Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis

Fraser, Matthew; Gorely, Trish; O’Malley, Chris; Muggeridge, David J.; Giggins, Oonagh M.; Crabtree, Daniel

doi:10.3390/ijerph19042302

Cited by 9 publications

(3 citation statements)

References 52 publications

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“…Favorable outcomes associated with digital interventions have been reported in individuals with musculoskeletal conditions [23,24] and in rural populations with a variety of health disorders [25][26][27]. Nevertheless, and once again, it is acknowledged that the determinants that characterize rural populations, such as age, socioeconomic level and education, are, on the other hand, linked with difficulties in accessing digital interventions [28] and have been related to lower access and use of digital health [29].…”

Section: Introductionmentioning

confidence: 99%

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Campos,

Costa,

Donato

et al. 2023

PLoS ONE

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Musculoskeletal conditions are a major source of disability worldwide, and its burden have been rising in the last decades. Rural areas, in particular, are associated with higher prevalence of these conditions as well as higher levels of disability, which is likely related to other determinants that affect these communities. Although digital health has been identified as a potential solution to mitigate the impact of these determinants, it is also known that these populations may face barriers that limit the implementation of these interventions. Therefore, the aim of this scoping review is to comprehensively map the evidence regarding the implementation of digital health interventions in rural populations with chronic musculoskeletal conditions. We will include studies published from the year 2000; that report the use of digital interventions that promote prevention, treatment or monitoring of any chronic musculoskeletal condition or chronic pain from musculoskeletal origin, in patients that live in rural areas. This protocol follows the methodological framework for scoping reviews proposed by Arksey and O’Malley, as well as the Joana Briggs Institute (JBI) approach. We will conduct the search on Medline (PubMed), EMBASE, Web of Science and Scopus, as well as grey literature databases. Two independent reviewers will screen titles and abstracts followed by a full-text review to assess the eligibility of the articles. Data extracted will include the identification of the digital interventions used, barriers and enablers identified by the patients or healthcare providers, the patient-level outcomes measured, and the implementation strategies and outcomes reported. By mapping the evidence on the implementation of digital health interventions in rural communities with musculoskeletal conditions, this scoping review will enhance our understanding of their applicability in real-world settings.

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Section: Introductionmentioning

confidence: 99%

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Campos,

Costa,

Donato

et al. 2023

PLoS ONE

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“…The economic burden of CVD is significant in Canada because CVD costs the health sector over $22.2 billion, including $7.6 billion for direct health care costs and $14.6 billion for indirect costs resulting from lost economic productivity due to disability or death [3]. CVD creates an extra burden in rural communities due to the high prevalence rates of CVD, high rates of CVD risk factors, and the systematic barriers to accessing health services [4][5]. Additionally, the older population living in rural areas with low socioeconomic and education levels are at higher risk of developing CVD than those in urban communities [6][7].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Community-based Cardiovascular Risk Factors Screening Program in Rural Community Shopping Mall: Health Takes Heart Study

MacDonald¹,

Alsrayheen²,

Taylor³

et al. 2023

ujph

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Cardiovascular disease (CVD) significantly impacts rural communities due to the high CVD prevalence rates compared with urban communities. This study aimed to assess the effectiveness of a community-based screening program for CVD risk factors by employing established risk factor scoring in a rural community. In this descriptive cross-sectional study, 1582 participants aged 20 and above participated in the screening program. Data was collected using a self-report questionnaire and measuring other CVD risk factors directly. The metabolic syndrome score and Framingham risk score (FRS) for 10-years of risk of developing heart attack and death were calculated for all participants. Then the level of follow-up with family physicians (FPs) following a screening program for CVD risk factors and a brief one-on-one educational intervention from a Registered Nurse to modify their risk factors was evaluated. The result revealed that 77% of the participants had 1 to 3 risk factors, and 52.7% followed up with FPs. Hypertension and abdominal obesity were the most common risk factors, with 51.1% and 55%, respectively. This study showed that 36.2% of the population had moderate to high FRS (death/MI>20%), and 30% had a high metabolic syndrome score. Community-based CVD risk factor screening successfully identified a high ratio of participants with high CVD risk factors and FRS. The screening program and educational interventions were beneficial in increasing public awareness of CVD risk factors, and a high percentage of participants with high FRS followed up with their FPs.

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“…Common and affordable smartwatches and fitness trackers might support remote patient monitoring (RPM) if the emergent data is high-enough quality to inform safe decision making (Iqbal et al, 2021, Kwok et al, 2021; Lu et al, 2020, Kang & Exworthy, 2022). Remote patient monitoring is particularly important for patients living in remote and rural areas where in-person care can be limited (Fraser et al, 2022; Liao et al, 2019; Canali et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Feasibility characteristics of wrist-worn fitness trackers in health status monitoring for post-COVID patients in remote and rural areas

Wiebe,

Mackay,

Krishnan

et al. 2023

Preprint

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IntroductionCommon, consumer-grade biosensors mounted on fitness trackers and smartwatches can measure an array of biometrics that have potential utility in post-discharge medical monitoring, especially in remote/rural communities. The feasibility characteristics for wrist-worn biosensors are poorly described for post-COVID conditions and rural populations.MethodsWe prospectively recruited patients in rural communities who were enrolled in an at-home rehabilitation program for post-COVID conditions. They were asked to wear a FitBit Charge 2 device and biosensor parameters were analyzed (e.g. heart rate, sleep, and activity). Electronic patient reported outcome measures (E-PROMS) for mental (bi-weekly) and physical (daily) symptoms were collected using SMS text or email (per patient preference). Exit surveys and interviews evaluated the patient experience.ResultsTen patients were observed for an average of 58 days and half (N=5) were monitored for 8 weeks or more. Five patients (50%) had been hospitalized with COVID (mean stay = 41 days) and 4 (36%) had required mechanical ventilation. As baseline, patients had moderate to severe levels of anxiety, depression, and stress; fatigue and shortness of breath were the most prevalent physical symptoms. Four patients (40%) already owned a smartwatch. In total, 575 patient days of patient monitoring occurred across 10 patients. Biosensor data was usable for 91.3% of study hours and surveys were completed 82.1% and 78.7% of the time for physical and mental symptoms, respectively. Positive correlations were observed between stress and resting heart rate (r=0.360, p<0.01), stress and daily steps (r=0.335, p<0.01), and anxiety and daily steps (r=0.289, p<0.01). There was a trend toward negative correlation between sleep time and physical symptom burden (r=-0.211, p=0.05). Patients reported an overall positive experience and identified the potential for wearable devices to improve medical safety and access to care. Concerns around data privacy/security were infrequent.ConclusionsWe report excellent feasibility characteristics for wrist-worn biosensors and e-PROMS as a possible substrate for multi-modal disease tracking in post-COVID conditions. Adapting consumer-grade wearables for medical use and scalable remote patient monitoring holds great potential.

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Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis

Cited by 9 publications

References 52 publications

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

The Effectiveness of Community-based Cardiovascular Risk Factors Screening Program in Rural Community Shopping Mall: Health Takes Heart Study

Feasibility characteristics of wrist-worn fitness trackers in health status monitoring for post-COVID patients in remote and rural areas

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