Use of Health-Related Apps and Telehealth in Adults with Epilepsy in Germany: A Multicenter Cohort Study

Zöllner, Johann Philipp; Noda, Antonio Sedeño; Mccoy, J. H.; Schulz, Juliane; Tsalouchidou, Panagiota-Eleni; Langenbruch, Lisa; Kovač, Stjepana; Knake, Susanne; Podewils, Felix von; Hamacher, Mario; Mann, Catrin; Leyer, Anne-Christine; Alphen, Natascha van; Schubert‐Bast, Susanne; Rosenow, Felix; Strzelczyk, Adam

doi:10.1089/tmj.2022.0238

Cited by 12 publications

(7 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, other COVID-19–related determinants that were included in our sample (ie, vaccine status, COVID-19 infection history in oneself or close others, and preventive medication), were not significantly associated with telemedicine use. This is in contrast with findings from German samples that looked at younger and adult individuals during the pandemic [ 23 32 33 ] and found significant associations of COVID-19–related factors with telemedicine use (ie, higher perceived severity of COVID-19 infection; having had COVID-19 infection; subjective COVID-19–related challenges; and COVID-19–related cognitive preoccupation, anxiety, and worries). However, when looking at a similar sample to our study, which consisted of middle-aged and older adults during the pandemic in Germany, Hajek and König [ 30 ] did not find significant associations of COVID-19–related factors with telemedicine service use.…”

Section: Discussioncontrasting

confidence: 99%

“…Whereas none of the included socioeconomic determinants were associated with telemedicine service use in our sample, some recent studies identified significant relationships. Findings regarding associations of sex and age with telemedicine use were mixed in recent studies conducted during the pandemic in Germany, with some studies observing higher rates of use in male and younger individuals [ 22 23 30-32 undefined undefined ]. When observing age groups in our sample, older age groups (65-74 and ≥75 years) were less likely to use telemedicine.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study

Neumann,

König,

Hajek

2024

JMIR Aging

View full text Add to dashboard Cite

Background The occurrence of the COVID-19 pandemic demanded fast changes in the delivery of health care. As a result, significant growth in the use of telemedicine services occurred. Research, especially from nationally representative German samples, is needed to better understand determinants of telemedicine use. Objective The purpose of this study was to identify determinants of telemedicine service use among middle-aged and older adults during the COVID-19 pandemic in Germany. Methods Cross-sectional, nationally representative data were taken from the German sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). The German Corona Survey 2 (n=2039), which was conducted between June and August 2021, was used for this study. Reporting experience with remote medical consultations during the COVID-19 pandemic served as the outcome measure. Associations with socioeconomic, psychological, social, health-related, and COVID-19–related determinants were examined using multiple Firth logistic regressions. Results Psychological factors including feeling nervous, anxious, or on edge (odds ratio [OR] 1.61, 95% CI 1.04-2.50; P=.03), feeling sad or depressed (OR 1.62, 95% CI 1.05-2.51; P=.03) and feelings of loneliness (OR 1.66, 95% CI 1.07-2.58; P=.02) were positively associated with telemedicine use. Moreover, forgoing medical treatment because of being afraid of being infected by SARS-CoV-2 (OR 1.81, 95% CI 1.10-2.97; P=.02) and describing limitations because of a health problem as severe were positively associated with the outcome (OR 2.11, 95% CI 1.12-4.00; P=.02). Socioeconomic and social factors were not significantly associated with telemedicine use in our sample. Conclusions Middle-aged and older individuals in Germany seem to use telemedicine services according to psychological needs and health limitations. Especially when psychological symptoms are experienced, telemedicine seems to be a promising service option in this age group. Future research is needed to confirm these initial findings in postpandemic circumstances.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study

Neumann,

König,

Hajek

2024

JMIR Aging

View full text Add to dashboard Cite

show abstract

“…This multicenter, cross-sectional Epi2020 study was conducted at four different epilepsy centers in Germany (Frankfurt am Main, Marburg, Münster, and Greifswald) that offer specialized in- and outpatient care for patients with epilepsy, epileptic encephalopathies, and syndromes associated with epilepsy [ 16 , 17 ]. Patients were instructed to complete a standardized questionnaire focusing on their QoL and other healthcare-related aspects of epilepsy.…”

Section: Methodsmentioning

confidence: 99%

Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany

Siebenbrodt

Willems

Podewils

et al. 2023

Neurol. Res. Pract.

