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December, 2014

self management

Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study

Cafazzo JA et al, J Med Internet Res, 14(3)

The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group.
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Published: 8 May 2012 |
Keyword(s): Adolescent, Canada, Cellular Phone, Chronic Disease, Diabetes Mellitus, mHealth, Self Care, Self Management

What patients want: relevant health information technology for diabetes self-management

King D et al, Health and Technology, 2012

Health information technology has great potential to promote efficiency in patient care and increase patient-provider communication, and patient engagement in their treatment. This paper explored qualitatively what patients with type 2 diabetes want from electronic resources that are designed to support their diabetes self-management. Data were collected via interviews and focus groups from managed care patients who had completed participation in either a web-based (MyPath) or in-person group-based (¡Viva Bien!) longitudinal diabetes self-management study. Content analysis identified common themes that highlighted participant interest in virtual and electronic programs to support diabetes self-management goals, and their desired content and features. Eighteen ¡Viva Bien! participants completed telephone interviews and 30 MyPath participants attended seven focus groups in 2010-2011.
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Published: 6 March 2012 |
Keyword(s): Behavior, Diabetes Mellitus Type 2, Health Information Technology, Self Management, United States

Two complementary personal medication management applications developed on a common platform: case report

Ross SE et al, J Med Internet Res, 13(3)

Adverse drug events are a major safety issue in ambulatory care. Improving medication self-management could reduce these adverse events. Researchers have developed medication applications for tethered personal health records (PHRs), but little has been reported about medication applications for interoperable PHRs.

Our objective was to develop two complementary personal health applications on a common PHR platform: one to assist children with complex health needs (MyMediHealth), and one to assist older adults in care transitions (Colorado Care Tablet).
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Published: 12 July 2011 |
Keyword(s): Adverse Drug Events, Disease Management, Electronic Health Records, Medication Adherence, Personal Health Records, Self Management, United States

An empowerment-based approach to developing innovative e-health tools for self-management

Alpay L et al, Health Informatics Journal, 17(4)

E-health is seen as an important technological tool in achieving self-management; however, there is little evidence of how effective e-health is for self-management. Example tools remain experimental and there is limited knowledge yet about the design, use, and effects of this class of tools. By way of introducing a new view on the development of e-health tools dedicated to self-management we aim to contribute to the discussion for further research in this area.
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Published: December 2011 |
Keyword(s): e-Health, Empowerment, Self Management

Empowerment, patient centred care and self-management

Pulvirenti M et al, Health Expectations, 2011

Patient or person centred care is widely accepted as the philosophy and practice that underpins quality care. An examination of the Australian National Chronic Disease Strategy and literature in the field highlights assumptions about the self-manager as patient and a focus on clinical settings.
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Published: 2 January 2012 |
Keyword(s): Australia, Chronic Diseases, Empowerment, Patient Care, Quality, Self Management

Management of Cardiovascular Risk Factors Is Leaving the Office: Potential Impact of Telemedicine

Krakoff LR. The Journal of Clinical Hypertension, 2011

Effective control of hypertension and the other cardiovascular risk factors has been dependent on primary medical care as provided by family practitioners and internists. The progressive reduction in availability of primary care for adult populations in the United States threatens the likelihood of better control of the risk factors and potential loss of opportunity for prevention of cardiovascular disease. Recent progress has been made in the use of home blood pressure monitoring for improvement in classification of risk for hypertensive patients. Several studies establish the feasibility of home pressure monitoring combined with telemedicine for improving control of hypertension. Some studies have explored the role of self-care for adjustment of medication, as well.
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Published: 26 September 2011 |
Keyword(s): Cardiovascular, Hypertension, Self Management, Telemedicine, United States

[Health 2.0 for psychiatrists]

Hoekstra R. Tijdschrift Voor Psychiatrie, 53(10)

The internet used to be mainly ‘one-way traffic’ (1.0). Nowadays it is becoming easy for internet users to communicate with each other via the web (2.0).

