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BACKGROUND: Various explicit screening tools, developed mostly in central Europe and the USA, assist clinicians in optimizing medication use for older adults. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria set, primarily based on the STOPP/START criteria set, is a current explicit tool originally developed for Eastern Europe and subsequently validated for broader use in Central European settings. Reviewed every three months to align with the latest scientific literature, it is one of the most up-to-date tools available. The tool is accessible via a free mobile app and website platforms, ensuring convenience for clinicians and timely integration of updates as needed. Healthcare providers often prefer to use their native language in medical practice, highlighting the need for prescribing tools to be translated and adapted into multiple languages to promote optimal medication practices. OBJECTIVE: To describe the protocol for cross-cultural and language validation of the TIME criteria in various commonly used languages and to outline its protocol for clinical validation across different healthcare settings. METHODS: The TIME International Study Group comprised 24 geriatric pharmacotherapy experts from 12 countries. In selecting the framework for the study, we reviewed the steps and outcomes from previous research on cross-cultural adaptations and clinical validations of explicit tools. Assessment tools were selected based on both their validity in accurately addressing the relevant issues and their feasibility for practical implementation. The drafted methodology paper was circulated among the study group members for feedback and revisions leading to a final consensus. RESULTS: The research methodology consists of two phases. Cross-cultural adaptation/language validation phase follows the 8-step approach recommended by World Health Organization. This phase allows regions or countries to make modifications to existing criteria or introduce new adjustments based on local prescribing practices and available medications, as long as these adjustments are supported by current scientific evidence. The second phase involves the clinical validation, where participants will be randomized into two groups. The control group will receive standard care, while the intervention group will have their treatment evaluated by clinicians who will review the TIME criteria and consider its recommendations. A variety of patient outcomes (i.e., number of hospital admissions, quality of life, number of regular medications [including over the counter medications], geriatric syndromes and mortality) in different healthcare settings will be investigated. CONCLUSION: The outputs of this methodological report are expected to promote broader adoption of the TIME criteria. Studies building on this work are anticipated to enhance the identification and management of inappropriate medication use and contribute to improved patient outcomes.
BACKGROUND: Effective diabetes management requires a multimodal approach involving lifestyle changes, pharmacological treatment, and continuous patient education. Self-management demands can be overwhelming for patients, leading to lowered motivation, poor adherence, and compromised therapeutic outcomes. In this context, digital health apps are emerging as vital tools to provide personalized support and enhance diabetes management and clinical outcomes. OBJECTIVE: This study evaluated the impact of the digital health application Vitadio on glycemic control in patients with type 2 diabetes mellitus (T2DM). Secondary objectives included evaluating its effects on cardiometabolic parameters (weight, BMI, waist circumference, blood pressure, and heart rate) and self-reported measures of diabetes distress and self-management. METHODS: In this 6-month, 2-arm, multicenter, unblinded randomized controlled trial, patients aged 18 years or older diagnosed with T2DM were randomly assigned (1:1) to an intervention group (IG) receiving standard diabetes care reinforced by the digital health app Vitadio or to a control group (CG) provided solely with standard diabetes care. Vitadio provided a mobile-based self-management support tool featuring educational modules, motivational messages, peer support, personalized goal setting, and health monitoring. The personal consultant was available in the app to provide technical support for app-related issues. The primary outcome, assessed in the intention-to-treat population, was a change in glycated hemoglobin (HbA1c) levels at 6 months. Secondary outcomes included changes in cardiometabolic measures and self-reported outcomes. Data were collected in 2 study centers: diabetologist practice in Dessau-Roßlau and the University of Dresden. RESULTS: Between November 2022 and June 2023, a total of 276 patients were screened for eligibility, with 149 randomized to in intervention group (IG; n=73) and a control group (CG; n=76). The majority of participants were male (91/149, 61%). The dropout rate at month 6 was 19% (121/149). While both groups achieved significant HbA1c reduction at 6 months (IG: mean -0.8, SD 0.9%, P<.001; CG: mean -0.3, SD 0.7%, P=.001), the primary confirmatory analysis revealed statistically significant advantage of the IG (adjusted mean difference: -0.53%, SD 0.15, 95% CI -0.24 to -0.82; P<.001; effect size [Cohen d]=0.67, 95% CI 0.33-1). Significant between-group differences in favor of the IG were also observed for weight loss (P=.002), BMI (P=.001) and systolic blood pressure (P<.03). In addition, Vitadio users experienced greater reduction in diabetes-related distress (P<.03) and obtained more pronounced improvements in self-care practices in the areas of general diet (P<.001), specific diet (P<.03), and exercise (P<.03). CONCLUSIONS: This trial provides evidence for the superior efficacy of Vitadio in lowering the HbA1c levels in T2DM patients compared to standard care. In addition, Vitadio contributed to improvements in cardiometabolic health, reduced diabetes-related distress, and enhanced self-management, highlighting its potential as an accessible digital tool for comprehensive diabetes management. TRIAL REGISTRATION: German Clinical Trials Registry DRKS00027405; https://drks.de/search/de/trial/DRKS00027405.
