scholarly journals Shaping the Future of Digitally Enabled Health and Care

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 17
Author(s):  
Maureen Spargo ◽  
Nicola Goodfellow ◽  
Claire Scullin ◽  
Sonja Grigoleit ◽  
Andreas Andreou ◽  
...  
Keyword(s):  
Older People ◽  
Chronic Conditions ◽  
Sense Of Self ◽  
Healthcare Services ◽  
Self Management ◽  
Ageing Population ◽  
Self Sufficiency ◽  
Medicines Use ◽  
Active Lifestyles ◽  
The Impact

People generally need more support as they grow older to maintain healthy and active lifestyles. Older people living with chronic conditions are particularly dependent on healthcare services. Yet, in an increasingly digital society, there is a danger that efforts to drive innovations in eHealth will neglect the needs of those who depend on healthcare the most—our ageing population. The SHAPES (Smart and Healthy Ageing through People Engaging in Supportive Systems) Innovation Action aims to create an open European digital platform that facilitates the provision of meaningful, holistic support to older people living independently. A pan-European pilot campaign will evaluate a catalogue of digital solutions hosted on the platform that have been specifically adapted for older people. ‘Medicines control and optimisation’ is one of seven themes being explored in the campaign and will investigate the impact of digital solutions that aim to optimise medicines use by way of fostering effective self-management, while facilitating timely intervention by clinicians based on remote monitoring and individualised risk assessments powered by artificial intelligence. If successful, the SHAPES Innovation Action will lead to a greater sense of self-sufficiency and empowerment in people living with chronic conditions as they grow older.

scholarly journals EXPLORING THE POWER OF COMBINATORIAL HEALTH TECHNOLOGIES TO SUPPORT SELF-MANAGEMENT OF COPD AMONG OLDER PEOPLE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S443-S443
Author(s):  
Sandra Varey ◽  
Mandy Dixon ◽  
Alejandra Hernandez ◽  
Ceu Mateus ◽  
Tom Palmer ◽  
...  
Keyword(s):  
Older People ◽  
Large Scale ◽  
Digital Health ◽  
Self Management ◽  
Chronic Obstructive ◽  
Test Bed ◽  
Long Term Conditions ◽  
Health Technologies ◽  
Healthcare Needs ◽  
The Impact

Abstract Ways to address the increasing healthcare needs of older people are a priority for the National Health Service (NHS) in England. The NHS England Test Bed programme was designed to trial new models of care that are supported by digital health technologies. This paper reports on findings from one Test Bed programme, the Lancashire and Cumbria Innovation Alliance (LCIA) – a partnership between NHS England, industry and Lancaster University, which ran from 2016 to 2018. A key aim of the LCIA Test Bed was to explore the extent to which supported self-care telehealth technology helped older people with long-term conditions to better self-manage their own care, promoting independence and enabling them to remain at home for longer. Each patient received a combination of health technologies over a six-month period. This paper presents results from the qualitative data that formed part of a large-scale mixed-methods evaluation. Specifically it draws on the analysis of 34 observational interviews with 17 participants with chronic obstructive pulmonary disease (COPD) to understand the role of these technologies in the self-management of their care. The data revealed that the majority of participants felt more confident about self-managing COPD as a result of their participation in the programme. These increases in confidence were the result of participants’ increased knowledge and skills in managing their COPD. The paper demonstrates how patients learned to better manage their respiratory condition, the impact of this learning on their daily lives and that of their family carers, and the implications for healthcare practice.

scholarly journals EFFICHRONIC study protocol: a non-controlled, multicentre European prospective study to measure the efficiency of a chronic disease self-management programme in socioeconomically vulnerable populations

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032073
Author(s):  
An L D Boone ◽  
Marta M Pisano-Gonzalez ◽  
Verushka Valsecchi ◽  
Siok Swan Tan ◽  
Yves-Marie Pers ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Vulnerable Populations ◽  
Chronic Conditions ◽  
Healthcare Services ◽  
Management Programme ◽  
Self Management ◽  
The European Union ◽  
Scientific Publications ◽  
General Data Protection Regulation ◽  
The Uk

