Regional anesthesia educational material utilization varies by World Bank income category: A mobile health application data study

Abstract

Introduction Regional anesthesia offers an alternative to general anesthesia and may be advantageous in low resource environments. There is a paucity of data regarding the practice of regional anesthesia in low- and middle-income countries. Using access data from a free Android app with curated regional anesthesia learning modules, we aimed to estimate global interest in regional anesthesia and potential applications to clinical practice stratified by World Bank income level. Methods We retrospectively analyzed data collected from the free Android app “Anesthesiologist” from December 2015 to April 2020. The app performs basic anesthetic calculations and provides links to videos on performing 12 different nerve blocks. Users of the app were classified on the basis of whether or not they had accessed the links. Nerve blocks were also classified according to major use (surgical block, postoperative pain adjunct, rescue block). Results Practitioners in low- and middle-income countries accessed the app more frequently than in high-income countries as measured by clicks. Users from low- and middle-income countries focused mainly on surgical blocks: ankle, axillary, infraclavicular, interscalene, and supraclavicular blocks. In high-income countries, more users viewed postoperative pain blocks: adductor canal, popliteal, femoral, and transverse abdominis plane blocks. Utilization of the app was constant over time with a general decline with the start of the COVID-19 pandemic. Conclusion The use of an in app survey and analytics can help identify gaps and opportunities for regional anesthesia techniques and practices. This is especially impactful in limited-resource areas, such as lower-income environments and can lead to targeted educational initiatives.

Pain management in cancer surgery: Global inequities and strategies to address them

“…19 The increasing availability of free openaccess medical education in the field of acute pain medicine may also be crucial to addressing geographical disparities in regional techniques, and, indeed, physicians in LMICs leverage such technology for regional anesthesia education more than their peers in high-income settings. 20 Ultimately, however, the barriers to the training and retention of specialists in low-resource countries are manifold and need to be addressed systematically at a national policy level with international collaboration. 21 Additionally, regional anesthetic techniques and patientcontrolled analgesic pumps rely on technology that was historically too exorbitant for its deployment in low-resource settings.…”

“…Even so, the effective and safe use of regional techniques requires a high degree of training commensurate with physicians who have undergone extensive postgraduate training 19 . The increasing availability of free open‐access medical education in the field of acute pain medicine may also be crucial to addressing geographical disparities in regional techniques, and, indeed, physicians in LMICs leverage such technology for regional anesthesia education more than their peers in high‐income settings 20 . Ultimately, however, the barriers to the training and retention of specialists in low‐resource countries are manifold and need to be addressed systematically at a national policy level with international collaboration 21 …”

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

“…Ainda, pode reduzir a morbidade perioperatória e fornecer analgesia prolongada (frequentemente 24 horas) sem sedação, diminuindo a administração e efeitos adversos das terapias farmacológicas para o manejo da dor pósoperatória, hemodinâmica estável, necessidade reduzida de outros anestésicos e oxigênio e rápida recuperação. Benefícios adicionais incluem redução de náuseas e vômitos e redução de disfunção cognitiva e alucinações (Ashokka et al, 2020;Cesur et al, 2020;Gangakhedkar & Chincholi, 2020;Herman et al, 2020;Moll et al, 2021;Moreira et al, 2020;Ponde et al, 2020;Uppal et al, 2020).…”

A mixed-method approach to assess users' intention to use mobile health (mHealth) using PLS-SEM and fsQCA

“…While Zion market research firm is expecting the mHealth apps market will hit US$111.1 billion by 2025 from US$8.0 billion in 2018 (Peng et al, 2020), Grand View Research has projected to increase the mHealth market at an annual compound rate of 17.6% from 2021 to 2028 (Tsakiliotis, 2021). Nevertheless, the Android mobile operating system had a global market share of 74.25% globally by the end of August 2020, with the highest penetration rates in low and middle-income countries (Moll et al, 2021).…”