Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen

Kernebeck, Sven; Busse, Theresa Sophie; Ehlers, Jan P.; Vollmar, Horst Christian

doi:10.1007/s00103-021-03415-9

Cited by 24 publications

(11 citation statements)

References 46 publications

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“…The literature review revealed that technology-based interventions are often associated with low adherence and high dropout rates. To increase acceptance and motivation to use the intervention and ensure better intervention outcomes, users should be involved in all phases of intervention development (Alberts et al, 2020; Kernebeck et al, 2021). A participatory development process would enable the assessment of target groups’ needs in order to take them into account during intervention development.…”

Section: Methodsmentioning

confidence: 99%

Development of an app-based maintenance programme to promote skin protection behaviour for patients with work-related skin diseases

Ristow

Wilke

John

et al. 2022

Health Education Journal

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Objectives: Digital interventions are increasingly used to support behaviour change. In the prevention of chronic work-related skin diseases, the sustainable implementation of appropriate skin protection behaviour following tertiary individual prevention is important. However, there exists no intervention to support the maintenance of these behaviour changes until now. We report the systematic development of a technology-based maintenance programme to support patients to sustainably implement skin protection behaviour and to overcome barriers. Design: Complex intervention development based on a five-step multi-methods process. Setting: Tertiary individual prevention of work-related skin disease in Germany. Methods: Intervention development comprised the following steps: literature review, qualitative focus groups with stakeholders, quantitative assessment of the patients’ needs, development of a programme theory, and intervention development and concept validation. Results: We developed a concept for a complex intervention based on results from the literature review, with seven reviews meeting the criteria; qualitative focus groups involving three dermatologists, five health educators, two psychologists and three employees of an accident insurance institution; and a quantitative needs assessment with 72 patients. Key requirements were derived from this process: for example, the need to develop an app to self-monitor skin protection behaviour and skin condition and to inform the individual about ways of dealing with barriers encountered during the uptake and maintenance of skin protection behaviour. In addition, patients will participate in an individual goal-setting exercise to identify individual behavioural goals. Conclusion: A technology-based approach to the prevention of work-related skin diseases was developed. During the process of development, the perspectives of relevant stakeholders and the target group were considered in a participatory way.

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Section: Methodsmentioning

confidence: 99%

Development of an app-based maintenance programme to promote skin protection behaviour for patients with work-related skin diseases

Ristow

Wilke

John

et al. 2022

Health Education Journal

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“…Informationen aus der digitalen Anwendung können Teil des Arztgesprächs und der Therapieanpassung werden. Dies kann Betroffene zur dauerhaften Nutzung motivieren [39]. Ein weiterer Vorteil wäre, dass die Skepsis gegenüber DiGA auf Seiten der Leistungserbringer abgebaut werden könnte.…”

Section: Diskussionunclassified

“…Allerdings ist der Nutzen eng an die tatsächliche Nutzung der Anwendung gekoppelt. Ohne Überwachung durch Leistungserbringer kann insbesondere bei Patienten mit psychischer Erkrankung eine digitale „Erschöpfung“ entstehen 38 , 39 . In der Folge wird die Anwendung nicht mehr effektiv oder gar nicht mehr genutzt und es kann kein positiver Versorgungseffekt erreicht werden 38 , 39 .…”

Section: Diskussionunclassified

“…Ohne Überwachung durch Leistungserbringer kann insbesondere bei Patienten mit psychischer Erkrankung eine digitale „Erschöpfung“ entstehen 38 , 39 . In der Folge wird die Anwendung nicht mehr effektiv oder gar nicht mehr genutzt und es kann kein positiver Versorgungseffekt erreicht werden 38 , 39 . Eine stärkere Einbindung von Ärzten, Therapeuten, Pflegekräften und Ernährungsberatern könnte dem entgegensteuern.…”

Section: Diskussionunclassified

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Digital Health Applications in der Neurologie und Psychiatrie