- MeSH
- diabetes mellitus 2. typu * krev terapie MeSH
- dospělí MeSH
- glykovaný hemoglobin analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mobilní aplikace * MeSH
- péče o sebe MeSH
- self-management MeSH
- senioři MeSH
- telemedicína MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
Klimatické změny vedou v posledních letech k prodloužení pylové sezóny, respektive k jejímu časnějšímu začátku. Mobilní aplikace umožnují dnes pacientům monitorovat aktuální pylovou situaci, zaznamenávat vlastní klinické obtíže a lépe dodržovat compliance k léčbě. Klinické projevy pylové alergie zahrnují nejčastěji alergickou rhinokonjunktivitidu. V příspěvku zmiňuji zásady symptomatické farmakoterapie alergické rýmy a kauzální léčbu - specifickou alergenovou imunoterapii.
Pollen season lasts longer because of its earlier start due to recent climate changes. Mobile apps enable pollen monitoring, help patients describe their clinical symptoms, and improve compliance with therapy. Allergic rhinoconjunctivitis is the most frequent clinical symptom. This paper provides info about symptomatic pharmacotherapy as well as about causal treatment- about specific allergen immunotherapy.
- MeSH
- alergeny škodlivé účinky terapeutické užití MeSH
- alergie * etiologie farmakoterapie MeSH
- antagonisté histaminu H1 terapeutické užití MeSH
- aplikace intranazální MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- imunoterapie metody MeSH
- informatika pro pacienty metody MeSH
- internet MeSH
- kombinovaná farmakoterapie MeSH
- lidé MeSH
- mobilní aplikace MeSH
- pyl škodlivé účinky MeSH
- sezónní alergická rýma * etiologie farmakoterapie MeSH
- Check Tag
- lidé MeSH
BACKGROUND: Mobile health (mHealth) is increasingly being used in contemporary health care provision owing to its portability, accessibility, ability to facilitate communication, improved interprofessional collaboration, and benefits for health outcomes. However, there is limited discourse on patient safety in real-world mHealth implementation, especially as care settings extend beyond traditional center-based technology usage to home-based care. OBJECTIVE: This study aimed to explore health care professionals' perspectives on the safety aspects of mHealth integration in real-world service provision, focusing on Hong Kong Special Administrative Region (SAR) and Wuhan city in mainland China. In Hong Kong SAR, real-world mHealth care provision is largely managed by the Hospital Authority, which has released various mobile apps for home-based care, such as Stoma Care, Hip Fracture, and HA Go. In contrast, mHealth care provision in Wuhan is institutionally directed, with individual hospitals or departments using consultation apps, WeChat mini-programs, and the WeChat Official Accounts Platform (a subapp within the WeChat ecosystem). METHODS: A multicenter qualitative study design was used. A total of 27 participants, including 22 nurses and 5 physicians, from 2 different health care systems were interviewed individually. Thematic analysis was used to analyze the data. RESULTS: The mean age of the participants was 32.19 (SD 3.74) years, and the mean working experience was 8.04 (SD 4.05) years. Most participants were female (20/27, 74%). Nearly half of the participants had a bachelor's degree (13/27, 48%), some had a master's degree (9/27, 33%), and few had a diploma degree (3/27, 11%) or a doctoral degree (2/27, 7%). Four themes emerged from the data analysis. Considering the current uncertainties surrounding mHealth implementation, participants emphasized "liability" concerns when discussing patient safety. They emphasized the need for "change management," which includes appropriate referral processes, adequate resources and funding, informed mHealth usage, and efficient working processes. They cautioned about the risks in providing mHealth information without ensuring understanding, appreciated the current regulations available, and identified additional regulations that should be considered to ensure information security. CONCLUSIONS: As health care systems increasingly adopt mHealth solutions globally to enhance both patient care and operational efficiency, it becomes crucial to understand the implications for patient safety in these new care models. Health care professionals recognized the importance of patient safety in making mHealth usage reliable and sustainable. The promotion of mHealth should be accompanied by the standardization of mHealth services with institutional, health care system, and policy-level support. This includes fostering mHealth acceptance among health care professionals to encourage appropriate referrals, accommodate changes, ensure patient comprehension, and proactively identify and address threats to information security.
