|
1
|
Georgakopoulou VE, Spandidos DA, Corlateanu A. Diagnostic tools in respiratory medicine (Review). Biomed Rep 2025; 23:112. [PMID: 40420977 PMCID: PMC12105097 DOI: 10.3892/br.2025.1990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Accepted: 04/30/2025] [Indexed: 05/28/2025] Open
Abstract
Recent advancements in diagnostic technologies have significantly transformed the landscape of respiratory medicine, aiming for early detection, improved specificity and personalized therapeutic strategies. Innovations in imaging such as multi-slice computed tomography (CT) scanners, high-resolution CT and magnetic resonance imaging (MRI) have revolutionized our ability to visualize and assess the structural and functional aspects of the respiratory system. These techniques are complemented by breakthroughs in molecular biology that have identified specific biomarkers and genetic determinants of respiratory diseases, enabling targeted diagnostic approaches. Additionally, functional tests including spirometry and exercise testing continue to provide valuable insights into pulmonary function and capacity. The integration of artificial intelligence is poised to further refine these diagnostic tools, enhancing their accuracy and efficiency. The present narrative review explores these developments and their impact on the management and outcomes of respiratory conditions, underscoring the ongoing shift towards more precise and less invasive diagnostic modalities in respiratory medicine.
Collapse
Affiliation(s)
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Alexandru Corlateanu
- Department of Pulmonology and Allergology, State University of Medicine and Pharmacy ‘Nicolae Testemitanu’, MD-2004 Chisinau, Moldova
| |
Collapse
|
|
2
|
Sykorova K, Mathew A, Pavel N, Gazerani P, Saidi T, Bakke Johnsen M, Lystad JU, Bull H, Fløystad Kvammen M, He HG, Jacoby J, Pikkarainen M. Exploring Stakeholders' Perceptions of Using Digital Health Technologies to Improve the Conservative Treatment of Adolescent Idiopathic Scoliosis: Qualitative Study. J Med Internet Res 2025; 27:e69089. [PMID: 40561463 DOI: 10.2196/69089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 03/28/2025] [Accepted: 04/24/2025] [Indexed: 06/28/2025] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) affects 2%-3% of adolescents, with conservative treatments like bracing and physiotherapeutic scoliosis-specific exercises (PSSEs) recommended for mild to moderate cases. However, patient compliance with these treatments is often low. Digital tools, including smartphone apps and web applications, offer capabilities such as spinal curvature monitoring, remote consultation, and reduction of health care professionals' workload. These tools may also enhance adherence by increasing motivation and providing real-time feedback, which can be particularly beneficial for patients struggling with brace discomfort or self-esteem concerns. Despite these potential benefits, research remains limited on how digital health technologies can specifically enhance conservative AIS treatment and improve patient outcomes. OBJECTIVE This study aimed to explore the perspectives of multiple stakeholders, including patients, caregivers, and health care providers, on using digital health technologies to improve AIS treatment adherence and outcomes. METHODS This qualitative research study was conducted in Norway and included 17 participants (1 medical doctor, 2 physiotherapists, 8 patients, 4 family caregivers, and 2 IT specialists). The study adhered to Norwegian regulations. After approval from authorities and approval of the study protocol, patients were recruited through the Norwegian Spine and Back Pain Organization. A portion of the sample was recruited through direct communication from one of the researchers. After obtaining written informed consent from all participants, 5 focus group interviews were conducted between April and June 2023. Data were transcribed, translated, and analyzed using a content analysis approach, with findings reviewed by 2 independent researchers for validation. RESULTS The content analysis revealed four key themes: (1) AIS-specific education and information, (2) psychosocial support for patients with AIS and community connection, (3) health care communication and access, and (4) treatment adherence to AIS and gamification. Participants highlighted the need for accessible, adolescent-friendly, and multilingual education on AIS; digital platforms for peer support; improved remote communication with health care providers; and gamification elements tailored to AIS challenges (eg, brace compliance tracking, avatar customization for self-expression, and real-time exercise feedback). CONCLUSIONS Key findings highlighted the need for accessible information, peer support, and better communication with health care providers, with gamification enhancing treatment adherence. The findings of this study show the potential of digital health technologies in AIS management through fostering accessible information, peer support, and improved communication with health care providers. Customized gamification features may further enhance adherence, offering actionable insights for clinical practice and future research.
Collapse
Affiliation(s)
- Kamila Sykorova
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Anna Mathew
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Nenad Pavel
- Department of Product Design, Faculty of Technology, Art and Design, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Parisa Gazerani
- Department of Life Sciences and Health, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Trust Saidi
- Department of Product Design, Faculty of Technology, Art and Design, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Marianne Bakke Johnsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - June Ullevoldsæter Lystad
- Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
| | - Helen Bull
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Mette Fløystad Kvammen
- Department of Sociology and Social Work, University of Agder, Kristiansand, Norway
- Norwegian Spine and Back Pain Association, Oslo, Norway
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Julia Jacoby
- Department of Product Design, Faculty of Technology, Art and Design, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Minna Pikkarainen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Department of Product Design, Faculty of Technology, Art and Design, OsloMet - Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
|
3
|
Grewal H, Dhillon G, Buddhavarapu V, Verma RK, Munjal RS, Sharma P, Sidhu G, Kashyap R, Surani S. Strategic insights of telehealth platforms and strengths, weaknesses, opportunities, and threats analysis of Amazon's clinical endeavors. World J Methodol 2025; 15:98513. [DOI: 10.5662/wjm.v15.i2.98513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic, revolutionizing traditional healthcare delivery models. Amazon Clinic's recent nationwide launch marks a significant milestone in this trend. This study aims to offer a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.
AIM To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.
METHODS The initial search terms included were, amazon clinic odds ratio (OR) amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health, from 2000 to 2023. This search yielded 111 articles, from which duplicates were removed, and unrelated titles were filtered out. Eight articles were retained for a final review, including comparative studies, usability research, retrospective analyses, observational studies, and review articles. The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.
RESULTS The review included eight articles focusing on various aspects of telehealth. Comparative studies highlighted differences between Teladoc and traditional physician offices, noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc. User demographics for Teladoc showed younger, less engaged patients. Usability studies emphasized the importance of website design for telemedicine adoption. Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods. Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times. The SWOT analysis identified Amazon Clinic's strengths, such as its vast consumer base and transparent pricing, and weaknesses like the lack of pediatric care. Opportunities included potential partnerships and service expansions, while threats involved competition and regulatory challenges.
CONCLUSION Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities. However, it faces challenges from established healthcare providers and regulatory landscapes. The future success of Amazon Clinic will depend on strategic collaborations, addressing service gaps, and navigating competition and regulations. Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.
Collapse
Affiliation(s)
- Harpreet Grewal
- Department of Radiology, Ascension Sacred Heart Hospital, Pensacola, FL 32503, United States
| | - Gagandeep Dhillon
- Department of Medicine, UM Baltimore Washington Medical Center, Glen Burnie, MD 21061, United States
| | - Venkata Buddhavarapu
- Department of Medicine, Banner Baywood Medical Center, Banner Health, Mesa, AZ 85206, United States
| | - Ram Kishun Verma
- Department of Sleep Medicine, Parkview Health System, Fort Wayne, IN 46845, United States
| | - Ripudaman Singh Munjal
- Department of Medicine, Touro university College of Osteopathic Medicine, Vallejo, CA 94592, United States
| | - Pranjal Sharma
- Department of Nephrology, Northeast Ohio Medical Center, Rootstown, OH 44272, United States
| | - Gurmanpreet Sidhu
- Department of Pathology, Government Medical College Patiala, Patiala 147001, Punjab, India
| | - Rahul Kashyap
- Department of Research, Wellspan Health, York, PA 17403, United States
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
| |
Collapse
|
|
4
|
Younis EA, El-Shenawy AK, Abdo SAE. Knowledge, attitude, and practice regarding telemedicine among physicians and employees at Tanta University Hospitals, Egypt. J Egypt Public Health Assoc 2025; 100:13. [PMID: 40526335 DOI: 10.1186/s42506-025-00194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Accepted: 05/27/2025] [Indexed: 06/19/2025]
Abstract
BACKGROUND Telemedicine is a key factor in increasing patient accessibility, satisfaction with treatment, and quality of care, effectively utilizing physicians' time, and improving communication among medical experts. Despite global interest in telemedicine, there is limited research exploring users' perspectives on telemedicine within the context of Egyptian university hospitals. This study aims to examine physicians' and employees' levels of knowledge, attitudes, and practices toward telemedicine. METHODS A cross-sectional study was conducted at Tanta University's medical campus from November 2023 to March 2024. One-thousand employees and physicians were surveyed. A self-administered questionnaire was used to collect the data. It consists of four sections: sociodemographic data, knowledge about telemedicine, attitude, and practice of telemedicine. RESULTS Half of physicians used telemedicine, and 38.2% of the employees have used e-health services. Applications of telemedicine included patients' investigations communicated through the Internet (76.4%), patients' management with drugs (71.4%), direct medical consultation between patient and physician (65.4%), second opinion consulting (57.6%), sharing experiences and new trends in medicine and surgery with other specialists in other countries (54%), and follow-up of patients through the electronic technologies (53%). About three-quarters of physicians and employees had a positive attitude toward telemedicine. The advantages reported include being easy to use (63%), reducing travel costs for patients (68.6%), and its importance during pandemics, e.g., COVID-19 (59.8%). However, our results indicated potential barriers when using telemedicine, including the need for training; elderly patients find difficulty dealing with technology, poor infrastructure, technical issues, difficulty for patients to express their feelings and communicate with physicians, and a lack of body language. CONCLUSION A considerable percentage of participants were already using telemedicine services, and they were satisfied with the telemedicine system. Though most participants had favorable attitudes toward telemedicine, potential barriers were reported, such as training for physicians and patients, difficulty dealing with technology, poor infrastructure, and technical issues. These findings underscore the need to develop and implement a regulatory framework that supports telemedicine adoption, including data protection, patient confidentiality, and reimbursement standards.
Collapse
Affiliation(s)
- Eman A Younis
- Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt.
| | - Amira K El-Shenawy
- Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt
| | - Sanaa A E Abdo
- Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt
| |
Collapse
|
|
5
|
Ivanitskaya LV, Zikos D, Erzikova E. Multidisciplinary Contributions and Research Trends in eHealth Scholarship (2000-2024): Bibliometric Analysis. J Med Internet Res 2025; 27:e60071. [PMID: 40522718 DOI: 10.2196/60071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/13/2024] [Accepted: 04/26/2025] [Indexed: 06/18/2025] Open
Abstract
BACKGROUND Fueled by innovations in technology and health interventions to promote, restore, and maintain health and safeguard well-being, the field of eHealth has yielded significant scholarly output over the past 25 years. OBJECTIVE This study aims to offer a big picture of research developments and multidisciplinary contributions to eHealth that shaped this field up to 2024. To that end, we analyze evidence from 3 corpora: 10,022 OpenAlex documents with eHealth in the title, the 5000 most relevant eHealth articles according to the Web of Science (WoS) algorithm, and all available (n=1885) WoS eHealth reviews. METHODS Using VOSviewer, we built co-occurrence networks for WoS keywords and OpenAlex concepts. We examined clusters, categorized terminology, and added custom overlays about eHealth technologies, stakeholders, and objectives. A cocitation map of sources referenced in WoS reviews helped identify scientific fields supporting eHealth. After synthesizing eHealth terminology, we proceeded to build a conceptual model of eHealth scholarship grounded in bibliometric evidence. RESULTS Several research directions emerged from bibliometric networks: eHealth studies on self-management and interventions, especially in mental health; telemedicine, telehealth, and technology acceptance; privacy, security, and design concerns; health information consumers' literacy; health promotion and prevention; mHealth and digital health; and HIV prevention. Conducted at the individual, health system, community, and society levels, eHealth studies focused on health and wellness across the human lifespan. Keywords such as internet (mean publication year 2017), telemedicine (2018), telehealth (2018), mHealth (2019), mobile health (2020), and digital health (2021) were strongly linked to literature indexed with eHealth (2019). Different types of eHealth apps were supported by research on infrastructures: networks, data exchange, computing technologies, information systems, and platforms. Researchers' concerns for eHealth data security and privacy, including advanced access control and encryption methods, featured prominently in the maps, along with terminology related to health analytics. Review authors cited a wide range of medical sources and journals specific to eHealth technologies, as well as journals in psychology, psychiatry, public health, policy, education, health communication, and other fields. The Journal of Medical Internet Research stood out as the most cited source. The concept map showed a prominent role of political science and law, economics, nursing, business, and knowledge management. Our empirically derived conceptual model of eHealth scholarship incorporated commonly researched stakeholder groups, eHealth application types, supporting infrastructure, health analytics concepts, and outcomes. CONCLUSIONS Drawing upon contributions from many disciplines, the field of eHealth has evolved from early studies of internet-enabled communications, telemedicine, and telehealth to research on mobile health and emerging digital health technologies serving diverse stakeholders. Digital health has become a popular alternative term to eHealth. We offered practical implications and recommendations on future research directions, as well as guidance on study design and publication.
Collapse
Affiliation(s)
- Lana V Ivanitskaya
- Health Administration Division, School of Health Sciences, The Herbert H and Grace A Dow College of Health Professions, Central Michigan University, Mount Pleasant, MI, United States
| | - Dimitrios Zikos
- Department of Healthcare Management and Leadership, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Elina Erzikova
- School of Communication, Journalism and Media, College of the Arts and Media, Central Michigan University, Mount Pleasant, MI, United States
| |
Collapse
|
|
6
|
Kumari AA, Wani TA, Liem M, Boyd J, Khan UR. Advancing Regional and Remote Health Care With Virtual Hospital Implementation: Rapid Review. JMIR Hum Factors 2025; 12:e64582. [PMID: 40460425 DOI: 10.2196/64582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 01/30/2025] [Accepted: 04/17/2025] [Indexed: 06/19/2025] Open
Abstract
BACKGROUND Disparities in health equity between metropolitan and rural areas are a global concern, especially in vast countries such as Australia, Canada, and the United States. Virtual care models in health care settings are promising in reducing inequalities, with virtual hospitals (VHs) potentially bridging the gap for isolated or underserved regions. However, evidence-based strategies and the complexities of VH implementation necessitate further research. OBJECTIVE This rapid review aims to examine the role of VHs in enhancing regional and remote health care by focusing on accessibility, patient and health care provider experiences, and implementation barriers and facilitators. It provides tailored recommendations for large-scale implementation in communities with access issues, contributing to the discussion on equitable health care. METHODS A rapid review was conducted in accordance with the World Health Organization guidelines. A systematic search was performed across PubMed, MEDLINE, CINAHL, and the La Trobe University Library for peer-reviewed articles published between January 2015 and March 2023. Additional gray literature was identified through Google searches and snowballing from relevant web articles. Studies were included if they focused on regional or remote populations and addressed VHs or virtual care. Studies that solely discussed hybrid models of care were excluded. Data were systematically extracted using a customized Microsoft Excel template. A mixed methods thematic analysis was conducted to identify recurring themes, barriers, facilitators, and recommendations related to VH implementation as well as patterns in clinical outcomes and stakeholder perspectives. RESULTS A total of 35 articles were included in this review, comprising 23 (66%) peer-reviewed studies and 12 (34%) gray literature sources. Positive clinical outcomes were reported in 9 (26%) articles, highlighting outcomes such as reduced disease transmission, improved patient safety, fewer admissions and readmissions, lower mortality, shorter hospital stays, and better adherence to clinical best practices. Health system outcomes were identified in 15 (43%) articles, including reduced costs, enhanced patient experience and safety, improved care delivery and health care provider support, greater efficiency, broader geographic coverage, and better integration of services. Patient and health care provider perspectives were discussed in 12 (34%) articles, with positive views attributed to convenience, time and cost savings, and improved service quality. Barriers and facilitators were the most frequently discussed themes, appearing in 27 (77%) and 26 (74%) articles, respectively, with challenges and enablers commonly linked to people, processes, technology, and financial sustainability. CONCLUSIONS VHs have the potential to revolutionize regional and remote health care by overcoming barriers, using facilitators, and following recommended practices, leading to better clinical outcomes and increased satisfaction for patients and health care providers.
