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TitleEffects of Telemedicine and mHealth on Systolic Blood Pressure Management in Stroke Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
AuthorsLv, M; Wu, T; Jiang, S; Chen, W; Zhang, J
JournalJMIR mHealth and uHealth
Publication Date11 Jun 2021
Date Added to PubMed12 Jun 2021
AbstractStroke is a common, harmful disease with high recurrence and mortality rates. Uncontrolled blood pressure is an important and changeable risk factor for stroke recurrence. Telemedicine and mobile health (mHealth) interventions may have the potential to facilitate the control of blood pressure among stroke survivors, but their effect has not been established. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to estimate the effects of telemedicine and mHealth interventions on the control of systolic blood pressure among stroke survivors. The research literature published up to June 28, 2020, and consisting of RCTs related to telemedicine and mHealth interventions was searched in PubMed, EMBASE, Web of Science, and the Cochrane Library. The Cochrane risk of bias tool (RoB 2.0) was used to evaluate the quality of the studies. The Cochran Q test and I2 statistic were used to assess heterogeneity. Data were meta-analyzed using a random-effects model. Mean difference (MD) with 95% CI and 95% prediction interval (PI) were calculated. In total, 9 RCTs with a total sample size of 1583 stroke survivors met the inclusion criteria. Compared with the usual care, telemedicine and mHealth had a significantly greater impact on the control of systolic blood pressure (MD -5.49; 95% CI -7.87 to -3.10; P<.001; 95% PI -10.46 to -0.51). A subgroup analysis showed that the intervention mode of telephone plus SMS text messaging (MD -9.09; 95% CI -12.71 to -5.46; P<.001) or only telephone (MD -4.34; 95% CI -6.55 to -2.13; P<.001; 95% PI -7.24 to -1.45) had a greater impact on the control of systolic blood pressure than usual care. Among the stroke survivors with an intervention interval ≤1 week (MD -6.51; 95% CI -9.36 to -3.66; P<.001; 95% PI -12.91 to -0.10) or a baseline systolic blood pressure ≥140 mm Hg (MD -6.15; 95% CI -9.44 to -2.86; P<.001; 95% PI -13.55 to 1.26), the control of systolic blood pressure using telemedicine and mHealth was better than that of usual care. In general, telemedicine and mHealth reduced the systolic blood pressure of stroke survivors by an average of 5.49 mm Hg compared with usual care. Telemedicine and mHealth are a relatively new intervention mode with potential applications for the control of systolic blood pressure among stroke survivors, especially those with hypertensive stroke.
TitleImproving cirrhosis care: The potential for telemedicine and mobile health technologies.
AuthorsStotts, MJ; Grischkan, JA; Khungar, V
JournalWorld journal of gastroenterology
Publication Date7 Aug 2019
Date Added to PubMed16 Aug 2019
AbstractDecompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that ensure high-value care of these patients, wide variations in clinical practice exist. In this opinion review, we discuss the quality gap in the care of patients with cirrhosis, including low levels of compliance with recommended cancer screening and other clinical outcome and patient-reported outcome measures. We posit that innovations in telemedicine and mobile health (mHealth) should play a key role in closing the quality gaps in liver disease management. We highlight interventions that have been performed to date in liver disease and heart failure-from successful teleconsultation interventions in the care of veterans with cirrhosis to the use of telemonitoring to reduce hospital readmissions and decrease mortality rates in heart failure. Telemedicine and mHealth can effectively address unmet needs in the care of patients with cirrhosis by increasing preventative care, expanding outreach to rural communities, and increasing high-value care. We aim to highlight the benefits of investing in innovative solutions in telemedicine and mHealth to improve care for patients with cirrhosis and create downstream cost savings.
TitleMobile Apps in Oncology: A Survey on Health Care Professionals' Attitude Toward Telemedicine, mHealth, and Oncological Apps.