- MeSH
- bezpečnost pacientů * MeSH
- dospělí MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- mobilní aplikace MeSH
- telemedicína * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Čína MeSH
- Hongkong MeSH
BACKGROUND: The number of mobile apps tailored for people living with mental health conditions has increased tremendously. However, the majority of the existing apps are not evidence-based and are being developed by teams without mental health expertise. OBJECTIVE: We aimed to explore psychiatrists' perceptions of what they and their patients need in a mental health app and eventually inform the design of future mobile apps in this area. METHODS: Semi-structured interviews were conducted with psychiatrists (N = 18) from three European countries: Austria, the Czech Republic, and Slovakia. Content analysis using inductive and deductive coding was used to analyze the interviews. RESULTS: Four major themes were deductively identified: current system, gaps in the current system, recommendations for a mobile app, and promoting app use. Psychiatrists provided a comprehensive list of app features they suggested would be helpful. Of particular importance seemed to be enabling patients to self-monitor various aspects of their lives and including an emergency plan. Participants also emphasized that the app should be positive and motivating for patients to use, with some suggesting that users be able to communicate with other users for support. Within the theme of "current system," a common topic was the current shortage of psychiatrists and the feelings of time pressure amongst existing psychiatrists. CONCLUSIONS: The results of this study can be used by software developers to inform future designs of mental health mobile apps, which will hopefully translate to a greater availability of evidence-based apps that address clinical needs.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Longitudinal investigation of the association between mobile health (mHealth) app use and attitudes toward one's body during adolescence is scarce. mHealth apps might shape adolescents' body image perceptions by influencing their attitudes toward their bodies. Adolescents might also use mHealth apps based on how they feel and think about their bodies. OBJECTIVE: This prospective study examined the longitudinal within-person associations between mHealth app use, body dissatisfaction, and physical self-worth during adolescence. METHODS: The data were gathered from a nationally representative sample of Czech adolescents aged between 11 and 16 years (N=2500; n=1250, 50% girls; mean age 13.43, SD 1.69 years) in 3 waves with 6-month intervals. Participants completed online questionnaires assessing their mHealth app use, physical self-worth, and body dissatisfaction at each wave. The mHealth app use was determined by the frequency of using sports, weight management, and nutritional intake apps. Physical self-worth was assessed using the physical self-worth subscale of the Physical Self Inventory-Short Form. Body dissatisfaction was measured with the items from the body dissatisfaction subscale of the Eating Disorder Inventory-3. The random intercept cross-lagged panel model examined longitudinal within-person associations between the variables. A multigroup design was used to compare genders. Due to the missing values, the final analyses used data from 2232 adolescents (n=1089, 48.8% girls; mean age 13.43, SD 1.69 years). RESULTS: The results revealed a positive within-person effect of mHealth app use on the physical self-worth of girls: increased mHealth app use predicted higher physical self-worth 6 months later (β=.199, P=.04). However, this effect was not consistent from the 6th to the 12th month: a within-person increase in using apps in the 6th month did not predict changes in girls' physical self-worth in the 12th month (β=.161, P=.07). Regardless of gender, the within-person changes in the frequency of using apps did not influence adolescents' body dissatisfaction. In addition, neither body dissatisfaction nor physical self-worth predicted app use frequency at the within-person level. CONCLUSIONS: This study highlighted that within-person changes in using mHealth apps were differentially associated with adolescents' body-related attitudes. While increased use of mHealth apps did not influence body dissatisfaction across genders, it significantly predicted higher physical self-worth in adolescent girls 6 months later. A similar association was not observed among boys after 6 months. These findings indicate that using mHealth apps is unlikely to have a detrimental impact on adolescents' body dissatisfaction and physical self-worth; instead, they may have a positive influence, particularly in boosting the physical self-worth of adolescent girls.
