| Title | Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review. |
| Authors | Brands, MR; Gouw, SC; Beestrum, M; Cronin, RM; Fijnvandraat, K; Badawy, SM |
| Journal | Journal of medical Internet research |
| Publication Date | 22 Dec 2022 |
| Date Added to PubMed | 23 Dec 2022 |
| Abstract | eHealth tools such as patient portals and personal health records, also known as patient-centered digital health records, can engage and empower individuals with chronic health conditions. Patients who are highly engaged in their care have improved disease knowledge, self-management skills, and clinical outcomes. We aimed to systematically review the effects of patient-centered digital health records on clinical and patient-reported outcomes, health care utilization, and satisfaction among patients with chronic conditions and to assess the feasibility and acceptability of their use. We searched MEDLINE, Cochrane, CINAHL, Embase, and PsycINFO databases between January 2000 and December 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible studies were those evaluating digital health records intended for nonhospitalized adult or pediatric patients with a chronic condition. Patients with a high disease burden were a subgroup of interest. Primary outcomes included clinical and patient-reported health outcomes and health care utilization. Secondary outcomes included satisfaction, feasibility, and acceptability. Joanna Briggs Institute critical appraisal tools were used for quality assessment. Two reviewers screened titles, abstracts, and full texts. Associations between health record use and outcomes were categorized as beneficial, neutral or clinically nonrelevant, or undesired. Of the 7716 unique publications examined, 81 (1%) met the eligibility criteria, with a total of 1,639,556 participants across all studies. The most commonly studied diseases included diabetes mellitus (37/81, 46%), cardiopulmonary conditions (21/81, 26%), and hematology-oncology conditions (14/81, 17%). One-third (24/81, 30%) of the studies were randomized controlled trials. Of the 81 studies that met the eligibility criteria, 16 (20%) were of high methodological quality. Reported outcomes varied across studies. The benefits of patient-centered digital health records were most frequently reported in the category health care utilization on the "use of recommended care services" (10/13, 77%), on the patient-reported outcomes "disease knowledge" (7/10, 70%), "patient engagement" (13/28, 56%), "treatment adherence" (10/18, 56%), and "self-management and self-efficacy" (10/19, 53%), and on the clinical outcome "laboratory parameters," including HbA1c and low-density lipoprotein (LDL; 16/33, 48%). Beneficial effects on "health-related quality of life" were seen in only 27% (4/15) of studies. Patient satisfaction (28/30, 93%), feasibility (15/19, 97%), and acceptability (23/26, 88%) were positively evaluated. More beneficial effects were reported for digital health records that predominantly focus on active features. Beneficial effects were less frequently observed among patients with a high disease burden and among high-quality studies. No unfavorable effects were observed. The use of patient-centered digital health records in nonhospitalized individuals with chronic health conditions is potentially associated with considerable beneficial effects on health care utilization, treatment adherence, and self-management or self-efficacy. However, for firm conclusions, more studies of high methodological quality are required. PROSPERO (International Prospective Register of Systematic Reviews) CRD42020213285; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=213285. |
| Link | http://doi.org/10.2196/43086 |
| Title | Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review of Modes of Delivery, Facilitators, and Barriers. |
| Authors | Liverpool, S; Mota, CP; Sales, CMD; Čuš, A; Carletto, S; Hancheva, C; Sousa, S; Cerón, SC; Moreno-Peral, P; Pietrabissa, G; Moltrecht, B; Ulberg, R; Ferreira, N; Edbrooke-Childs, J |
| Journal | Journal of medical Internet research |
| Publication Date | 23 Jun 2020 |
| Date Added to PubMed | 23 May 2020 |
| Abstract | There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible. This review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs. A literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts "child and adolescent mental health," "digital intervention," and "engagement." Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively. This study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP's engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs. The development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs. |
| Link | http://doi.org/10.2196/16317 |
| Title | Annual Research Review: Digital health interventions for children and young people with mental health problems - a systematic and meta-review. |
| Authors | Hollis, C; Falconer, CJ; Martin, JL; Whittington, C; Stockton, S; Glazebrook, C; Davies, EB |
| Journal | Journal of child psychology and psychiatry, and allied disciplines |
