Patients' attitudes towards mobile health in Singapore: a cross-sectional study.

BACKGROUND: Smartphone-mediated mobile health (mHealth) has the potential to assist patients with medication adherence and disease monitoring. This study aimed to describe the awareness and usage of, and attitudes towards, mHealth among smartphone-owning patients in a tertiary hospital in Singapore. METHODS: A self-administered cross-sectional survey was systematically offered to patients at the Singapore General Hospital from August to September 2018. Participants were included if they were at least 18 years old, owned a smartphone, and could speak and read simple English. No identifiable data was collected. Responses were summarized using descriptive statistics. Multiple logistic regression analysis was used to identify factors associated with awareness and usage of, and attitudes towards, mHealth. RESULTS: Four-hundred and two eligible responses were received, with most participants reporting having completed tertiary education (63.7%) and having chronic medical conditions (71.1%), with a mean age of about 43 years. On average, participants were aware of 3.7 out of 7 mHealth functions and used 1.9 functions. Most patients were aware that smartphones could be used for general health/fitness tracking, obtaining health information, and appointment management. Most (76.3%) participants were keen to learn to use mHealth in future, and 63.2% agreed that mHealth could help them better manage their health. CONCLUSIONS: Although mHealth usage among patients was low, most patients held positive attitudes towards mHealth. For mHealth to fulfill its potential, strategies to improve the awareness and usage among patients need to be explored.

Management of hepatitis B reactivation in lymphoma patients on rituximab with past hepatitis B exposure: An observational study.

BACKGROUND: Currently, a standardized approach to prevent and manage hepatitis B reactivation in lymphoma patients with past hepatitis exposure receiving rituximab in Singapore is lacking. This study is designed to report the current management approach and outcomes associated with hepatitis B reactivation. OBJECTIVES: The primary objective was to report 6-, 12-, 24-month cumulative hepatitis B reactivation-related outcomes. Secondary objectives were to report monitoring frequencies of hepatitis B DNA and liver function tests performed in lymphoma patients with resolved hepatitis B receiving rituximab, and anti-viral prophylaxis use. METHODOLOGY: This was a single centre, retrospective observational study. Patients with resolved hepatitis B initiated on rituximab from January 2011 to December 2015 were identified and reviewed over a two-year period starting from the date of rituximab initiation. Relevant parameters were obtained from electronic medical records. Hepatitis B reactivation was defined by hepatitis B DNA levels 20 IU/ml (1.30 log/ml) and above. Data were analysed using descriptive statistics. RESULTS: Seventy-five patients were retrospectively reviewed over a two-year period. Hepatitis B reactivation was defined as hepatitis B DNA levels ≥20 IU/ml (1.30 log/ml). The 24-month cumulative hepatitis B reactivation rate was 4.0%. The median (interquartile range) number of hepatitis B DNA tests performed during treatment, initial six-month follow-up, and subsequent follow-up were 1.0 (0.0-2.6), 1.0 (0.0-2.0), and 1.0 (0.0-3.1), respectively. CONCLUSION: Large variations in hepatitis B reactivation monitoring and management strategies were observed. Further studies are required to develop and determine a standardised protocol that could contribute to safer and more cost-effective care for lymphoma patients with resolved hepatitis B on rituximab.

Public attitudes towards mobile health in Singapore: a cross-sectional study.

BACKGROUND: Smartphone-mediated mobile health (mHealth) may assist patients with medication adherence, and disease monitoring. This study aimed to describe awareness and usage of, and attitudes towards, mHealth among the public in Singapore who own a smartphone. It also aimed to identify factors that influenced the above in the study population. METHODS: An online cross-sectional survey was administered via convenience sampling in November 2017. Participants were included if they were at least 18 years old and owned a smartphone. No identifiable data was collected. Responses were summarized using descriptive statistics. Multiple logistic regression analysis was used to identify factors associated with awareness and usage of, and attitudes towards, mHealth. RESULTS: Participants (n=199) were mostly of Chinese ethnicity (84.4%), female (64.8%), young (mean age 33.7 years), and generally healthy (86.9% reported no chronic medical conditions). On average, participants were aware of 4.4 out of 7 mHealth functions and used 2.2 functions. Managing appointments, and fitness/diet tracking were the most well-known (93.5% and 82.4% respectively), and widely used (80.6% and 59.8% respectively) functions. A simple interface, data security, and being free to use, were rated as the most important factors influencing participants' willingness to use mHealth. Most (64.3%) participants were keen to learn to use mHealth in future, 49.7% believed mHealth could help improve their health, but only 13.1% were willing to pay for it. Being employed (OR 3.71) was associated with higher mHealth usage, adjusted for baseline smartphone usage. Participants living in non-subsidized housing were more keen to try (OR 3.18), and willing to pay (OR 3.36) for mHealth. CONCLUSIONS: Participants generally held positive attitudes towards mHealth, although usage was low. Lack of willingness to pay, and socioeconomic factors, are potential barriers to the widespread adoption of mHealth. Future research specifically involving patients is needed.