- MeSH
- dítě MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladiství MeSH
- mobilní aplikace * MeSH
- nespokojenost s tělem * psychologie MeSH
- osobní uspokojení MeSH
- představa o vlastním těle psychologie MeSH
- prospektivní studie MeSH
- průzkumy a dotazníky MeSH
- sebepojetí * MeSH
- telemedicína * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
V súčasnosti, aj napriek významnému pokroku v terapii akútnych kardiovaskulárnych (KV) príhod, miera kontroly krvného tlaku a dyslipidémií, ako hlavných rizikových faktorov KV-ochorení (KVO), stagnuje a tradičné prístupy často zlyhávajú. Iniciatívy v oblasti digitálnej medicíny sa začali objavovať už predtým, ako pandémia COVID-19 zásadne ovplyvnila spôsob poskytovania zdravotnej starostlivosti. Artériová hypertenzia je ideálnym kandidátom na vzdialený manažment a digitálne riešenia v tejto oblasti rýchlo pribúdajú. Štúdie preukázali, že metódy telemedicíny signifikantne znižujú systolický, ako aj diastolický tlak pacientov a pomáhajú zlepšovať dosahovanie cieľových hodnôt tlaku a adherenciu k terapii. Bolo však taktiež preukázané, že metódy mHealth (mobile Health) museli byť spojené so súbežnou konzultáciou so zdravotníkom. Aplikácie na monitorovanie vlastného zdravia, prípadne ,,selfcouching‘‘, ktoré fungovali na pasívnom zbere dát, nepreukázali vyššie uvedené výsledky. Taktiež sa ukázalo, že existujú mnohé prekážky v implementácii týchto technológií, ako sú prístrojové (používanie validovaných tlakomerov a metód merania), finančné (úhrady zo zdravotného poistenia, náklady pre pacienta), legislatívne (hlavne ochrana osobných údajov) a taktiež neexistujúca štandardizácia v tejto oblasti. Metódy telemedicíny sa začali uplatňovať aj pri manažmente dyslipidémií, lebo sa zistilo, že vzdialený manažment pacienta so súbežným informovaním samotného pacienta o jeho KV-riziku môže výrazne dopomôcť k zlepšeniu adherencie k terapii a v dosahovaní cieľových hodnôt lipidových parametrov.
Currently, despite significant advances in the treatment of acute cardiovascular (CV) events, rates of blood pressure control and dyslipidemia, as major risk factors for CV disease (CVD), are stagnant and traditional approaches often fail. Initiatives in digital medicine have already started to emerge before the COVID-19 pandemic fundamentally impacted the way healthcare is delivered. Arterial hypertension is an ideal candidate for remote management, and digital solutions in this area are rapidly gaining traction. Studies have shown that telemedicine methods significantly reduce both systolic and diastolic blood pressure of patients and help improve achievement of target blood pressure values and adherence to therapy. However, it was also shown that mHealth (mobile Health) methods had to be associated with concurrent consultation with a healthcare professional. Self-monitoring or “selfcouching” apps that worked on passive data collection did not show the above results. It has also been shown that there are many barriers to the implementation of these technologies, such as instrumentation (use of validated blood pressure monitors and measurement methods), financial (health insurance reimbursement, cost to the patient), legislative (mainly privacy) and also the lack of standardization in this area. Telemedicine methods have also started to be applied in the management of dyslipidemia, where it has been found that remote patient management with simultaneous information to the patient about his/her CV risk can significantly help to improve adherence to therapy and in achieving target values of lipid parameters.
