Promoting Self-management and Patient Activation Through eHealth: Protocol for a Systematic Literature Review and Meta-analysis

Moradian, Saeed; Liu, Geoffrey; Maguire, Roma; Krzyzanowska, Monika K.; Butler, Marcus O.; Cheung, Chantal; Signorile, Marisa; Gregorio, N de; Ghasemi, Shiva; Howell, Doris

doi:10.2196/38758

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…Additionally, a systematic review and meta-analysis is being conducted to identify the potential and limitations of e-health interventions for supporting cancer patients in managing their cancer-related symptoms, which will help inform the development of this ePRO system. 32 Moreover, we conducted semi-structured interviews with 13 cancer patients who participated in our previous ePRO study 33 in order to gain insight into the acceptability of ePROs, their feasibility within patient care processes and their integration into patients’ daily routines. The interview guide, which included a flexible list of open-ended questions, was designed to enable participants to express their experiences, opinions, and emotions in their own words.…”

Section: Contextual Inquirymentioning

confidence: 99%

Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment

Moradian,

Ghasemi,

Boutorabi

et al. 2023

Cancer Inform

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Introduction: Immunotherapy has revolutionized the treatment of many different types of cancer, but it is associated with a myriad of immune-related adverse events (irAEs). Patient-reported outcome (PRO) measures have been identified as valuable tools for continuously collecting patient-centered data and are frequently used in oncology trials. However, few studies still research an ePRO follow-up approach on patients treated with Immunotherapy, potentially reflecting a lack of support services for this population. Methods: The team co-developed a digital platform (V-Care) using ePROs to create a new follow-up pathway for cancer patients receiving immunotherapy. To operationalize the first 3 phases of the CeHRes roadmap, we employed multiple methods that were integrated throughout the development process, rather than being performed in a linear fashion. The teams employed an agile approach in a dynamic and iterative manner, engaging key stakeholders throughout the process. Results: The development of the application was categorized into 2 phases: “user interface” (UI) and “user experience” (UX) designs. In the first phase, the pages of the application were segmented into general categories, and feedback from all stakeholders was received and used to modify the application. In phase 2, mock-up pages were developed and sent to the Figma website. Moreover, the Android Package Kit (APK) of the application was installed and tested multiple times on a mobile phone to proactively detect and fix any errors. After resolving some technical issues and adjusting errors on the Android version to improve the user experience, the iOS version of the application was developed. Discussion: By incorporating the latest technological developments, V-Care has enabled cancer patients to have access to more comprehensive and personalized care, allowing them to better manage their condition and be better informed about their health decisions. These advances have also enabled healthcare professionals to be better equipped with the knowledge and tools to provide more effective and efficient care. In addition, the advances in V-Care technology have allowed patients to connect with their healthcare providers more easily, providing a platform to facilitate communication and collaboration. Although usability testing is necessary to evaluate the efficacy and user experience of the app, it can be a significant investment of time and resources. Conclusion: The V-Care platform can be used to investigate the reported symptoms experienced by cancer patients receiving Immune checkpoint inhibitors (ICIs) and to compare them with the results from clinical trials. Furthermore, the project will utilize ePRO tools to collect symptoms from patients and provide insight into whether the reported symptoms are linked to the treatment. Clinical Relevance: V-Care provides a secure, easy-to-use interface for patient-clinician communication and data exchange. Its clinical system stores and manages patient data in a secure environment, while its clinical decision support system helps clinicians make decisions that are more informed, efficient, and cost-effective. This system has the potential to improve patient safety and quality of care, while also helping to reduce healthcare costs.

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Section: Contextual Inquirymentioning

confidence: 99%

Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment

Moradian,

Ghasemi,

Boutorabi

et al. 2023

Cancer Inform

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“…We used the SMD, which refers to behaviors associated with taking action to manage and engage in one’s care and is negatively associated with fatalism about one’s health [ 49 ]. Recent evidence indicates that self-management and patient activation can be supported by the use of HIT [ 51 ]; however, this relationship has not yet been examined in older adults. Patients with a diagnosis of cancer are reported to have 70% higher odds of being activated [ 32 , 35 ], hence we controlled for the effect of cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Examining the Impact of Selected Sociodemographic Factors and Cancer-Related Fatalistic Beliefs on Patient Engagement via Health Information Technology Among Older Adults: Cross-Sectional Analysis