AuthorsKessel, KA; Vogel, MME; Schmidt-Graf, F; Combs, SE
JournalJournal of medical Internet research
Publication Date24 Nov 2016
Date Added to PubMed26 Nov 2016
AbstractMobile apps are an evolving trend in the medical field. To date, few apps in an oncological context exist. The aim was to analyze the attitude of health care professionals (HCPs) toward telemedicine, mHealth, and mobile apps in the field of oncology. We developed and conducted an online survey with 24 questions evaluating HCPs' general attitude toward telemedicine and patients using medical mobile apps. Specific questions on the possible functionality for patients and the resulting advantages and disadvantages for both the patients' and HCPs' daily clinical routine were evaluated. A total of 108 HCPs completed the survey. In all, 88.9% (96/108) considered telemedicine useful and 84.3% (91/108) supported the idea of an oncological app complementing classical treatment. Automatic reminders, timetables, and assessment of side effects and quality of life during therapy were rated as the most important functions. In contrast, uncertainty regarding medical responsibility and data privacy were reasons mostly named by critics. Most (64.8%, 70/108) were in favor of an alert function due to data input needing further clarification, and 94% (66/70) were willing to contact the patient after a critical alert. In all, 93.5% (101/108) supported the idea of using the collected data for scientific research. Moreover, 75.0% (81/108) believed establishing a mobile app could be beneficial for the providing hospital. A majority of HCPs are in favor of telemedicine and the use of oncological apps by patients. Assessing side effects can lead to quicker response and thus lower inconvenience for patients. Clinical data, such as life quality and treatment satisfaction, could be used to evaluate and improve the therapy workflow. Eventually, a mobile app would enhance the patients' relationship to their treating department because they are in permanent contact.
TitleMobile Health Usage, Preferences, Barriers, and eHealth Literacy in Rheumatology: Patient Survey Study.
AuthorsKnitza, J; Simon, D; Lambrecht, A; Raab, C; Tascilar, K; Hagen, M; Kleyer, A; Bayat, S; Derungs, A; Amft, O; Schett, G; Hueber, AJ
JournalJMIR mHealth and uHealth
Publication Date12 Aug 2020
Date Added to PubMed18 Jul 2020
AbstractMobile health (mHealth) defines the support and practice of health care using mobile devices and promises to improve the current treatment situation of patients with chronic diseases. Little is known about mHealth usage and digital preferences of patients with chronic rheumatic diseases. The aim of the study was to explore mHealth usage, preferences, barriers, and eHealth literacy reported by German patients with rheumatic diseases. Between December 2018 and January 2019, patients (recruited consecutively) with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis were asked to complete a paper-based survey. The survey included questions on sociodemographics, health characteristics, mHealth usage, eHealth literacy using eHealth Literacy Scale (eHEALS), and communication and information preferences. Of the patients (N=193) who completed the survey, 176 patients (91.2%) regularly used a smartphone, and 89 patients (46.1%) regularly used social media. Patients (132/193, 68.4%) believed that using medical apps could be beneficial for their own health. Out of 193 patients, only 8 (4.1%) were currently using medical apps, and only 22 patients (11.4%) stated that they knew useful rheumatology websites/mobile apps. Nearly all patients (188/193, 97.4%) would agree to share their mobile app data for research purposes. Out of 193 patients, 129 (66.8%) would regularly enter data using an app, and 146 patients (75.6%) would welcome official mobile app recommendations from the national rheumatology society. The preferred duration for data entry was not more than 15 minutes (110/193, 57.0%), and the preferred frequency was weekly (59/193, 30.6%). Medication information was the most desired app feature (150/193, 77.7%). Internet was the most frequently utilized source of information (144/193, 74.6%). The mean eHealth literacy was low (26.3/40) and was positively correlated with younger age, app use, belief in benefit of using medical apps, and current internet use to obtain health information. Patients with rheumatic diseases are very eager to use mHealth technologies to better understand their chronic diseases. This open-mindedness is counterbalanced by low mHealth usage and competency. Personalized mHealth solutions and clear implementation recommendations are needed to realize the full potential of mHealth in rheumatology.
TitleFactors Determining Patients' Choice Between Mobile Health and Telemedicine: Predictive Analytics Assessment.
AuthorsKhairat, S; Liu, S; Zaman, T; Edson, B; Gianforcaro, R
JournalJMIR mHealth and uHealth
Publication Date8 Jun 2019
Date Added to PubMed15 Jun 2019
AbstractThe solution to the growing problem of rural residents lacking health care access may be found in the use of telemedicine and mobile health (mHealth). Using mHealth or telemedicine allows patients from rural or remote areas to have better access to health care. The objective of this study was to understand factors influencing the choice of communication medium for receiving care, through the analysis of mHealth versus telemedicine encounters with a virtual urgent clinic. We conducted a postdeployment evaluation of a new virtual health care service, Virtual Urgent Clinic, which uses mHealth and telemedicine modalities to provide patient care. We used a multinomial logistic model to test the significance and predictive power of a set of features in determining patients' preferred method of telecare encounters-a nominal outcome variable of two levels (mHealth and telemedicine). Postdeployment, 1403 encounters were recorded, of which 1228 (87.53%) were completed with mHealth and 175 (12.47%) were telemedicine encounters. Patients' sex (P=.004) and setting (P<.001) were the most predictive determinants of their preferred method of telecare delivery, with significantly small P values of less than .01. Pearson chi-square test returned a strong indication of dependency between chief concern and encounter mediums, with an extremely small P<.001. Of the 169 mHealth patients who responded to the survey, 154 (91.1%) were satisfied by their encounter, compared with 31 of 35 (89%) telemedicine patients. We studied factors influencing patients' choice of communication medium, either mHealth or telemedicine, for a virtual care clinic. Sex and geographic location, as well as their chief concern, were strong predictors of patients' choice of communication medium for their urgent care needs. This study suggests providing the option of mHealth or telemedicine to patients, and suggesting which medium would be a better fit for the patient based on their characteristics.