Collapse
Affiliation(s)
- Artika Archana Kumari
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Tafheem Ahmad Wani
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Michael Liem
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - James Boyd
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Urooj Raza Khan
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| |
Collapse
|
|
7
|
Gehrmann J, Hahn F, Stephan J, Steger A, Rattka M, Rudolph I, Federle D, Heller J, Wunderlin G, Laugwitz KL, Barthel P, Veith S, Martens E. Current Use, Challenges, Barriers, and Chances of Telemedicine in the Ambulatory Sector in Germany-A Survey Study Among Practicing Cardiologists, Internists, and General Practitioners. Telemed J E Health 2025; 31:779-792. [PMID: 39909467 DOI: 10.1089/tmj.2024.0528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2025] Open
Abstract
Introduction: Digital technologies, such as telemedicine and wearable devices, are transforming health care by enhancing cross-sectoral care and targeted health responses. Despite these advancements, challenges such as data protection, lack of interoperability, reimbursement, and financial costs hinder telemedicine's broader implementation, especially within the German health care system. This study explores the use, acceptance, and barriers of telemedicine among cardiologists, internists, and general practitioners in Germany. Methods: A web-based survey was conducted from October 2023 to January 2024, targeting cardiologists, internists, and general practitioners. The survey assessed current telemedicine usage, acceptance, and barriers. Data analysis included descriptive statistics and exploratory cluster analysis. Results: Of the 172 physicians analyzed, 76.2% were cardiologists. Telemonitoring (45.9%) and wearable devices (26.2%) were the most used telemedicine applications, whereas video consultations (11.0%) and apps (19.2%) were less common. Despite high costs (57.7%), insufficient technical expertise (20.8%), and lack of system interoperability (45.8%), respondents rated telemedicine positively and saw several chances and potentials. Cluster analysis identified four user groups: The pioneers, the focused practitioners, the using skeptics, and the uninformed distanced, each with unique needs and challenges. Discussion: The acceptance of elemedicine among physicians indicates recognition of its benefits for patient care. Only half of the respondents felt reasonably well informed about telemedicine. Overall, our study shows the current use of telemedicine as well as the acceptance, barriers, and challenges perceived in the German ambulatory sector. It underlines the increasing importance of telemedicine for patient care and highlights existing barriers to enable wider implementation in the outpatient sector. The results show that telemedicine in Germany is on a promising path. The biggest obstacles still appear to be reimbursement and the technical infrastructure.
Collapse
Affiliation(s)
- Jan Gehrmann
- Institute of General Practice and Health Services Research, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Social Determinants of Health, Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Franziska Hahn
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Johannes Stephan
- Social Determinants of Health, Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Alexander Steger
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Manuel Rattka
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Isabel Rudolph
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - David Federle
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Josephine Heller
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Geraldine Wunderlin
- Department of Obstetrics and Gynecology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Karl-Ludwig Laugwitz
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- German Center for Cardiovascular Research, Aurich, Germany
| | - Petra Barthel
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stefan Veith
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- General Practice Schirum, Aurich, Germany
| | - Eimo Martens
- Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- European Reference Network Guard Heart, Munich, Germany
- German Telemedicine Society, Berlin, Germany
| |
Collapse
|
|
8
|
Shapoo N, Shapoo N, Rehman A, Boma N. Smart Healthcare: The Role of Digital Health in Modern Medicine. HEALTH CARE SCIENCE 2025; 4:179-187. [PMID: 40568626 PMCID: PMC12185370 DOI: 10.1002/hcs2.70019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Revised: 02/25/2025] [Accepted: 03/27/2025] [Indexed: 06/28/2025]
Abstract
Digital health is transforming healthcare by integrating advanced technologies to make healthcare more accessible, efficient, and personalized. From electronic health records, telemedicine, wearable devices, and artificial intelligence to the recent smart hospitals, digital health is improving patient care and outcomes while reducing healthcare costs. However, the integration of digital health faces several challenges, including data privacy, cybersecurity risks, and inequitable access to technology. This article provides an overview of the current state of digital health, key challenges in implementation, and potential solutions to maximize the benefits of digital health and ensure efficient, equitable, and patient-centered healthcare in the future.
Collapse
Affiliation(s)
- Nidha Shapoo
- Department of MedicineNew York Medical College/Metropolitan HospitalNew YorkUSA
| | - Naveed Shapoo
- Department of AnesthesiaSheikh Khalifa Medical CityAjmanUnited Arab Emirates
| | - Abdul Rehman
- Department of MedicineNew York Medical College/Metropolitan HospitalNew YorkUSA
| | - Noella Boma
- Department of MedicineNew York Medical College/Metropolitan HospitalNew YorkUSA
| |
Collapse
|
|
9
|
Goulding R, Goodwin J, O’Donovan A, Saab MM. Transgender and gender diverse youths' experiences of healthcare: A systematic review of qualitative studies. J Child Health Care 2025; 29:523-545. [PMID: 38131632 PMCID: PMC12145476 DOI: 10.1177/13674935231222054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Transgender and gender-diverse (TGD) populations are identified as high-risk for negative healthcare outcomes. Limited data exists on experiences of TGD youths in healthcare. The review aim is to systematically review literature on healthcare experiences of TGD youths. Seven electronic databases were systematically searched for relevant studies. Pre-determined eligibility criteria were used for inclusion with a double-screening approach. Sixteen studies were included. Studies included were quality appraised, data were extracted, and findings were synthesized narratively. Four narratives were identified including experiences of: accessing care, healthcare settings and services, healthcare providers, and healthcare interventions. Long waiting times, lack of competent providers, and fear were reported as challenges to accessing gender-affirming care. Negative experiences occurred in mental health services and primary care, while school counseling and gender clinics were affirming. Puberty blockers and hormone-replacement therapy were identified as protective factors. TGD youths are at risk of negative health outcomes due to an under resourced healthcare system. Further research is needed to assess interventions implemented to improve TGD youth's experiences.
Collapse
Affiliation(s)
- Ryan Goulding
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Aine O’Donovan
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Mohamad M. Saab
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
|
10
|
Leong R, Sanderson KE, Klassen AF, Ratcliffe EM, Zuniga-Villanueva G. Comparing the suitability of virtual versus in-person care: Perceptions from pediatricians. J Telemed Telecare 2025; 31:667-672. [PMID: 37904516 PMCID: PMC12095875 DOI: 10.1177/1357633x231205329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/18/2023] [Indexed: 11/01/2023]
Abstract
ObjectivesThe COVID-19 pandemic compelled a portion of healthcare to be delivered virtually. As the pandemic waned, health systems strived to find a balance between re-incorporating in-person care while maintaining virtual care. To find when virtual or in-person encounters are more appropriate, we surveyed pediatricians' perceptions when comparing the suitability of virtual care to in-person care.MethodsWe surveyed a Canadian tertiary-level pediatric hospital where pediatricians assessed whether specific clinical encounters or tasks were more or less effective virtually than when performed in person. Pediatricians also rated the importance of clinical and patient factors when deciding if a patient needs to be seen in person.ResultsOf 160 pediatrics faculty members, 56 (35%) responded to the survey. When assessing different types of clinical encounters, triage, multidisciplinary meetings, discharge, and follow ups were more likely to favor virtual encounters. However, first consultations and family meetings were more likely to favor in-person encounters. Regarding clinical tasks, pediatricians were more likely to endorse explaining test results, offering treatment recommendations, and obtaining patient histories virtually. On the contrary, there was a preference for physical examinations, assessing patients visually, and assessing developmental milestones to be performed in person. When deciding if a patient should be seen in person versus virtual, pediatricians rated the patient's condition and communication barriers as the most important factors favoring an in-person appointment.DiscussionThese results offer an initial framework for pediatricians when choosing which encounter type may be most appropriate for their patients between virtual or in-person appointments.
Collapse
Affiliation(s)
- Russell Leong
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Kate E Sanderson
- Hamilton Health Sciences Centre for Evidence-Based Implementation, McMaster University, Hamilton, ON, Canada
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | | | - Gregorio Zuniga-Villanueva
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, Tecnológico de Monterrey, Monterrey, NL, Mexico
| |
Collapse
|
|
11
|
Powers JS. Implementation of a virtual dementia system of care in a VA health setting. BMC Geriatr 2025; 25:380. [PMID: 40437383 PMCID: PMC12117758 DOI: 10.1186/s12877-025-06034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2025] [Accepted: 05/08/2025] [Indexed: 06/01/2025] Open
Abstract
OBJECTIVE Dementia care remains supportive and geriatric resources are scarce. We describe a dementia system of care consisting of virtual and e-consults working through the primary care provider, as well as providing virtual group caregiver support. These models were developed based on patient and caregiver preferences and necessitated by the Covid public health emergency. METHODS A geriatrician supported dementia consult clinic transitioned to a virtual model of care. A centrally located caregiver support group providing a 4-week curriculum and delivered in conjunction with a social worker similarly transitioned to virtual support. Primary care providers generated consults and were provided educational consultations regarding dementia diagnoses and management in the primary care setting. RESULTS Between 2018 and 2024, 1176 consultations were provided during this period as the clinic transitioned from in-person to virtual consultation. Recommendation categories included: (1) diagnostic testing, (2) medication recommendations and deprescribing, (3) referral for formal neuropsychological testing, (4) psychiatric referral for behavioral concerns, (5) primary care management and goals of care, (6) safety considerations, (7) home and community-based services, and (8) caregiver support. Providers continue to send new consultations and request follow-up advice on previous consults. A total of 72 family caregivers participated in a virtual 4-class support curriculum. CONCLUSIONS/IMPACT Virtual and e-consult dementia care working through the primary care provider, as well as virtual group caregiver support, are feasible, acceptable and sustainable models of dementia care to efficiently utilize scarce geriatrics resources serving a wide geographic area. A virtual dementia system of care may facilitate PCP delivery of supportive care for persons living with dementia, dementia care navigation, and caregiver support.
Collapse
Affiliation(s)
- James S Powers
- Geriatric Research Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, 37212, USA.
| |
Collapse
|
|
12
|
Paget SP, McIntyre S, von Huben A, Stewart K, Williams T, Maly E, Ford K, Woolfenden S, Nassar N. Telemedicine for Children With Cerebral Palsy Before, During, and After the COVID-19 Pandemic: An Australian Cohort Study. J Child Neurol 2025:8830738251339960. [PMID: 40398494 DOI: 10.1177/08830738251339960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2025]
Abstract
OBJECTIVE To examine telemedicine use in children with cerebral palsy before, during and since the COVID-19 pandemic. Methods: A retrospective cohort study of 1162 children with cerebral palsy (40.3% female, birth years 2005-2017), attending specialist outpatient clinics at 2 pediatric hospitals in New South Wales, Australia. We categorized outpatient visits from January 2018 to May 2023 as in-person or telemedicine and compared usage pre-, during, and post-COVID-19 periods. Neighborhood socioeconomic disadvantage and geographical remoteness were defined by residential postcode. Results: Of 48 896 outpatient encounters, 11 929 (24.4%) used telemedicine. Telemedicine rates increased during COVID-19 (20.2 per 100 persons/month) and declined post-COVID-19 (15.2 per 100 persons/month, P < .001). Neighborhood socioeconomic disadvantage was associated with higher median outpatient and telemedicine encounter rates. Regional/remote children had lower median outpatient and telemedicine rates. Conclusion: Telemedicine use declined since lifting of COVID-19 pandemic restrictions. Further support will be required to sustain rates and learn from pandemic experiences.
Collapse
Affiliation(s)
- Simon P Paget
- The Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Kids Rehab, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Amy von Huben
- Menzies Centre for Health Policy & Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kirsty Stewart
- The Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Kids Rehab, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Tracey Williams
- Kids Rehab, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Emma Maly
- CP Quest, Cerebral Palsy Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Ford
- CP Quest, Cerebral Palsy Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sue Woolfenden
- Community Paediatrics Research Group, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- The Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy & Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
|
13
|
Xavier R, Rammal A, Wahbea R, Khalil H. Telemedicine Utilization Among Nurses in the UAE: Adoption, Training, and Infrastructure Readiness. Telemed J E Health 2025. [PMID: 40387603 DOI: 10.1089/tmj.2025.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2025] Open
Abstract
Background: Telemedicine (TM) is a crucial component of modern health care, yet its adoption in nursing remains suboptimal. Effective integration requires structured training, institutional support, and digital infrastructure. Purpose: This study investigates TM utilization among nurses in the United Arab Emirates (UAE), focusing on its integration into practice, the training received, and the resources available to support its implementation. Methods: A cross-sectional survey was conducted among 434 nurses across hospitals and clinics in Dubai Health, UAE. The survey assessed demographic and professional details, TM experience, training availability, infrastructure, and institutional support. Data were analyzed using descriptive statistics and logistic regression. Results: While 70% of nurses reported TM availability, only 27% actively used it. Usage frequency varied, with 18% utilizing TM daily, 8% weekly, and 10% monthly. Adoption was highest in pediatric and geriatric care (50%) and lowest in intensive care units (11%). Remote patient monitoring and health education (47%) were the most common applications, whereas specialty consultations had the lowest use (17%). Logistic regression identified TM availability (OR = 2.1) and prior training (OR = 3.0) as key predictors of utilization (p < 0.001). However, only 14% of participating nurses had received formal TM training, though 90% expressed willingness to participate in future programs. Nurses' demographics, job titles, years of experience, and health sector did not significantly predict TM utilization (p > 0.05). Conclusion: TM has the potential to transform nursing practice, but its integration requires enhanced training programs, infrastructure investment, and institutional support. Addressing these gaps will optimize TM utilization and improve health care delivery.
