology and neurology, including program directors, to provide expert opinion, guidance and formulate recommendations on educational requirements, research endeavors, and learning techniques and opportunities in utilizing digital health interventions for management of pain. IRB approval was not required. Conclusions: We hope that this manuscript will serve as the basis of designing a comprehensive educational program and outlining opportunities for research that prioritizes optimal care for pain patients and leverages the unique and complementary knowledge base within our fields. Key words: Digital pain; Physiatry; anesthesiology; Neurology; Competency; Accreditation Council Graduate Medical education Citation: Nasir A, Mahmood SH. Optimizing training programs and opportunities for professional development in the era of digital pain interventions: A unique opportunity for collaboration. Anaesth. pain intensive care 2021;25(1): 76–80. D0I: 10.35975/apic.v25i1.1444 Received: 24 October 2020; Reviewed: 22 November 2020; Accepted: 5 December 2020

scholarly journals The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia J. Lucas ◽  
Alastair D. Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Social Resources ◽  
Health Interventions ◽  
Structured Interviews ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract Background Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aims To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups. Methods A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically. Results A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender. Conclusion This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

scholarly journals Effectiveness of digital health interventions for diabetes: systematic review of systematic reviews

2021 ◽  
Author(s):  
Bonkana Maiga ◽  
Cheick O Bagayoko ◽  
Mohamed Ali Ag Ahmed ◽  
Abdrahamane Anne ◽  
Marie-Pierre Gagnon ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Digital Health ◽  
Scientific Evidence ◽  
Relevant Information ◽  
Health Interventions ◽  
Care Utilization ◽  
Clinical Indicators ◽  
Health Technologies ◽  
Digital Interventions ◽  
Effective Interventions

Abstract Background The use of digital health technologies to tackle diabetes has been particularly flourishing in recent years. Previous studies have shown to varying degrees that these technologies can have an impact on diabetes prevention and management. Objective The aim of this review is to summarize the best evidence regarding the effectiveness of digital health interventions to improve one or more diabetes indicators. Methods We included all types of interventions aimed at evaluating the effect of digital health on diabetes. We considered at all types of digital interventions (mobile health, teleconsultations, tele-expertise, electronic health records, decision support systems, e-learning, etc.). We included systematic reviews published in English or French over the last 29 years, from January 1991 to December 2019, that met the inclusion criteria. Two reviewers independently reviewed the titles and abstracts of the studies to assess their eligibility, and extracted relevant information according to a predetermined grid. Any disagreement was resolved by discussion and consensus between the two reviewers, or involved a third author as referee. Results In total in our review of journals, we included 10 reviews. The outcomes of interest were clinical indicators of diabetes that could be influenced by digital interventions. These outcomes had to be objectively measurable indicators related to diabetes surveillance and management that are generally accepted by diabetes experts. Six of the ten reviews showed moderate to large significant reductions in glycated hemoglobin (HBA1c) levels compared to controls. Most reviews reported overall positive results and found that digital health interventions improved health care utilization, behaviours, attitudes, knowledge and skills. Conclusion Based on a large corpus of scientific evidence on digital health interventions, this overview could help identify the most effective interventions to improve diabetes indicators.

scholarly journals The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

2020 ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia Lucas ◽  
Alastair D Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Social Resources ◽  
Health Interventions ◽  
Structured Interviews ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract BackgroundType 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aimsTo gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.MethodsA purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.ResultsA diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.ConclusionThis research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

scholarly journals Mobile safety alarms based on global positioning system technology in elderly care: a systematic review of evidence based on a general evidence framework for digital health technologies (Preprint)

2021 ◽  
Author(s):  
Maria Ehn ◽  
Matt X Richardson ◽  
Sara Landerdahl Stridsberg ◽  
W. Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Global Positioning System ◽  
Systematic Reviews ◽  
Social Care ◽  
Digital Health ◽  
Elderly Care ◽  
Grey Literature ◽  
Health Technologies ◽  
Tier 1 ◽  
Global Positioning ◽  
Standard Framework