TitleMobile Phone-Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial.
AuthorsSun, C; Sun, L; Xi, S; Zhang, H; Wang, H; Feng, Y; Deng, Y; Wang, H; Xiao, X; Wang, G; Gao, Y; Wang, G
JournalJMIR mHealth and uHealth
Publication Date4 Jan 2019
Date Added to PubMed6 Jan 2019
AbstractPrevious studies on telemedicine interventions have shown that older diabetic patients experience difficulty in using computers, which is a barrier to remote communication between medical teams and older diabetic patients. However, older people in China tend to find it easy to use mobile phones and personal messaging apps that have a user-friendly interface. Therefore, we designed a mobile health (mHealth) system for older people with diabetes that is based on mobile phones, has a streamlined operation interface, and incorporates maximum automation. The goal of the research was to investigate the use of mobile phone-based telemedicine apps for management of older Chinese patients with type 2 diabetes mellitus (T2DM). Variables of interest included efficacy and safety. A total of 91 older (aged over 65 years) patients with T2DM who presented to our department were randomly assigned to one of two groups. Patients in the intervention group (n=44) were provided glucometers capable of data transmission and received advice pertaining to medication, diet, and exercise via the mHealth telemedicine system. Patients assigned to the control group (n=47) received routine outpatient care with no additional intervention. Patients in both groups were followed up at regular 3-month intervals. After 3 months, patients in the intervention group showed significant (P<.05) improvement in postprandial plasma glucose level. After 6 months, patients in the intervention group exhibited a decreasing trend in postprandial plasma glucose and glycated hemoglobin levels compared with the baseline and those in the control group (P<.05). Mobile phone-based telemedicine apps help improve glycemic control in older Chinese patients with T2DM. China Clinical Trial Registration Center ChiCTR 1800015214; (Archived by WebCite at
TitleTelemedicine and Mobile Health Technology Are Effective in the Management of Digestive Diseases: A Systematic Review.
AuthorsHelsel, BC; Williams, JE; Lawson, K; Liang, J; Markowitz, J
JournalDigestive diseases and sciences
Publication Date1 Jun 2018
Date Added to PubMed18 Apr 2018
AbstractMobile applications and interactive websites are an increasingly used method of telemedicine, but their use lacks evidence in digestive diseases. This study aims to explore digestive disease studies that use telemedicine to effectively manage disease activity, help monitor symptoms, improve compliance to the treatment protocol, increase patient satisfaction, and enhance the patient-to-provider communication. EBSCO, PubMed, and Web of Science databases were searched using Medical Subject Headings and other keywords to identify studies that utilized telemedicine in patients with digestive disease. The PRISMA guidelines were used to identify 20 research articles that had data aligning with 4 common overlapping themes including, patient compliance (n = 13), patient satisfaction (n = 11), disease activity (n = 15), and quality of life (n = 13). The studies focused on digestive diseases including inflammatory bowel disease (n = 7), ulcerative colitis (n = 4), Crohn's Disease (n = 1), irritable bowel syndrome (n = 6), and colorectal cancer (n = 2). From the studies included in this systematic review, patient compliance and patient satisfaction ranged between 25.7-100% and 74-100%, respectively. Disease activity, measured by symptom severity scales and physiological biomarkers, showed improvements following telemedicine interventions in several, but not all, studies. Similar to disease activity, general and disease-specific quality of life showed improvements following telemedicine interventions in as little as 12 weeks in some studies. Telemedicine and mobile health technology may be effective in managing disease activity and improving quality of life in digestive diseases. Future studies should explore both gastrointestinal and gastroesophageal diseases using these types of interventions.
TitleAssessment of the Intention to Use Mobile Health Applications Using a Technology Acceptance Model in an Israeli Adult Population.