Collapse
Affiliation(s)
- Rexy Xavier
- Dubai Health, Rashid Hospital, Dubai, United Arab Emirates
| | - Ali Rammal
- Dubai Health, Rashid Hospital, Dubai, United Arab Emirates
| | - Rasha Wahbea
- Dubai Health, Rashid Hospital, Dubai, United Arab Emirates
| | - Heba Khalil
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
|
14
|
Asomugha AU, Pakai A. Trends and Shifts in Swedish Telemedicine Consultations During the Pre-COVID-19, COVID-19, and Post-COVID-19 Periods: Retrospective Observational Study. JMIR Form Res 2025; 9:e60294. [PMID: 40378415 PMCID: PMC12101801 DOI: 10.2196/60294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 11/08/2024] [Accepted: 11/10/2024] [Indexed: 05/18/2025] Open
Abstract
Background In recent times, the telemedicine landscape has changed dramatically; it serves as a bridge, connecting health care providers and patients, especially during challenges such as the recent COVID-19 pandemic. Objective This study seeks to explore the Swedish telemedicine landscape in terms of primary patient symptoms for teleconsultation and the patterns of telemedicine use in the periods before COVID-19, during COVID-19, and after COVID-19, including the primary care use dynamics with respect to the teleconsultations done. Methods Secondary data was used in this observational retrospective study. The study population consisted of Swedish residents who had online telemedicine consultations. Telemedicine consultations were divided by text and video delivery; the period of analysis ranged from November 2018 to June 2023. The statistical methods used for the data analysis were descriptive analysis, 2-way cross tabulation, and a generalized linear model. Results During the pandemic, the number of teleconsultations concerning general, unspecified symptoms increased in comparison to the other analyzed symptoms, signaling a change in care-seeking behavior under epidemiological pressure. General health-related issues were the most pronounced symptom across all periods: 186.9 of 1000 consultations before COVID-19, 1264.6 of 1000 consultations during COVID-19, and 319.2 of 1000 consultations after COVID-19. There was no significant main effect of COVID-19 period on the number of telemedicine consultation meetings (F2=1.653; P=.38). The interaction effect between delivery type and period was statistically significant (F2=14.723; P<.001). Conclusions The findings are in favor of the COVID-19 pandemic having had a considerable effect on telemedicine use. Telemedicine could subsequently be used more often for general health consultations and acute conditions. Video consultations were more prominent because of the importance of bidirectional communication. The study suggests that there was a transformation of patterns of demand for health care; there is a necessity for health care systems to respond to these changes.
Collapse
Affiliation(s)
- Adaora Uloma Asomugha
- Doctoral School of Health Sciences, University of Pécs, Vörösmarty M u 4, Pécs, 7621, Hungary, 36 2818544910
| | - Annamaria Pakai
- Doctoral School of Health Sciences, University of Pécs, Vörösmarty M u 4, Pécs, 7621, Hungary, 36 2818544910
| |
Collapse
|
|
15
|
Caramia F, D’Angelantonio E, Lucangeli L, Camomilla V. Validation of Low-Cost IMUs for Telerehabilitation Exercises. SENSORS (BASEL, SWITZERLAND) 2025; 25:3129. [PMID: 40431921 PMCID: PMC12115807 DOI: 10.3390/s25103129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 05/07/2025] [Accepted: 05/12/2025] [Indexed: 05/29/2025]
Abstract
Telerehabilitation, a specialized domain within telemedicine, supports remote physical rehabilitation and progress monitoring. Wearable sensors can improve this service by providing reliable monitoring of movement parameters, offering objective information into patients' rehabilitation sessions. This study presents the development and validation of a telerehabilitation system including a rehabilitation protocol, low-cost wearable inertial measurement units (IMUs) and a set of metrics descriptive of movement capacity to analyze rehabilitation exercises. Eleven medically stable elders (9 females, 2 males; age: 72.6 ± 5.0 years; height: 1.66 ± 0.09 m; mass: 67.8 ± 9.8 kg) performed 12 rehabilitation upper/lower limb and trunk exercises. Movement analysis was conducted using a prototypical IMU sensor and commercially available IMU as a reference. Each exercise was automatically segmented into single repetitions, from which selected metrics were computed. Bland-Altman analysis was performed to evaluate measurement agreement and consistency between the systems across all parameters. Results indicate acceptable measurement agreement for key rehabilitation metrics, including movement quantity, accelerations intensity, and movement smoothness. However, angular velocity and movement stability reveal technical limitations requiring refinement prior to clinical implementation. Balancing measurement reliability and affordability of telerehabilitation system remains a crucial factor to offer an effective service to individuals with diverse health conditions.
Collapse
Affiliation(s)
- Federico Caramia
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy; (F.C.); (E.D.); (L.L.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy
| | - Emanuele D’Angelantonio
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy; (F.C.); (E.D.); (L.L.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy
- Technoscience PST, Via Enrico Toti, 04100 Latina, Italy
| | - Leandro Lucangeli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy; (F.C.); (E.D.); (L.L.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy
- Technoscience PST, Via Enrico Toti, 04100 Latina, Italy
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy; (F.C.); (E.D.); (L.L.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 6, 00135 Rome, Italy
| |
Collapse
|
|
16
|
Gozum IEA, Flake CCD. Encountering the Other in the Digital Sphere: Emmanuel Levinas' "Ethics of the Face" and the Implications for Virtual Healthcare Ethics in Contemporary Society. JOURNAL OF RELIGION AND HEALTH 2025:10.1007/s10943-025-02336-0. [PMID: 40346398 DOI: 10.1007/s10943-025-02336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2025] [Indexed: 05/11/2025]
Abstract
The rise of virtual healthcare presents new ethical challenges, particularly regarding the quality and nature of patient-provider relationships. French philosopher Emmanuel Levinas' ethics of the face, which centers on the ethical responsibility of encountering the Other, offers a profound lens for examining these challenges. This philosophical exploration explores how the digital mediation of patient interactions in virtual healthcare affects the ethical encounter described by Levinas. We argue that while virtual healthcare can enhance accessibility, it risks diminishing the relational depth critical to healthcare ethics. As a proposal, this study outlines strategies for integrating Levinasian principles into virtual healthcare practices to emphasize empathy and attentiveness and acknowledge the patient's irreducible humanity, even through technological interfaces. Lastly, this paper calls for rethinking virtual healthcare to preserve the ethical command of responsibility toward the Other.
Collapse
Affiliation(s)
- Ivan Efreaim A Gozum
- Institute of Religion, University of Santo Tomas, 1008, Sampaloc, Manila, Philippines.
- The Graduate School, University of Santo Tomas, 1008, Sampaloc, Manila, Philippines.
| | - Chastene Christopher D Flake
- College of Allied Medical Professions, Angeles University Foundation, 2009, Angeles City, Philippines
- Office of Total Quality Management, Angeles University Foundation, 2009, Angeles City, Philippines
| |
Collapse
|
|
17
|
Ahmed MM, Okesanya OJ, Olaleke NO, Adigun OA, Adebayo UO, Oso TA, Eshun G, Lucero-Prisno DE. Integrating Digital Health Innovations to Achieve Universal Health Coverage: Promoting Health Outcomes and Quality Through Global Public Health Equity. Healthcare (Basel) 2025; 13:1060. [PMID: 40361838 PMCID: PMC12071628 DOI: 10.3390/healthcare13091060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2025] [Revised: 04/29/2025] [Accepted: 05/03/2025] [Indexed: 05/15/2025] Open
Abstract
Digital health innovations are reshaping global healthcare systems by enhancing access, efficiency, and quality of care. Technologies such as artificial intelligence, telemedicine, mobile health applications, and big data analytics have been widely applied to support disease surveillance, enable remote care, and improve clinical decision making. This review critically identifies persistent implementation challenges that hinder the equitable adoption of digital health solutions, such as the digital divide, limited infrastructure, and weak data governance, particularly in low- and middle-income countries (LMICs). It aims to propose strategic pathways for integrating digital innovations to strengthen universal health coverage (UHC) and bridge health disparities in the region. By analyzing the best global practices and emerging innovations, this study contributes to the ongoing dialogue on leveraging digital health for inclusive, scalable, and sustainable healthcare delivery in underserved regions.
Collapse
Affiliation(s)
- Mohamed Mustaf Ahmed
- SIMAD Institute for Global Health, SIMAD University, Mogadishu 2526, Somalia;
- Faculty of Medicine and Heath Sciences, SIMAD University, Mogadishu 2526, Somalia
| | - Olalekan John Okesanya
- Department of Public Health and Maritime Transport, University of Thessaly, 382 21 Volos, Greece;
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta 110101, Ogun State, Nigeria; (U.O.A.); (T.A.O.)
| | - Noah Olabode Olaleke
- Department of Medical Laboratory Science, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife 220282, Osun State, Nigeria;
| | - Olaniyi Abideen Adigun
- Department of Medical Laboratory Science, Nigerian Defence Academy, Kaduna 800001, Kaduna State, Nigeria;
| | - Uthman Okikiola Adebayo
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta 110101, Ogun State, Nigeria; (U.O.A.); (T.A.O.)
| | - Tolutope Adebimpe Oso
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta 110101, Ogun State, Nigeria; (U.O.A.); (T.A.O.)
| | - Gilbert Eshun
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH8 9YL, UK;
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- Center for Research and Development, Cebu Normal University, Cebu 6000, Philippines
- Center for University Research, University of Makati, Makati City 1644, Philippines
| |
Collapse
|
|
18
|
Ye M, Liu Z, Xie W, Shou M, Wang S, Lin X, Xu Y, Yao M, Chen J, Shou Y, Wu J, Guan L. Implementation of Telemedicine for Patients With Dementia and Their Caregivers: Scoping Review. J Med Internet Res 2025; 27:e65667. [PMID: 40324768 DOI: 10.2196/65667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 02/07/2025] [Accepted: 03/11/2025] [Indexed: 05/07/2025] Open
Abstract
BACKGROUND As dementia advances, symptoms and associated concerns lead to significant distress for both the patients and their caregivers. Telemedicine has the capacity to alleviate care-related issues for patients with dementia and their family caregivers. OBJECTIVE This study aims to synthesize the implementation strategies for providing telemedicine to assist patients with dementia and their caregivers in home and community settings and to examine its effectiveness and implementation barriers. METHODS In accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, a systematic search was conducted across 6 databases, including MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and ProQuest. The eligibility criteria for peer-reviewed English publications from January 2000 up to January 2025 encompassed research studies related to telemedicine services for individuals diagnosed with dementia and caregivers. RESULTS This study included 54 articles, comprising 14,446 participants from 10 countries. In total, 4 major themes emerged from the articles: the design of telemedicine services, effectiveness of telemedicine, external environmental factors, and barriers in telemedicine implementation. Cognitive training was addressed in 28 studies. Within the domain of work and leisure, 24 solutions were identified. Most reviewed studies indicated favorable experiences with telemedicine services and highlighted perceived personal and social benefits among patients with dementia, as well as identified barriers to accessing and using such services. CONCLUSIONS Future studies should encompass the enhancement of digital accessibility for individuals with restricted resources and limited technological proficiency, the use of randomized controlled trial methodologies to ascertain the comparative efficacy of various service delivery modes, and the augmentation of sample diversity.
Collapse
Affiliation(s)
- Mengfei Ye
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Zheng Liu
- Department of Pharmacology, School of Medicine, Shaoxing University, Shaoxing, China
| | - Weigen Xie
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Mengna Shou
- Department of Women's Health, Shaoxing Maternity and Child Health Care Hospital, Shaoxing, China
| | - Shengpang Wang
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Xuebing Lin
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Yan Xu
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Miner Yao
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Jialu Chen
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Yunli Shou
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Jingzhu Wu
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| | - Lili Guan
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center of Shaoxing University, Shaoxing, China
| |
Collapse
|
|
19
|
Acharjee P, Prasad SK, Singh VV, Ray M, Acharjee A. Microbiota dysbiosis impact on the immune system dysregulation in Huntington's disease (HD). INTERNATIONAL REVIEW OF NEUROBIOLOGY 2025; 180:57-94. [PMID: 40414643 DOI: 10.1016/bs.irn.2025.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2025]
Abstract
Huntington's disease (HD) is a neurodegenerative disorder characterized by motor, cognitive, and psychiatric impairments caused by Huntingtin (HTT) gene mutations, resulting in the mutant huntingtin (mHTT) protein. Both innate and adaptive immunities play crucial roles in the pathogenesis of HD. In this chapter, we explore the vital role of the gut microbiota in HD, emphasizing its impact on the immune response and brain health via the gut-brain axis. Dysbiosis influences immune responses and HD pathogenesis through microbial metabolites such as short-chain fatty acids (SCFAs) and pathogen-associated molecular patterns (PAMPs). We discuss advanced mathematical models, telemedicine, and biosensors for tracking HD progression and detecting gut dysbiosis. Nutritional interventions to restore microbiota balance and using artificial intelligence and machine learning to predict disease prognosis and personalized treatments have been highlighted. Based on their unique immune profiles and gut microbiota, personalized medicine has been proposed as a promising strategy for effective HD treatment.
Collapse
Affiliation(s)
- Papia Acharjee
- Biochemistry and Molecular Biology Unit, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Shambhu Kumar Prasad
- Biochemistry and Molecular Biology Unit, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Vishal Vikram Singh
- Biochemistry and Molecular Biology Unit, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Mukulika Ray
- Department of Molecular, Cellular, and Biochemical Sciences, Sidney Frank Hall of Life Sciences, Brown University, Providence, RI, United States
| | - Arup Acharjee
- Molecular Omics Laboratory, Department of Zoology, University of Allahabad, Prayagraj, India.
| |
Collapse
|
|
20
|
Aminparvin H, Henrichs L, Auger C, Dumassais S, Renaud J, Wittich W. Follow-up in low vision rehabilitation for users of assistive technology: a scoping review. Disabil Rehabil Assist Technol 2025; 20:721-732. [PMID: 39607837 DOI: 10.1080/17483107.2024.2433035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 11/17/2024] [Accepted: 11/18/2024] [Indexed: 11/30/2024]
Abstract
Assistive technology (AT) is crucial for aiding activities of daily living in individuals with visual impairment; yet, without systematic follow-up device abandonment rates remain high. This scoping review synthesizes existing literature on follow-up processes in individuals with visual impairment undergoing vision rehabilitation with AT. Employing the Arksey and O'Malley framework, this review comprehensively searched seven databases, identifying 1,061 articles, of which 43 were selected for analysis, using the concepts of visual impairment, rehabilitation, and assistive technology. The publications span from 1989 to 2022. Most studies (n = 36, 83%) utilized a mixed-methods design, and 51% (n = 22) originated from the United States. Devices for near vision were the most commonly prescribed type of AT. Follow-up methods included questionnaires and interviews, with most follow-ups conducted at the client's home. Follow-up timing varied across studies, whereby 37% (n = 16) occurred after one or more years and 33% (n = 14) between one week and four months. Three categories of outcome measures emerged: generic outcomes, task-specific outcomes, and a combination of both. The review identified several gaps in the literature, including a scarcity of research concerning follow-up of AT particularly for both the type and timing of follow-up.