Self Cite

View full text Add to dashboard Cite

Background Assessment of quality of life (QoL) has become an important indicator for chronic neurological diseases. While these conditions often limit personal independence and autonomy, they are also associated with treatment-related problems and reduced life expectancy. Epilepsy has a tremendous impact on the QoL of patients and their families, which is often underestimated by practitioners. The aim of this work was to identify relevant factors affecting QoL in adults with epilepsy. Methods This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis. Results Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18–83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale – depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001). Conclusion Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient’s tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment. Trial Registration German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).

show abstract

“…Nevertheless, access remains limited in the field because they are only available at some dedicated centers or during clinical trials. 25 , 26 Moreover, interventions combining self‐management education including medication reminders and a seizure diary, are scarce. Considering this, Neuroventis developed Helpilepsy Plus (Neuroventis, BV, Overijse, Belgium), a prototype stand‐alone smartphone‐delivered self‐care treatment program for adults with epilepsy.…”

Section: Introductionmentioning

confidence: 99%

“…Digital solutions for people with epilepsy have been scientifically investigated around the world. Nevertheless, access remains limited in the field because they are only available at some dedicated centers or during clinical trials 25,26 . Moreover, interventions combining self‐management education including medication reminders and a seizure diary, are scarce.…”

Section: Introductionmentioning

confidence: 99%

A multicenter randomized controlled feasibility trial of a digital self‐management intervention for adults with epilepsy

Michaelis,

Knake,

Rosenow

et al. 2024

Epilepsia Open

Self Cite

View full text Add to dashboard Cite

ObjectiveSelf‐management interventions may enhance health‐related quality of life (HRQoL) in epilepsy. However, several barriers often impair their implementation in the real world. Digital interventions may help to overcome some of these barriers. Considering this, the Helpilepsy Plus Prototype was developed as a prototype smartphone‐delivered self‐care treatment program for adults with epilepsy.MethodsThe 12‐week Helpilepsy Plus Prototype was evaluated through a randomized controlled feasibility trial with a waiting‐list control (WLC) group. Outcome measurement at baseline and at 12 weeks assessed adherence to the prototype intervention and changes in epilepsy‐related outcomes. The primary endpoint was patient autonomy measured with EASE, and secondary endpoints included HRQoL measured with QOLIE‐31, health literacy measured with HLQ, anxiety, and depression symptoms measured with HADS. Semi‐structured interviews were conducted with a heterogeneous sample of participants to assess user‐friendliness and usefulness. The prototype program was delivered through the Neuroventis Platform (Neuroventis, BV, Overijse, Belgium), a certified medical device (under EU/MDD Class I, and EU/MDR grace period).ResultsNinety‐two patients were included (46 in the intervention group, 46 in WLC). Most participants (63%, 58/92 women, median age 30 years) had pharmacoresistant epilepsy (61%, 56/92). Only 22% of participants (10/46) in the intervention group completed at least half of all intervention sessions. No significant differences between the intervention group and WLC were observed. Although there was a larger proportion of patients in the intervention group with meaningful improvements in HRQoL compared to WLC (19/46 versus 11/46), the difference was not significant (p = 0.119). Qualitative feedback showed that participants would appreciate more personalization, such as adaptation of the content to their current epilepsy knowledge level, a more interactive interface, shorter text sections, and interaction through reminders and notifications.SignificanceDigital interventions should allow sufficient scope for personalization and interaction to increase patient engagement and enable benefits from self‐care apps. Feedback loops allow the participatory development of tailored interventions.Plain Language SummaryIn this study, we investigated the effectiveness of an app‐based self‐help intervention. Study participants were either randomly assigned to a group that had access to the app or a group that received access to the app after the end of the study. Although a larger proportion of participants in the intervention group showed a relevant improvement in quality of life, the difference between the two groups was not statistically significant. Less than one‐fifth of participants in the intervention group attended at least half of all intervention sessions; patient feedback showed that patients required more personalization and interactive options.

show abstract

Use of Health-Related Apps and Telehealth in Adults with Epilepsy in Germany: A Multicenter Cohort Study

Cited by 12 publications

References 37 publications

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study

Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany

A multicenter randomized controlled feasibility trial of a digital self‐management intervention for adults with epilepsy

Contact Info

Product

Resources

About