| Publication Date | 1 Apr 2017 |
| Date Added to PubMed | 13 Dec 2016 |
| Abstract | Digital health interventions (DHIs), including computer-assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost-effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence-base for DHIs and considers the key research questions and approaches to evaluation and implementation. We conducted a meta-review of scoping, narrative, systematic or meta-analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. Twenty-one reviews were included in the meta-review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost-effectiveness of DHIs. Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, small sample sizes, lack of blinded outcome assessment, combining different comparators, short-term follow-up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHIs for CYP. |
| Link | http://doi.org/10.1111/jcpp.12663 |
| Title | Methods of usability testing in the development of eHealth applications: A scoping review. |
| Authors | Maramba, I; Chatterjee, A; Newman, C |
| Journal | International journal of medical informatics |
| Publication Date | 1 Jun 2019 |
| Date Added to PubMed | 29 Apr 2019 |
| Abstract | The number of eHealth applications has exponentially increased in recent years, with over 325,000 health apps now available on all major app stores. This is in addition to other eHealth applications available on other platforms such as PC software, web sites and even gaming consoles. As with other digital applications, usability is one of the key factors in the successful implementation of eHealth apps. Reviews of the literature on empirical methods of usability testing in eHealth were last published in 2015. In the context of an exponentially increasing rate of App development year on year, an updated review is warranted. To identify, explore, and summarize the current methods used in the usability testing of eHealth applications. A scoping review was conducted on literature available from April 2014 up to October 2017. Four databases were searched. Literature was considered for inclusion if it was (1) focused on an eHealth application (which includes websites, PC software, smartphone and tablet applications), (2) provided information about usability of the application, (3) provided empirical results of the usability testing, (4) a full or short paper (not an abstract) published in English after March 2014. We then extracted data pertaining to the usability evaluation processes described in the selected studies. 133 articles met the inclusion criteria. The methods used for usability testing, in decreasing order of frequency were: questionnaires (n = 105), task completion (n = 57), 'Think-Aloud' (n = 45), interviews (n = 37), heuristic testing (n = 18) and focus groups (n = 13). Majority of the studies used one (n = 45) or two (n = 46) methods of testing. The rest used a combination of three (n = 30) or four (n = 12) methods of testing usability. None of the studies used automated mechanisms to test usability. The System Usability Scale (SUS) was the most frequently used questionnaire (n = 44). The ten most frequent health conditions or diseases where eHealth apps were being evaluated for usability were the following: mental health (n = 12), cancer (n = 10), nutrition (n = 10), child health (n = 9), diabetes (n = 9), telemedicine (n = 8), cardiovascular disease (n = 6), HIV (n = 4), health information systems (n = 4) and smoking (n = 4). Further iterations of the app were reported in a minority of the studies (n = 41). The use of the 'Think-Aloud' (Pearson Chi-squared test: χ2 = 11.15, p < 0.05) and heuristic walkthrough (Pearson Chi-squared test: χ2 = 4.48, p < 0.05) were significantly associated with at least one further iteration of the app being developed. Although there has been an exponential increase in the number of eHealth apps, the number of studies that have been published that report the results of usability testing on these apps has not increased at an equivalent rate. The number of digital health applications that publish their usability evaluation results remains only a small fraction. Questionnaires are the most prevalent method of evaluating usability in eHealth applications, which provide an overall measure of usability but do not pinpoint the problems that need to be addressed. Qualitative methods may be more useful in this regard. The use of multiple evaluation methods has increased. Automated methods such as eye tracking have not gained traction in evaluating health apps. Further research is needed into which methods are best suited for the different types of eHealth applications, according to their target users and the health conditions being addressed. |
| Link | http://doi.org/10.1016/j.ijmedinf.2019.03.018 |
| Title | Editorial: Telemedicine During and Beyond COVID-19. |
| Authors | Bhaskar, S; Nurtazina, A; Mittoo, S; Banach, M; Weissert, R |
| Journal | Frontiers in public health |
| Publication Date | 1 Dec 2021 |