Collapse
Affiliation(s)
| | - Leif Henrichs
- School of Optometry, Université de Montréal, Montréal, Canada
| | - Claudine Auger
- School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montréal métropolitain, Montreal, Canada
| | - Shirley Dumassais
- School of Optometry, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montréal métropolitain, Montreal, Canada
| | - Judith Renaud
- School of Optometry, Université de Montréal, Montréal, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montréal métropolitain, Montreal, Canada
| |
Collapse
|
|
21
|
Lee K. Strategies to Optimize Recovery in Frail Patients With Cardiovascular Disease Through Exercise-Based Cardiac Rehabilitation. J Lipid Atheroscler 2025; 14:159-173. [PMID: 40492184 PMCID: PMC12145963 DOI: 10.12997/jla.2025.14.2.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Revised: 12/09/2024] [Accepted: 12/18/2024] [Indexed: 06/11/2025] Open
Abstract
Cardiovascular disease (CVD) remains a critical global health challenge, with frailty in older adults further exacerbating the risk of adverse outcomes. Exercise-based cardiac rehabilitation (EBCR) offers a promising approach to improving cardiovascular function, reducing mortality, and enhancing quality of life in individuals with CVD. However, frail patients often encounter unique barriers, including reduced muscle strength, impaired mobility, and logistical challenges, which hinder their participation in traditional EBCR programs. Resistance training has been shown to improve muscle strength, balance, and functional independence while reducing fall risk, making it a key intervention for frail individuals. Aerobic exercise, when introduced gradually, further enhances cardiovascular endurance and overall resilience. Telehealth exercise strategies can provide an effective means of overcoming logistical barriers by fostering adherence and enabling real-time adjustments to exercise regimens, despite challenges such as digital literacy. This narrative review highlights innovative strategies integrating personalized exercise regimens and telehealth solutions to address the unique needs of frail patients. By prioritizing adaptable, accessible, and evidence-based strategies, an evolved EBCR approach holds the potential to significantly improve long-term health outcomes and quality of life for this vulnerable population.
Collapse
Affiliation(s)
- Kyuwan Lee
- Department of Kinesiology and Sports Studies, Ewha Womans University, Seoul, Korea
| |
Collapse
|
|
22
|
Ng JH, See MH, Haridah A, Lai LL, Wong LP. Patients' Acceptability and Perspective on Utilizing Telemedicine in Breast Cancer Care and Management. Telemed J E Health 2025; 31:624-633. [PMID: 39772892 DOI: 10.1089/tmj.2024.0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2025] Open
Abstract
Background: Telemedicine has emerged as a promising solution to address the challenges of providing continuous care to breast cancer patients, particularly in remote areas. This study aims to assess the acceptability of using telemedicine for breast cancer follow-up. Methods: A cross-sectional study utilizing a self-administered survey was conducted from January to March 2024 among 450 breast cancer patients at the Universiti Malaya Medical Center, Malaysia. Partial least-squares structural equation modeling was used to identify factors such as demographics, patients' characteristics, experience with telemedicine, attitudes, and concern of telemedicine use influencing willingness to use telemedicine for breast cancer follow-up. Results: Of the total 450 complete responses received, nearly half (49.3%) reported being somewhat likely to seek telemedicine for breast cancer follow-up, while only 11.1% reported being very likely. Comfort with telemedicine emerged as the strongest predictor of willingness to use it (β = 0.757, p < 0.001). A higher level of concern significantly negatively impacted willingness (β = -0.138, p < 0.001). However, attitudes toward telemedicine (β = 0.059, p = 0.144) were not significantly associated with its use. Among demographic factors, only age (β = 0.074, p = 0.018) was significantly positively associated with the willingness to use telemedicine, while education levels were found to have a significant inverse association (β = -0.076, p = 0.034). Conclusions: Improving comfort with telemedicine and addressing various concerns about its use for breast cancer follow-up through educational programs and support services are essential. Tailoring communication and support for different age groups and education levels can also enhance acceptance and utilization.
Collapse
Affiliation(s)
- Jing-Hui Ng
- Breast and Endocrine Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Mee-Hoong See
- Breast and Endocrine Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Alias Haridah
- Center for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Lee-Lee Lai
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Li Ping Wong
- Center for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian, China
- Department of Medicine, College of Medicine, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| |
Collapse
|
|
23
|
Khoshsirat S, Soleimanpour H, Rezaei‐Hachesu P. Strengths, Weaknesses, Opportunities, and Threats (SWOT) of Implementing Teleconsultation: A Systematic Review. Health Sci Rep 2025; 8:e70645. [PMID: 40330766 PMCID: PMC12051437 DOI: 10.1002/hsr2.70645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 03/12/2025] [Accepted: 03/26/2025] [Indexed: 05/08/2025] Open
Abstract
Background and Aims The COVID-19 pandemic has changed the traditional models of providing services in health systems. One of the recommended ways to provide healthcare services in this era is teleconsultation. This study aimed to determine the strengths, weaknesses, opportunities, and threats (SWOTs) of teleconsultation from the general practitioner's point of view and to implement it in the COVID-19 era. Methods A systematic review was conducted by searching online databases, including the PubMed, Scopus, and WOS databases, from the beginning to January 1, 2024, without restrictions and using relevant keywords. All studies that mentioned at least one of the areas of strength, weakness, opportunities, or threats related to teleconsultation were included in the study. We used content analysis to combine the results. Results Ultimately, 32 studies were included in this review. The most important factors were determined in four domains. Strengths included ease of use of technology, reduction of time and cost, and facilitating documentation. Weaknesses included a lack of physical exams, less direct communication, and internet-related problems. The opportunities included the increasing progress of medical technologies worldwide, continuity of care, and people's interest in the daily use of new technologies. Threats included sociocultural barriers, the need for continuous training, and competing interests. Conclusion Examining internal and external factors is important for formulating a plan. Identifying these factors and using them can lead to the formulation of effective and efficient programs in the field of teleconsultation for general practitioners in the era of COVID-19. Without paying attention to these issues, adopting appropriate plans to minimize weaknesses and threats, and effectively using strengths and opportunities to implement telemedicine projects, there is a possibility of failure and waste of time, effort, and credit in the health sector.
Collapse
Affiliation(s)
- Shiva Khoshsirat
- Department of Health Information TechnologySchool of Management and Medical Informatics, Tabriz University of Medical SciencesTabrizIran
| | - Hassan Soleimanpour
- Medical Philosophy and History Research Center, Emergency and Trauma Care Research CenterImam Reza General Hospital, Tabriz University of Medical SciencesTabrizIran
| | - Peyman Rezaei‐Hachesu
- Department of Health Information TechnologySchool of Management and Medical Informatics, Tabriz University of Medical SciencesTabrizIran
| |
Collapse
|
|
24
|
Singh MP, Keche YN. Ethical Integration of Artificial Intelligence in Healthcare: Narrative Review of Global Challenges and Strategic Solutions. Cureus 2025; 17:e84804. [PMID: 40568260 PMCID: PMC12195640 DOI: 10.7759/cureus.84804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2025] [Indexed: 06/28/2025] Open
Abstract
Artificial intelligence (AI) is revolutionizing healthcare, offering innovative solutions to enhance diagnostic accuracy, treatment efficacy, and accessibility. However, integrating AI into clinical practice raises significant ethical implications, necessitating clear guidelines and frameworks. This paper provides a comprehensive review of the ethical landscape surrounding AI deployment in healthcare across various countries and regions. It explores AI's transformative potential while underscoring the need to prioritize patient safety, transparency, accountability, data privacy, fairness, and human oversight. The paper analyzes existing guidelines from the European Union, the United States, India, Australia, and Africa, identifying common ethical principles and considerations. It discusses challenges and proposes suggestions for addressing issues such as data quality and bias, transparency, privacy and security, accessibility and equity, and robust legal and regulatory frameworks. By fostering a comprehensive understanding of the ethical implications and guidelines surrounding AI in healthcare, this paper aims to contribute to the responsible development and equitable deployment of these transformative technologies.
Collapse
Affiliation(s)
- Madhusudan P Singh
- Pharmacology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Yogendra N Keche
- Pharmacology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| |
Collapse
|
|
25
|
Ahmad F. Optimizing Treatment: The Role of Pharmacology, Genomics, and AI in Improving Patient Outcomes. Drug Dev Res 2025; 86:e70093. [PMID: 40285487 DOI: 10.1002/ddr.70093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2025] [Revised: 03/27/2025] [Accepted: 04/17/2025] [Indexed: 04/29/2025]
Abstract
Recent advances in pharmacology are revolutionizing drug discovery and treatment strategies through personalized medicine, pharmacogenomics, and artificial intelligence (AI). The objective of the present study is to review the role of personalized medicine, pharmacogenomics, and AI-based strategies in optimizing patient outcomes with improved drug efficacy and reduced side effects. A comprehensive review was performed to debate the utility of pharmacogenomics in the prediction of drug response, the role of AI in drug discovery, and the utility of personalized medicine in the clinic. This review highlights how drug discovery and treatment techniques are evolving with the aid of personalized medicine, pharmacogenomics, and AI. Personalized medicine makes the treatment fit the DNA pattern for higher efficacy and minimal side effects. Pharmacogenomics forecasts the action of a drug in terms of genetic difference. AI speeds up drug discovery to enhance the effectiveness and accuracy of finding and evaluating drug leads. Studies show that customized medicine charts therapy to an individual patient's individual genetic profile, resulting in better therapy. Pharmacogenomics facilitates precise drug selection by considering genetic variations, reducing adverse reactions. AI speeds up drug discovery by applying predictive modeling and data-driven evaluation to propel optimized drug development pathways. Together, these advances are enabling more efficient and safer treatment practices across medical disciplines. The combination of pharmacology, genomics, and AI is revolutionizing contemporary healthcare through the personalization of treatments, improved drug safety, and therapeutic outcomes. The future of research should be on optimizing these techniques and overcoming ethical and regulatory issues to facilitate broader clinical implementation.
Collapse
Affiliation(s)
- Fazil Ahmad
- Department of Anesthesia Technology, College of Applied Medical Sciences in Jubail, Imam Abdulrahman Bin Faisal University, Jubail, Saudi Arabia
| |
Collapse
|
|
26
|
Alyahya RSW. The perceptions, attitudes and experiences of service users with telehealth speech-language pathology services. JOURNAL OF COMMUNICATION DISORDERS 2025; 115:106527. [PMID: 40203646 DOI: 10.1016/j.jcomdis.2025.106527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 03/19/2025] [Accepted: 04/01/2025] [Indexed: 04/11/2025]
Abstract
AIMS To investigate the perceptions, attitudes, and experiences of clients and caregivers towards telehealth Speech-Language Pathology (SLP) services. METHODS A comprehensive questionnaire was developed and validated to investigate the perceptions, attitudes, and experiences of service users towards telehealth services. The questionnaire included questions related to telehealth experience, client's preferences, and the perceived facilitators, barriers, advantages, and disadvantages of telehealth. Phone survey was used to collect data from clients and caregivers of clients who received telehealth SLP services during and after the COVID-19 pandemic. RESULTS A total of 293 clients and caregivers participated in this study. The findings indicated that 97.95 % of the respondents reportedly received telehealth SLP services for the first time during the COVID-19 pandemic, mainly through video-communication (51.2 %), and for different clinical services, with therapy (31.04 %) and monitoring (31.28 %) being the highest services. Of the total respondents, 54.95 % felt that telehealth appointments were similar to in-person appointments. However, 41.30 % of the respondents preferred receiving in-person appointments. Statistical analyses indicated that eight factors were perceived by service users as significant primary facilitators of telehealth (e.g., good internet connection, available resources, experience with technology), whereas only three factors were perceived as significant primary barriers (e.g., poor image/sound quality, and client's communication impairments). Furthermore, 10 factors were perceived as significant primary advantages of telehealth (e.g., reduced cost and travel time), while only one factor was identified as a significant primary disadvantage (inability to conduct a physical examination). CONCLUSIONS Service users identified numerous advantages of telehealth, including improved access to healthcare, and reduced costs, while only one disadvantage was identified (lack of physical examinations). The perceived facilitators and barriers of telehealth by service users can be classified into technology-related factors (e.g., comfort with technology, internet connection) and client-related factors (e.g., client's cognitive and sensory abilities). These technology and client-related factors should be considered by policy makers and funding bodies while planning the establishment or expansion of telehealth services.
Collapse
Affiliation(s)
- Reem S W Alyahya
- Department of Language and Communication Sciences, School of Health and Psychological Sciences, City, University of London, London, United Kingdom; Communication and Swallowing Disorders Department, King Fahad Medical City, Riyadh, Saudi Arabia.
| |
Collapse
|
|
27
|
Ehrentraut H, Puskarevic A, Kunsorg A, Abulizi I, Mayr A, Jung M, Schillings M, Temme C, Pütz A, Coburn M, Wittmann M. Improved Perioperative Risk Education Through the Use of an Interactive Online Anaesthesia Education Tool (iPREDICT): A Prospective, Randomised Controlled Single-Centre Clinical Trial. J Clin Med 2025; 14:3131. [PMID: 40364161 PMCID: PMC12072581 DOI: 10.3390/jcm14093131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Revised: 04/24/2025] [Accepted: 04/28/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Involving patients in the preoperative anaesthetic assessment (PAA) process can improve their understanding of risks and contribute to better postoperative recovery and outcomes. The iPREDICT study aims to investigate the feasibility of using an interactive consultation tool (ICT) to improve patient awareness of anaesthesia-related risks. Methods: This prospective, single-centre, randomised, placebo-controlled clinical study included patients scheduled for elective surgery under general or combined general and regional anaesthesia. Participants were randomly assigned to online anaesthesia risk education in the ICT group (intervention) or a control group that watched a video without anaesthetic risk content. Both groups received a face-to-face PAA and were assessed about anaesthetic risk knowledge after PAA and two days later. Results: A total of 373 participants were randomised, and 315 completed the assigned online module prior to their PAA. The proportion of male participants was higher (>60%). Most participants already had prior anaesthesia experience. After PAA, 243 patients completed the first risk recall #1 questionnaire, with the ICT group identifying significantly more correct risks than the control group (median 13.0 vs. 11.0, p < 0.05). In risk recall #2, conducted two days after the PAA, knowledge retention remained stable in the control group, while the experimental group showed further improvement (median 14.0 vs. 13.0, p < 0.05). Conclusions: Using the ICT significantly improved patients' knowledge of anaesthesia-related risks. These results suggest that interactive patient education tools are a feasible and effective way to improve patients' understanding of perioperative anaesthesia risks, potentially contributing to better outcomes, which needs to be addressed in future projects.