IntroductionMore than 70% of world mortality is due to chronic conditions. Furthermore, it has been proven that social determinants have an enormous impact on both health-related behaviour and on the received attention from healthcare services. These determinants cause health inequalities. The objective of this study is to reduce the burden of chronic diseases in five European regions, hereby focusing on vulnerable populations, and to increase the sustainability of health systems by implementing a chronic disease self-management programme (CDSMP).Methods and analysis2000 people with chronic conditions or informal caregivers belonging to vulnerable populations, will be enrolled in the CDSMP in Spain, Italy, the UK, France and the Netherlands. Inclusion of patients will be based on geographical, socioeconomic and clinical stratification processes. The programme will be evaluated in terms of self-efficacy, quality of life and cost-effectiveness using a combination of validated questionnaires at baseline and 6 months from baseline.Ethics and disseminationThis study will follow the directives of the Helsinki Declaration and will adhere to the European Union General Data Protection Regulation. The project’s activities, progress and outcomes will be disseminated via promotional materials, the use of mass media, online activities, presentations at events and scientific publications.Trial registration numberISRCTN70517103; Pre-results.

scholarly journals Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program

2018 ◽  
Vol 42 (5) ◽  
pp. 542 ◽  
Author(s):  
Sharon Lawn ◽  
Sara Zabeen ◽  
David Smith ◽  
Ellen Wilson ◽  
Cathie Miller ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Disease ◽  
Length Of Stay ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Hospital Admissions ◽  
Self Management ◽  
Psychosocial Needs ◽  
Post Discharge ◽  
The Impact

Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health’s Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P = 0.037) and complex needs (P < 0.001) received more post-discharge contacts by HARP staff than those suffering from diabetes, renal conditions and psychosocial needs when they lived alone. Similarly, respiratory (P < 0.001), heart disease (P = 0.015) and complex needs (P = 0.050) patients had more contacts, with an increased number of episodes than those suffering from diabetes, renal conditions and psychosocial needs. Conclusion The Flinders Program appeared to have significant positive impacts on HARP patients that could be more effective if high-risk groups, such as respiratory patients with no carers and respiratory and heart disease patients aged 0–65, had received more targeted care. What is known about the topic? Chronic conditions are common causes of premature death and disability in Australia. Besides mental and physical impacts at the individual level, chronic conditions are strongly linked to high costs and health service utilisation. Hospital avoidance programs such as HARP can better manage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help individuals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add? This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia’s health system. What are the implications for practitioners? Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management support achieve significant reductions in potentially avoidable hospitalisation and emergency department presentation rates, though sex, type of chronic condition and living situation appear to matter. Benefits might also accrue from the combination of contextual factors (such as the Flinders Program, supportive service management, clinical champions in the team) that work synergistically.

scholarly journals Lack of meaningful activity on acute physical hospital wards: Older people’s experiences

2017 ◽  
Vol 81 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Channine Clarke ◽  
Caroline Stack ◽  
Marion Martin
Keyword(s):  
Occupational Therapy ◽  
Older People ◽  
Interpretative Phenomenological Analysis ◽  
Sense Of Self ◽  
Phenomenological Analysis ◽  
Physical And Mental Health ◽  
Meaningful Activity ◽  
Increased Risk ◽  
Hospital Wards ◽  
The Impact

Introduction Research suggests that older people on acute physical hospital wards are at increased risk of physical and mental health decline due to inactivity during their stay. Whilst studies have highlighted potential causes of such inactivity, there exists a paucity of occupational therapy research that explores engagement in meaningful occupation from patients’ perspectives in hospital settings. Method Interpretative phenomenological analysis was used to gain a deeper understanding of how 18 older people spent their time on hospital wards and the impact this had on their feelings of wellbeing. Interviews were carried out and analysed using interpretive phenomenological analysis guidelines. Findings Patients experienced a lack of meaningful activity on the wards which resulted in feelings of passivity, boredom and a sense of alienation from their normal roles, routines and sense of self. Despite a willingness to engage in activity, barriers were suggested as limited resources, hospital routines and personal limitations. Suggestions of potential meaningful activities were made. Conclusion Occupational therapy services need to review service provision and provide an occupation-focused service, ensuring that patients’ engagement in meaningful activities is seen as an integral part of their role in order to maintain patients’ mental and physical wellbeing. Recommendations for further research are highlighted.