To describe the concept of Health 2.0 and to explore the possibilities of 2.0-technology for psychiatry.
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Published: 2011 |
Keyword(s): Health 2.0, Information Technology, Internet, Netherlands, Psychiatry, Self Management

Features of Mobile Diabetes Applications: Review of the Literature and Analysis of Current Applications Compared Against Evidence-Based Guidelines

Chomutare T et al, J Med Internet Res, 13(3)

Interest in mobile health (mHealth) applications for self-management of diabetes is growing. In July 2009, we found 60 diabetes applications on iTunes for iPhone; by February 2011 the number had increased by more than 400% to 260. Other mobile platforms reflect a similar trend. Despite the growth, research on both the design and the use of diabetes mHealth applications is scarce. Furthermore, the potential influence of social media on diabetes mHealth applications is largely unexplored.
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Published: 22 September 2011 |
Keyword(s): Diabetes Mellitus, Education, Electronic Health Records, mHealth, Personal Health Records, Self Management, Self-monitoring, Social Networks

Twelve-month outcomes of an Internet-based diabetes self-management support program

Glasgow RE et al, Patient Education and Counseling, 2011

Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs.

We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n=463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors.
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Published: 15 September 2011 |
Keyword(s): Chronic Diseases, Diabetes Mellitus, Internet, Self Management, United States

A High Road to Dutch Healthcare Reform

Dumaij ACM et al, Handbook of Digital Homecare - Successes and Failures, 2011

This study aims to assess the adoption potential of healthcare innovations in their infancy. Such an assessment is useful, since the context of the innovations change rapidly as a result of the health care reform process. Successful innovations comply to a complex system of social, technical, and financial attributes. First we narrow down the vast amount of innovations in healthcare into a review set of innovations and select attributes of successful innovations from literature. Next the compliance of the review set with the attributes is assessed by an expert panel.
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Published: 2011 |
Keyword(s): Digital Homecare, Electronic Health Records, Innovation, Netherlands, Self Management

Impact of Telehealth on Patient Self-management of Heart Failure: A Review of Literature

Radhakrishnan K, Jacelon C. The Journal of Cardiovascular Nursing, 2011

The objective of the study was to explore the impact of telehealth interventions on individuals’ self-care of heart failure (HF).

Heart failure is a chronic illness that requires a complex treatment regimen over a long period. Historically, effective self-care has been difficult for this population. There is a need for innovative and effective approaches to improve individual self-care. Telehealth can potentially help individuals with HF follow the plan of care resulting in improved health outcomes and a better quality of life.
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Published: 9 May 2011 |
Keyword(s): Digital Homecare, Heart Failure, Literature Review, Self Care, Self Management, Telehealth, Telemedicine, Telemonitoring

On-line health companion contact among chronically ill in the Netherlands

Dumaij ACM, Tijssen ECG. Health and Technology, 1(1)

A health companion is a patient who supports another patient or patient group with a similar health condition. Health companions deliver more and more support by the Internet. However, little is known about the characteristics of the users, their motivation, type of technology used and effects on health and the healthcare delivery process. The objective of the paper is to understand motivation, technology and effects of on-line health companion contact in the Netherlands concerning chronic diseases (DBM, COPD, CHF, CRD, CMD). The On-line Health Companion Contact Model was created to frame the research process. An extensive on-line questionnaire was taken from patients with various chronic disorders and using on-line health companion contact to obtain quantitative and qualitative data.
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Published: 29 March 2011 |
Keyword(s): Chronic Diseases, Internet, Netherlands, Patient Empowerment, Self Management

Living Profiles: design of a health media platform for teens with special healthcare needs

Chira P et al, Journal of Biomedical Informatics, 43(5 Suppl)

Living Profiles is a health media platform in development that aggregates multiple data flows to help teens with special healthcare needs (SHCN), particularly with regard to self-management and independence. A teen-oriented personal health record (PHR) incorporates typical teen behaviors and attitudes about health and wellness, encompasses how teens perceive and convey quality of life, and aligns with data related to their chronic medical condition. We have conceived a secure personalized user interface called the Quality of Life Timeline, which will assist with the transition from pediatric care to an adult provider through modules that include a mood meter, reminder device, and teleport medicine. With this personalized PHR, teens with SHCN can better understand their condition and its effects on daily activities and life goals and vice versa; additionally, use of this PHR allows for better information sharing and communication between providers and patients. The use of a teen-oriented tool such as Living Profiles can impact teens’ overall quality of life and disease self-management, important attributes for a successful transition program.

