Telemedicine Programs in Respiratory Diseases

Telemedicine programs are widely used in respiratory diseases, more often in patients with chronic obstructive pulmonary diseases (COPD). Telemedicine platforms use several devices to measure vital signs such as heart rate, respiratory rate, pulsioximetry or blood pressure between others. It is not unusual that patients could do questionnaires about clinical situation or communicate with their nurses via telephone, video-calling and/or Skype. The majority of results has been positive, with reduction in the number of emergency visits, hospitalizations and noninvasive ventilations. Despite their promising results, telemedicine programs/platforms are slow to implement. In this chapter, we reviewed some of the factors related to telemedicine implementation such as patients’ adherence, impact of telemedicine design and professionals\u27 resistance to change between others

Design and Prototype Evaluation of a Mini Program for Diet Management Focusing on Patients with Chronic Kidney Disease

Background Chronic kidney disease (CKD) is a global public health problem and has become a common chronic non-communicable disease threatening human well-being. There is no effective cure for CKD, and once it progresses to end-stage renal disease, only renal replacement therapy can be performed, which brings a heavy medical burden to families and the country. Dietetic-nutritional management is closely related to delaying the progression of CKD and improving health outcomes and is essential in the treatment of CKD. However, dietary compliance of patients is currently a major challenge in clinical work. With the integration of mobile Internet and healthcare, mobile health, represented by smartphones, has become an important tool for healthcare services. Previous studies have shown that information tools can motivate users to make positive eating behavior changes and improve their confidence in achieving their dietary goals. In recent years, diet management tools for CKD patients have gradually increased in China, but most patients still face difficulties in self-managing their diet at home. Aims Given that the advantages of WeChat Mini Program in China and the cost limitation of the study, the purpose of this study is to follow the concept of human-centred design to design an open accessible WeChat Mini Program for home diet management, and with CKD patients and caregivers as the target users, to ultimately improve the patient's experience of diet management and improve their dietary compliance to obtain the optimal benefits of medical nutrition therapy. To understand the usability and design flaws of this Mini Program through the prototype development and evaluation, to further improve the design and provide a reference for future development. Methods This study was divided into three stages. The first stage was the requirements analysis of diet management Mini Program: stakeholders, i.e., CKD patients and caregivers, renal dietitians, nephrologists, and specialist nurses, were interviewed through a qualitative study to explore their functional needs and suggestions for the Mini Program. The second stage was the design and expert evaluation of the Mini Program for CKD patients: based on literature review and stakeholders' requirements analysis and drawing on the features of the existing applications on the market, the first draft of the written design of this Mini Program was completed and then the written design and technical feasibility of the Mini Program were evaluated by multidisciplinary experts, including renal dietitians, nephrologists and specialist nurses, as well as WeChat Mini Program development technicians, to further revise and finalize the written design of this Mini Program. The third stage was prototype development and evaluation of the Mini Program: using Mocking Bot to develop the prototype and then was a mixed study, 15 testers were recruited to evaluate the prototype by convenience sampling. mHealth App Usability Questionnaire (MAUQ) (patient version) was used to collect quantitative usability scores, and qualitative interviews were conducted to explore their experience and suggestions for improvement of the Mini Program. Results 1. Requirements analysis of diet management Mini Program: 22 stakeholders were interviewed, including 9 CKD patients, 4 caregivers, and 9 clinical professionals. Three themes are extracted, which are attitudes towards the Mini Program (overall, highly expected the Mini Program for diet management), functional requirements of the Mini Program (including provide comprehensive diet management information, diet decision support, professional diet self-management skills, and emotional support channels), and performance requirements of the Mini Program (easy to use and learn, with simple interface). There are 12 specific functional requirements, which is expected to provide reliable dietary knowledge, food nutrient query, individualized dietary advice, dietary nutrition monitoring, customize individual recipes, recommend disease-specific foods, diet record and analysis, nutrition consultation, promote family participation, communication among patients, user feedback, and intelligent reminder. 2. Design and expert evaluation of the Mini Program: After two rounds of evaluation and feedback from multidisciplinary experts, the final version of the written design of the Mini Program was formed, including 4 modules, namely, Home Page, Interactive Community, Health Record, Personal Centre; and 19 functions, including Site Search, Diet Management, Popular Science Articles, and News (Home Page), Circle of Patients, My Doctors, Doctor's Lectures, My Family (Interactive Community), BP Record, BG Record, Wt. Record, Exercise Record (Health Record), and Basic Information Setting, Health Report, My equipment, My favourites, My Posts, Product Introduction, Feedback and Help (Personal Centre). 3. Prototype development and evaluation of the Mini Program: the prototype developed in this study was high-fidelity and interactive. Quantitative result: the mean value of the overall scoring of MAUQ was 1.39, with a standard deviation of 0.29, indicating that patients and caregivers recognize the Mini Program as usable. Qualitative result: clinical professionals, CKD patients, and caregivers who participated in the testing have a high acceptance of the Mini Program. Clinical professionals consider the Mini Program to be comprehensive, helpful for patients' diet management, and to reduce the burden of clinical diet education; patients and caregivers consider the Mini Program to be a comprehensive, easy-to-use, and practical tool that facilitates access to professional knowledge, improves their confidence in diet management and social support, and they have a positive attitude towards using it and express their great expectations. The main shortcomings of the Mini Program are the need to adjust the colour scheme and optimize the layout of the user interface and to highlight the main functions of diet management, and to realize the function of voice use if the development technology is feasible. Conclusion The Mini Program designed in this study meet the needs and demands of home diet management for CKD patients and may positively affect their diet self-management. In the future, we consider further collaboration with information technology companies and clinical usability assessment and effectiveness evaluation would be necessary, to determine the clinical effect and economic cost-effectiveness of interventions for CKD patients based on such a WeChat Mini Program, and to promote the close integration of mHealth and clinical practice

