Enhance Patient Engagement Research Articles

A Comprehensive Survey on Requirements and Design of AI-Powered Clinical Intelligence Systems in Healthcare

With the increasing complexity of healthcare services, artificial intelligence (AI) is emerging as a vital tool to support medical practitioners by providing real-time clinical insights, automating routine documentation, and enhancing patient engagement. This survey investigates the design requirements, technical challenges, and ethical considerations for AI-powered clinical intelligence systems intended for healthcare environments. Our study is based on a survey conducted with healthcare professionals, patients, and AI researchers, capturing diverse perspectives on functionality, usability, data privacy, and ethical concerns. This paper synthesizes these insights into a detailed requirement analysis that can guide the development of clinically effective, ethically sound, and user-centric AI systems. Through this analysis, we aim to lay the groundwork for creating AIdriven tools that improve clinical workflows, foster better patient outcomes, and support healthcare professionals in delivering quality care.

The impact of different radiology report formats on patient information processing: a systematic review.

Since radiology reports are primarily written for health professionals, patients may experience difficulties understanding jargon and terminology used, leading to anxiety and confusion. This review evaluates the impact of different radiology report formats on outcomes related to patient information processing, including perception, decision (behavioral intention), action (actual health behavior), and memory (recall of information). PubMed, Web of Science, EMBASE, and PsycInfo were searched for relevant qualitative and quantitative articles describing or comparing ways of presenting diagnostic radiology reports to patients. Two reviewers independently screened for relevant articles and extracted data from those included. The quality of articles was assessed using the Mixed Methods Appraisal Tool. Eighteen studies, two qualitative and sixteen quantitative, were included. Sixteen studies compared multiple presentation formats, most frequently traditional unmodified reports (n = 15), or reports with anatomic illustrations (n = 8), lay summaries (n = 6) or glossaries (n = 6). Glossaries, illustrations, lay summaries, lay reports or lay conclusions all significantly improved participants' cognitive perception and perception of communication of radiology reports, compared to traditional reports. Furthermore, these formats increased affective perception (e.g., reduced anxiety and worry), although only significant for lay reports and conclusions. Modifying traditional radiology reports with glossaries, illustrations or lay language enhances patient information processing. Question Identifying the impact of different radiology report formats on outcomes related to patient information processing to enhance patient engagement through online access to radiology reports. Findings Lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations increase patients' satisfaction with and understanding of their radiology reports. Clinical relevance To increase patients' satisfaction, perceived usefulness and understanding with radiology reports, the use of lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations is recommended. These modifications decrease patients' unnecessary insecurity, confusion, anxiety and physician consultations after viewing reports.

Research on healthcare data sharing in the context of digital platforms considering the risks of data breaches

BackgroundWithin China's healthcare landscape, the sharing of medical data has emerged as a pivotal force propelling advancements in the insurance sector and enhancing patient engagement with healthcare services. However, medical institutions often exhibit reluctance toward data sharing due to apprehensions regarding data security and privacy safeguards. To navigate this conundrum, our research introduces and empirically validates a model grounded in evolutionary game theory, offering a robust theoretical framework and actionable strategies for facilitating healthcare data sharing while harmonizing the dual imperatives of data utility and privacy preservation.MethodsIn this paper, we construct an evolutionary game model involving medical institutions, big data innovation platforms, and insurance companies within the context of digital platforms. The model integrates exogenous causes of data breaches, endogenous causes of data breaches, compensation payments, government penalties, subsidies, unreasonable fees, claims efficiency, and insurance fraud.ResultsThe stability analysis of the evolutionary game identifies eight equilibrium points among medical institutions, platforms, and insurance companies. Numerical simulations demonstrate convergence toward strategy E7 = (0, 0, 1), suggesting a trend for medical institutions to adopt a fully anonymous information-sharing strategy, platforms to implement strict regulation, and insurance companies to opt for an auditing approach. Sensitivity analysis reveals that the parameters selected in this study significantly influence the players' behavioral choices and the game's equilibria.ConclusionsWhen breaches occur, medical institutions tend to seek co-sharing between platforms and insurance companies. This promotes enhanced regulation by platforms and incentivizes insurance companies to perform audits. If the responsibility for the breach is attributed to the platform or the insurance company, the liability sharing system will push healthcare organizations to choose a fully anonymous information sharing strategy. Otherwise, medical institutions will choose partially anonymous information sharing for more benefits. In case of widespread data leakage, the amount of compensation shall augment, and the role of compensation shall replace the role of government supervision. Then, the government shall penalize them, which shall reduce the motivation of each subject.