Úvod: Mnohé štúdie a metaanalýzy preukázali, že telemonitorovanie krvného tlaku ako aj iných faktorov metabolického syndrómu môže zlepšiť ich manažment. Avšak mnoho pacientov nevyužíva telemonitorovanie kvôli osobným, technologickým a iným bariéram. Cieľom tejto štúdie bolo zistenie aké sú perspektívy a prekážky telemonitoringu lipitenzie na Slovensku z pohľadu pacienta. Metódy: Táto štúdia bola realizovaná ako dotazníková a mala za cieľ osloviť 2 545 pacientov. Dotazník pozostával z častí zameraných na osobné charakteristiky pacienta, návyky z hľadiska merania krvného tlaku (TK), na využívanie smart-technológií, ich predpokladané prínosy a prekážky z hľadiska pacienta ako aj na znalosť lipidového profilu a kardiovaskulárneho rizika samotným pacientom. Výsledky: Celkovo sme získali 252 odpovedí od pacientov (9,9 %). Z celkového počtu opýtaných má arteriálnu hypertenziu 67,4 %, kým nefarmakologickú terapiu užíva 7,9 %. Denne si TK meria len 21,2 % hypertonikov, signifikantne vyšší počet mužov ako žien (p = 0,011) a najčastejšie si meria TK veková kategória 31–45 rokov. Až 19,4 % využíva nositeľné zariadenia a 6,3 % tlakomery prepojené s aplikáciou. Signifikantne častejšie smart-technológie využíva kategória 31–45-ročných (p = 0,01). Závažné prekážky využitia smart-technológií neboli identifikované, väčšina si vyžadovala funkciu vzdialených konzultácií, úpravy liekov a jednoduché užívateľské rozhranie. Väčšina pacientov nevie svoju hodnotu LDL-cholesterolu a až 45,7 % tých čo vie, malo zvýšené hladiny. Záver: Celkovo prevláda záujem o využitie metód telemedicíny krvného tlaku, pri jej implementácii na Slovensku bude však nutná spolupráca pacienta a lekára.
Introduction: Numerous studies and meta-analyses have demonstrated that telemonitoring of blood pressure and other factors of metabolic syndrome can improve their management. However, many patients do not use telemonitoring due to personal, technological, and healthcare barriers. The aim of this study was to identify the perspectives and barriers to telemonitoring of lipid levels in Slovakia from the patient’s point of view. Methods: This study was conducted as a questionnaire-based survey targeting 2,545 patients. The questionnaire consisted of sections focused on patients’ personal characteristics, habits regarding blood pressure measurement, the use of smart technologies, their perceived benefits and barriers, as well as the patients’ knowledge of their lipid profile and cardiovascular risk. Results: A total of 252 responses were obtained (9.9 % response rate). Among the respondents, 67.4 % had hypertension, while 7.9 % were on non-pharmacological therapy. Only 21.2 % of hypertensive patients measured their blood pressure daily, with a significantly higher proportion of men compared to women (p = 0.011), and the most frequent blood pressure monitoring was observed in the 31–45 age group. A total of 19.4 % used wearable devices, and 6.3 % used blood pressure monitors connected to an app. Smart technology use was significantly more common in the 31–45 age group (p = 0.01). No severe barriers to the use of smart technologies were identified; most patients required features such as remote consultations, medication adjustments, and user-friendly interfaces. The majority of patients were unaware of their LDL-C values, and 45.7 % of those who were aware had elevated levels. Conclusion: There is a prevailing interest in implementing telemedicine methods for blood pressure monitoring. However, collaboration between patients and physicians will be necessary for its successful implementation in Slovakia.
- MeSH
- digitální zdraví MeSH
- dyslipidemie prevence a kontrola MeSH
- hypertenze * epidemiologie prevence a kontrola MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- statistika jako téma MeSH
- telemedicína * metody MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