| Date Added to PubMed | 3 Apr 2021 |
| Abstract | |
| Link | http://doi.org/10.3389/fpubh.2021.662617 |
| Title | Children must co-design digital health research. |
| Authors | |
| Journal | The Lancet. Digital health |
| Publication Date | 1 May 2023 |
| Date Added to PubMed | 10 Apr 2023 |
| Abstract | |
| Link | http://doi.org/10.1016/S2589-7500(23)00071-7 |
| Title | Digital Health Technologies in Pediatric Trials. |
| Authors | Sacks, L; Kunkoski, E; Noone, M |
| Journal | Therapeutic innovation & regulatory science |
| Publication Date | 1 Nov 2022 |
| Date Added to PubMed | 29 Mar 2022 |
| Abstract | Advances in the miniaturization of sensors and other technologies provide opportunities to collect physiological and/or functional data directly from patients participating in clinical trials. The use of such technologies in children is particularly promising. Objective, quantifiable measurements made by these technologies, often on a continuous or frequent basis, may provide more robust data than the episodic reports from caregivers that are used in traditional pediatric trials. We reviewed the pros and cons of these technologies for use in a variety of pediatric diseases, including seizure and neuromuscular disorders, cardiorespiratory diseases, and metabolic disorders. Correlation between sensor measurements and patient observations or traditional clinical measurements varied depending on the disease being evaluated. There was a notable dearth of reports on the use of digital health technology in pediatric patients. Given the range of sensors and measurements that can be made by DHTs, selection of the design, metrics and types of sensors best suited to disease evaluation presents challenges for adoption of these technologies in clinical trials. Traditional measurements of drug effects are often deficient, particularly in the evaluation of infants and young children. The opportunity to make objective, frequent measurements may increase our power to detect and quantify responses to therapy in these populations. Further research and evaluation are needed to realize the full scientific potential of remote monitoring in pediatric clinical trials. |
| Link | http://doi.org/10.1007/s43441-021-00374-w |
| Title | Maternal-child telehealth. |
| Authors | McCartney, P |
| Journal | MCN. The American journal of maternal child nursing |
| Publication Date | 1 Dec 2005 |
| Date Added to PubMed | 29 Dec 2004 |
| Abstract | |
| Link |
| Title | Mobile Health Approaches to Breastfeeding. |
| Authors | Lewkowitz, AK; Cahill, AG |
| Journal | Clinical obstetrics and gynecology |
| Publication Date | 1 Jun 2021 |
| Date Added to PubMed | 5 Apr 2021 |
| Abstract | Breastfeeding is available to nearly all women and has well-established short-term and long-term health benefits for mothers and infants. However, rates of breastfeeding initiation and continuation vary significantly according to sociodemographic factors, particularly in the United States. Mobile health (mHealth) interventions such as web-based/online education or smartphone applications have showed promise in increasing breastfeeding initiation and supporting breastfeeding continuation, and the importance of such mHealth-based breastfeeding support has increased significantly during the ongoing COVID-19 pandemic. This expert commentary reviews prior studies on mHealth in breastfeeding and highlights areas for future research on this topic. |
| Link | http://doi.org/10.1097/GRF.0000000000000606 |
| Title | Leverage of mHealth integration in Maternal and child health services and COVID-19 Pandemic. |
| Authors | Jabeen, R; Mohammad, A |
| Journal | JPMA. The Journal of the Pakistan Medical Association.. |
| Publication Date | 1 Feb 2023 |
| Date Added to PubMed | 21 Feb 2023 |
| Abstract | The growing use of mobile phones has enabled potential mobile health users to respond to various healthcare crises, even during the COVID-19 pandemic. In low- and middle-income countries where people lack access to basic healthcare, various "mHealth" interventions have been proven effective. In addition, it would facilitate public health researchers in developing new ways to improve the sustainability of MNCH programmes during emergencies or public health alerts. This article aims to provide evidence of mHealth integration in Pakistan's MNCH programme and to look into unique techniques used during the COVID-19 pandemic. This article suggested four key innovative mHealth strategies, including improving communication, teleconsultation, and CHW accessibility via mobile phones, providing free medication supplies to ANC&PNC mothers during health emergencies; and advocating for women's access to abortion services when necessary to support safe abortion. This article observes that mHealth can help improve maternal health in Pakistan and other LMICs by increasing human resource management and training, quality service delivery, and teleconsultation. However, additional digital health solutions are needed to attain SGD 3. |
| Link | http://doi.org/10.47391/JPMA.5156 |