Collapse
Affiliation(s)
- Heidi Ehrentraut
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Alma Puskarevic
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Andrea Kunsorg
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Izdar Abulizi
- Department of Medical Biometry and Statistics, University of Marburg, 35037 Marburg, Germany (A.M.)
| | - Andreas Mayr
- Department of Medical Biometry and Statistics, University of Marburg, 35037 Marburg, Germany (A.M.)
| | - Milan Jung
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Maximilian Schillings
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Caroline Temme
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Annika Pütz
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Mark Coburn
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| | - Maria Wittmann
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany; (A.P.); (A.K.); (M.S.); (C.T.); (A.P.); (M.C.); (M.W.)
| |
Collapse
|
|
28
|
Aderinto N, Olatunji G, Kokori E, Babalola AE, Ogieuhi IJ, Aboje JE, Egbunu E, Adefusi T, Ukoaka BM, Moradeyo A, Omoworare O, Olatunji D. Telepsychiatry in Africa: overcoming barriers to access and care. DISCOVER MENTAL HEALTH 2025; 5:64. [PMID: 40299230 PMCID: PMC12040767 DOI: 10.1007/s44192-025-00197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 04/22/2025] [Indexed: 04/30/2025]
Abstract
Telepsychiatry presents a transformative opportunity to address Africa's significant mental health challenges. With a high prevalence of psychiatric disorders and limited access to care, particularly in rural and marginalized communities, innovative solutions are urgently needed. This paper has explored the potential of telepsychiatry to overcome geographical barriers and address the shortage of mental health professionals in Africa. Despite its potential, telepsychiatry faces challenges such as technological barriers, stigma, and regulatory issues. However, these challenges can be addressed with concerted efforts from governments, healthcare organizations, and communities. Developing robust regulatory frameworks, investing in infrastructure, and promoting cultural sensitivity are essential steps towards realizing the full potential of telepsychiatry in Africa. Looking to the future, telepsychiatry holds promise for revolutionizing mental healthcare delivery on the continent. Through continued research, evaluation, and innovation, telepsychiatry can become a cornerstone of mental healthcare provision, ensuring that no one is left behind in accessing the care they need.
Collapse
Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Emmanuel Kokori
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | | | - John Ehi Aboje
- College of Health Sciences, Benue State University, Benue, Nigeria
| | | | - Temiloluwa Adefusi
- Department of Medicine and Surgery, Bowen University Teaching Hospital, Iwo, Nigeria
| | | | - Abdulrahmon Moradeyo
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | | | - Doyin Olatunji
- Department of Health Sciences, Western Illinois University, Macomb, USA
| |
Collapse
|
|
29
|
Durojaiye OC, Fiori C, Cartwright K. Delivery of Outpatient Parenteral Antimicrobial Therapy (OPAT) in an Ever-Changing National Health Service (UK): Benefits, Barriers, and Opportunities. Antibiotics (Basel) 2025; 14:451. [PMID: 40426518 PMCID: PMC12108282 DOI: 10.3390/antibiotics14050451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Revised: 04/24/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025] Open
Abstract
Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to manage a broad range of infections, enabling patients to receive intravenous antibiotics safely outside inpatient settings. In this review, we examine the current landscape of OPAT practice across the United Kingdom (UK), assessing its clinical, economic, and operational impact. The benefits of OPAT for patients and the National Health Service (NHS), as well as its associated risks, are discussed. Additionally, we explore the challenges hindering its broader implementation within the UK. Finally, we highlight recent innovations and emerging applications of OPAT relevant to the NHS, underscoring key considerations for its future expansion and emphasising the need for a nationally coordinated strategy to realise its full potential.
Collapse
Affiliation(s)
- Oyewole Christopher Durojaiye
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK;
- OPAT Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK;
| | - Charlotte Fiori
- OPAT Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK;
| | - Katharine Cartwright
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK;
| |
Collapse
|
|
30
|
Ramírez-Mejía MM, Martínez-Sánchez FD, Córdova-Gallardo J, Méndez-Sánchez N. Evaluating the RESET care program: Advancing towards scalable and effective healthcare solutions for metabolic dysfunction-associated liver disease. World J Hepatol 2025; 17:105254. [PMID: 40308819 PMCID: PMC12038424 DOI: 10.4254/wjh.v17.i4.105254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Revised: 02/26/2025] [Accepted: 03/08/2025] [Indexed: 04/25/2025] Open
Abstract
In this article, we discuss the recently published article by Soni et al. This study explores the effectiveness of a comprehensive digital health program, RESET care, which integrates personalized dietary plans, structured exercise, and cognitive behavioral therapy delivered through a mobile app equipped with Internet of Things devices such as body composition analyzers and smartwatches. Metabolic dysfunction-associated liver disease (MASLD), a global health burden affecting approximately 25% of the population, demands sustainable lifestyle modifications as its primary management strategy. The study reports that 100% of participants in the comprehensive intervention group (diet + exercise + cognitive behavioral therapy) achieved a weight reduction ≥ 7% (6.99 ± 2.98 kg, 7.00% ± 3.39%; P = 0.002), a clinically significant threshold for MASLD improvement. In addition, participants showed a mean weight reduction of 6.99 kg (101.10 ± 17.85 vs 94.11 ± 17.38, P < 0.001) and a body mass index reduction of 2.18 kg/m² (32.90 ± 3.02 vs 30.72 ± 3.41, P < 0.001). These results underscore the potential of digital health platforms to provide scalable, evidence-based solutions for the treatment of MASLD. While these results highlight the potential of digital platforms in the scalable and personalized management of MASLD, the small study sample size and short duration of follow-up limit the generalizability of the results. Future large-scale, long-term trials are needed to confirm sustained benefits, cost-effectiveness, and broader applicability. This letter contextualizes the study within the evolving landscape of MASLD management and emphasizes the clinical implications of integrating digital technologies into standard care.
Collapse
Affiliation(s)
- Mariana M Ramírez-Mejía
- Plan of Combined Studies in Medicine, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04360, Mexico
- Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
| | | | | | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04360, Mexico.
| |
Collapse
|
|
31
|
Hendy A, Farghaly Abdelaliem SM, Zaher A, Sadek BN, Nashwan AJ, Al-Jabri MMA, Ahmeda A, Hendy A, Alabdullah AAS, Sinnokrot SM. Telehealth satisfaction among patients with chronic diseases: a cross-sectional analysis. PeerJ 2025; 13:e19245. [PMID: 40297466 PMCID: PMC12036575 DOI: 10.7717/peerj.19245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 03/11/2025] [Indexed: 04/30/2025] Open
Abstract
Background The study aims to assess telehealth satisfaction among patients with chronic diseases focusing on key demographic and clinical factors that influence satisfaction. Methods A descriptive cross-sectional study was conducted using a self-reported online questionnaire between December 1, 2023, and January 30, 2024. The study targeted chronic patients who had been using telehealth for at least three months. After screening for eligibility and ensuring data completeness, responses from 1,070 patients from three non-governmental hospitals were included in the analysis. The questionnaire covered demographic, socio-economic, and technology-related data, as well as a telehealth satisfaction scale. Results A total of 62.9% of patients reported being satisfied with the telehealth services they received, while 37.1% expressed dissatisfaction. Logistic regression analysis identified several factors associated with patient satisfaction. The constant term was significantly positive (coefficient = 4.129, p < 0.001), indicating a baseline high level of satisfaction. Age negatively impacted satisfaction (coefficient = -0.191, p < 0.001), with older patients being less satisfied. Male patients showed a higher satisfaction rate (coefficient = 0.473, p = 0.047), while education level, particularly having a bachelor's degree, was strongly associated with increased satisfaction (coefficient = 1.977, p < 0.001). Marital status (married) was not a significant predictor (p = 0.403), whereas employment status (working) had a positive association with satisfaction (coefficient = 1.445, p < 0.001). Income level (sufficient and save) did not significantly affect satisfaction (p = 0.561). Having children was positively associated with satisfaction (coefficient = 1.189, p < 0.001). Conclusion Addressing demographic, socio-economic, and technological needs can enhance patient satisfaction with telehealth services. Tailoring services to specific patient preferences, especially for older patients and those needing continuous training, can improve telehealth effectiveness and acceptance.
Collapse
Affiliation(s)
- Abdelaziz Hendy
- Pediatric Nursing Department, Faculty Nursing Ain Shams University, Cairo, Egypt
| | | | - Ahmed Zaher
- Psychiatric Mental Health Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Bothayna N. Sadek
- Assistant Professor, Pediatric Nursing Department, Faculty Nursing Ain Shams University, Cairo, Egypt
| | - Abdulqadir J. Nashwan
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Ahmad Ahmeda
- Department of Basic Medical Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Ahmed Hendy
- Department of Mechanics and Mathematics, Western Caspian University, Baku, Azerbaijan
- Department of Computational Mathematics and Computer Science, Institute of Natural Sciences and Mathematics, Ural Federal University, Yekaterinburg, Russia
| | - Amany Anwar Saeed Alabdullah
- Department of Maternity and Pediatric Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | |
Collapse
|
|
32
|
Marini C, Steinberg MH, Miron CD, Irwin M, Schantz BL, Ginsberg DL, Marmar CR, Simon NM, Noulas P, Szuhany KL. Examination of Patient and Provider Satisfaction, Benefits, and Challenges with Psychiatric Outpatient and Hospital-Based Telehealth Treatment during the COVID-19 Pandemic. Psychiatr Q 2025:10.1007/s11126-025-10150-w. [PMID: 40268852 DOI: 10.1007/s11126-025-10150-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2025] [Indexed: 04/25/2025]
Abstract
OBJECTIVE During the COVID-19 pandemic, telemental health (TMH) use rapidly increased. Though patients report satisfaction with TMH, acceptability among different psychiatric providers (inpatient, outpatient, nurses) and for various diagnoses is less understood. This study aimed to expand understanding by examining TMH acceptability, benefits, and barriers for providers and patients during the early transition to TMH in the COVID-19 pandemic. METHODS Online anonymous surveys evaluated patient (n = 64) and provider (n = 39) satisfaction with and perceived benefits and challenges to TMH from October-December 2020 on 5-point Likert scales. Qualitative data was collected and themes identified. RESULTS Outpatient (3.97 ± 1.05) and inpatient (3.11 ± 1.6) providers, including nurses, reported high satisfaction with TMH, despite over 50% never having used TMH prior to the pandemic. TMH was viewed as acceptable across diagnoses, including serious mental illness and substance use. Provider-rated benefits of outpatient TMH versus in-person visits included COVID safety (mean difference[MD] = 3.05), travel (MD = 2.95), and reduced cancellations (MD = 1.81). Inpatient TMH similarly included COVID safety benefits (MD = 3.31), but also challenges related to team-based service provision (MD = 1.68) and working with trainees (MD = 1.19). Qualitative themes identified TMH challenges (e.g., technological: 56.7% patients, 66.7% providers) and benefits (e.g., convenience/flexibility: 80% patients, 81.5% providers). CONCLUSIONS TMH was associated with high satisfaction for patients and across provider types and patient diagnoses. This study provides further support that TMH across clinical settings allows for greater flexibility and accessibility to evidence-based care, and ongoing benefits even outside the context of the COVID-19 pandemic. It suggests the benefits of ongoing training of staff and trainees in TMH.
Collapse
Affiliation(s)
- Christina Marini
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Margot H Steinberg
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Carly D Miron
- The Graduate Center, City University of New York, New York, NY, USA
| | - Matthew Irwin
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Bryana L Schantz
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - David L Ginsberg
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Charles R Marmar
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Naomi M Simon
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Paraskevi Noulas
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Kristin L Szuhany
- NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 8th Floor, New York, NY, 10016, USA.
| |
Collapse
|
|
33
|
Hijazi H, Alyahya MS, Alolayyan MN, Ajayneh F, Al Abdi R, Hossain A, AlMarzooqi A, Alameddine M. Exploring the impact of interaction dynamics and professional capacity and development on cognitive medical errors: a multiple-case study of healthcare professionals in Jordan. BMC MEDICAL EDUCATION 2025; 25:598. [PMID: 40269959 PMCID: PMC12020236 DOI: 10.1186/s12909-025-07082-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 03/31/2025] [Indexed: 04/25/2025]
Abstract
BACKGROUND Addressing cognitve medical errors (MEs) and their contributing factors has emerged as a crucial factor in enhancing patient safety and attaining improved clinical outcomes. This study aimed to examine the impact of interaction dynamics and professional capability and development on cognitive MEs (i.e., mistakes, slips, or lapses) from the perspectives of healthcare professionals in Jordan. METHODS A multiple-case study design was employed with a cross-sectional approach. Our study investigated three prominent Jordanian hospitals in the northern region (government, private, and teaching) through a pretested, valid, and reliable survey. Using a convenience sampling, 400 participants from three occupational categories, including physicians, nurses, and clinical managers were invloved. The relationships among the study variables were examined through structural equation modeling (SEM) following Confirmatory Factor Analysis (CFA) conducted using AMOS software. RESULTS The results of CFA demonstrated that the model fit indices are acceptable (RMSEA = 0.069; CFI = 0.901; Chisq/df = 2.92; p <.05). The SEM analysis revealed a significant positive association between gaps in professional capacity and development, which comprises three subscales: training needs, continuous medical education, and skills, abilities, and competencies of healthcare professionals, and cognitive MEs (β = 0.40; p <.05). In contrast, a significant negative correlation was found between interaction dynamics among healthcare professionals, including two subscales: interpersonal communication, and teamwork and mutual support, and cognitive MEs (β = - 0.21; p <.05). CONCLUSION Our findings advocate for fostering a hospital culture that consolidates efforts to prioritize patient care coordination, and teamwork cohesion, while also minimizing gaps in unmet needs for training and continuing education, and addressing shortcomings in the skills and job competence of healthcare professionals as essential proactive steps to migirate cognitive MEs in Jordanian hospitals.
