scholarly journals The feasibility, efficacy and efficiency of eHealth-supported pediatric asthma care implemented in daily clinical practice: a 6-month proof of concept study. (Preprint)

2020 ◽  
Author(s):  
Mattienne Kamp ◽  
Pamela Hartgerink ◽  
Jean MM Driessen ◽  
Boony Thio ◽  
Hermie Hermens ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Early Detection ◽  
Asthma Control ◽  
Cost Efficiency ◽  
Pediatric Asthma ◽  
Self Management ◽  
Intention To Use ◽  
Proof Of Concept ◽  
Asthma Care

BACKGROUND Strategies aimed at the early detection of loss of asthma control can effectively reduce the burden of the disease. However, broad implementation in clinical practice has not been accomplished so far. We are in need of research investigating the operationalization of eHealth pediatric asthma care in practice, revealing the most potential benefits in terms of adoption, efficiency and effectiveness. This may lay the foundation for targeted effectiveness studies with the lessons learned. OBJECTIVE The aim of this proof of concept study was to investigate the feasibility and explore the efficacy and cost-efficiency of an eHealth program implemented in daily clinical pediatric asthma practice. METHODS We designed an eHealth-supported pediatric asthma program facilitating early detection of loss of asthma control while increasing symptom awareness and self-management. Asthma control was monitored by objective home-measurements in the web-based Puffer-app to allow timely medical anticipation and prevent treatment delay. Children with moderate-to-severe asthma and a high medical consumption were asked to participate in the eHealth program for 6 months. The clinical feasibility was investigated by measures of participation and patient reported health and care outcomes. Moreover, the implementation experiences of the health care professionals (HCP’s) were evaluated in a focus group. Technical feasibility was investigated by measures of technology use, system usability and technology acceptance. The efficacy and cost-efficiency of the eHealth care were explored by comparing pre-post program differences in asthma outcomes (asthma control, lung function and therapy adherence) and medical consumption. RESULTS 35/41 children volunteered for participation, of which 30 finished the 6-month eHealth program. 75% of these children indicated that eHealth helped to control their asthma during the program. HCPs preferred making safe and substantiated medical decisions based on home measurements and real time communication with patients during symptoms. The Puffer-app scored highest on ease of use (77.1%) and intention to use (81.0%) and scored lowest on control over the system (64.4%) and enjoyment (65.6%). With an average patients’ time commitment of 15 minutes, eHealth care led to a 80% gross reduction in healthcare utilization, 8.6% increase (P =.40) in asthma control, 25.0% increase (P =.04) in the self-management level and a 20.4% improved (P =.02) therapy adherence. CONCLUSIONS Children and parents were eager to participate in the study, expressed a high intention to use the Puffer-app and indicated it was easy to work with. eHealth asthma care is feasible, enables safe remote care and is beneficial to the majority of asthmatic children in terms of health outcomes and health care utilization.

scholarly journals Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study

2018 ◽  
Vol 16 ◽  
pp. 147997231876771 ◽  
Author(s):  
Wanis H Ibrahim ◽  
Fatima Rasul ◽  
Mushtaq Ahmad ◽  
Abeer S Bajwa ◽  
Laith I Alamlih ◽  
...  
Keyword(s):  
Health Care ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Medical Condition ◽  
Action Plan ◽  
Well Being ◽  
Chronic Medical Condition ◽  
Uncontrolled Asthma ◽  
Asthma Care ◽  
In Pregnancy

Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.

scholarly journals Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform (Preprint)

2017 ◽  
Author(s):  
Samina Abidi ◽  
Michael Vallis ◽  
Helena Piccinini-Vallis ◽  
Syed Ali Imran ◽  
Syed Sibte Raza Abidi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Clinical Practice ◽  
Behavior Change ◽  
Self Management ◽  
Change Strategies ◽  
Educational Support ◽  
Behavior Change Interventions ◽  
Patients With Diabetes ◽  
Primary Care Practitioners

BACKGROUND Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. OBJECTIVE The aim of this study was to develop and evaluate a computerized decision support platform called “Diabetes Web-Centric Information and Support Environment” (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines–based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. METHODS A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners’ readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association’s (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients’ progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient’s self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. RESULTS For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool’s screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. CONCLUSIONS This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients’ feedback is now being used to make necessary modification to DWISE.

scholarly journals The feasibility, efficacy and efficiency of eHealth-supported pediatric asthma care : a 6-month study in daily clinical practice. (Preprint)

10.2196/24634 ◽  
2020 ◽  
Author(s):  
Mattienne Kamp ◽  
Pamela Hartgerink ◽  
Jean MM Driessen ◽  
Boony Thio ◽  
Hermie Hermens ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pediatric Asthma ◽  
Daily Clinical Practice ◽  
Asthma Care

Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

2020 ◽  
Vol 5 (5) ◽  
pp. 1175-1187
Author(s):  
Rachel Glade ◽  
Erin Taylor ◽  
Deborah S. Culbertson ◽  
Christin Ray
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Cochlear Implants ◽  
Practice Patterns ◽  
The United States ◽  
Care Providers ◽  
Aural Rehabilitation ◽  
Starting Point ◽  
Clinical Models ◽  
Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

Intention to Use Electronic Health Care Records System Measure

2011 ◽  
Author(s):  
José Manuel Ortega Egea ◽  
María Victoria Román González
Keyword(s):  
Health Care ◽  
Intention To Use ◽  
Electronic Health ◽  
Health Care Records
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