BackgroundAdvancements in information technology (IT) and its increasingly ubiquitous nature expand the ability to engage patients in the health care process and motivate health behavior change.ObjectiveOur aim was to systematically review the (1) impact of IT platforms used to promote patients’ engagement and to effect change in health behaviors and health outcomes, (2) behavior theories or models applied as bases for developing these interventions and their impact on health outcomes, (3) different ways of measuring health outcomes, (4) usability, feasibility, and acceptability of these technologies among patients, and (5) challenges and research directions for implementing IT platforms to meaningfully impact patient engagement and health outcomes.MethodsPubMed, Web of Science, PsycINFO, and Google Scholar were searched for studies published from 2000 to December 2014. Two reviewers assessed the quality of the included papers, and potentially relevant studies were retrieved and assessed for eligibility based on predetermined inclusion criteria.ResultsA total of 170 articles met the inclusion criteria and were reviewed in detail. Overall, 88.8% (151/170) of studies showed positive impact on patient behavior and 82.9% (141/170) reported high levels of improvement in patient engagement. Only 47.1% (80/170) referenced specific behavior theories and only 33.5% (57/170) assessed the usability of IT platforms. The majority of studies used indirect ways to measure health outcomes (65.9%, 112/170).ConclusionsIn general, the review has shown that IT platforms can enhance patient engagement and improve health outcomes. Few studies addressed usability of these interventions, and the reason for not using specific behavior theories remains unclear. Further research is needed to clarify these important questions. In addition, an assessment of these types of interventions should be conducted based on a common framework using a large variety of measurements; these measurements should include those related to motivation for health behavior change, long-standing adherence, expenditure, satisfaction, and health outcomes.
Despite improved breast cancer survival rates with the use of tamoxifen and aromatase inhibitors, patients remain at risk for cancer recurrence and mortality because of nonadherence to medication. The objective of this review was to identify factors associated with nonadherence among patients with breast cancer. Electronic databases were searched for studies, and potentially relevant studies were retrieved and assessed for eligibility. Potential factors associated with nonadherence were identified, and they included patient-related factors (e.g., patient beliefs and knowledge, fear of adverse effects, forgetfulness, smoking, age, race), therapy-related factors (e.g., duration, side effects, additional prescribed medications, treatment interfering with lifestyle), healthcare system factors (e.g., patient/provider relationships), socioeconomic factors (e.g., medication costs, burden, scheduling problems, religion, marital status), and disease-related factors (e.g., comorbidities, stage of breast cancer). Those findings highlight the need for development of interventions to promote long-term adherence in patients with breast cancer.
Background: Knowing the type of pharmacy used by the patient is meaningful to the pharmacist. Previous studies have assessed different factors predicting the kind of pharmacy selection and reached inconsistent findings. Objectives: To identify patient and health-related factors associated with pharmacy type selection. Methods: The Andersen Behavioral Model of Health Service Use was used to organize the selection of patient characteristics and categorize them as predisposing, enabling, and need factors. The dependent variable was the type of pharmacy used. Logistic regression was used to predict the association between patient-related characteristics and the type of pharmacy used. Results: Older age respondents were less likely to use independent pharmacies (OR = 0.992) and more likely to use mail pharmacy services (OR = 1.026). Highly educated people showed higher use of chain and mail pharmacies (OR = 1.272, 1.185, respectively) and less tendency to use the independent, supermarket, and prescription-only pharmacy types. Men were less likely to use chain pharmacies (OR = 0.932) and more likely to use supermarket pharmacies than women. Patients who use Medication Therapy Management (MTM) services had higher odds of using independent and supermarket pharmacies (OR = 2.808, 1.689, respectively). Patients with a higher number of chronic diseases and experienced side effects of medications were more likely to use independent pharmacies (OR for number of disease = 1.097 and for side effects = 1.095). Conclusions: This study’s findings identify characteristics associated with selecting certain pharmacy settings and direct future research to include other predictors encompassing beliefs, attitudes, and other social factors.
Cancer is the leading cause of morbidity and mortality worldwide, contributing to more than 23 million new cases in 2019 and nearly 10 million deaths in 2022. [1][2][3] Cancer is a multifaceted and diverse disease characterized by abnormal and uncontrolled cell proliferation. Cancer development is traditionally considered a result of genetic dysregulations. Nevertheless, epigenetic aberrations are now known to cooperate with genetic alterations to generate the cancer phenotype.Epigenetic modifications occur at a very early stage in neoplastic development and have a similar effect on stimulating malignant transformation and subsequent tumour growth as genetic mutations. 4 Epigenetic
ABSTRACT Objective: To explore how disease-related causality is formally represented in current ontologies and identify their potential limitations. Methods: We conducted a systematic literature search on eight databases (PubMed, Institute of Electrical and Electronic Engendering (IEEE Xplore), Association for Computing Machinery (ACM), Scopus, Web of Science databases, Ontobee, Open Biological and Biomedical Ontology (OBO) Foundry, and Bioportal. We included studies published between January 1, 1970, and December 9, 2020, that formally represent the notions of causality and causation in the medical domain using ontology as a representational tool. Further inclusion criteria were publication in English and peer-reviewed journals or conference proceedings. Two authors (SS, RM) independently assessed study quality and performed content analysis using a modified validated extraction grid with pre-established categorization. Results: The search strategy led to a total of 8,501 potentially relevant papers, of which 50 met the inclusion criteria. Only 14 out of 50 (28%) specified the nature of causation, and only 7 (14%) included clear and non-circular natural language definitions. Although several theories of causality were mentioned, none of the articles offers a widely accepted conceptualization of how causation and causality can be formally represented. Conclusion: No current ontology captures the wealth of available concepts of causality. This provides an opportunity for the development of a formal ontology of causation/causality. (Abstract: 213 words)
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