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27th January 2025
A perioperative eHealth tool used alongside standard care has been shown to successfully support older patients with abdominal aortic aneurysm throughout their treatment journey.
The app was well used and valued by patients, providing information and positive lifestyle advice before, during and after operations. Patients also appreciated the ability to share the application with relatives, the researchers found.
What’s more, healthcare staff also saw benefits as the app aided the management of a prehabilitation programme and enhanced the digital transformation of healthcare, decreasing their workload.
In the prospective, single-centre cohort study, patients were offered the opportunity to download the app before undergoing abdominal aortic aneurysm surgery. The app provided a range of information for patients, including information about their condition and the surgical techniques involved (endovascular aneurysm repair and open surgical repair), as well as perioperative lifestyle advice, such as exercise programmes, ensuring a healthy diet rich in protein, geriatric care and advice on stopping smoking or drinking alcohol.
The majority of patients reported positive responses using the eHealth app and valued the ability to share relevant information with their relatives.
Over 90% of patients with abdominal aortic aneurysm installed the app (n=59/65), with 10% deactivating it after installation. The mean age of users was 74, and 85% were male. Users were active on the app, opening it a median of 67 times. The interquartile range (IQR) was 33–127, indicating the range of times that patients interacted with the app.
The satisfaction questionnaire was completed by 90% of the participants, rating their experiences with the eHealth tool on a scale from 0 to 10. The median scores were 8 for guidance (IQR 6–8), 8 for information provision (IQR 6–8), 7 for usefulness (IQR 6–8.5) and 8 for recommendation to others (IQR 6–9).
Seven patients provided more in-depth feedback in a semi-structured interview and described positive experiences, particularly related to healthy lifestyle advice and the ability to share information about their abdominal aortic aneurysm care with relatives.
The researchers said the user data and feedback highlighted several areas for improvement, but they emphasised the wide-reaching benefits of using an eHealth tool for supplementary care in older patients with abdominal aortic aneurysm.
Reference
Gjosha, B et al. Positive Experiences with the Use of an eHealth Smartphone Application During the Treatment of an Abdominal Aortic Aneurysm. Annals of Vascular Surgery; Oct 24: DOI: 10.1016/j.avsg.2024.07.112.
19th December 2023
A new app designed to reduce isolation and mental burden among young cancer patients is to undergo a national rollout across Denmark in 2024 after a successful pilot.
The ‘Kræftværket‘ (The Cancer Forge) app provides teenagers and young adults in cancer treatment with a comprehensive suite of features including symptom tracking, access to health information and a supportive online community with whom to share treatment experiences.
The app aims to alleviate loneliness and enhance young people‘s mechanisms for coping with their disease and was developed in collaboration with young cancer patients and healthcare professionals.
It is the first digital health solution of its kind in Europe targeted at young cancer patients for national health system implementation.
Professor Helle Pappot, professor in clinical oncology at University of Copenhagen and clinical professor at Rigshospitalet, University Hospital of Copenhagen, Denmark, was instrumental in the app‘s development.
She said: ‘The app has proven to be a good tool for creating an overview of and mastering one‘s illness, that both the healthcare system and the patients can benefit from. Our research shows that young people find the app supportive and meaningful.
‘The solution has been a crucial tool in empowering patients to manage their disease, and through our clinical research we have been able to document the positive impact on a patient’s quality of life.‘
A pilot study led by the University of Copenhagen, which was published in the journal JMIR Mhealth Uhealth in 2019, investigated the feasibility of a smartphone app among adolescent and young adult patients with cancer in active treatment and post-treatment.
A total of 20 participants, 10 in active treatment and 10 in post-treatment, were recruited at Rigshospitalet and asked to use the Kræftværket app as they deemed appropriate over a six-week period.
The participants were asked to complete the 30-item European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire before and after the six-week period.
The post-treatment group experienced a significant increase in overall QoL after the six-week period (global QoL: baseline 62.5, SD 22.3; after six weeks 80.8, SD 9.7; P=.04).
For the group in active treatment, the QoL remained stable throughout the six weeks.
The researchers concluded that use of the smartphone app in this patient population was feasible and had a possible effect on QoL and therefore was ‘warranted for this population‘.
The app will be implemented across all five Danish regions in the new year, with the developers hoping that international expansion will be possible in future.
Andreas Dam, CEO of Daman – the digital health company behind the app‘s development – said: ‘Our work in co-creation with patients has been pivotal in creating a space that not only provides technological solutions but also emotional support for young cancer patients.‘
18th December 2023
A new app providing information on blood clots and how to reduce the risk of developing one has been developed by Oxford University Hospitals NHS Foundation Trust and Thrombosis UK for at-risk patients.
