132 Adherence to National Institute for Health and Care Excellence Guidance on Methotrexate Blood Monitoring in a Central London National Health Service Trust
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Review of Mobile Apps for Women With Anxiety in Pregnancy: Maternity Care Professionals’ Guide to Locating and Assessing Anxiety Apps
Background Mental health and pregnancy apps are widely available and have the potential to improve health outcomes and enhance women’s experience of pregnancy. Women frequently access digital information throughout their pregnancy. However, health care providers and women have little information to guide them toward potentially helpful or effective apps. Objective This review aimed to evaluate a methodology for systematically searching and reviewing commercially available apps that support pregnant women with symptoms of anxiety in order to assist maternity care professionals in identifying resources that they could recommend for these women. Methods A stepwise systematic approach was used to identify, select, describe, and assess the most popular and highly user-rated apps available in the United Kingdom from January to March 2021. This included developing a script-based search strategy and search process, writing evaluation criteria, and conducting a narrative description and evaluation of the selected apps. Results Useful search terms were identified, which included nonclinical, aspirational, and problem-based phrases. There were 39 apps selected for inclusion in the review. No apps specifically targeted women with anxiety in pregnancy. Of the 39 apps included in the review, 33 (85%) focused solely on mind-body techniques to promote relaxation, stress reduction, and psychological well-being. Only 8 of the 39 (21%) apps included in the review reported that health care professionals had contributed to app development and only 1/39 (3%) provided empirical evidence on the effectiveness and acceptability of the app. The top 12/39 (31%) apps were evaluated by 2 independent reviewers using the developed criteria and scores. There was a small negative correlation between the reviewers’ scores and app user rating scores, with higher user rating scores associated with lower reviewer scores. Conclusions App developers, publishers, and maternity care professionals should seek advice from women with lived experience of anxiety symptoms in pregnancy to locate, promote, and optimize the visibility of apps for pregnant women. There is a lack of resources that provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity care providers are limited in their ability to locate and recommend acceptable and trustworthy apps because of the lack of information on the evidence base, development, and testing of apps. Maternity care professionals and women need access to libraries of trusted apps that have been evaluated against relevant and established criteria.
Review of Mobile Apps for Women With Anxiety in Pregnancy: Maternity Care Professionals’ Guide to Locating and Assessing Anxiety Apps
Background Mental health and pregnancy apps are widely available and have the potential to improve health outcomes and enhance women’s experience of pregnancy. Women frequently access digital information throughout their pregnancy. However, health care providers and women have little information to guide them toward potentially helpful or effective apps. Objective This review aimed to evaluate a methodology for systematically searching and reviewing commercially available apps that support pregnant women with symptoms of anxiety in order to assist maternity care professionals in identifying resources that they could recommend for these women. Methods A stepwise systematic approach was used to identify, select, describe, and assess the most popular and highly user-rated apps available in the United Kingdom from January to March 2021. This included developing a script-based search strategy and search process, writing evaluation criteria, and conducting a narrative description and evaluation of the selected apps. Results Useful search terms were identified, which included nonclinical, aspirational, and problem-based phrases. There were 39 apps selected for inclusion in the review. No apps specifically targeted women with anxiety in pregnancy. Of the 39 apps included in the review, 33 (85%) focused solely on mind-body techniques to promote relaxation, stress reduction, and psychological well-being. Only 8 of the 39 (21%) apps included in the review reported that health care professionals had contributed to app development and only 1/39 (3%) provided empirical evidence on the effectiveness and acceptability of the app. The top 12/39 (31%) apps were evaluated by 2 independent reviewers using the developed criteria and scores. There was a small negative correlation between the reviewers’ scores and app user rating scores, with higher user rating scores associated with lower reviewer scores. Conclusions App developers, publishers, and maternity care professionals should seek advice from women with lived experience of anxiety symptoms in pregnancy to locate, promote, and optimize the visibility of apps for pregnant women. There is a lack of resources that provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity care providers are limited in their ability to locate and recommend acceptable and trustworthy apps because of the lack of information on the evidence base, development, and testing of apps. Maternity care professionals and women need access to libraries of trusted apps that have been evaluated against relevant and established criteria.
BACKGROUND Mental health and pregnancy Apps are widely available and have the potential to improve health outcomes and enhance women’s experience of pregnancy. Women frequently access digital information throughout their pregnancy. Healthcare providers and women have little information to guide them to potentially helpful or effective Apps. OBJECTIVE To develop a methodology to systematically search and evaluate commercially available Apps in order to assist maternity care professionals to identify resources to recommend to pregnant women with symptoms of anxiety. METHODS A stepwise systematic approach to identify, select, describe and assess the most popular and user rated Apps available in the UK from January – March 2021. This included developing a script-based search strategy and search process, developing evaluation criteria and conducting a narrative evaluation and description of the selected Apps. RESULTS Useful search terms were identified which included non-clinical, aspirational and problem-based phrases. There were 39 Apps selected for inclusion in the review. No Apps were located which specifically targeted women with anxiety in pregnancy. Of the 39 Apps included in the review, 33 focused solely on mind-body techniques to promote relaxation, stress reduction and psychological wellbeing. Only eight of the 39 Apps included in the review reported that healthcare professionals had contributed to the App development and only one provided empirical evidence on the effectiveness and acceptability of the App. The top 12 Apps were evaluated by two independent reviewers using the developed criteria and scores. The was a small negative correlation between the reviewers scores and App user rating scores, with higher user rating scores associated with lower reviewer scores. CONCLUSIONS App developers, publishers and maternity care professionals should seek advice from women with lived experience of pregnancy anxiety symptoms to assist in locating, promoting and optimising the visibility of Apps for pregnant women. There is a lack of resources which provide coping strategies based on current evidence for the treatment of anxiety in pregnancy. Maternity Care Providers are hindered in their ability to locate and recommend acceptable and trustworthy Apps due to the lack of information on the evidence-base, development and testing of Apps. Maternity care professionals and women need access to libraries of trusted Apps which have been evaluated against relevant and established criteria.
Insulin Resistance as an Indicator of Differentiation for the Formation of Risk Groups for Non-Alcoholic Fatty Liver Disease in Patients Without Type 2 Diabetes Mellitus, as a Part of Ontological Model of Non-Alcoholic Fatty Liver Disease
The aim: Using cluster analysis, to identify a high-risk group for NAFLD and develop a differential approach to examination, treatment and prevention of the disease based on IR indices, among NAFLD and non-NAFLD patients without type 2 diabetes mellitus (T2DM). Materials and methods: Clinical, anthropometric, laboratory methods, ultrasound, computational and statistical techniques were applied. Results: Cluster analysis was performed on the laboratory tests results: glucose, insulin, HOMA-IR index, HOMA2 Calculator (%B – beta-cell function, %S – insulin sensitivity, IR – insulin resistance). 5 groups of patients were formed, according to increasing HOMA-IR index and IR. Group II was found to be transient in IR formation, it included the majority of non-NAFLD patients (87%), and we consider it to be the risk group for NAFLD. Group V – with the highest IR scores, where 92% of patients had NAFLD and 73% had a high Fatty Liver Index – is considered to be a very high-risk group for developing T2DM. Conclusions: 1. According to the results of cluster analysis, 5 groups of patients with different IR levels were identified. 2. In the second group, where non-NAFLD patients predominate, insulin resistance begins to form. 3. Groups III and IV – patients with high HOMA-IR index – had significant ultrasound findings indicating hepatic steatosis. 4. Group V included patients with NAFLD, with high HOMA-IR index and the highest risk of developing T2DM.
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