Integrating Social and Health Services for People, Communities, Homes, and Places

2021 ◽  
pp. 21-66
Author(s):  
Maddalena Illario ◽  
Vincenzo De Luca ◽  
Regina Roller-Wirnsberger
Keyword(s):  
Older Adults ◽  
Technological Innovation ◽  
Circular Economy ◽  
Fear Of Falling ◽  
Healthcare Services ◽  
Ageing Population ◽  
Ageing Society ◽  
Regional Policies ◽  
Framework Approach ◽  
The Impact

The challenge of an ageing population requires a paradigmatic shift in the way we provide social and healthcare services, demanding the need to prioritize the functionality and independence of older adults. The risk and subsequent fear of falling is one of the most high-risk states for older adults, as it generates a destabilizing effect on their health that is often hard to recover. It is essential to thoroughly address their risk factors and mitigators. This discussion needs to be made in light of a person-centered perspective that goes beyond fragilities to capitalize on the strengths of the older adults. The chapter provides examples of how to connect assessment, interventions, and monitoring to a coherent framework approach that mitigates the risks and the impact of falls on an ageing society. The authors explore how technological innovation, urban planning, and regional policies that are culturally relevant can be incorporated in creating a circular economy while meeting the needs of an aging population and preventing falls and cognitive decline.

Are social media users more satisfied with their life than non-users? A study on older Italians

2021 ◽  
pp. 1-13
Author(s):  
Emanuela Sala ◽  
Gabriele Cerati ◽  
Alessandra Gaia
Keyword(s):  
Social Media ◽  
Life Satisfaction ◽  
Older People ◽  
Age Groups ◽  
Household Survey ◽  
Active Ageing ◽  
Ageing Population ◽  
Italian Case ◽  
Use Of Social Media ◽  
The Impact

Abstract Despite older people's increasing use of social media (SM), there is relatively little research investigating the impact of SM use on wellbeing in the ageing population. This study investigates the relationship between SM use and life satisfaction, a key dimension of wellbeing, in three age groups. We focus on the Italian case, which is particularly relevant because Italy is one of the countries both with the highest incidence of older people and the lowest uptake of SM in Europe. Applying linear regression modelling techniques, we analyse data from the 2018 Multipurpose Survey – Aspects of Everyday Living, a large probability-based household survey. For two age groups, we find a positive relationship between SM use and life satisfaction which weakens after controlling for older people's demographic and socio-economic characteristics, health conditions and social network characteristics. Given the grey digital divide that still exists in some European countries, we conclude with a call for urgent interventions to remove the hurdles that prevent frail older people from enjoying the benefits of an active ageing, fully exploiting the potential of SM use.

scholarly journals Shift to Virtual Self-Management Programs During COVID-19: Ensuring Access and Efficacy for Older Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Pamela Sanchez-Villagomez ◽  
Claudia Zurlini ◽  
Maggie Wimmer ◽  
Linda Roberts ◽  
Bertilia Trieu ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthcare Services ◽  
Self Management ◽  
Daily Routine ◽  
Management Skills ◽  
Physically Active ◽  
Virtual Self ◽  
Significant Difference ◽  
The Face ◽  
The Impact

Background: The COVID-19 pandemic resulted in significant uncertainty and disruption to many aspects of daily living, including physical activity, socialization opportunities, and access to healthcare services. Under these conditions, at-risk older adults are even more likely to be inactive and isolated, leading to potential exacerbation of musculoskeletal and chronic conditions and emotional distress. This case study provides an overview of our experience and best practices developed during our shift from onsite programming to virtual.Methodology: HSS utilized varied online approaches, including phone/video conference classes, webinars, on-demand videos and email campaigns to successfully transition programs. Due to this shift, HSS changed its evaluation to an online approach, using a mixed method to adequately assess the impact of programs.Results: Between April and August 2020, our virtual programs reached 428,766 participants, resulting in a 10,807% increase in program reach. Most participants assessed were 60 years or older (72%) and reported knowledge (85%) and self-management skills (83%) gained as well as high program satisfaction (90%). Analyses of program data did not show any statistical significant difference in self-reported health outcomes. However, qualitative results showed virtual programming helped to foster social connectivity during COVID-19, helped to build a daily routine, and positively impacted mental and physical health.Conclusion: Shifting to virtual programming in the face of the pandemic enabled us to deliver effective programs affording our community the opportunity to stay physically active and socially connected despite the quarantine orders.