BACKGROUND Global Positioning System (GPS) alarms aim at supporting users in independent daily indoor and outdoor activities. GPS alarms are implemented in social care, particularly in Nordic countries. Previous systematic reviews report lack of clear evidence of the effectiveness of GPS alarms on the health and welfare of users and their families, as well as social care provision. Evidence on effectiveness can support informed decision on implementation of health and welfare technologies. Standardized evidence frameworks have been developed to ensure that new technologies are clinically effective and offer economic value. However, systematic reviews seldom assess identified evidence using the frameworks. OBJECTIVE This study provides an up-to-date systematic review on evidence from existing studies of GPS-based alarms’ effects on health, welfare and social provision in elderly care, compared to non-GPS standard care. Moreover, the study findings are assessed against the evidence standard framework for digital health technologies (DHTs) established by the National Institute for Health and Care Excellence (NICE) in UK. METHODS The review was conducted according to recommended guidelines. Primary studies published in peer-reviewed and grey literature between January 2005 and August 2020 were identified through searches in 13 databases and several sources of grey literature. Articles were included if the studied population was persons 50 years and older, who either received social care for elderly or social care for persons with dementia; employed GPS devices that enabled the users to initiate alarms and/or localization of user position and/or geofencing functions as an intervention; were performed in Canada, US, EU, Singapore, Australia, New Zealand, Hong Kong, South Korea, or Japan; and addressed outcomes related to health, welfare and social care outcomes by use of quantitative methods. Study findings were categorized and summarized according to the requirements for “active monitoring” DHTs (i.e. tier 3b) of the NICE evidence standard framework. RESULTS 16 of the 986 screened records met the eligibility criteria. 7 peer-reviewed publications and 9 grey literature studies contributed with information. Best practice evidence was identified according to standards for tier 1 category “Relevance to current pathways in health/social care system” and minimum standard evidence was identified according to standards for tier 1 category “Credibility with health, social care professionals” of the NICE framework. However, several evidence categories in tiers 1 and 2 could not be assessed and no clear evidence demonstrating effectiveness in outcomes or improvements in outcomes could be identified. The evidence required for DHTs tracking patient location (tier 3b) in the NICE framework was therefore insufficient. CONCLUSIONS The evidence in current grey and peer-reviewed literature for GPS-based mobile alarms’ beneficial effects on health and welfare of older adults and social care provision is insufficient. Future research should utilize knowledge produced in previous studies and systematic reviews. CLINICALTRIAL Not required, no primary study.

scholarly journals Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis

10.2196/23180 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23180
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Subjective Experience ◽  
Digital Health ◽  
Meta Analysis ◽  
Grey Literature ◽  
Positive Association ◽  
Health Intervention ◽  
Health Interventions ◽  
Vote Counting

Background The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. Objective This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). Methods Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. Results Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). Conclusions The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.

scholarly journals Barriers and Enablers to Adoption of Digital Health Interventions to Support the Implementation of Dietary Guidelines in Early Childhood Education and Care: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Alice Grady ◽  
Courtney Barnes ◽  
Luke Wolfenden ◽  
Christophe Lecathelinais ◽  
Sze Lin Yoong
Keyword(s):  
Early Childhood ◽  
Digital Health ◽  
Guideline Implementation ◽  
Dietary Guidelines ◽  
Health Interventions ◽  
Cross Sectional ◽  
Childcare Centers ◽  
Health Technologies ◽  
Barriers And Enablers ◽  
Dietary Guideline

BACKGROUND Few Australian childcare centers provide foods consistent with sector dietary guidelines. Digital health technologies are a promising medium to improve the implementation of evidence-based guidelines in the setting. Despite being widely accessible, the population-level impact of such technologies has been limited due to the lack of adoption by end users. OBJECTIVE This study aimed to assess in a national sample of Australian childcare centers (1) intentions to adopt digital health interventions to support the implementation of dietary guidelines, (2) reported barriers and enablers to the adoption of digital health interventions in the setting, and (3) barriers and enablers associated with high intentions to adopt digital health interventions. METHODS A cross-sectional telephone or online survey was undertaken with 407 childcare centers randomly sampled from a publicly available national register in 2018. Center intentions to adopt new digital health interventions to support dietary guideline implementation in the sector were assessed, in addition to perceived individual, organizational, and contextual factors that may influence adoption based on seven subdomains within the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health and care technologies framework. A multiple-variable linear model was used to identify factors associated with high intentions to adopt digital health interventions. RESULTS Findings indicate that 58.9% (229/389) of childcare centers have high intentions to adopt a digital health intervention to support guideline implementation. The <i>changes needed in team interactions</i> subdomain scored lowest, which is indicative of a potential barrier (mean 3.52, SD 1.30), with <i>organization’s capacity to innovate</i> scoring highest, which is indicative of a potential enabler (mean 5.25, SD 1.00). The two NASSS subdomains of <i>ease of the adoption decision</i> (<i>P</i>&lt;.001) and <i>identifying work and individuals involved in implementation</i> (<i>P</i>=.001) were significantly associated with high intentions to adopt digital health interventions. CONCLUSIONS A substantial proportion of Australian childcare centers have high intentions to adopt new digital health interventions to support dietary guideline implementation. Given evidence of the effectiveness of digital health interventions, these findings suggest that such an intervention may make an important contribution to improving public health nutrition in early childhood.

