Exploring the barriers and facilitators for the use of digital health technologies for the management of COPD: a qualitative study of clinician perceptions.

BACKGROUND: Digital health technology (DHT) promises to support patients and healthcare professionals (HCPs) to optimize the management of chronic obstructive pulmonary disease (COPD). However, there is a lack of evidence demonstrating the effectiveness of DHT for the management of COPD. One reason for this is the lack of user-involvement in the development of DHT interventions in COPD meaning their needs and preferences are rarely accounted for in the design phase. Although HCP adoption issues have been identified in relation to DHT, little is known about the challenges perceived by HCPs providing care to COPD patients. Therefore, this study aims to qualitatively explore the barriers and facilitators HCPs perceive for the use of DHT in the management of COPD. METHODS: Participants (n = 32) were recruited using snowball sampling from two university hospitals and several general practitioner clinics. A semi-structured interview was conducted with each participant. NVivo 12 software was used to complete thematic analysis on the data. RESULTS: Themes identified include: data quality; evidence-based care; resource constraints; and digital literacy presented as barriers; and facilitators include the following themes: digital health training and education; improving HCP digital literacy; and Personalized prescribing. Patient-centered approaches, such as pulmonary rehabilitation and shared decision-making were suggested as implementation strategies to ease the adoption of digital health for the management of COPD. CONCLUSION: These findings contribute new insights about the needs and preferences of HCPs working in COPD regarding DHT. The findings can be used to help mitigate user-experience issues by informing the design of person-centered implementation and adoption strategies for future digital health interventions in COPD.

Application of displacement reactions in flame photometry-II Emission flame photometric determination of alkaline earth metals in the presence of interfering anions.

For the emission flame photometric determination of strontium and barium in the presence of interfering ions such as phosphate, sulphate, arsenate and oxalate, calibration or simple standard addition methods cannot be used. Greatly reduced errors can be achieved by dividing the sample solution into four equal parts and adding to each certain known amounts of two metal ions. One of these is identical to the determinand (e.g., strontium or barium) the other has similar characteristics to it (e.g., calcium). The amounts of these metals are chosen so that the total (molar) concentration of these should be identical in all solutions, but the ratio of the concentrations of the two metals should be different. The emission of the determinand metal must be measured, and a standard addition plot produced. The amount of determinand present in the sample can be obtained from the intersection of the emission vs. concentration line with the concentration axis.

Application of displacement reactions in flame photometry-I: the determination of phosphate by a flame emission method.

Phosphate ions decrease the flame emission of calcium, but this effect can be partly offset by adding a second metal which partly displaces calcium from the non-excitable species. For the determination of phosphate the sample solution is divided into four equal parts; to each of these, various amounts of calcium and barium ions are added such that the total (molar) concentration of the metals is constant. Plotting the intensity measured at 630 nm vs. the calcium content of the solution gives a straight line, the slope of which depends on the concentration of phosphate ions present. The method is suitable for rapid determination of phosphate. Accuracy and precision are within the usual limits characteristic of flame photometric methods.

Determination of lanthanum by flame photometric titration.

The flame emission of lanthanum at 560 mmu decreases linearly with phosphate concentration until a 1:1 molar ratio is reached, and then remains practically constant. Lanthanum can be titrated with phosphate, the equivalence point being detected from the change in emission intensity. Errors due to consumption of solution by the atomizer can be kept low by using short spraying times and low galvanometer damping. The average error is about -1% for 0.1M solutions and less than -5% for 0.01M. The method gives good results in the presence of titanium(III), zirconium, thorium and aluminium but cerium(III) and yttrium seriously interfere.