Digital health intervention for children with ADHD to improve mental health intervention, patient experiences, and outcomes: a study protocol

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to timely and targeted mental health intervention for children at significant risk for poor outcomes. The present paper will describe our planned protocol to evaluate the efficacy of CoolTaCo via randomized control trial (RCT).Methods/designWe will recruit 60 children (ages 8–12) with ADHD who will be randomized to either immediate (n = 30) or delayed (n = 30) treatment (i.e., a waitlist control group). Among those randomized to immediate treatment, half will be assigned to DHI (delivered via a smartwatch and smartphone application), the other half to an active control treatment as usual (TAU). Unlike the DHI group, the TAU group will receive the smartwatch with no assigned activities, applications, or interventions on the devices. The intervention period will last 16 weeks; after a participant has been in the delayed treatment group for 16 weeks and has completed the post-waiting period assessment, they will be randomly assigned to either the intervention or active control group. Thus, 30 participants will complete the intervention, and 30 will complete the active control, with half of the total sample completing a waitlist period.DiscussionIndividuals with ADHD have complex needs. Despite improvement in outcomes following cognitive behavioral therapies (CBT) and pharmaceutical treatment, long-term maintenance is a challenge often not addressed by traditional medical approaches, and, as we described, ineffective approaches to information sharing across points of care create further barriers to progress. Our research will fill a significant gap in translating early treatment investments and gains into long-term, sustainable outcomes.This study was registered as a clinic trial at ClinicalTrials.gov (Digital Health Intervention for Children With ADHD, ID# NCT06456372) on 06/13/2024.

Identifying critical elements in using Question Prompt Lists at the pharmacy counter to induce patient activation—using principles of conversation analysis

BackgroundThe incorporation of Question Prompt Lists (QPLs) into pharmacy interactions has been tested as an innovative strategy aimed at enhancing patient engagement and addressing personal information needs. However, there is a gap in understanding regarding how QPLs induce or reduce patient activation and contribute to improved medical treatment. The specific aim of the study was therefore to qualitatively describe how pharmacy encounters in which QPL are introduced unfold, in order to identify and discuss relevant interactional mechanisms that induce or reduce patient activation. MethodsThe QPL, which includes questions about usage, interaction, side effects, and follow-up, was introduced to patients during pharmacy encounters. Employing a qualitative inductive approach based on principles from conversation analysis (CA), audio-recordings from 56 QPL encounters in community pharmacies were transcribed and thematically analysed. ResultsMost meetings began with along initiation phase focused on determining which medications to take home. This was followed by an introduction to the QPL and a natural break where the pharmacist left to get the medicines, giving the patient an opportunity to contemplate their needs, as prompted by the QPL. While the QPL itself was not explicitly explained or discussed, the majority of patients asked questions and shared personal information. Even those who were disinterested felt compelled to justify their stance, demonstrating the influence of the norm of reciprocity. However, instances of unsolicited information provision by the pharmacist, were still identified. ConclusionThis study demonstrates that Question Prompt Lists (QPLs) can enhance patient activation in pharmacy encounters, even without detailed explanations, but their impact is not straightforward. The presence of the QPL encouraged patients to engage, share personal information, and ask questions. These findings suggest that QPLs can create opportunities for patient involvement, even in brief pharmacy interactions.