scholarly journals Development of a Smartphone Application for the Treatment of Chronic pain in Older adults based on the Daily life experience of Pain Ecological monitoring and management app for chronic pain in older adults - EMMA: Protocol for the EMMA design and feasibility study (Preprint)

2021 ◽  
Author(s):  
Katharina Ledermann
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Older People ◽  
Chronic Conditions ◽  
Daily Life ◽  
Ecological Monitoring ◽  
Cognitive Behavioral ◽  
Self Management ◽  
Trial Period ◽  
Management Interventions

BACKGROUND Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy (CBT) is recommended for older people with chronic pain. However, online treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. OBJECTIVE To address this problem, we will develop a psychological internet-based intervention based on ecological monitoring of daily life experiences with chronic pain, called EMMA to support self-management of chronic pain in older adults. METHODS The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a CoDesign approach and actively involves the end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user centered intervention design. For the CoDesign process, we will include 10 older adults without chronic pain that will discuss the requirements in workshops in order to ensure suitability for older adults. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain that will test all features of the intervention for a period of eight consecutive weeks. After the trial period, validated instruments to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms will be filled out by the participants. Participants will be invited to take part in a semi-structured telephone interview after the trial period to explore their experiences using the app. Required changes to assure usability and acceptability will afterwards directly implemented in the application. RESULTS EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention irrespective of place and time to target chronic pain in older adults. CONCLUSIONS Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored pain self-management interventions.

scholarly journals Introduction: Themed Section on the Costs of Long-Term Care for Older People

2007 ◽  
Vol 6 (3) ◽  
pp. 349-351
Author(s):  
Alison Bowes
Keyword(s):  
Older People ◽  
Evidence Base ◽  
Royal Commission ◽  
Ageing Population ◽  
Term Care ◽  
Alternative Funding ◽  
Care Services ◽  
Care And Support ◽  
History Of ◽  
The Impact

Cost has long been a preoccupation in policy documents concerned with the care and support of older people (Means and Smith, 1998; Royal Commission, 1999). A history of moral panic about the ageing population coupled with a stereotype of older people as a dependent and ‘unproductive’ sector of society have combined to produce negatively focused debate, lacking in evidential support. Most recently, Wanless (2006) has highlighted the limitations of the evidence base and the narrowness of debate concerning the provision of social care services, arguing both for more informed debate and for consideration of the impact of developments in services and alternative funding models.

scholarly journals Ageing, immunity and influenza: a role for probiotics?

2013 ◽  
Vol 73 (2) ◽  
pp. 309-317 ◽  
Author(s):  
Parveen Yaqoob
Keyword(s):  
Gut Microbiota ◽  
Older People ◽  
Influenza A ◽  
Respiratory Infections ◽  
Ageing Population ◽  
Susceptibility To Infection ◽  
Age Related ◽  
Randomised Controlled ◽  
Adjuvant Effects ◽  
The Impact

Influenza is a major cause of death in the over 65s. Increased susceptibility to infection and reduced response to vaccination are due to immunosenscence in combination with medical history and lifestyle factors. Age-related alterations in the composition of the gut microbiota have a direct impact on the immune system and it is proposed that modulation of the gut microbiota using pre- and probiotics could offer an opportunity to improve immune responses to infections and vaccination in older people. There is growing evidence that probiotics have immunomodulatory properties, which to some extent are strain-dependent, and are strongly influenced by ageing. Randomised controlled trials suggest that probiotics may reduce the incidence and/or severity of respiratory infections, although there is limited data on older people. A small number of studies have examined the potential adjuvant effects of selected probiotics for vaccination against influenza; however, the data is inconsistent, particularly in older people. This review describes the impact of age-related changes in the gut on the immune response to respiratory infections and evaluates whether restoration of gut microbial homoeostasis by probiotics offers an opportunity to modulate the outcome of respiratory infections and vaccination against influenza in older people. Although there is promising evidence for effects of probiotics on human health, there is a lack of consistent data, perhaps partly due to strain-specific differences and an influence of the age of the host. Further research is critical in evaluating the potential use of probiotics in respiratory infections and vaccination in the ageing population.

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