Collapse
Grants
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
- 2020346 Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan
Collapse
Affiliation(s)
- Heba Hijazi
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
| | - Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Main N Alolayyan
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Farah Ajayneh
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rabah Al Abdi
- Electrical, Computer, and Biomedical Engineering Department, College of Engineering, Abu Dhabi University, Abu Dhabi, United Arab Emirates
- Biomedical Engineering Department, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Hossain
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alounoud AlMarzooqi
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamad Alameddine
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
|
34
|
Alansari AN, Zaazouee MS, Najar S, Elshanbary AA, Mesaoud M. Telemedicine applications in pediatric emergency surgery and trauma: a systematic review of diagnostic accuracy and clinical effectiveness. Pediatr Surg Int 2025; 41:122. [PMID: 40261379 PMCID: PMC12014790 DOI: 10.1007/s00383-025-06023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2025] [Indexed: 04/24/2025]
Abstract
AIM This review examines the effectiveness, implementation factors, and outcomes of telemedicine applications in managing surgical emergencies and trauma in pediatric patients. METHODS We conducted a systematic review following PRISMA guidelines. Comprehensive searches were performed across four major databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception to January 2025. Studies that investigate telemedicine interventions in pediatric (ages 0-18) emergency surgery and trauma settings were included. RESULTS Eleven studies met inclusion criteria, comprising 6 retrospective cohorts, 3 cross-sectional studies, 1 prospective cohort, and 1 case series. Diagnostic accuracy was consistently high across applications (sensitivity: 93.8-100%; specificity: 82.6-99.7%). Telemedicine demonstrated effectiveness in preventing unnecessary transfers, with one study reporting 16 prevented transfers. Remote-guided procedures showed comparable accuracy to in-person assessment, particularly in point-of-care ultrasound (sensitivity: 93.8%, specificity: 99.7%). High satisfaction rates were reported among families and healthcare providers. CONCLUSIONS This review highlights the potential of telemedicine in pediatric emergency surgery and trauma care, particularly in enhancing access to specialized care and maintaining diagnostic accuracy. However, the generalizability of findings remains limited due to variations in study methodologies. Future research should emphasize prospective designs and economic evaluations to clarify the cost-benefit ratio of implementation. Establishing standardized protocols and enhancing provider training will be essential for the effective and sustainable integration of telemedicine into pediatric trauma systems.
Collapse
Affiliation(s)
- Amani N Alansari
- Department of Pediatric Surgery, Hamad Medical Corporation, P.O Box: 3050, Doha, Qatar.
| | | | - Safaa Najar
- Department of Pediatric Surgery, Hamad Medical Corporation, P.O Box: 3050, Doha, Qatar
| | | | - Marwa Mesaoud
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| |
Collapse
|
|
35
|
Martins D, Lewerenz S, Carmo A, Martins H. Interoperability of telemonitoring data in digital health solutions: a scoping review. Front Digit Health 2025; 7:1502260. [PMID: 40330872 PMCID: PMC12052697 DOI: 10.3389/fdgth.2025.1502260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 03/19/2025] [Indexed: 05/08/2025] Open
Abstract
Objectives This scoping review explores the existing literature on the interoperability of telemonitoring systems in cross-border healthcare settings. It focuses on identifying technical standards, enablers, and barriers to effective telemonitoring data exchange across healthcare systems and geographies. Methods A systematic search was conducted across databases (MEDLINE, PubMed, ISI Web of Knowledge, DBLP, and Scopus) from January 2000 to May 2023, using keywords such as "telemonitoring", "interoperability", "technical standards", and "cross-border data exchange". Eligibility criteria included peer-reviewed studies examining the interoperability of telemonitoring systems across healthcare providers and cross-border settings. A total of 861 studies were identified, and 25 met the inclusion criteria. Results The review identified diverse technical standards, including HL7 FHIR, ISO/IEEE 11073, and IHE profiles, used in telemonitoring systems. However, significant gaps were found in the literature regarding the operational challenges of telemonitoring systems, particularly in cross-border contexts. Many studies focused on technical aspects, with fewer addressing organizational and legal issues. Data transport types, such as Bluetooth and REST APIs, were mentioned, but no common standard for data exchange between devices was identified. Discussion The findings highlight the need for further research on the deployment of telemonitoring systems, particularly in cross-border contexts. The lack of harmonization in technical standards poses a barrier to achieving seamless interoperability. The review calls for the development of a robust framework to support telemonitoring integration across healthcare systems. Conclusions While telemonitoring shows promise in improving healthcare delivery, significant interoperability challenges remain. Developing common standards at the European level is essential to enhance cross-border telemonitoring services and patient care.
Collapse
Affiliation(s)
- Diogo Martins
- ISCTE Business School, University Institute of Lisbon, Lisbon, Portugal
| | - Simon Lewerenz
- ISCTE Business School, University Institute of Lisbon, Lisbon, Portugal
| | - Anderson Carmo
- ISCTE Business School, University Institute of Lisbon, Lisbon, Portugal
| | - Henrique Martins
- ISCTE Business School, University Institute of Lisbon, Lisbon, Portugal
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| |
Collapse
|
|
36
|
Ashmawy R, Zeina S, Kamal E, Shelbaya K, Gawish N, Sharaf S, Redwan EM, Mehanna A. A reliable tool for assessment of acceptance of e-consultation service in hospitals: the modified e-consultation Technology Acceptance Model (TAM) questionnaire. J Egypt Public Health Assoc 2025; 100:6. [PMID: 40261534 PMCID: PMC12014876 DOI: 10.1186/s42506-025-00187-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/13/2025] [Indexed: 04/24/2025]
Abstract
INTRODUCTION Innovative approaches like e-consultation services are critical for improving access to healthcare and promoting equity, particularly in under-resourced settings. Despite their growing prominence, limited tools are available to assess healthcare professionals' acceptance and satisfaction with these services. This study aimed to validate the modified e-consultation TAM questionnaire as a reliable instrument for assessing physicians' perspectives on e-consultation service. METHODS This study focuses exclusively on physicians receiving (not providing) e-consultation service within the Egyptian Ministry of Health and Population. The tool used for assessing their acceptance of the service consists of three sections: demographic data, items assessing perceived usefulness (PU) and perceived ease of use (PEU) of e-consultation, and questions addressing physicians' satisfaction, challenges, and suggestions to improve e-consultation services. The questionnaire was subjected to thorough validation, including face validity evaluated by an expert panel and construct validity which was assessed through factor analysis. RESULTS The modified e-consultation TAM questionnaire demonstrated excellent internal reliability, with Cronbach's alpha coefficient exceeding 0.92 for both PU and PEU. Exploratory factor analysis identified two domains, PU and PEU, explaining 81.17% of the variance, with factor loadings ranging from 0.661 to 0.912. Confirmatory factor analysis (CFA) confirmed the two-factor model, with standardized factor loadings between 0.80 and 0.95, a Comparative Fit Index (CFI) of 0.95, and a Root Mean Square Error of Approximation (RMSEA) of 0.084. CONCLUSION The modified e-consultation TAM questionnaire proves to be a reliable and valid tool for evaluating physicians' acceptance of and satisfaction with e-consultation service. This tool offers potential for future research and practical applications, providing valuable insights to improve the implementation of e-consultation services and inform strategies for advancing healthcare access and equity globally.
Collapse
Affiliation(s)
- Rasha Ashmawy
- Department of Clinical Research, Maamora Chest Hospital, Alexandria, MoHP, Egypt.
- Clinical Research Administration, Directorate of Health Affairs, Alexandria, MoHP, Egypt.
| | - Sally Zeina
- Department of Clinical Research, Maamora Chest Hospital, Alexandria, MoHP, Egypt
| | - Ehab Kamal
- Medical Research Division, National Research Center, Giza, Egypt
| | - Khaled Shelbaya
- National Heart Institute, Giza, Egypt
- Research Department, Alnas Hospital, Cairo, Egypt
| | | | - Sandy Sharaf
- Department of Clinical Research, Maamora Chest Hospital, Alexandria, MoHP, Egypt
| | - Elrashdy M Redwan
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg EL-Arab, Alexandria, Egypt
| | - Azza Mehanna
- Department of Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| |
Collapse
|
|
37
|
Zickuhr L, Sobrero A, Albert D, Alexander AS, Bonnett-Ami T, Dill S, Dowell S, Ferucci ED, Herndon C, Kumar B, Leverenz D, Mandal J, Rana A, Tan IJ, Venuturupalli S, Westrich-Robertson T, Bolster MB, Kolfenbach J, American College of Rheumatology Workforce Solutions Committee. Development, Usability, and Validity Evidence of a Rheumatology Telehealth Feedback Form. Arthritis Care Res (Hoboken) 2025. [PMID: 40254905 DOI: 10.1002/acr.25552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 02/23/2025] [Accepted: 04/08/2025] [Indexed: 04/22/2025]
Abstract
OBJECTIVE Rheumatology telehealth is widespread, making it essential that rheumatology fellows-in-training (FITs) achieve competence delivering telehealth care before entering the workforce. Feedback enhances telehealth skill development. This study develops a Rheumatology Telehealth Feedback Form (RTFF) that incorporates existing data and expertise as well as gathers validity evidence supporting its use. METHODS The American College of Rheumatology Workforce Solutions Committee formed a working group with expertise in rheumatic diseases, telehealth, and medical education. The working group conducted a modified Delphi and focus groups to define content grounded in Rheumatology Telehealth Competencies and evidence-based practice as well as develop the RTFF. Rheumatology educators and FITs piloted the RTFF during patient care and simulated telehealth encounters, rating the helpfulness of the RTFF and providing data to calculate intraclass correlation coefficients (ICCs). RESULTS The modified Delphi identified 16 skills essential to conducting rheumatology telehealth encounters, which were converted into 17 items on the RTFF. Comment boxes prompted supplementary narrative. Five educators and 10 FITs piloted the materials. All educators (5 of 5) "agreed" or "strongly agreed" that the RTFF helped teach rheumatology telehealth skills. ICCs calculated from two simulated telehealth encounters demonstrated moderately to strongly supportive interrater reliability (ICC = 0.857 and 0.632, respectively). CONCLUSION The RTFF incorporates an evidence-based, expert consensus of the skills most essential for rheumatology telehealth encounters. Educators can use the RTFF as a guide for observing FITs delivering telehealth care, providing formative feedback, and helping FITs develop their skills before entering the workforce. The RTFF is the first direct observation formative assessment tool designed for teaching rheumatology telehealth skills.
Collapse
Affiliation(s)
- Lisa Zickuhr
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Alberto Sobrero
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Daniel Albert
- Dartmouth College Geisel School of Medicine, Lebanon, New Hampshire
| | - Amanda S Alexander
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine
| | | | - Sarah Dill
- Lakeview Rheumatology, Yakima, Washington
| | | | | | | | - Bharat Kumar
- University of Iowa Carver College of Medicine, Iowa City
| | - David Leverenz
- Duke University School of Medicine, Durham, North Carolina
| | | | - Amaad Rana
- Yale School of Medicine, New Haven, Connecticut
| | - Irene J Tan
- Einstein Philadelphia Jefferson Health, Philadelphia, Pennsylvania
| | | | | | | | | | | |
Collapse
|
|
38
|
Maghalian M, Veisi S, Mirghafourvand M, Rezaei M, Samad-Soltani T, Naghizadeh A, Ghanbari-Homaie S. Developing and testing a mobile application for imparting knowledge: the positive birth experience guideline to midwifery students. BMC MEDICAL EDUCATION 2025; 25:577. [PMID: 40253315 PMCID: PMC12008986 DOI: 10.1186/s12909-025-07147-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/08/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND Given the importance of the care provided during labour and childbirth and its impact on the childbirth experience, as well as the fact that proper training of midwives can improve the quality of care, this study aims to design World Health Organization guideline for positive childbirth experience in the form of a mobile application (Phase One) and examine its effectiveness in imparting knowledge among midwifery students (Phase Two). METHODS This study employed a research and development methodology. In the initial phase, the "Positive Birth Experience Application" was designed based on the WHO recommendations for the intrapartum period. The second phase utilized a one-group pretest-posttest design. After one month of using the application, 30 midwifery students from Tabriz University of Medical Sciences in Tabriz, Iran completed knowledge (posttest) and evaluation questionnaires. The data was analyzed using SPSS Version 24 software. A Paired Samples T-test was conducted to assess the students' knowledge before and after the intervention. RESULTS The results of the pilot study showed a statistically significant difference (P < 0.001) in the mean knowledge scores of the students regarding the WHO guideline before and after the intervention. After the intervention, the students had higher knowledge scores compared to before using the application [(Mean Difference = 4.75; (95% Confidence Interval = 3.56 to 5.93)]. The analysis for the evaluation of the application indicated that the highest mean (SD = Standard Deviation) scores were observed for the information quality and system quality subscales, which were 50.7 (8.03) and 47.9 (11.6), respectively. In contrast, the lowest mean (SD) scores were associated with the service quality and user satisfaction subscales, which were 23.9 (7.43) and 25.6 (6.62), respectively. CONCLUSIONS The positive birth experience application can be used as an educational method to increase students' knowledge of the recommendations of the WHO regarding intrapartum care. The evaluation of this application by the students demonstrated that it can provide valuable and high-quality information related to intrapartum care, thus enhancing their knowledge in this area.
Collapse
Affiliation(s)
- Mahsa Maghalian
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Veisi
- Health Informatics, Urmia University of Medical Science, Urmia, Iran
| | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mansour Rezaei
- Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asma Naghizadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
|
39
|
Buchan MC, Katapally TR, Bhawra J. Application of an Innovative Methodology to Build Infrastructure for Digital Transformation of Health Systems: Developmental Program Evaluation. JMIR Form Res 2025; 9:e53339. [PMID: 40245398 PMCID: PMC12046263 DOI: 10.2196/53339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 08/23/2024] [Accepted: 03/02/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND The current public health crises we face, including communicable disease pandemics such as COVID-19, require cohesive societal efforts to address decision-making gaps in our health systems. Digital health platforms that leverage big data ethically from citizens can transform health systems by enabling real-time data collection, communication, and rapid responses. However, the lack of standardized and evidence-based methods to develop and implement digital health platforms currently limits their application. OBJECTIVE This study aims to apply mixed evaluation methods to assess the development of a rapid response COVID-19 digital health platform before public launch by engaging with the development and research team, which consists of interdisciplinary researchers (ie, key stakeholders). METHODS Using a developmental evaluation approach, this study conducted (1) a qualitative survey assessing digital health platform objectives, modifications, and challenges administered to 5 key members of the software development team and (2) a role-play pilot with 7 key stakeholders who simulated 8 real-world users, followed by a self-report survey, to evaluate the utility of the digital health platform for each of its objectives. Survey data were analyzed using an inductive thematic analysis approach. Postpilot test survey data were aggregated and synthesized by participant role. RESULTS The digital health platform met original objectives and was expanded to accommodate the evolving needs of potential users and COVID-19 pandemic regulations. Key challenges noted by the development team included navigating changing government policies and supporting the data sovereignty of platform users. Strong team cohesion and problem-solving were essential in the overall success of program development. During the pilot test, participants reported positive experiences interacting with the platform and found its features relatively easy to use. Users in the community member role felt that the platform accurately reflected their risk of contracting COVID-19, but reported some challenges interacting with the interface. Those in the decision maker role found the data visualizations helpful for understanding complex information. Both participant groups highlighted the utility of a tutorial for future users. CONCLUSIONS Evaluation of the digital health platform development process informed our decisions to integrate the research team more cohesively with the development team, a practice that is currently uncommon given the use of external technology vendors in health research. In the short term, the developmental evaluation resulted in shorter sprints, and the role-play exercise enabled improvements to the log-in process and user interface ahead of public deployment. In the long term, this exercise informed the decision to include a data scientist as part of both teams going forward to liaise with researchers throughout the development process. More interdisciplinarity was also integrated into the research process by providing health system training to computer programmers, a key factor in human-centered artificial intelligence development.