The ‘Let’s Talk Clots’ app will be advertised on discharge paperwork for patients hospitalised with thrombosis, deep vein thrombosis, pulmonary embolism and venous thromboembolism (VTE).
It shares medically-approved, key information about clots, including reducing risk, the signs and symptoms, diagnosis and UK approved treatments and therapies.
There are also details on recovery, including pain and breathlessness, managing anxiety and worry, regaining wellbeing, fitness and returning to everyday activities.
The app also aims to help prevent hospitalisations from blood clots by outlining considerations around risk factors such as pregnancy, family planning, travel and work and managing other conditions or treatments alongside risk factors or a personal medical history of thrombosis.
The app is also being promoted via postcards and posters around the trust‘s hospital sites in Oxford and Banbury, and the team hopes to include the app‘s details on patients‘ admission paperwork in future.
Sarah Havord, a VTE prevention nurse at Oxford University Hospitals and blood clot prevention specialist, said: ‘This resource is very much needed, providing free access to medically-approved information across the blood clot journey and, I believe, will help to save lives and restore lives affected by blood clots.
‘The app started simply as an idea of mine, and has been developed in collaboration with Thrombosis UK, allied healthcare professionals, individuals who have been diagnosed with a blood clot, and their family members. I have been overwhelmed by the amount of support and help provided.‘
The NHS estimates that one in 20 people will experience a VTE during their lives. It is also linked with hospitalisation, with an estimated 55-60% of VTE cases occurring during or after a hospital stay.
Covid-19 has particularly affected awareness of thrombosis, with a paper published in the journal Thrombosis Research reporting a 31% incidence of thrombotic complications in ICU patients with Covid-19.
The app is now available for download for both Apple and Android users.
8th June 2021
Weight loss in patients with type 2 diabetes improves metabolic outcomes such as insulin resistance and glycaemic control. This is particularly important in Asian populations where data indicate an increased prevalence of obesity. While traditionally lifestyle interventions have been delivered in face-to-face sessions, potential barriers such as the need for formal appointments, travel and associated costs, together with potential time constraints, can limit the value of these sessions.
In recent years, the development of smartphone technology has enabled the delivery of lifestyle interventions for patients with long-term conditions and which circumvent some of the problems encountered with face-to-face meetings. However, the effectiveness of smartphone-based apps can depend, to some extent, on the cultural appropriateness of the material provided. In an attempt to examine the value of a culturally and contextualised smartphone app, designed to deliver lifestyle interventions, a team from the Department of Dietetics, National University Hospital, Singapore, undertook a randomised, controlled trial to compare a smartphone-based intervention with usual care. Included participants were adults with type 2 diabetes with a body mass index (BMI) of 23 or greater and at the start of the study, all participants received a single advisory session from a dietician concerning weight and physical activity. Intervention participants were then required to use the app for at least 6 months (to track weight and activity levels) and to communicate (via the app) regularly with a dietician. The primary outcome was the change in body weight after six months, whereas secondary outcomes were changes in metabolic profiles (e.g., HbA1c, fasting blood glucose, blood pressure).
Findings
In total, 204 participants were enrolled and randomised to the intervention (99) or control. The mean age of intervention participants was 51.6 years (33.3% female) with an average weight of 84 kg and BMI of 30.3. After six months, participants in the intervention group had a significantly greater mean weight loss (3.6 kg vs 1.2kg, intervention vs control, p < 0.01). In addition, there was a greater change in mean HbA1c levels (-0.7% vs 0.03%, intervention vs control) and in the proportion of participants seeing a reduction in their use of diabetic medications (23.3% vs 5.4%, intervention vs control). There were also favourable changes in fasting glucose levels and diastolic blood pressure. Finally, nearly two-thirds (62%) of intervention participants used the smartphone app at least 75% of the days during the 6-month period.
Commenting on their findings, the authors noted how the intervention group’s weight loss was comparable to the results achieved from face-to-face sessions and, more importantly, this loss was sustained over a six-month period. The authors concluded that the smartphone app led to significant weight loss and metabolic parameters and that future work should focus on the lifestyle factors more likely to achieve successful outcomes.
Citation
Lim SL et al. Effect of a Smartphone App on Weight Change and Metabolic Outcomes in Asian Adults with Type 2 Diabetes. A Randomised Clinical Trial. JAMA Netw Open 2021
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