Mobile heath applications for self-management in chronic lung disease: a systematic review.

Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information: The online version contains supplementary material available at 10.1007/s13721-023-00419-0.

Features and characteristics of publicly available mHealth apps for self-management in chronic obstructive pulmonary disease.

Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective: To report the characteristics and features of publicly available apps for COPD self-management. Methods: MHealth apps designed for patients' COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results: From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions: Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.

Patient satisfaction with virtual evaluation, diagnosis, and treatment of CRPS.

Background: The COVID-19 pandemic has led to an increased reliance on virtual care in the rehabilitation setting for patients with conditions such as complex regional pain syndrome (CRPS). Aims: The aim of this study was to perform a quality improvement initiative to assess patient satisfaction and ensure that outcomes following virtual assessment, diagnosis, and treatment of CRPS with prednisone are safe and effective. Methods: An online survey was distributed to 18 patients with CRPS who had been seen virtually between March and December 2020 through a rehabilitation clinic and treated with oral prednisone. Thirteen participants completed the survey, which was designed de novo by our team to evaluate participant perceptions and satisfaction regarding the virtual care experience. Also included in the survey was a CRPS-specific validated patient-report questionnaire (Hamilton Inventory for CRPS: PR-HI-CRPS), which allowed participants to describe their specific symptoms and associated functional and psychosocial impacts, both previously (pretreatment baseline) and at the time of survey (posttreatment). Results: CRPS symptoms and related impacts were scored as significantly improved from baseline following treatment with prednisone. Likert scale results from survey responses related to patients' experiences and satisfaction with the virtual care process were analyzed; the majority of patients reported satisfaction with a virtual appointment for evaluation of CRPS, as well as with subsequent treatment decisions based on virtual assessment. Conclusions: This quality improvement study suggests that virtual care is a potential option for a patient-accepted approach to overcoming challenges with in-person care imposed by the COVID-19 pandemic and could help inform future considerations in addressing geographic and patient-specific disparities in access to specialist care for CRPS.

Contexte: La pandémie de COVID-19 a donné lieu à un recours accru aux soins de réadaptation virtuels pour les patients souffrant d'affections telles que le syndrome douloureux régional complexe (SDRC).Objectifs: L'objectif de cette étude était de réaliser une initiative d'amélioration de la qualité afin d'évaluer la satisfaction des patients et de veiller à ce que les suites à l'évaluation, au diagnostic et au traitement virtuel du SDRC par la prednisone soit sûres et efficaces.Méthodes : Un sondage en ligne a été distribué à 18 patients atteints de SDRC qui avaient été vus virtuellement entre mars et décembre 2020 par le biais d'une clinique de rééducation et qui avaient été traités par prednisone orale. Treize participants ont répondu au sondage, qui avait été conçu de novo par notre équipe, afin d'évaluer les perceptions et la satisfaction des participants à l'égard de leur expérience de soins virtuels. Le sondage comprenait aussi un questionnaire validé par le patient propre au SDRC, (le Hamilton Inventory for CRPS: PR-HI-CRPS), qui a permis aux participants de décrire leurs symptômes spécifiques, ainsi que les effets fonctionnels et psychosociaux qui y étaient associés précédemment (avant le traitement) et à la date de l'enquête (post-traitement).Résultats: Les notes accordées par les participants ont révélé que les symptômes du SDRC et leurs répercussions s'étaient significativement améliorés aprés le traitement par la prednisone. Les résultats sur l'échelle de Likert découlant des réponses aux questions de l'enquête sur l'expérience des patients et leur satisfaction à l'égard du processus de soins virtuels ont été analysés. La majorité des patients se sont déclarés satisfaits du rendez-vous virtuel pour l'évaluation du SDRC, ainsi que des décisions de traitement ultérieures basées sur l'évaluation virtuelle.Conclusions: Cette étude d'amélioration de la qualité suggére que les soins virtuels sont une option envisageable en tant qu'approche acceptée par le patient pour surmonter les difficultés liées aux soins en personne imposées par la pandémie de COVID-19. Elle pourrait donc aider à éclairer les considérations futures dans le traitement des disparités géographiques et les celles qui sont spécifiques aux patients dans l'accés aux soins spécialisés pour le SDRC.

The Role of Occupational Therapy in Pulmonary Rehabilitation Programs: Protocol for a Scoping Review.

BACKGROUND: Chronic respiratory diseases are highly prevalent and compromise an individual's ability to perform activities of daily living (ADLs) and participate in meaningful life roles. Pulmonary rehabilitation (PR) is a well-established intervention aimed at restoring an individual's exercise capacity and improving their ability to complete their ADLs. Occupational therapists help individuals engage in meaningful "occupations," improving their health and well-being. Given the concordance in the aims of PR and the occupational therapy (OT) scope of practice, occupational therapists appear to be well suited as key players in PR programs. However, the benefits of adding OT to PR programs have been sparsely reported in the literature and the role of OT in PR has never been synthesized or reported in national and international guidelines. OBJECTIVE: The aim of this review is to explore the role of OT in PR programs, the current guideline recommendations for the inclusion of OT in PR programs, the estimated prevalence of OT in PR programs, and the reported or anticipated effects of OT interventions in PR programs. METHODS: The review will be conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews. A comprehensive search will be undertaken in the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE, and CINAHL (EBSCO) to identify and retrieve relevant literature published in English, French, or Portuguese. Gray literature on international OT association websites will also be identified, including position statements and guidelines relevant to PR programs. All literature published since the establishment of the effectiveness of PR for chronic respiratory disease in 1994 that explores OT in PR programs for these patients will be included. Search results will be exported to Covidence for title, abstract, and full-text screening by two independent reviewers. Data will be extracted by two independent reviewers using a pilot-tested template including the following: the number of PR programs including OT (specifically from surveys), the purpose of the study, the study design, patient characteristics, respiratory conditions included, PR components, OT role, outcomes, and results. Findings will be presented using a narrative summary, supplemented by figures and/or tables. Key themes will be displayed in an infographic or schematic. RESULTS: The study was initiated in January 2021 and registered with the Open Science Framework (OSF) in February 2021, prior to title and abstract screening. Data collection and analysis and drafting of the manuscript will occur throughout 2021, with expected publication in 2022. CONCLUSIONS: The results of this scoping review will help health care professionals improve patient care by broadening their understanding and awareness of the role of OT in PR programs. This role clarification may help to inform program development and clinical decision making and will serve to optimize the delivery of multidisciplinary care for patients in PR programs, ultimately improving patient outcomes. TRIAL REGISTRATION: OSF Registries ZH63W; https://osf.io/zh63w. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30244.