A conceptual framework for integrating digital transformation in healthcare marketing to boost patient engagement and compliance

This paper presents a conceptual framework for integrating digital transformation in healthcare marketing to enhance patient engagement and compliance with treatment regimens. As healthcare systems evolve, the adoption of digital technologies has become imperative for fostering meaningful interactions between patients and providers. The proposed framework emphasizes leveraging digital marketing techniques, data analytics, and personalized communication strategies to strengthen patient-provider relationships and improve health outcomes. At the core of the framework is the use of digital marketing techniques, including social media outreach, content marketing, and mobile applications, to reach patients effectively. These tools facilitate the dissemination of vital health information and resources, enabling patients to make informed decisions about their care. By utilizing data analytics, healthcare organizations can gain insights into patient behaviors, preferences, and demographics, allowing for the customization of marketing efforts to meet the specific needs of diverse patient populations. Personalized communication strategies are pivotal in this framework, as they empower healthcare providers to deliver tailored messages that resonate with individual patients. This personalization fosters a sense of connection and trust, encouraging patients to engage actively in their treatment plans. By utilizing patient data, providers can send reminders, educational content, and motivational messages that enhance treatment adherence and compliance. Moreover, the framework addresses the importance of feedback loops, where healthcare organizations continuously gather and analyze patient responses to marketing efforts. This iterative process allows for the optimization of strategies, ensuring they remain effective and relevant over time. By fostering a culture of engagement, organizations can cultivate long-term relationships with patients, ultimately leading to improved health outcomes. In conclusion, this conceptual framework serves as a strategic guide for healthcare organizations aiming to harness digital transformation in their marketing efforts. By integrating digital marketing techniques, data analytics, and personalized communication strategies, organizations can enhance patient engagement, improve treatment adherence, and positively impact overall health outcomes.

Enhancing patient education and engagement through digital intelligence tools in dermatology

This comprehensive digital health review examines the expanding landscape of digital intelligence tools within dermatology, specifically examining the innovative role of AI-powered applications aimed at educating and engaging patients in managing their skin health. Drawing upon a wide array of existing research, this review scrutinizes the evolution and impact of various digital tools. These include interactive apps that leverage AI algorithms to deliver tailored skincare guidance, considering factors such as skin type, concerns, and environmental factors. Additionally, the review explores the emerging use of immersive virtual reality experiences to deepen patients’ understanding of skin conditions, offering vivid simulations and educational content. These innovative approaches showcase significant promise in not only improving patient outcomes but also fostering greater treatment adherence and overall satisfaction with dermatological care. Looking ahead, future research should prioritize fine-tuning AI algorithms to further personalize patient recommendations, exploring the integration of wearable technology for real-time monitoring, and conducting longitudinal studies to evaluate the sustained effectiveness and scalability of digital intelligence tools in promoting patient education and engagement. Moreover, innovative strategies such as gamification techniques and social support platforms hold considerable potential for enhancing patient empowerment and involvement in managing their skin health. Leveraging digital intelligence tools will eventually redefine the landscape of dermatological care, empowering patients and optimizing treatment outcomes through enhanced education and engagement.

Probing clarity: AI-generated simplified breast imaging reports for enhanced patient comprehension powered by ChatGPT-4o