Collapse
Affiliation(s)
- M Claire Buchan
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Tarun Reddy Katapally
- DEPtH Lab, Faculty of Health Sciences, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Jasmin Bhawra
- CHANGE Research Lab, School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada
| |
Collapse
|
|
40
|
Graever L, Mafra PC, Figueira VK, Miler VN, Sobreiro JDSL, Silva GPDCD, Issa AFC, Savassi LCM, Dias MB, Melo MM, Fonseca VBPD, Nóbrega ICPD, Gomes MK, Santos LPRD, Lapa E Silva JR, Froelich A, Dominguez H. Telehealth Support From Cardiologists to Primary Care Physicians in Heart Failure Treatment: Mixed Methods Feasibility Study of the Brazilian Heart Insufficiency With Telemedicine Trial. JMIR Cardio 2025; 9:e64438. [PMID: 40246296 PMCID: PMC12046267 DOI: 10.2196/64438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 02/10/2025] [Accepted: 03/10/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND Heart failure is a prevalent condition ideally managed through collaboration between health care sectors. Telehealth between cardiologists and primary care physicians is a strategy to improve the quality of care for patients with heart failure. Still, the effectiveness of this approach on patient-relevant outcomes needs to be determined. OBJECTIVE This study aimed to assess the feasibility of telehealth support provided by cardiologists for treating patients with heart failure to primary care physicians from public primary care practices in Rio de Janeiro, Brazil. METHODS We used mixed methods to assess the feasibility of telehealth support. From 2020 to 2022, we tested 2 telehealth approaches: synchronous videoconferences (phase A) and interaction through an asynchronous web platform (phase B). The primary outcome was feasibility. Exploratory outcomes were telehealth acceptability of patients, primary care physicians, and cardiologists; the patients' clinical status; and prescription practices. Qualitative methods comprised content analysis of 3 focus groups and 15 individual interviews with patients, primary care physicians, and cardiologists. Quantitative methods included the baseline assessment of 83 patients; a single-arm, before-and-after assessment of clinical status in 58 patients; and an assessment of guideline-directed medical therapy in 28 patients with reduced ejection fraction measured within 1 year of follow-up. We integrated qualitative and quantitative data using a joint display table and used the A Process for Decision-Making After Pilot and Feasibility Trials framework for feasibility assessment. RESULTS Telehealth support from cardiologists to primary care physicians was generally well accepted. As barriers, patients expressed concern about reduced direct access to cardiologists, primary care physicians reported work overload and a lack of relative advantage, and cardiologists expressed concern about the sustainability of the intervention. Quantitative analysis revealed an overall poor baseline clinical status of patients with heart failure, with 53% (44/83) decompensated, as expected. Compliance with guideline-directed medical therapy for the treatment of heart failure with reduced ejection fraction after telehealth showed a modest improvement for β-blockers (17/20, 85% to 18/19, 95%) and renin-angiotensin-aldosterone system inhibitors (14/20, 70% to 15/19, 79%) but a drop in the prescription of spironolactone (16/20, 80% to 15/20, 75%). Neprilysin and sodium-glucose cotransporter 2 inhibitors were introduced in 4 and 1 patient, respectively. Missing record data precluded a more precise analysis. The feasibility assessment was positive, favoring the asynchronous modality. Potential modifications include more effective patient and professional recruitment strategies and educational activities to raise awareness of collaborative support in primary care. CONCLUSIONS Telehealth was feasible to implement. Considering the stakeholders' views and insights on the process is paramount to attaining engagement. Missing data must be anticipated for future research in this setting. Considering the recommended adaptations, the intervention can be studied in a cluster-randomized trial.
Collapse
Affiliation(s)
- Leonardo Graever
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Priscila Cordeiro Mafra
- Instituto de Atenção à Saúde São Francisco de Assis, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Vanessa Navega Miler
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
- Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Júlia Dos Santos Lima Sobreiro
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
- Faculdade de Medicina, Instituto de Educação Médica, Rio de Janeiro, Brazil
| | | | - Aurora Felice Castro Issa
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
- Faculdade de Medicina, Instituto de Educação Médica, Rio de Janeiro, Brazil
| | - Leonardo Cançado Monteiro Savassi
- Departamento de Medicina de Família e Comunidade, Saúde Mental e Coletiva, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | | | | | | | | | - Maria Kátia Gomes
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto de Atenção à Saúde São Francisco de Assis, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José Roberto Lapa E Silva
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anne Froelich
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helena Dominguez
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
|
41
|
Nopour R. Barriers and facilitators of using tele-oncology in cancer care: a scoping review. BMC Health Serv Res 2025; 25:541. [PMID: 40229656 PMCID: PMC11995487 DOI: 10.1186/s12913-025-12731-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2025] [Accepted: 04/09/2025] [Indexed: 04/16/2025] Open
Abstract
BACKGROUND AND AIM Identifying barriers and facilitators of tele-oncology adoption is essential in enhancing healthcare stakeholders' decision-making on its leverage. This study aims to review the existing literature on barriers and facilitators to understand this topic better. MATERIALS AND METHODS This scoping review was conducted based on the PRISMA extension for scoping reviews (PRISMA-ScR). The Web of Sciences, PubMed, and Scopus scientific databases were investigated to obtain articles. The data on barriers and facilitators were extracted from the included articles and finalized through the joint meeting. The aggregated barriers and facilitators were synthesized and categorized into themes using qualitative content analysis. This method categorized thematically similar barriers and facilitators into similar themes. We also used the descriptive statistics method of data (frequency and percentage), depicted data in table and figure formats, and synthesized the data narratively to show the findings on the included studies' characteristics. RESULTS Twelve articles from 685 records retrieved from the databases were employed in this study on this topic. Forty-eight barriers and 92 facilitators of tele-oncology use were obtained, including personal, technical, data management, managerial, and legal factors. The most critical barriers and facilitators were regarding the lack of technical requirements and usability characteristics of technologies in cancer care, respectively. CONCLUSION Considering the barriers and facilitators of using tele-oncology in cancer care through analyzing the existing studies can have a key role in optimizing the decision-making of various healthcare stakeholders, including policymakers, managers, and others involved in enhancing the patient care process. It can also be crucial in increasing the chances of technology acceptance in healthcare.
Collapse
Affiliation(s)
- Raoof Nopour
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
42
|
Agarwal N, Anand R, Jindal A, Baghel R, Kashyap R, Nag G, Bharti J, Singh G. Impact of Tele-Kangaroo Mother Care (KMC) Clinics on the Respiratory Outcomes of Newborns. Indian J Pediatr 2025:10.1007/s12098-025-05528-4. [PMID: 40220205 DOI: 10.1007/s12098-025-05528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 03/20/2025] [Indexed: 04/14/2025]
Abstract
OBJECTIVES To assess the respiratory outcomes of newborns receiving Kangaroo mother care (KMC) in remote units of Chhattisgarh, India by providing telementoring to medical staff and parents. METHODS In 2022, this comparative study was carried out at one SNCU in Chhattisgarh, India. The study consisted of gathering data before intervention and utilizing video call technology for remote mentoring to encourage KMC among both staff and parents. Quality improvement initiatives were executed under supervision. Subsequently, data on mortality and morbidity was collected and compared with pre-intervention data. RESULTS The KMC rate increased from 4.5% to 100% by the end of 2022 and remained consistent in 2023. The median latency for starting KMC decreased to 0 d. Long KMC for more than 8 h was seen in 61.4% of babies who received KMC. Oxygen usage dropped from 93.4% to 39.8%. The median days of respiratory support decreased from 3 d to 0 d. The incidence of apnea reduced from 30.3% to 13%. Total adverse outcomes [death, leave-against-medical-advice (LAMA) and referral] reduced from 35.8% (n = 95) to 18.3% (n = 62) (p < 0.05) [Relative Risk (RR): 0.51; 95% Confidence Interval (CI): 0.39-0.67] CONCLUSIONS: Using telemedicine technology for promotion and maintenance of KMC is an effective approach to decrease the mortality rate, morbidity rate, and overall cost of care for newborns who are admitted to SNCUs located remotely.
Collapse
Affiliation(s)
- Nikita Agarwal
- Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rohit Anand
- Department of Neonatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
| | - Atul Jindal
- Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rajesh Baghel
- Department of Pediatrics, District Hospital, Kondagaon, India
| | - Rudra Kashyap
- Department of Pediatrics, District Hospital, Kondagaon, India
| | | | | | - Gajendra Singh
- UNICEF Raipur Office, UNICEF, Raipur, Chhattisgarh, India
| |
Collapse
|
|
43
|
Virag M, Kovacs R, Marovics G, Toth L, Sandor B, Voros P, Gyori-Dani V, Nagy F, Eorsi D, Sandor J, Kiss I, Vincze F, Palinkas A, Perjes A, Rendeki S, Maroti P. Bridging healthcare gaps through specialized mobile healthcare services to improve healthcare access and outcomes in rural Hungary. Sci Rep 2025; 15:12692. [PMID: 40221601 PMCID: PMC11993730 DOI: 10.1038/s41598-025-97447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 04/04/2025] [Indexed: 04/14/2025] Open
Abstract
Telemedicine offers promising solutions to healthcare challenges in underserved rural areas. This study evaluates a public insurance-based telemedicine system implemented in Hungary, where 12 Mobile Healthcare Service Centers (MHSCs) provided general and specialist care to over 21,000 residents across five rural districts. During the six-month study period, 1,889 individuals received medical care through 4,118 healthcare events. The intervention led to the identification of 105 new hypertension cases and 26 new diabetes cases. Patient feedback was overwhelmingly positive, with 96% willing to recommend the service, and nearly all doctors expressing a willingness to continue participation. A 10% reduction in relative referral rates was observed, suggesting that the system helped alleviate pressure on traditional healthcare providers. Additionally, 2,026 screenings, 1,572 chronic care visits, and 151 laboratory tests were conducted, demonstrating the broad utilization of the service. The estimated monthly operational cost of the telemedicine system was approximately $250,000, which exceeded the national primary healthcare funding of $160,000 per month, highlighting the financial implications of scaling similar programs. The findings indicate that mobile telemedicine services can improve healthcare accessibility in underserved areas and reduce healthcare disparities. Further research is needed to assess the long-term effects of such interventions.
Collapse
Affiliation(s)
- Mark Virag
- Medical School, Department of Public Health Medicine, University of Pecs, Szigeti str. 12, HU-7624, Pecs, Hungary
| | - Rita Kovacs
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
| | - Gergely Marovics
- Medical School, Department of Public Health Medicine, University of Pecs, Szigeti str. 12, HU-7624, Pecs, Hungary
| | - Luca Toth
- Medical School, Clinical Centre, Department of Neurosurgery, University of Pecs, Ret str. 2, Pecs, HU-7624, Hungary
| | - Barbara Sandor
- Medical School, Clinical Centre, 1st Department of Medicine, Division of Preventive Cardiology and Rehabilitation, University of Pecs, Pecs, HU-7624, Hungary
| | - Peter Voros
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
| | - Veronika Gyori-Dani
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai str. 26, Debrecen, HU-4028, Hungary
| | - Ferenc Nagy
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
| | - Daniel Eorsi
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, 25 Üllői Str, Budapest, HU-1091, Hungary
| | - Janos Sandor
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai str. 26, Debrecen, HU-4028, Hungary.
| | - Istvan Kiss
- Medical School, Department of Public Health Medicine, University of Pecs, Szigeti str. 12, HU-7624, Pecs, Hungary
| | - Ferenc Vincze
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai str. 26, Debrecen, HU-4028, Hungary
| | - Anita Palinkas
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai str. 26, Debrecen, HU-4028, Hungary
| | - Abel Perjes
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
| | - Szilard Rendeki
- Medical School, Medical Skills Education and Innovation Centre, Universitys of Pecs, Szigeti str. 12, Pecs, HU-7624, Hungary
| | - Peter Maroti
- Hungarian Charity Service of the Order of Malta, Fortuna str. 10, Budapest, H-1014, Hungary
- Medical School, Medical Skills Education and Innovation Centre, Universitys of Pecs, Szigeti str. 12, Pecs, HU-7624, Hungary
- Medical School, 3D Printing and Visualization Centre, University of Pecs, Boszorkany str. 2, Pecs, HU-7624, Hungary
| |
Collapse
|
|
44
|
Liu W, Li Y, Gao S, Wang X, Zhang F. Evaluation of the efficacy of online healthcare system for the remote management of type 2 diabetes mellitus. Medicine (Baltimore) 2025; 104:e42156. [PMID: 40228265 PMCID: PMC11999414 DOI: 10.1097/md.0000000000042156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 04/01/2025] [Indexed: 04/16/2025] Open
Abstract
Diabetes mellitus has emerged as a globally prevalent chronic disease among middle-aged and elderly populations, with type 2 diabetes mellitus (T2DM) constituting over 90% of diagnosed cases. The pathophysiological alterations and associated complications of this metabolic disorder exert profound detrimental effects on patients' quality of life and long-term health outcomes. The study aimed to investigate the impact of an online healthcare system on glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), body mass index (BMI), and blood pressure (BP) in patients with type 2 diabetes mellitus. A total of 950 patients with type 2 diabetes mellitus were enrolled in the online healthcare platform and subsequently categorized into 2 groups based on their visit frequency over a period of approximately 6 months (180 days ± 10%). The control group included 203 patients with only 1 visit, while the observation group comprised 747 patients with twice or more. Comparative analysis was conducted between the 2 groups to assess the levels of HbA1c, LDL-C, BMI, and BP control, as well as compliance rates. The analysis revealed that the observation group showed notably lower levels of HbA1c, LDL-C, and BP compared to the control group. While there was no significant variance in BMI between the groups, the observation group experienced a substantial reduction in BMI over the 6-month period. Our findings substantiate that telemedicine complemented by an online healthcare system, based on the traditional medical model, effectively regulated HbA1c, LDL-C, BMI, and BP in patients with type 2 diabetes mellitus. This approach facilitates enhanced patient self-management, improved disease knowledge, better quality of life, and favorable prognosis.