Sander

2023

Nervenheilkunde

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ZUSAMMENFASSUNG Hintergrund Digitale Anwendungen liefern kontinuierlich Gesundheitsinformationen, die sowohl Patient en als auch Leistungserbringer unterstützen können. Digitale Gesundheitsanwendungen (DiGA) sollen das Potenzial in Deutschland nutzbar machen. Ziel Ziel der Arbeit ist die Darstellung verfügbarer DiGA im Bereich der Neurologie und Psychiatrie sowie eine Gegenüberstellung mit dem Potenzial digitaler Anwendungen. Material und Methoden Informationen über verfügbare DiGA aus dem Anwendungsverzeichnis des Bundesinstituts fürArzneimittel und Medizinprodukte (BfArM) werden dargestellt und kritisch diskutiert. Ergebnisse DiGA in Neurologie und Psychiatrie vermitteln den Zugang zu psychotherapeutischen Maßnahmen und kognitiver Verhaltenstherapie. Tragbare Sensoren und Künstliche Intelligenz sind kaum integriert. Verbreitete neurologische Indikationen sind nicht abgedeckt, Leistungserbringer sind unzureichend integriert. Diskussion DiGA sind ein erster Schritt in Richtung digital unterstützter Neurologie und Psychiatrie. Weitere Anstrengungen sind erforderlich, um den Bedarf an innovativen, digitalen Lösungen abzudecken und eine effiziente Integration in die Versorgung zu gewährleisten.

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“…Adherence e concept of adherence to digital interventions is roughly de ned as the degree to which the user followed the program as it was designed, which can also be paraphrased as "intended use" or "use as it is designed" (57). Adherence to the digital physiotherapy intervention will be automatically recorded by the app, in compliance with the scheduled sessions.…”

Section: Secondary Explanatory Outcomesmentioning

confidence: 99%

Digital physiotherapy intervention in children in a low resource setting in Anantapur (India): Study protocol for a randomized controlled trial

Estebanez-Pérez

Martín-Valero

Morales

et al. 2022

Front. Public Health

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IntroductionIn rural India the scarcity of physiotherapists and inequalities complicate the recovery of traumatized children. This study protocol will explore a digital physiotherapy intervention in children with ankle fracture in a low-resource setting to improve functional independence and quality of life.Methods and analysisA randomized clinical trial with a mixed quantitative-qualitative design will be carried out. It is a single-blind study, where the evaluator does not know the nature of the intervention. Sixty subjects will be enrolled and randomly divided into two groups: the experimental group (EG) will receive a 4-week digital physiotherapy intervention through an app in a recycled mobile device after hospital discharge; the control group (CG) will receive the physiotherapy standard care recommended for patients discharged from the hospital. Subjects will receive a baseline (T0-pre) assessment of Functional Independence and Quality of Life. At the end of the 4-week intervention (T1-post) a new assessment of the outcome will be performed adding data on adherence, satisfaction (ad hoc questionnaire and TSQ), and barriers of use. Qualitative outcomes will also be explored. The author's hypothesized that the implementation of a digital physiotherapy intervention is feasible and effective to improve functional independence and quality of life. This study protocol is the first to explore the effect of digital physiotherapy intervention in children's patients in a low resource setting (Anantapur).DiscussionThe successful delivery of the intervention, an optimal adherence records, the absence of significant adverse effects, user satisfaction level and the qualitative analysis of limitations, will demonstrate the effectiveness of these procedure. This study will add more evidence in support the use of digital physiotherapy practice as an effective tool. User particularities, provider's capacity, technological and cultural limitations, and considerations for vulnerable populations will be taken into account.Clinical trial registrationNCT04946695 (https://clinicaltrials.gov/).

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Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen

Cited by 24 publications

References 46 publications

Development of an app-based maintenance programme to promote skin protection behaviour for patients with work-related skin diseases

Development of an app-based maintenance programme to promote skin protection behaviour for patients with work-related skin diseases

Digital Health Applications in der Neurologie und Psychiatrie

Digital physiotherapy intervention in children in a low resource setting in Anantapur (India): Study protocol for a randomized controlled trial

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