BackgroundTo assess the reliability and comprehensibility of breast radiology reports simplified by artificial intelligence using the large language model (LLM) ChatGPT-4o.MethodsA radiologist with 20 years’ experience selected 21 anonymized breast radiology reports, 7 mammography, 7 breast ultrasound, and 7 breast magnetic resonance imaging (MRI), categorized according to breast imaging reporting and data system (BI-RADS). These reports underwent simplification by prompting ChatGPT-4o with “Explain this medical report to a patient using simple language”. Five breast radiologists assessed the quality of these simplified reports for factual accuracy, completeness, and potential harm with a 5-point Likert scale from 1 (strongly agree) to 5 (strongly disagree). Another breast radiologist evaluated the text comprehension of five non-healthcare personnel readers using a 5-point Likert scale from 1 (excellent) to 5 (poor). Descriptive statistics, Cronbach’s α, and the Kruskal–Wallis test were used.ResultsMammography, ultrasound, and MRI showed high factual accuracy (median 2) and completeness (median 2) across radiologists, with low potential harm scores (median 5); no significant group differences (p ≥ 0.780), and high internal consistency (α > 0.80) were observed. Non-healthcare readers showed high comprehension (median 2 for mammography and MRI and 1 for ultrasound); no significant group differences across modalities (p = 0.368), and high internal consistency (α > 0.85) were observed. BI-RADS 0, 1, and 2 reports were accurately explained, while BI-RADS 3–6 reports were challenging.ConclusionThe model demonstrated reliability and clarity, offering promise for patients with diverse backgrounds. LLMs like ChatGPT-4o could simplify breast radiology reports, aid in communication, and enhance patient care.Relevance statementSimplified breast radiology reports generated by ChatGPT-4o show potential in enhancing communication with patients, improving comprehension across varying educational backgrounds, and contributing to patient-centered care in radiology practice.Key PointsAI simplifies complex breast imaging reports, enhancing patient understanding.Simplified reports from AI maintain accuracy, improving patient comprehension significantly.Implementing AI reports enhances patient engagement and communication in breast imaging.Graphical

Integrating an AI-powered symptom assessment application (SAA) in a hospital network in Portugal

Abstract Introduction Patients often struggle to understand medical information and healthcare worker shortage strains health systems. Integrating SAAs that guide patients and provide diagnostic decision support (DDS) to doctors can help. This study evaluates the impact of the SAA ‘Ada’, a class IIa medical device, after its integration into the patient portal of a Portuguese hospital network, CUF, on clinical workflow and patient health. Methods This on-going post-market quality improvement study, started in Nov 2023 and has enrolled 664 participants. Participating doctors complete a baseline survey. Consenting patients conduct symptom assessments and answer survey questions within the app. The patient’s symptom report is shared with their physician, who then completes a post-consultation survey. Results After using Ada, 86% of patients could enter all their symptoms, 79% felt more prepared for their consultation, and 39% felt less health anxiety (N = 664). In the baseline survey, most doctors utilize online resources (96%) in the absence of a symptom checker, followed by discussions with colleagues (65%) for challenging cases (N = 26). In the post-consultation survey, 95% of doctors found Ada’s condition suggestions reasonable, with only 10% disagreeing with its triage classification. Doctors reported time saving and increased consultation efficiency (64%), and 59% felt more confidence in their diagnosis. A majority said that Ada provided them with additional information about patients (77%). Ada also improved consultation efficiency (74%), preparation (78%), patient engagement (82%), and health knowledge (77%; N = 22). Conclusions By providing personalized health information, Ada prepares patients for their consultation, resulting in improved patient engagement and facilitation of clinical conversation. Incorporating a SAA into routine patient care enhances quality of consultation, reduces consultation time, increases efficiency, and provides DDS to doctors. Key messages • Digital health enhances patient engagement, clinical efficiency, and diagnostic decision support for doctors in healthcare settings. • Ada’s personalized health information empowers patients, improves consultations, and reduces health-related anxiety.

Semmelweis University’s innovative Center of Preventive Services in support of healthy ageing