Collapse
Affiliation(s)
- Wenjing Liu
- Qingdao University, Qingdao Medical College, Qingdao, Shandong, China
| | - Ying Li
- Department of Endocrinology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao 266042, Shandong, China
| | - Shan Gao
- Department of Endocrinology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao 266042, Shandong, China
| | - Xiuxiu Wang
- Department of Endocrinology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao 266042, Shandong, China
| | - Fanghua Zhang
- Department of Endocrinology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao 266042, Shandong, China
| |
Collapse
|
|
45
|
Chakrabarti A, Oladele R, Hermsen E, Novis de Figueiredo ML, Muñoz P, Johnson M. Building upon the core elements of antifungal stewardship: practical recommendations for effective antifungal stewardship in resource-limited settings. Expert Rev Anti Infect Ther 2025:1-19. [PMID: 40074556 DOI: 10.1080/14787210.2025.2479011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 02/26/2025] [Accepted: 03/04/2025] [Indexed: 03/14/2025]
Abstract
INTRODUCTION Despite the crucial importance of effective AFS in resource-limited settings, such settings remain comparatively underserved and underrepresented in terms of resource-setting-specific guidance and research. Further practical contextualization and application of current AFS best practices is thus necessary. AREAS COVERED A panel of leading experts from diverse countries (India, Nigeria, Spain, and the US) was brought together to provide recommendations for practical and effective implementation of AFS in resource-limited settings. We have adapted and contextualized the Centers for Disease Control and Prevention's (CDC) seven core elements and the Mycoses Study Group Education and Research Consortium's (MSGERC) recommendations for facilities in resource-limited settings through a resource-stratified approach. Where relevant to facilities based on their context and respective resources across multiple dimensions, facilities may choose to prioritize certain recommendations that may be more immediately actionable before implementing others. EXPERT OPINION We recommend future studies to examine the efficacy, cost-effectiveness, and practicality of our recommendations in resource-limited settings to enable them to effectively prioritize, channel or gradually increase resource capacity at hand. AFS interventions should be integrated within a larger systemic framework (e.g. city, state, national, regional, international) with collaboration among institutional leadership, ID specialists, healthcare workers, public, policymakers, and pharmaceutical industry.
Collapse
Affiliation(s)
| | - Rita Oladele
- College of Medicine, University of Lagos, Lagos, Nigeria
| | | | | | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Melissa Johnson
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
|
46
|
Unni EJ, Schougaard LMV, Aiyegbusi OL, Mate KKV, Austin EJ, Greffin K, Roberts N, Grove BE, Muehlan H. Expert consensus on implementing patient-reported outcomes in telehealth: findings from an international Delphi study. J Patient Rep Outcomes 2025; 9:40. [PMID: 40205292 PMCID: PMC11981999 DOI: 10.1186/s41687-025-00872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 03/28/2025] [Indexed: 04/11/2025] Open
Abstract
BACKGROUND Using Patient Reported Outcomes (PROs) in clinical care can reduce healthcare service utilization by improving the quality of care. Telehealth, defined by WHO, as the use of "telecommunications and virtual technology to deliver healthcare outside of traditional healthcare facilities", can facilitate a dynamic dialogue between patients and healthcare providers for timely interventions. With the increased use of telehealth facilitated by the infrastructure development during the COVID-19 pandemic, there is an opportunity to utilize telehealth for PRO implementation and a need for guidelines for using PROs via telehealth. This study aimed to generate expert consensus on the utilization of PROs in telehealth. METHODS Delphi methodology was used to achieve consensus among international experts with a predetermined consensus threshold of 70%. Experts were mainly identified through the ISOQOL Clinical Practice SIG. Surveys asked a combination of structured and open-ended questions about the conceptualization of PROs in telehealth, its applicability, target population, implementation challenges and successful strategies, evaluation approaches, and the essential stakeholders. Data from each round were iteratively analyzed using descriptive statistics (quantitative data) and content analysis (qualitative data). RESULTS Out of 24 invitations sent, 17 completed the first round, and 11 completed all three rounds. Respondents were equally distributed between clinicians and researchers and 70% had used PROs via telehealth before the pandemic. Consensus was achieved and some of the relevant aspects are monitoring patients for applicability; individuals with chronic diseases as the target population; resources, staff buy-in, and clinical workflow as the implementation challenges and strategies; utilization metrics for evaluation; and clinicians and patients as essential stakeholders. Though consensus was not reached for the conceptualization of PROs using telehealth, the modified FDA definition of telehealth with the addition of its purpose, and the mode of administration was the most acceptable version. See attached table. CONCLUSION The expert consensus achieved provides important insights from an international perspective on how PROs are currently used via telehealth and the needed implementation support to advance their expansion in research and practice. Lack of consensus on the definition of PROs in telehealth signals the continued rapid evolution of their use and the need for additional research.
Collapse
Affiliation(s)
| | - Liv Marit Valen Schougaard
- AmbuFlex, Centre for Patient-reported Outcomes, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Kedar K V Mate
- Faculty of Medicine, McGill University, Montreal, Canada
| | | | - Klara Greffin
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany.
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
| | - Natasha Roberts
- STARS Education and Research Alliance, Metro North Health, Herston, QLD, Australia
- The University of Queensland, Herston, QLD, Australia
| | - Birgith Engelst Grove
- AmbuFlex, Centre for Patient-reported Outcomes, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Holger Muehlan
- Division of Medical Psychology, Department of Medicine, Health & Medical University, Erfurt, Germany
| |
Collapse
|
|
47
|
Astete Cornejo J, Cruz-Ausejo L, Cainamarks Alejandro J, Burgos-Flores MA, Ambrosio-Melgarejo J, Rosales Rimache J, García Cruz S. Barriers and limitations to the development of a telemental health service for workers in Peru- A user-centered approach. PLoS One 2025; 20:e0321401. [PMID: 40202969 PMCID: PMC11981184 DOI: 10.1371/journal.pone.0321401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/04/2025] [Indexed: 04/11/2025] Open
Abstract
INTRODUCTION Over the past decade, the surge in digital healthcare services has transformed traditional healthcare, requiring multidisciplinary engagement to adapt to the digital realm. The rise of telehealth services, particularly amid COVID-19, has been widely embraced globally, but its implementation in Peru faces unique challenges, including infrastructure issues and economic constraints. Therefore, this research aims to identify the barriers and limitations in developing a telemental health service for screening, evaluation, and timely referral of vulnerable occupational groups. MATERIALS AND METHODS A qualitative study was undertaken. We adopted a phenomenological approach, utilizing semi-structured interviews with vulnerable occupational groups and decision-makers. We conducted 23 interviews: 5 providers of telemental health services, 5 teachers users, 5 police officers users and 5 health professionals of telemental health services, and 3 decision-makers involved in telemental health regulation in Peru.; exploring experiences, barriers, and facilitators related to mental telemental health. The interviews were recorded and transcribed verbatim, furthermore, a thematic analysis was done to identify key themes. RESULTS The research identified barriers and limitations to developing a telemental health services screening service based on the experiences of workers, some of them were related to user dissatisfaction, emphasizing the need for personalized solutions beyond technical aspects. Scheduling issues call for flexibility and improved communication. Healthcare professionals' varied experiences highlight the necessity for targeted training, while successful telemental health services integration demands addressing resource limitations through a comprehensive approach. CONCLUSION The study advocates for a holistic, user-centred paradigm in telemental health services implementation, addressing both technological aspects and human and systemic elements. Multifaceted challenges inherent in telemental health, particularly in Peru, emphasize the need for strategic interventions by stakeholders. The study calls for a policy shift towards enhancing telemental health equity through system-level changes and eliminating structural barriers for marginalized populations.
Collapse
Affiliation(s)
- John Astete Cornejo
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Liliana Cruz-Ausejo
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Jimmy Cainamarks Alejandro
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Miguel Angel Burgos-Flores
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Juan Ambrosio-Melgarejo
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Jaime Rosales Rimache
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | | |
Collapse
|
|
48
|
Iacoviello M, Gori M, Grandaliano G, Minutolo R, Pitocco D, Trevisan R. A holistic approach to managing cardio-kidney metabolic syndrome: insights and recommendations from the Italian perspective. Front Cardiovasc Med 2025; 12:1583702. [PMID: 40264513 PMCID: PMC12011791 DOI: 10.3389/fcvm.2025.1583702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Accepted: 03/24/2025] [Indexed: 04/24/2025] Open
Abstract
Cardio-kidney metabolic (CKM) syndrome represents a complex and circular interplay of cardiovascular, renal, and metabolic dysfunctions, significantly contributing to global morbidity and mortality. This expert opinion synthesizes insights from a panel of Italian specialists in cardiology, nephrology, and diabetology, advocating for a holistic and integrated framework for CKM management. The recommendations underline the critical need for early identification and stratification of CKM stages, fostering an interdisciplinary approach that bridges specialties and ensures comprehensive care. Emphasizing innovative pathways for collaboration, including dynamic referral protocols, telemedicine, and shared decision-making, the proposed strategies aim to overcome structural and organizational barriers in healthcare. By promoting a unified approach, the framework seeks to streamline CKM care, enhance communication among specialists, and improve the coordination of services. This holistic strategy represents a pivotal step toward mitigating disease progression, improving clinical outcomes, and enhancing the quality of life for patients with CKM syndrome.
Collapse
Affiliation(s)
- Massimo Iacoviello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mauro Gori
- Division of Cardiology, Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giuseppe Grandaliano
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Nephrology, Dialysis and Transplantation Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberto Minutolo
- Unit of Nephrology, Dept of Advanced Medical and Surgery Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Dario Pitocco
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberto Trevisan
- Endocrinology and Diabetes Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| |
Collapse
|
|
49
|
Cătălina GR, Gheorman V, Gheorman V, Forțofoiu MC. The Role of Neuroinflammation in the Comorbidity of Psychiatric Disorders and Internal Diseases. Healthcare (Basel) 2025; 13:837. [PMID: 40218134 PMCID: PMC11988559 DOI: 10.3390/healthcare13070837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 03/08/2025] [Accepted: 04/02/2025] [Indexed: 04/14/2025] Open
Abstract
Psychiatric disorders and internal diseases frequently co-occur, posing significant challenges due to overlapping symptoms, shared pathophysiological mechanisms, and increased healthcare burdens. Neuroinflammation has emerged as a central mechanism linking these conditions, driven by systemic inflammation, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and autonomic nervous system (ANS) imbalance. This review synthesizes current evidence on the role of neuroinflammation in comorbid conditions such as depression, anxiety, cardiovascular disease, and diabetes mellitus, emphasizing bidirectional relationships and shared inflammatory pathways. This analysis identifies gaps in longitudinal studies, biomarker validation, and the integration of multidisciplinary care models. Emerging therapeutic approaches, including IL-6 inhibitors, vagus nerve stimulation, and behavioral interventions, show promise but remain underexplored in combined applications. Furthermore, disparities in research representation limit the generalizability of findings and highlight the need for inclusive clinical trials. Addressing these gaps through precision medicine, advanced biomarker monitoring technologies, and equitable healthcare strategies could transform the management of these complex comorbidities. By advancing our understanding of neuroinflammatory mechanisms and promoting integrated interventions, this review underscores the need for a collaborative, patient-centered approach to improve outcomes and reduce the global burden of psychiatric and internal disease comorbidities.
Collapse
Affiliation(s)
| | - Victor Gheorman
- Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Veronica Gheorman
- Department of Medical Semiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mircea-Cătălin Forțofoiu
- Department of Medical Semiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| |
Collapse
|
|
50
|
Milic J, Zrnic I, Grego E, Jovic D, Stankovic V, Djurdjevic S, Sapic R. The Role of Artificial Intelligence in Managing Bipolar Disorder: A New Frontier in Patient Care. J Clin Med 2025; 14:2515. [PMID: 40217964 PMCID: PMC11989407 DOI: 10.3390/jcm14072515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2025] [Revised: 03/24/2025] [Accepted: 03/28/2025] [Indexed: 04/14/2025] Open
Abstract
Background/Objectives: Bipolar disorder (BD) is a complex and chronic mental health condition that poses significant challenges for both patients and healthcare providers. Traditional treatment methods, including medication and therapy, remain vital, but there is increasing interest in the application of artificial intelligence (AI) to enhance BD management. AI has the potential to improve mood episode prediction, personalize treatment plans, and provide real-time support, offering new opportunities for managing BD more effectively. Our primary objective was to explore the potential role of AI in transforming the management of BD, specifically in mood tracking, prediction, and personalized treatment regimens. Methods: To explore the potential role of AI in transforming BD management, we conducted a review of recent literature using key search terms. We included studies that discussed AI applications in mood tracking, prediction, and treatment personalization. The studies were selected based on their relevance to AI's role in BD management, with attention to the PICO criteria: Population-individuals diagnosed with BD; Intervention-AI tools for mood prediction, treatment personalization, and real-time support; Comparison-traditional treatment methods (when available); Outcome-measures of mood episode prediction, treatment effectiveness, and improvements in patient care. Results: The findings from recent research reveal promising developments in the use of AI for BD management. Studies suggest that AI-powered tools can enable more proactive and personalized care, improving treatment outcomes and reducing the burden on healthcare professionals. AI's ability to analyze data from wearable devices, smartphones, and even social media platforms provides valuable insights for early detection and more dynamic treatment adjustments. Conclusions: While AI's application in BD management is still in its early stages, it presents transformative potential for improving patient care. However, further research and development are crucial to fully realize AI's potential in supporting BD patients and optimizing treatment efficacy.
Collapse
Affiliation(s)
- Jelena Milic
- Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, Dr Subotića Starijeg 5, 11 000 Belgrade, Serbia
- European Faculty “Kallos”, Ratarski put 8a, 11 000 Belgrade, Serbia
| | - Iva Zrnic
- Regional Medical Chamber of Belgrade, 11 000 Belgrade, Serbia
| | - Edita Grego
- Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, Dr Subotića Starijeg 5, 11 000 Belgrade, Serbia
| | - Dragana Jovic
- Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, Dr Subotića Starijeg 5, 11 000 Belgrade, Serbia
| | - Veroslava Stankovic
- The College of Health Science, Academy of Applied Studies, 11 000 Belgrade, Serbia
| | | | - Rosa Sapic
- Faculty of Health Studies, University of Bjeljina, 76 300 Bjeljina, Bosnia and Herzegovina
| |
Collapse
|