Published: October 2010 |
Keyword(s): Adolescent, Electronic Health Records, Patient Care Management, Personal Health Records, Quality of Life, Self Management, United States

Web-Based Self-Management for Patients with Multiple Sclerosis: A Practical, Randomized Trial

Miller DM et al, Telemedicine and e-Health, 17(1)

No studies have addressed the use of electronic personal health records (e-PHRs) for self-management in complex neurological disorders. We assessed and tested an Internet-based self-management system that utilized the e-PHR and determined its impact on self-assessed well-being, clinician-assessed well-being, and healthcare utilization in patients with multiple sclerosis (MS).
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Published: 9 January 2011 |
Keyword(s): Clinical Trials, Electronic Health Records, Multiple Sclerosis, Personal Health Records, Randomized Controlled Trials, Self Management, United States

Factors affecting home care patients’ acceptance of a web-based interactive self-management technology

Or CKL et al, J Am Med Inform Assoc, 18(1)

With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients’ acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive self-management innovation among home care patients.
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Published: 3 December 2010 |
Keyword(s): Behaviour, Home Care, Innovation, Patient, Perceived usefulness, Self Management, Web

Outcomes of Minimal and Moderate Support Versions of an Internet-Based Diabetes Self-Management Support Program

Glasgow RE et al, Journal of General Internal Medicine, 25(12)

Internet and other interactive technology-based programs offer great potential for practical, effective, and cost-efficient diabetes self-management (DSM) programs capable of reaching large numbers of patients. This study evaluated minimal and moderate support versions of an Internet-based diabetes self-management program, compared to an enhanced usual care condition.
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Published: 17 August 2010 |
Keyword(s): Behaviour, Diabetes Mellitus, Disparities, Internet, Self Management, United States

Mobile phone technologies and advanced data analysis towards the enhancement of diabetes self-management

Kouris I et al, International Journal of Electronic Healthcare, 5(4)

Advances in the area of mobile and wireless communication for healthcare (m-Health) along with the improvements in information science allow the design and development of new patient-centric models for the provision of personalised healthcare services, increase of patient independence and improvement of patient’s self-control and self-management capabilities. This paper comprises a brief overview of the m-Health applications towards the self-management of individuals with diabetes mellitus and the enhancement of their quality of life. Furthermore, the design and development of a mobile phone application for Type 1 Diabetes Mellitus (T1DM) self-management is presented.
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Published: 2010 |
Keyword(s): Cellular Phone, Diabetes Mellitus, mHealth, Quality of Life, Self Management

Information and communication technologies for better patient self-management and self-efficacy

Ilioudi S et al, International Journal of Electronic Healthcare, 5(4)

Achieving benefits from the introduction of ICTs as part of processes aimed at building sustainable self-efficacy and self-management is very difficult, not least because of a desire to avoid simply replacing patient dependency on health professionals with dependency on technology. Chronic illnesses require ongoing attention that differs from traditional, encounter-based care for acute illnesses. Patients with chronic illnesses such as asthma, cardiovascular disease, depression, diabetes, heart failure and migraine headaches play a central role in managing the broad array of factors that contribute to their health. Individuals with diabetes, for example, provide close to 95% of their own care.
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Published: 2010 |
Keyword(s): Chronic Diseases, Healthcare Technology, ICT, Patient, Personalised Medicine, Self Efficacy, Self Management

The case for home monitoring in hypertension

Padfield PL. BMC Medicine, 8(1)

Although the assessment of cardiovascular risk in individual patients takes into account a range of risk factors, the diagnosis and management of hypertension (high blood pressure) is largely determined by a single numerical value, albeit that often several readings are taken over time. Given the critical impact of a decision to embark on lifelong drug therapy the importance of ensuring that a blood pressure (BP) record is both accurate and representative is clear. However, there is good evidence that the variability of BP is such that even if measurement is of the highest quality it can be difficult to say with confidence whether a patient is above or below a treatment threshold.
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Published: 27 September 2010 |
Keyword(s): Blood Pressure, Home Monitoring, Hypertension, Patient Empowerment, Self Management

Evolution of a web-based, prototype Personal Health Application for diabetes self-management

Fonda SJ et al, Journal of Biomedical Informatics, 43(5 S1)

Behaviors carried out by the person with diabetes (e.g., healthy eating, physical activity, judicious use of medication, glucose monitoring, coping and problem-solving, regular clinic visits, etc.) are of central importance in diabetes management. To assist with these behaviors, we developed a prototype PHA for diabetes self-management that was based on User-Centered Design principles and congruent with the anticipatory vision of Project Health Design (PHD). This article presents aspects of the prototype PHA’s functionality as conceived under PHD and describes modifications to the PHA now being undertaken under new sponsorship, in response to user feedback and timing tests we have performed.
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Published: October 2010 |
Keyword(s): Applications, Diabetes, Electronic Health Records, Internet, Personal Health Records, Self Management, Telemedicine, User Centered Design

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