AuthorsShemesh, T; Barnoy, S
JournalTelemedicine journal and e-health : the official journal of the American Telemedicine Association
Publication Date1 Sep 2020
Date Added to PubMed14 Jan 2020
AbstractBackground: Mobile health applications (mHealth apps) have now gained global popularity. However, evaluating the level of their use over time still remains a pertinent challenge. According to the Technology Acceptance Model (TAM), perceived ease of use and usefulness predict attitudes toward technology utilization. Together, these factors serve as determinants of behavioral intention to use the technology, which in turn predicts actual use. Purpose: We sought to elucidate factors affecting behavioral intention to use mHealth apps in an Israeli adult population sample. Methods: A modified TAM Likert Scale questionnaire-based survey was offered to 200 participants, with 168 respondents. Results: Sixty one percent of participants reported using mHealth apps on their smartphones, 81% of whom used mHealth apps from health maintenance organization providers. Generation Y participants displayed more confidence with the use of mHealth apps, and were less concerned about compromising the confidentiality of their health records. Furthermore, answers to TAM-related questions among mHealth apps users were significantly more positive, compared with nonuser TAM components that accounted for 51% of the total variance in the intention to use mHealth apps. Discussion: TAM constructs were related to the behavioral intention to continue to use mHealth apps. Health organizations as providers of mHealth apps were strong determinants of their acceptance and utilization. Generational differences in user competence were observed; however, whether user experience or interface design represents the underlying differentials remains to be elucidated, and developers of health care-related mobile technologies will need to address this question.
TitleUsability Challenges for Health and Wellness Mobile Apps: Mixed-Methods Study Among mHealth Experts and Consumers.
AuthorsLiew, MS; Zhang, J; See, J; Ong, YL
JournalJMIR mHealth and uHealth
Publication Date30 Jan 2019
Date Added to PubMed31 Jan 2019
AbstractBy 2019, there will be an estimated 4.68 billion mobile phone users globally. This increase comes with an unprecedented proliferation in mobile apps, a plug-and-play product positioned to improve lives in innumerable ways. Within this landscape, medical apps will see a 41% compounded annual growth rate between 2015 and 2020, but paradoxically, prevailing evidence indicates declining downloads of such apps and decreasing "stickiness" with the intended end users. As usability is a prerequisite for success of health and wellness mobile apps, this paper aims to provide insights and suggestions for improving usability experience of the mobile health (mHealth) app by exploring the degree of alignment between mHealth insiders and consumers. Usability-related major themes were selected from over 20 mHealth app development studies. The list of themes, grouped into 5 categories using the Nielsen usability model, was then used as a framework to identify and classify the responses from mHealth expert (insider) interviews. Responses from the qualitative phase were integrated into some questions for a quantitative consumer survey. Subsequently, categorical data from qualitative mHealth insider interviews and numerical data from a quantitative consumer survey were compared in order to identify common usability themes and areas of divergence. Of the 5 usability attributes described in Nielsen model,  Satisfaction ranked as the top attribute for both mHealth insiders and consumers. Satisfaction refers to user likability, comfort, and pleasure. The consumer survey yielded 451 responses. Out of 9 mHealth insiders' top concerns, 5 were similar to those of the consumers. On the other hand, consumers did not grade themes such as Intuitiveness as important, which was deemed vital by mHealth insiders. Other concerns of the consumers include in-app charges and advertisements. This study supports and contributes to the existing pool of mixed-research studies. Strengthening the connectivity between suppliers and users (through the designed research tool) will help increase uptake of mHealth apps. In a holistic manner, this will have a positive overall outcome for the mHealth app ecosystem.
TitleThe Use of Telemedicine and Mobile Technology to Promote Population Health and Population Management for Psychiatric Disorders.
AuthorsTurvey, C; Fortney, J
JournalCurrent psychiatry reports
Publication Date16 Oct 2017
Date Added to PubMed17 Oct 2017
AbstractThis article discusses recent applications in telemedicine to promote the goals of population health and population management for people suffering psychiatric disorders. The use of telemedicine to promote collaborative care, self-monitoring and chronic disease management, and population screening has demonstrated broad applicability and effectiveness. Collaborative care using videoconferencing to facilitate mental health specialty consults has demonstrated effectiveness in the treatment of depression, PTSD, and also ADHD in pediatric populations. Mobile health is currently being harnessed to monitor patient symptom trajectories with the goal of using machine learning algorithms to predict illness relapse. Patient portals serve as a bridge between patients and providers. They provide an electronically secure shared space for providers and patients to collaborate and optimize care. To date, research has supported the effectiveness of telemedicine in promoting population health. Future endeavors should focus on developing the most effective clinical protocols for using these technologies to ensure long-term use and maximum effectiveness in reducing population burden of mental health.
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