Abstract Issue/problem Europe’s aging population presents substantial hurdles for healthcare sustainability. To alleviate the social and economic impacts of age-related diseases, promoting healthy aging is imperative. However, motivating individuals to adopt a healthier lifestyle proves challenging. Description of the problem Semmelweis University, a leading institution in medicine, health sciences, and health care in Hungary and Central Eastern Europe, has addressed this challenge by establishing the Center of Preventive Services (CPS), serving 12,500 Semmelweis University employees. The CPS conducts comprehensive health risk assessments and offers consultations with specialists in preventive medicine, public health, dietetics, physiotherapy, and health psychology. Motivational interviewing is used to enhance patient engagement and commitment to healthy lifestyle changes. Results The CPS has effectively integrated preventive services into the university’s healthcare system, reaching a significant number of employees. Early results show improvements in participants’ lifestyle and health behaviors due to the effective use of motivational interviewing. According to the first preliminary result, a study on step count conducted within the CPS found that those taking part in motivational interviewing session were able to increase their average daily step count by 1074 (95% Confidence Interval: 116-2033) steps more than controls. Lessons The Semmelweis University’s CPS provides valuable lessons for integrating healthy aging-focused preventive care into healthcare systems: 1. Effective preventive care requires targeted interventions based on detailed risk assessment and motivational interviewing; 2. Embedding preventive services within existing health infrastructure improves accessibility and utilization; 3. Collaborative and multidisciplinary approaches are essential to comprehensively address the needs of ageing populations. Key messages • Motivational interviewing boosts the effectiveness and engagement of preventive health services, which is essential to meet the challenges of ageing populations. • The Semmelweis University’s model program shows that embedding preventive services into the infrastructure of existing institutions like universities is scalable for better public health.

Delivering shared decision-making before transcatheter aortic valve implantation using digital and remote techniques to enhance patient engagement and convenience

Abstract Introduction Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for patients with aortic stenosis. However, the choice between TAVI, surgery, wait and watch or conservative management needs to be based upon multiple factors including comorbidity, life expectancy, anatomy, local experience and, critically, informed patient preference. In this context, engaging patients in a shared decision-making (SDM) process becomes essential, but this practice is generally underused. Purpose To comply with both international guidance and the National Institute for Health and Care Excellence (NICE) UK recommendations, in January 2023 we established a formal SDM pathway for TAVI, utilising digital solutions as much as possible to minimise the logistic impact for both hospital and patients. We aimed to quantitatively measure the compliance of the digital SDM meeting from the patients’ perspective with the NICE recommended essential and enhanced discussion standards. Methods Patients are contacted when the multidisciplinary heart team recommends TAVI, then offered digital or, where appropriate, physical patient decision aids and a link to a TAVI-specific explanatory video. One week later, patients are invited to a virtual comprehensive SDM meeting where a specialist nurse discusses aortic stenosis and treatment options with the patient as per the NICE recommended standards, allowing time for questioning and review. From December 2022 to June 2023, a custom developed questionnaire was administered to 20 patients prior to, and 28 patients after the implementation of the SDM meeting protocol, directly addressing the patients’ perception of adherence to the NICE standards. This was provided to the patients after the TAVI procedure via an online tool. The answers to the 12 core questions were converted into a Likert scale (1 to 5) and the global satisfaction scores for the 2 patient groups, reported as the average Likert score across the 12 questions, were compared with the Wilcoxon Rank-Sum Test. Results The global satisfaction score was significantly higher for the post-SDM group than for the pre-SDM group (mean 4.27 vs 3.55, p<0.001). The percentage of patients who gave positive (Likert 4-5) responses to each individual question was consistently higher in the post-SDM group. The percentage of patients giving negative (Likert 1-2) responses was substantially lower in the post-SDM group. Conclusions The SDM pathway and the virtual tools provided proved effective in delivering SDM in compliance with international guidance and NICE recommended standards from the patient’s perspective. A similar approach leveraging digital technology to minimise cost and enhance patient convenience could be implemented for other treatments and across other institutions.Questionnaire results

Wearable Devices for Training and Patient Monitoring: A Comprehensive Review

Introduction:Wearable technologies and remote patient monitoring (RPM) are transforming sports and healthcare by enabling continuous and real-time monitoring of various health parameters. These innovations hold significant potential for improving training outcomes in physical rehabilitation and fitness programs, managing chronic diseases, and enhancing patient engagement. Aim of the Study:This review aims to summarize and highlight the most relevant findings on the current status, clinical applications, challenges, and prospects of wearable health-related sensing technologies in the context of training and chronic disease management. Material and Methods:A review of scientific publications from 2018 to 2024 was conducted using PubMed and Google Scholar databases. Keywords such as "wearable," "remote patient monitoring," "sensors," "training," and "chronic disease management" were used. Conclusions:Wearable devices are gaining popularity among the entire population, not only among individuals with chronic health conditions. The use of wearable technologies has shown promise in improving training and health outcomes by providing continuous monitoring, personalized care, and enhanced training programs. However, challenges such as data accuracy, privacy concerns, and integration with healthcare systems must be addressed and present opportunities for future advancements.