scholarly journals Associations between Digital Health Intervention Engagement and Dietary Intake: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3281
Author(s):  
Tessa Delaney ◽  
Matthew Mclaughlin ◽  
Alix Hall ◽  
Sze Lin Yoong ◽  
Alison Brown ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Subjective Experience ◽  
Digital Health ◽  
Grey Literature ◽  
Health Interventions ◽  
User Engagement ◽  
Narrative Synthesis ◽  
Subjective Experiences ◽  
Early Evidence ◽  
The Relationship

There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted.

scholarly journals The role of health technologies in primary care interventions: A systematic review (Preprint)

2020 ◽  
Author(s):  
Geronimo Jimenez ◽  
David Matchar ◽  
Gerald Koh Choon Huat ◽  
MJJ Rianne van der Kleij ◽  
Niels H. Chavannes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Digital Health ◽  
Grey Literature ◽  
Chronically Ill ◽  
Prescribing Practices ◽  
Health Technologies ◽  
Monitoring Technologies ◽  
Multicomponent Interventions

BACKGROUND Several countries around the world have implemented multicomponent interventions to enhance primary care (PC), as a way of strengthening their health systems to cope with an ageing, chronically ill population, and rising costs. Some of these efforts have included technology-based enhancements as one of their features to support the overall intervention, but their details and impact have not been explored. OBJECTIVE To identify the role of digital/health technologies within wider, multi-feature interventions aimed at enhancing PC, and to describe the type of technologies used, aim and stakeholder, and potential impacts. METHODS A systematic review was performed, following Cochrane guidelines. An electronic search, supplemented with manual and grey literature searches, was conducted to identify multicomponent interventions which included at least one technology-based enhancement. After title/abstract and full text screening, selected articles were assessed for quality based on their study design. A descriptive, narrative synthesis was used for analysis and presentation of results. RESULTS Fourteen out of 37 articles (38%) described the inclusion of a technology-based innovation, as part of their multicomponent interventions to enhance PC. The most common identified technologies were the use of electronic health records, data monitoring technologies and online portals with messaging platforms. The most common aim of these technologies was to improve continuity of care and comprehensiveness, which resulted in increased patient satisfaction, increased PC visits compared to specialist visits, and the provision of more health prevention education and improved prescribing practices. Technologies seem also to increase costs and utilization for some parameters, such as increased consultation costs and increased number of drugs prescribed. CONCLUSIONS Technologies and digital health have not played a major role within comprehensive innovation efforts aimed at enhancing PC, reflecting that these technologies have not yet reached maturity or wider acceptance as a means for improving PC. Stronger policy and financial support is needed, as well as the advocacy of key stakeholders, to encourage the introduction of efficient technological innovations, backed by evidence-based research, so that digital technologies can fulfill the promise of supporting a strong, sustainable primary care.

scholarly journals How people with type two diabetes in England learn about digital health technologies, and what are the barriers to access and motivators for use? A qualitative study

2020 ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia Lucas ◽  
Alastair D Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Health Interventions ◽  
Structured Interviews ◽  
Web Based ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract BackgroundType 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, digital health interventions might make no difference, or worse, exacerbate health inequity. Study aimsTo gain insights into how and why people with T2D access and use web-based self-care technology and how experiences vary between individuals and social groups.MethodsA purposive sample of people with experience of using a web-based intervention to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.ResultsA diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about Digital Health Technology (DHT) that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHT are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHT from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHT because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to technology and self-care support, and these in turn were influenced by age and gender.ConclusionThis research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHT to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when interventions are developed and implemented.

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