Account¹

2023

JMIR Aging

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Background Despite the role of health information technology (HIT) in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults with a high burden of chronic diseases such as cancer. This study examines the role of selected sociodemographic factors and cancer-related fatalistic beliefs on patient engagement expressed through HIT use for patient engagement in adults aged ≥65 years. We controlled for cancer diagnosis to account for its potential influence on patient engagement. Objective This study has 2 aims: to investigate the role of sociodemographic factors such as race, education, poverty index, and psychosocial factors of cancer fatalistic beliefs in accessing and using HIT in older adults and to examine the association between access and use of HIT in the self-management domain of patient activation that serves as a precursor to patient engagement. Methods This is a secondary data analysis of a subset of the Health Information National Trend Survey (Health Information National Trend Survey 4, cycle 3). The subset included individuals aged ≥65 years with and without a cancer diagnosis. The relationships between access to and use of HIT to several sociodemographic variables and psychosocial factors of fatalistic beliefs were analyzed. Logistic and linear regression models were fit to study these associations. Results This study included 180 individuals aged ≥65 years with a cancer diagnosis and 398 without a diagnosis. This analysis indicated that having less than a college education level (P=<.001), being an individual from an ethnic and minority group (P=<.001), and living in poverty (P=.001) were significantly associated with decreased access to HIT. Reduced HIT use was associated with less than a college education (P=.001) and poverty(P=.02). This analysis also indicated that fatalistic beliefs about cancer were significantly associated with lower HIT use (P=.03). Specifically, a 1-point increase in the cancer fatalistic belief score was associated with a 36% decrease in HIT use. We found that controlling for cancer diagnosis did not affect the outcomes for sociodemographic variables or fatalistic beliefs about cancer. However, patients with access to HIT had a self-management domain of patient activation (SMD) score of 0.21 points higher (P=.003) compared with patients who did not have access. SMD score was higher by 0.28 points (P=.002) for individuals who used HIT and 0.14 points higher (P=.04) who had a prior diagnosis of cancer. Conclusions Sociodemographic factors (education, race, poverty, and cancer fatalistic beliefs) impact HIT access and use in older adults, regardless of prior cancer diagnosis. Among older adults, HIT users report higher self-management, which is essential for patient activation and engagement.

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Improving Self-Efficacy and Patient Activation in Cancer Survivors through Digital Health Interventions: Findings from the PERSIST Project (Preprint)

Arioz,

Mlakar,

Smrke

et al. 2024

Preprint

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BACKGROUND Cancer survivors face various challenges but also demonstrate resilience and find ways to adapt and cope with life after cancer. Self-efficacy and patient activation are two crucial factors that significantly impact the well-being of cancer survivors. These concepts play a vital role in enabling cancer survivors to take control of their health, manage their treatment effectively, and achieve positive long-term outcomes. OBJECTIVE The aim of this study is to assess the impact of a mobile health system (mHealthApp) to improve the self-efficacy and patient activation of breast cancer and colorectal cancer survivors. METHODS This study presents the findings from clinical trials conducted according to the published study protocol of the PERSIST project that was funded by European Commision to support cancer survivors using digital health technologies. The acceptability and usability of the mHealthApp, as well as the perceived self-efficacy and satisfaction with care, were assessed using validated tools such as CASE-cancer, PAM, and SUS. RESULTS The results indicate that the PERSIST project partially achieved its predefined objectives and hypotheses by enhancing the self-confidence and satisfaction of cancer survivors with healthcare and improving the effectiveness of cancer treatment and follow-up procedures to some extent. CONCLUSIONS The PERSIST project demonstrates the potential to improve clinical outcomes, empower patients, and contribute to broader social goals in cancer survivorship. However, larger studies involving a more diverse patient population and a greater number of clinicians are necessary to establish the effectiveness of digital therapies in cancer survivorship care and to provide additional data and evidence.

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Promoting Self-management and Patient Activation Through eHealth: Protocol for a Systematic Literature Review and Meta-analysis

Cited by 3 publications

References 38 publications

Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment

Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment

Examining the Impact of Selected Sociodemographic Factors and Cancer-Related Fatalistic Beliefs on Patient Engagement via Health Information Technology Among Older Adults: Cross-Sectional Analysis

Improving Self-Efficacy and Patient Activation in Cancer Survivors through Digital Health Interventions: Findings from the PERSIST Project (Preprint)

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