The FLASHFIT Interactive Device in Healthcare: Revolutionizing Patient Engagement and Monitoring

The study investigates the effectiveness of the FLASHFIT interactive device in enhancing patient engagement and monitoring within healthcare settings. As digital health solutions become increasingly vital, FLASHFIT aims to bridge the gap between patients and healthcare providers by promoting active participation in health management. This research employs a mixed-methods approach, combining quantitative data from patient usage metrics with qualitative feedback from users and healthcare professionals. Preliminary findings indicate that FLASHFIT significantly improves patient adherence to treatment plans and fosters a sense of autonomy in health management. Moreover, real-time monitoring capabilities facilitate timely interventions, enhancing overall patient outcomes. The study concludes that integrating interactive devices like FLASHFIT into healthcare practices empowers patients and streamlines communication between patients and providers, suggesting a transformative potential for future healthcare delivery models. Keywords: FLASHFIT interactive device, patient engagement and monitoring

Enhancing patient engagement through CRM systems: A pathway to improved healthcare delivery

This research paper explores the critical role of Customer Relationship Management (CRM). systems in enhancing patient engagement and improving overall healthcare delivery. With the increasing emphasis on patient-centered care, healthcare organizations are seeking innovative solutions to foster stronger relationships with patients, streamline interactions, and improve service quality. Drawing on insights gained from implementing CRM systems at eMedic Technologies Africa, the study analyzes how these platforms can significantly enhance communication, facilitate personalized care, and drive operational efficiency within healthcare settings. CRM systems serve as a powerful tool for managing patient interactions, enabling healthcare providers to gather and analyze data on patient preferences, behaviors, and needs. This data-driven approach allows organizations to tailor services and communications, leading to increased patient satisfaction and loyalty. By streamlining administrative processes, CRM systems reduce the burden on healthcare staff, allowing them to focus on delivering high-quality care. The paper proposes a comprehensive framework for integrating CRM tools into healthcare operations. This framework includes key components such as data management, communication strategies, and patient feedback mechanisms. By effectively leveraging CRM capabilities, healthcare organizations can improve appointment scheduling, enhance follow-up care, and provide timely reminders for preventive services. Furthermore, the study emphasizes the importance of fostering a culture of patient engagement, where healthcare providers actively seek feedback and involve patients in their care decisions.Ultimately, this research highlights the transformative potential of CRM systems in healthcare delivery. By prioritizing patient engagement through effective CRM implementation, healthcare organizations can not only improve patient outcomes but also achieve greater operational efficiency. The findings underscore the need for a strategic approach to adopting CRM technologies, ensuring that healthcare providers are well-equipped to meet the evolving demands of patients and navigate the complexities of modern healthcare. This paper serves as a valuable resource for healthcare leaders looking to enhance patient engagement and optimize service delivery through innovative CRM solutions. Keywords: CRM Systems, Patient Engagement, Healthcare Delivery, Operational Efficiency, Digital Healthcare Solutions

App-Timizing Cardiac Rehabilitation: Enhancing Patient Engagement with Mobile Health Applications

App-Timizing Cardiac Rehabilitation: Enhancing Patient Engagement with Mobile Health Applications

Leveraging machine learning to enhance appointment adherence at a novel post-discharge care transition clinic.

This study applies predictive analytics to identify patients at risk of missing appointments at a novel post-discharge clinic (PDC) in a large academic health system. Recognizing the critical role of appointment adherence in the success of new clinical ventures, this research aims to inform future targeted interventions to increase appointment adherence. We analyzed electronic health records (EHRs) capturing a wide array of demographic, socio-economic, and clinical variables from 2168 patients with scheduled appointments at the PDC from September 2022 to August 2023. Logistic regression, decision trees, and eXtreme Gradient Boosting (XGBoost) algorithms were employed to construct predictive models for appointment adherence. The XGBoost machine learning model outperformed logistic regression and decision trees with an area under the curve (AUC) of 72% vs 65% and 67%, respectively, in predicting missed appointments, despite limited availability of historical data. Key predictors included patient age, number of days between appointment scheduling and occurrence, insurance status, marital status, and mental health and cardiac disease conditions. Findings underscore the potential of machine learning predictive analytics to significantly enhance patient engagement and operational efficiency in emerging healthcare settings. Optimizing predictive models can help balance the early identification of patients at risk of non-adherence with the efficient allocation of resources. The study highlights the potential value of employing machine learning techniques to inform interventions aimed at improving appointment adherence in a post-discharge transition clinic environment.

Can Digital Health Improve Therapeutic Compliance in Oncology?

Therapeutic compliance, or adherence, is critical in oncology because of the complexity and duration of cancer treatment regimens. Nonadherence can lead to suboptimal therapeutic outcomes, increased disease progression, higher mortality rates, and elevated health care costs. Traditional methods to enhance compliance, such as patient education and regular follow-ups, have shown limited success. This review examines the potential of digital health technologies to improve adherence in oncology. Various studies and trials are analyzed to assess the effectiveness of these technologies in supporting patients with cancer. mHealth applications have been shown to improve medication adherence through features like medication reminders and symptom tracking. Telemedicine facilitates continuous care and reduces the need for travel, significantly improving adherence and patient satisfaction. Patient-reported outcome measures enhance clinical decision making and personalized treatment plans by incorporating patient feedback. Electronic medical records and patient portals improve compliance by providing easy access to medical information and fostering better patient-provider communication. Connected pillboxes aid in consistent medication intake and reduce dispensing errors. Digital health technologies offer significant benefits in oncology by enhancing patient engagement, improving adherence to treatment protocols, and enabling comprehensive cancer care management. However, challenges such as the digital divide, data privacy concerns, and the need for tailored interventions must be addressed. Future research should focus on evaluating the effectiveness of digital interventions and developing personalized digital health tools to maximize therapeutic compliance.

Patient Engagement in a Mobile App-Based Rehabilitation Program for Total Hip or Knee Arthroplasty: Secondary Data Analysis of a Randomized Controlled Trial.

Health care professionals use mobile apps to support patients' rehabilitation after total hip or knee arthroplasty. Understanding patient engagement in such mobile health interventions can help tailor these interventions to better support patients. This study aimed to investigate patient engagement in a mobile app-based arthroplasty rehabilitation program and to investigate the association between patient engagement and their characteristics. Data were extracted from a pool of 42 participants in the experimental arm of a randomized controlled trial that used a mobile app (WeChat [Tencent Holdings Limited])-based program to support patients' rehabilitation after total hip or knee arthroplasty. The primary outcomes were the number of days the participants accessed the program and completed recommended rehabilitation tasks. Secondary outcomes included data on the participants' posts on a discussion forum, messages sent by the participants, access to the program components, and reading and sharing the program content. Generalized linear models were used to analyze the association between patient engagement and personal characteristics. The participants reported in a rehabilitation diary accessing the program on a mean of 5.2 (SD 2) days per week and completing recommended rehabilitation tasks on a mean of 6.5 (SD 0.8) days per week. The majority (31/42, 74%) posted on the discussion forum, with a mean of 18.1 (SD 21.2) posts. Most participants (37/42, 88%) sent messages to health care professionals, with a mean of 14 (SD 15.9) messages. The program components were visited for a total of 525 times. The program content was read 898 times and shared 82 times in total. Generalized linear models showed that both primary outcomes, the number of days the participants accessed the program (B=6.46, 95% CI 1.98-15.35; χ21=11.1, P=.001) and the number of days they completed rehabilitation tasks (B=2.65, 95% CI 0.45-5.48; χ21=5.7, P=.02), were positively associated with having a high school education or above. In addition, the number of posts on the discussion forum was positively associated with living with family, having a high school education or above, undergoing total knee arthroplasty, having comorbidities, and the score of self-efficacy but was negatively associated with age. The number of messages sent by the participants was positively associated with having a high school education or above, having comorbidities, and the score of self-efficacy. Patient engagement in mobile arthroplasty rehabilitation is associated with their education level, cohabitation status, age, type of surgery, presence of comorbidities, and sense of self-efficacy. Program developers can consider these characteristics and use strategies, such as family involvement, in the design of mobile arthroplasty rehabilitation programs to enhance patient engagement in such interventions. Australian New Zealand Clinical Trials Registry ACTRN12621000867897; https://tinyurl.com/mtdw25fp.

A Structured Social Media Health Support Program after Bariatric Surgery.

Social media networks have been found to provide emotional, instrumental, and social support, which may contribute to improved adherence to postbariatric surgery care recommendations. This study aimed to evaluate the impact of an online social media-based, health care professional-led, educational and support program on patients' long-term engagement with and adherence to follow-up guidelines, self-care recommendations, and weight management after bariatric surgery. An observational cohort study, employing mixed methods, accompanied a 12-week interactive, structured, social media psychoeducational intervention program delivered on Facebook. Program participants, who had undergone one bariatric surgery within the past 1 to 7 years and were at least 18 years old at the time of surgery, were invited to join the program via posts online. Interested individuals were provided information about the program and the accompanying evaluation study, and those who met requirements completed study questionnaires before and after the program. Questionnaires included demographic and anthropometric information; postoperative recommendations received and their clarity and implementation; attitudes toward recommendation adherence; and well-being. Daily system data on program engagement were collected from the Facebook website. Of the 214 participants enrolled in the program, 101 (80.2% female, mean age 43.8 ± 9.1 years and mean body mass index 30.2 ± 6.8 kg/m2, 1-7 years after bariatric surgery) completed both baseline and end-of-program questionnaires and were included in the analysis. Following the program, improvements were observed in most aspects of participants' adherence to postoperative recommendations and well-being. Close to half of the participants (44.6%) reported reaching their postoperative target weight at the end of the program or maintaining it throughout the program. Video posts drew higher participant engagement than other media, and content about proteins received the highest number of reactions. However, participants' active engagement gradually declined over time. Interactive health support on social media can positively enhance patient engagement, adherence to treatment recommendations, health outcomes, and overall well-being.

Impact of NHI copayment adjustments on healthcare seeking behavior: the mediating role of health facility identification

ObjectiveThis study investigates the impact of healthcare consumers’ involvement, price perception, and attitude toward National Health Insurance (NHI) copayment adjustments on their healthcare-seeking behavior, focusing on the mediating role of health facility identification.MethodsA questionnaire survey was conducted among outpatient customers in Taiwan from October 2023 to March 2024, resulting in 746 valid responses. The survey included demographic variables, involvement, price perception, attitude, health facility identification, and healthcare-seeking behavior. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis with SPSS 20.0.ResultsThe study found that involvement, price perception, and attitude significantly influence healthcare-seeking behavior. Health facility identification was identified as a significant mediator in the relationship between copayment perception and healthcare-seeking behavior. The regression analysis also highlighted the impact of demographic factors such as age, education level, marital status, and annual income on healthcare-seeking behavior. The path model illustrated the complex interplay between perceptual factors and their influence on healthcare-seeking behavior.ConclusionThis study emphasizes the importance of consumer involvement, price perception, and attitude in shaping healthcare utilization patterns. Health facility identification plays a crucial mediating role, suggesting that stronger patient-provider relationships can mitigate potential negative impacts of copayment adjustments. Policymakers and healthcare providers should enhance patient engagement, foster strong patient-facility identification, and provide targeted support for vulnerable groups to ensure equitable access to healthcare services despite copayment changes.