Models and theories of care applicable to predicting and improving adherence behaviours among Chronic Kidney Disease (CKD) patients

Introduction: Models which relate to cognitive variables and processes may apply to adherence behaviours in patients with chronic conditions. Management of Chronic  Kidney Disease (CKD) requires incorporation of these models to facilitate the positive adherence behaviours among patients.Aim: This article critiques models and theories of care applicable to predicting and improving adherence behaviours among patients with chronic kidney disease (CKD).Methods: Medline, Ebsco, PubMed, Google Scholar, Cinahl and grey  literature were used to identify the relevant articles from the years  1990-2018. A conclusive search was done using the following key words: Models OR ‘Theories of care AND Prediction [tab]’ AND Improving AND adherence behaviours AND Chronic Kidney DiseaseResults: The search identified 23 articles containing information on models and theories of care applicable to the management of CKD patients. The Common-Sense Model, Orem Self-care and Theory of Planned Behaviour Models were applied in predicting and improving adherence among CKD patients. Other identified possible models in predicting and improving adherence included Tran’s Theoretical Model, the Theory of Reasoned Action, and the Social Cognitive and Health Belief Models.Conclusion: These theories and models provide a baseline assessment regarding predicting and improving adherence in chronic kidney disease patients. However, there is no model or theory which comprehensively explains an understanding of predicting and improving adherence of CKD patients to their management, hence the need to consider the available models/theories to effectively engage CKD patients with their integrated management to promote the highest level of adherent  behaviour._________________________________________________________________________Key words: Models/theories of care, prediction, adherence, Chronic Kidney Disease stages 1 to 5

3D Printing of Dietary Products for the Management of Inborn Errors of Intermediary Metabolism in Pediatric Populations

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/The incidence of Inborn Error of Intermediary Metabolism (IEiM) diseases may be low, yet collectively, they impact approximately 6–10% of the global population, primarily affecting children. Precise treatment doses and strict adherence to prescribed diet and pharmacological treatment regimens are imperative to avert metabolic disturbances in patients. However, the existing dietary and pharmacological products suffer from poor palatability, posing challenges to patient adherence. Furthermore, frequent dose adjustments contingent on age and drug blood levels further complicate treatment. Semi-solid extrusion (SSE) 3D printing technology is currently under assessment as a pioneering method for crafting customized chewable dosage forms, surmounting the primary limitations prevalent in present therapies. This method offers a spectrum of advantages, including the flexibility to tailor patient-specific doses, excipients, and organoleptic properties. These elements are pivotal in ensuring the treatment’s efficacy, safety, and adherence. This comprehensive review presents the current landscape of available dietary products, diagnostic methods, therapeutic monitoring, and the latest advancements in SSE technology. It highlights the rationale underpinning their adoption while addressing regulatory aspects imperative for their seamless integration into clinical practice.Peer reviewe

Mobile Health Technologies

Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain