Team Of Health Care Professionals Research Articles

Implications of Agile Values in Software Engineering for Agility in Breast Cancer Treatment: Protocol for a Comparative Study.

Breast cancer treatment has been described as a dynamic and patient-centered approach that emphasizes adaptability and flexibility throughout the treatment process. Breast cancer is complex, with varying subtypes and stages, making it important to tailor treatment plans to each patient's unique circumstances. Breast cancer treatment delivery relies on a multidisciplinary team of health care professionals who collaborate to provide personalized care and quick adaptation to changing conditions to optimize outcomes while minimizing side effects and maintaining the patient's quality of life. However, agility in breast cancer treatment has not been defined according to common agile values and described in language comprehensible to breast cancer professionals. In the rapidly evolving landscape of breast cancer treatment, the incorporation of agile values from software engineering promises to enhance patient care. Our objective is to propose agile values for breast cancer treatment adopted and adapted from software engineering. We also aim to validate how these values conform to the concept of agility in the breast cancer context through referencing past work. We applied a structured research methodology to identify and validate 4 agile values for breast cancer treatment. In the elicitation phase, through 2 interviews, we identified 4 agile values and described them in language that resonates with breast cancer treatment professionals. The values were then validated by a domain expert and discussed in the context of supporting work from the literature. Final validation entailed a domain expert conducting a walkthrough of the 4 identified agile values to adjust them as per the reported literature. Four agile values were identified for breast cancer treatment, and among them, we validated 3 that conformed to the concept of agility. The fourth value, documentation and the quality of documentation, is vital for breast cancer treatment planning and management. This does not conform to agility. However, its nonagility is vital for the agility of the other values. None of the identified agile values were validated as partially conforming to the concept of agility. This work makes a novel contribution to knowledge in identifying the first set of agile values in breast cancer treatment through multidisciplinary research. Three of these values were evaluated as conforming to the concept of agility, and although 1 value did not meet the concept of agility, it enhanced the agility of the other values. It is anticipated that these 4 agile values can drive oncology practice, strategies, policies, protocols, and procedures to enhance delivery of care. Moreover, the identified values contribute to identifying quality assurance and control practices to assess the concept of agility in oncology practice and breast cancer treatment and adjust corresponding actions. We conclude that breast cancer treatment agile values are not limited to 4. RR1-10.2196/53124.

Hospital discharge using salbutamol as required after acute attacks of wheeze in children: a service evaluation

ObjectiveMost UK hospitals discharge children after acute wheeze with advice to give regular salbutamol using a fixed dose weaning regime. We have introduced and evaluated the safety and efficacy of...

Enhancing Disaster Triage Competencies through Simulation-Based Training: An Interventional Study among Undergraduate Nursing Students

This pre–post interventional study explores the effectiveness of simulation-based training in enhancing disaster nursing skills among nursing students at Taif University, Saudi Arabia. The training, which uses a realistic train accident simulation and involves a response team of healthcare professionals, aims to improve knowledge and performance in crisis management and triage during mass casualty incidents. The study’s necessity stems from the critical role nurses play in disaster response, requiring a comprehensive understanding of challenges, collaboration among stakeholders, and improved capabilities. A random sample of 101 nursing students voluntarily participated in the study, with the necessary approvals obtained. We measured their emergency management skills and knowledge using a detailed questionnaire (27 items) and conducted pretest and posttest evaluations. Data analysis was performed using SPSS. The results indicate the training’s effectiveness, as a significant portion of participants achieved high performance levels in the posttest, contrasting with a higher percentage of fail-level grades in the pretest. These findings underscore the potential to improve disaster management protocols and nursing professionals’ preparedness in Saudi Arabia. The study emphasizes the importance of comprehensive education in disaster nursing in enhancing emergency response and patient outcomes.

Digital Patient Reported Outcome Measures Platform for Post-COVID-19 Condition and Other Long-Term Conditions: User-Centered Development and Technical Description.

Post-COVID-19 condition (PCC), colloquially known as long COVID, is a multisystem condition characterized by persistent symptoms beyond 4 weeks after the SARS-CoV-2 infection. More than 60 million people with PCC worldwide need prompt assessment, diagnosis, and monitoring, with many requiring specialist help from a multidisciplinary team of health care professionals (HCPs). Consequently, a scalable digital system is required for both people with PCC and HCPs to capture the breadth of symptoms and their impact on health, using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). We aim to develop and implement a novel PCC digital PROM (DPROM) platform for (1) securely collecting PROM and PREM data from people with PCC, (2) enabling users to monitor symptoms longitudinally and assess response to treatment, (3) generating reports for the electronic health records (EHRs), (4) providing summary reports on PCC services based on national requirements, and (5) facilitating the sharing of relevant data with authorized research teams to accelerate our understanding of this new condition and evaluate new strategies to manage PCC. We (1) undertook requirement analysis with people with PCC, HCPs, and researchers to identify the needs of the DPROM platform and determine its required functionalities; (2) designed and developed a clinically useful web portal for staff and a mobile app for patients, with a web-based alternative app to improve patient and staff choice, limit the risk of digital exclusion, and account for variability across services; (3) determined the PROMs and PREMs that PCC services would prefer to use on the platform; and (4) designed the summary report function that can be generated for each user for the EHR and for reporting to national health authorities. A DPROM platform to record PCC symptom profile, condition severity, functional disability, and quality of life, based on the C19-YRS (Yorkshire Rehabilitation Scale) and other PROMs and PREMs, was developed. Individual-level medical information and details on the COVID-19 illness can be captured systematically. The platform generates easy-to-understand scores, radar plots and line graphs for people with PCC to self-monitor their condition and for HCPs to assess the natural course of the condition and the response to interventions. Clinics can configure a suite of PROMs and PREMs based on their local and national service and commissioning requirements and support research studies which require large-scale data collection on PROMs. The DPROM platform enables automatic aggregate data analysis for services to undertake service evaluation and cost-effectiveness analysis. The DPROM platform generated summary report can be uploaded to the EHRs of people with PCC. A multifunctional DPROM platform to assess, grade, and monitor PCC has been developed. Future research will analyze the system's usability in specialist PCC clinical services and other long-term conditions.

The effect of body mass index on self-rated health in middle-aged and older adults: evidence from the China health and retirement longitudinal study.

Health promotion for middle-aged and older people has received a lot of attention recently in the context of healthy aging. Furthermore, it is unclear how body mass index (BMI) presently affects self-rated health (SRH), a reliable and representative indicator of health. This study used longitudinal follow-up data from the China Health and Retirement Longitudinal Study (CHARLS). Systematic collection of information on the socio-demographic, lifestyle, and health status of the subjects. Binary logistic regression was used to investigate the relationship between BMI and SRH, and gender-specific variations were examined. Subgroup analysis was used to examine interactions, and the results of the research stability were demonstrated. After adjusting for age, gender, education level, marital status, place of residence, number of chronic diseases, alcohol consumption, smoking, depressive symptoms, and SRH at baseline, it was found that obesity grade 1 and obesity grade 2 were good contributors to SRH compared to normal weight individuals, and this association was different in males and females. According to the results of the subgroup analyses, those under 65years old, with junior high school or less education, with a spouse, residing in a city, having one chronic disease, and not smoking or drinking, respectively, all had stable positive associations between obesity and SRH. Our findings suggest that obesity may be associated with good SRH. Teams of healthcare professionals should revisit the potential impact of obesity among middle-aged and older adults and focus on developing prevention strategies for morbid obesity.

Creating and sustaining a digital community of practice for quality improvement in South-East Asia during the COVID-19 pandemic

IntroductionEnsuring quality of care in Low and Middle Income countries (LMICs) is challenging. Despite the implementation of various quality improvement (QI) initiatives in public and private sectors, the sustenance of...

Management of chemotherapy hypersensitivity reactions and desensitization: An SGO clinical practice statement

ObjectiveThe goal of this practice statement is to help members and their multidisciplinary teams recognize infusion reactions and hypersensitivity reactions in the clinical setting. It will provide recommendations to help guide response to reactions and desensitization when appropriate, to promote safe use of chemotherapeutic agents among all providers in the delivery process. MethodsA multi-disciplinary team of healthcare professionals from the Society of Gynecologic Oncology Education Committee collaborated to review peer reviewed literature and guidelines to develop a practice statement on the management of chemotherapy hypersensitivity reactions and desensitization regimens. ResultsThere is always potential for a patient to have a reaction to any medication, with both infusion reactions and hypersensitivity reactions potentially occurring in the treatment of gynecologic cancers. Premedication to prevent reactions should be given at least prior to infusion for regimens that include the most common agents associated with reactions. At the time when reaction is occurring it might be difficult to distinguish between an infusion reaction versus true hypersensitivity given the similarities in signs and symptoms, therefore it is important that orders to manage reactions be included in every chemotherapy order set so the infusion nurse can provide immediate interventions while waiting for the provider to arrive to assess the patient. Desensitization is a potential option to allow the patient to continue to receive the offending agent. While a variety of desensitization regimens have been presented in the literature, the goal is to minimize steps and variability to decrease opportunity for errors during chemotherapy preparation or administration. ConclusionIncorporating a review of the literature and clinical experience from the SGO Education Committee, this paper provides an overview of current approaches for prevention and management of reactions to commonly used chemotherapy agents for gynecologic cancers.

Facilitators and barriers to optimal home blood pressure management in patients with hypertensive disorders of pregnancy in a tertiary care facility in Abuja, Nigeria: a qualitative research study

BackgroundNigeria has one of the highest burdens of maternal deaths globally, and hypertensive disorders of pregnancy (HDP) are the leading cause of maternal morbidity and mortality in the country. There is a significant implementation gap in utilizing evidence-based practices for the management of HDP in Nigeria. This study evaluated facilitators and barriers to implementing a home blood pressure monitoring program to improve management of HDP.MethodsFrom August 2022 to September 2022, we conducted 15 semi-structured, key informant interviews and 4 focus group discussions among patients, health care workers, and administrators at University of Abuja Teaching Hospital (UATH), a tertiary care centre in Nigeria. The study used the Consolidated Framework for Implementation Research to assess five domains: individual characteristics, inner and outer settings, intervention characteristics, and process of implementation. Audio files were transcribed, and data were analysed using a combination of inductive and deductive approaches. We also conducted 32 brief surveys on the participants to assess acceptability, appropriateness, and feasibility of a blood pressure monitoring program.ResultsThe study sample consisted of healthcare workers (n=22) including specialists in cardiology, obstetrics and gynaecology, maternal-foetal medicine, nurses/midwives and resident doctors as well as patients (n=10). Mean (SD) age was 39.5 (10.9), and 78% were female. Participants identified facilitators including the perceived simplicity of home blood pressure monitoring program, high burden of HDP, and availability of a multi-disciplinary team of healthcare professionals with expertise in HDP management. Barriers identified were cost, limited knowledge of HDP amongst patients, limited transportation networks, inconsistent management protocols, and inadequate manpower and facilities. Survey results indicated that between 81% and 88% of participants reported that a blood pressure monitoring program would be acceptable, 56%-72% reported that it would be appropriate, and 47%-69% reported that it would be feasible.ConclusionThis study identified facilitators and barriers while highlighting key implementation strategies to leverage and effectively address these respectively to enable successful implementation of a home blood pressure monitoring program. It also demonstrated that a home blood pressure monitoring program was considered acceptable, appropriate and feasible among respondents interviewed at UATH.

The Expectations and Acceptability of a Smart Nursing Home Model Among Chinese Older Adults and Family Members: A Qualitative Study

This study aims to explore the expectations and acceptability of a smart nursing home model among Chinese older adults and their family members based on a scoping review that defines the concept of smart nursing homes. A qualitative case study was employed for this research. Semi-structured in-depth interviews and focus group discussions were conducted on WeChat. Participants were purposively sampled through snowball sampling in Hainan and Dalian, China. A total of 28 older adults aged 60-75 and six adult children were interviewed until data saturation was achieved, followed by a thematic analysis. The expectations of smart nursing homes include 1) quality of care supported by governments and societies; 2) smart technology applications; 3) the presence of a skilled healthcare professional team; 4) access and scope of basic medical services; and 5) integration of medical services. The acceptability of smart nursing homes included factors such as stakeholders' perceived efficaciousness, usability, and collateral damages of using smart technologies, and the coping process of adoption was influenced by factors such as age, economic status, health status, education, and openness to smart technologies among older adults. Chinese older adults and their family members hold a positive perception of the smart nursing home model. The qualitative evidence regarding their expectations and acceptability of smart nursing homes contributes valuable insights for a wide range of stakeholders involved in the planning and implementation of smart nursing homes.

Interprofessional Education in Diabetes Care—Findings from an Integrated Review

Diabetes is a leading non-communicable disease with a huge and predictably increasing burden on individuals, societies and governments. Interprofessional education (IPE) aims to enhance healthcare providers’ competence and patient care by providing well-organised, coordinated interprofessional care (IPC) within teams of healthcare professionals of different disciplines. Interprofessional practices are crucial in diabetes care. However, evidence on the effect of diabetes-specific IPE on diabetes outcomes is limited. This study aims to survey and report recent findings on the impact of interprofessional approaches on the outcomes of diabetes management. A systematic search of PubMed and Google Scholar from 2008 was adopted to identify relevant studies. After screening for relevance, the studies used in this review were thematically analysed, and two main categories of the findings were isolated: the impact of IPE and IPC on enhanced care provision and on improved diabetes self-management. The results indicate that healthcare professionals and students and people with diabetes benefit from IPE/IPC to improve diabetes outcomes and quality of care. However, improving diabetes care is achieved when inhibitors are addressed to incorporate IPE in health professions curricula and to support IPC in clinical settings.

An Investigative Analysis of the Role of Multidisciplinary Teams in Cancer Management: Assessing Advantages and Obstacles

Background: Multidisciplinary team (MDT) meetings are vital for improving patient outcomes and treatment plans, yet their effectiveness remains uncertain. Existing research demonstrates that collaborative treatment plans in cancer care lead to better results than those made by individual practitioners. The impact of MDT meetings on patients' management outcomes is significant. Aim: To evaluate the distribution, characteristics, and diagnoses of cancer patients. Additionally, it seeks to assess the influence of MDT meetings on clinical decision-making and the subsequent impact on patient outcomes. Subjects and methods: A descriptive investigation analyzed a cohort of 150 cancer patients receiving care at Benghazi Medical Center from January to June 2022. Diagnoses were established through comprehensive clinical evaluations, laboratory assessments, radiographic imaging, and histopathological examinations. Medical interventions were determined collaboratively by a multidisciplinary team of healthcare professionals, leveraging their specialized expertise for optimal patient management. Results: The study found that individuals aged 41–60 comprised the largest proportion of cancer patients (49.3%). Females accounted for the majority (62%) of cases, and most participants were from Benghazi (69.3%). Gastrointestinal tract (GIT) cancers were the most prevalent (58.7%), followed by breast tumors in women (14.7%) and pancreatic tumors (6%). Treatment decisions, tailored to individual patient needs, were made collaboratively by the multidisciplinary team. Chemotherapy, radiotherapy, or a combination was chosen for 47.3% of cases, while surgical resection was appropriate for 30.7% of cases. The study's findings support the hypothesis that MDT meetings contribute to effective and up-to-date management guidelines. Neglecting discussions about cancer patients poses significant risks that can no longer be ignored. MDT meetings mitigate these risks and ensure comprehensive medical decisions. Conclusion: The study observed that chemotherapy and surgical resection were frequently selected as treatment options. It emphasized the importance of Multidisciplinary Team (MDT) meetings in guiding clinical decision-making. However, further feedback regarding the optimal format of MDT meetings is required. Establishing standardized MDT protocols is imperative for enhancing patient management outcomes.

Parents' understanding and experiences of blood component transfusion in the neonatal intensive care unit: A qualitative study.

Blood component transfusion is a common intervention in the neonatal intensive care unit (NICU). Parents consent on their babies' behalf. This study aimed to explore parents' understandings and experiences of consenting and the subsequent blood transfusion. A "low inference" qualitative descriptive semi-structured interview approach was utilised. Grounded theory was employed. Parents described their memories of babies' transfusions, their responses to the consent process and assessed the written information they were given. A purposive sample of 17 parents whose babies required blood transfusion in the NICU participated. Parents talked about their initial fears of transfusion, later replaced by confidence in the process and results of transfusion and trust in the healthcare professional team. The main themes elicited by the interviews were parents' expectations and outcomes of transfusion, parents' prior and current opinions of transfusion, parents trust in healthcare professionals and how parents would like to receive information about transfusions in the NICU. Parents in our study trust information from the healthcare professionals caring for their baby and would like more specific information about how blood transfusion will impact their baby, in a variety of means. Parents felt that blood transfusions were beneficial for their babies.

Nurse Practitioners in Community Health Care: A Rapid Scoping Review of Their Role, Tasks, Responsibilities, and Implementation in Northwest Europe

The objective of this rapid scoping review is to provide an overview of studies from northwest Europe that describe and evaluate community care delivered by a nurse practitioner (NP) in a team of healthcare professionals. In particular, we explore the roles of NPs within community care, the perceived impact at the patient and informal caregivers levels, and influencing factors (facilitating and impeding). This rapid scoping review was performed in accordance with Prisma RR guidelines. Data were collected from online databases between October and December 2020 and an update in March 2023. Medline was used for the search string, and the following databases were searched: Cinahl, Cochrane, Embase, Medline, and Web of Science (WoS). All studies described the roles of NPs, including their tasks and responsibilities in community care. The main findings about the roles were that NPs in community care diagnose, treat patients, and support and advise informal caregivers. They refer and perform case management for (frail) older people. They train DNs and take on project and strategic management roles. The results showed that the NP meets the increasing and complex care demands in patients’ homes. The main findings about the perceived impacts were that patients and informal caregivers were generally satisfied with the deployment of the NP. Healthcare professionals experienced the benefits of NPs working in community care. Some healthcare professionals were sceptical when the role was first introduced, but attitudes improved after they worked alongside NPs. Other influencing factors were the competences of the NP, i.e., have a pioneering mentality, a clear vision, and a job profile from community care organisations, and having to collaborate with allied healthcare professionals. However, implementation of the NP in community care is still in its infancy in northwest Europe. This review will help policy makers and professionals understand the potential impact of this role and enhance it in the context of community care.

Six years of the Angels Initiative: Aims, achievements, and future directions to improve stroke care worldwide.

The rate of stroke-related death and disability is four times higher in low- and middle-income countries (LMICs) than in high-income countries (HICs), yet stroke units exist in only 18% of LMICs, compared with 91% of HICs. In order to ensure universal and equitable access to timely, guideline-recommended stroke care, multidisciplinary stroke-ready hospitals with coordinated teams of healthcare professionals and appropriate facilities are essential.Established in 2016, the Angels Initiative is an international, not-for-profit, public-private partnership. It is run in collaboration with the World Stroke Organization, European Stroke Organisation, and regional and national stroke societies in over 50 countries. The Angels Initiative aims to increase the global number of stroke-ready hospitals and to optimize the quality of existing stroke units. It does this through the work of dedicated consultants, who help to standardize care procedures and build coordinated, informed communities of stroke professionals. Angels consultants also establish quality monitoring frameworks using online audit platforms such as the Registry of Stroke Care Quality (RES-Q), which forms the basis of the Angels award system (gold/platinum/diamond) for all stroke-ready hospitals across the world.The Angels Initiative has supported over 1700 hospitals (>1000 in LMICs) that did not previously treat stroke patients to become "stroke ready." Since its inception in 2016, the Angels Initiative has impacted the health outcomes of an estimated 7.46 million stroke patients globally (including an estimated 4.68 million patients in LMICs). The Angels Initiative has increased the number of stroke-ready hospitals in many countries (e.g. in South Africa: 5 stroke-ready hospitals in 2015 vs 185 in 2021), reduced "door to treatment time" (e.g. in Egypt: 50% reduction vs baseline), and increased quality monitoring substantially.The focus of the work of the Angels Initiative has now expanded from the hyperacute phase of stroke treatment to the pre-hospital setting, as well as to the early post-acute setting. A continued and coordinated global effort is needed to achieve the target of the Angels Initiative of >10,000 stroke-ready hospitals by 2030, and >7500 of these in LMICs.

Pulmonary Rehabilitation

Reduced exercise capacity, skeletal muscle dysfunction, and a physically inactive lifestyle are linked with symptoms of fatigue and dyspnea in people suffering from chronic lung disease. Numerous such extrapulmonary manifestations have been identified as treatable aspects of pulmonary rehabilitation (PR). PR is an extensive personalized non-pharmaceutical intervention, encompassing, but not limited to, exercise training, respiratory therapy, and education. The content and goals of a PR-program are based on a comprehensive patient assessment at the time of rehabilitation admission, with personalized therapies provided by a multidisciplinary team of healthcare professionals. This article provides an overview of PR including possible indications, therapy contents (e. g. exercise training, respiratory therapy), and evidence (COPD, interstitial lung disease, COVID-19). Finally, options for pulmonary rehabilitation maintenance services in Germany are presented.

Practice Barriers for Nurse Practitioners in Rural Hospitals

Nurse practitioners (NPs) are regarded as part of the primary healthcare professional team in rural hospitals, which often faced difficulties in hiring doctors. Only a few studies have been conducted that assess the barriers to practice for NPs in rural hospitals in Taiwan. This study was designed to explore the barriers of practice for NPs working in rural hospitals. A qualitative research approach was used in this study, and participants were recruited using purposive sampling. Data on barriers to clinical practice were collected using face-to-face, in-depth interviews. A total of 10 NPs participated in this study. The three barriers identified were patient safety concerns, the impact of limited medical resources and the demands and heavy workload on NPs, and the difficulties of balancing the interests of profit-oriented hospitals and patients' personal medical insurance rights. To reduce barriers to practice, NPs require additional training from the government to strengthen their clinical knowledge and skills. In addition, when facing insufficient support from the Department of Health, these NPs may leverage online hospital marketing and crowdfunding platforms to obtain necessary software/hardware resources for their rural hospitals. If universal health insurance and personal medical insurance are misused within a hospital, NPs should have the moral courage to speak up and should be provided with adequate protection under rules and regulations that allow them to report cheating, illegal behaviors, and other activities that waste / misdirect healthcare resources.

STRATEGIES FOR IMPROVING OPERATIONAL EFFECTIVENESS IN THE CLINICAL LABORATORYAT KING FAHD ARMED FORCES HOSPITAL (KFAFH)

Background:Laboratory turnaround time is considered one of the most important indicators of work efficiency in hospitals. Physicians always need timely results to make effective clinical decisions, especially in the emergency department. These results can guide physicians to admit patients to the hospital, discharge them home, or do further investigations. Objectives:To reduce troponin turnaround time (TAT) to less than 60min using coordinated process improvement methods Methods: A retrospective study in the ED Laboratory at King Fahd Armed Forces Hospital (KFAFH). A team of lab specialists conducted a Root cause analysis with the Fishbone diagram and applied Focus PDCA to the process. The time taken from receiving the test to the release of results in minutes was considered the Turnaround time (TAT) for the Trop I test. Results:The average TAT time was brought down from 101 minutes to consistently less than 35 minutes by September 2019. Conclusion:With an interdisciplinary team of healthcare professionals, the Turnaround time for troponin Iwas successfully reduced in our Emergency Department by 70% in 2019.

Using co-design to develop INTERCEPT, a mobile health (mHealth) App, for the secondary prevention of cardiovascular disease

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Health Research Board, Ireland SOLVE CHD SYNERGY Grant, University of Sydney, Australia Background Co-design adopts a participatory, person-centred approach to the development of health interventions, which aims to maximise their acceptance and effectiveness. However, despite this many mobile applications are designed with little input from target end users, resulting in poor uptake and usage. Purpose The aim of our study was to optimize the evolution of the INTERCEPT (I-App) mHealth app by integrating target users’ (patients and healthcare professionals) perspectives into its design and development. Methods A core project team of health care professionals (nurse specialists, physicians, physiotherapists, dietitians, psychologists and a pharmacist), software developers and patients was established. A four phase iterative anrticipatory approach to the design process for I-App was adopted using online workshops conducted over a 12-month period. Phase one involved identification of the guiding principles, content and design features. In phase two, a working prototype of the I-App was developed and in phase three a beta version of this prototype was pilot tested among the project team and reviewed for clarity of language, ease of navigation and functionality. Phase four involved user acceptance testing of the I-App with patients who had a recent cardiac event (<2 years). Improvements in the usability of the app were assessed using the System Usability Scale (SUS), which was administered pre and post user acceptance testing. Results From target user insights and scientific literature five key design principles were identified: simplicity and ease of use; behavioural change through goal setting; self-monitoring and use of rewards; provision of credible information and data privacy. Medication adherence, psychosocial support and tracking physiologic parameters like blood pressure were considered important components. Usability testing of I-App resulted in 64 recommendations for the app and of these 51 were implemented. Significant improvements in SUS scores were observed from 61 to 82 (p<0.001) demonstrating the effectiveness of adopting a co-design apporach. Conclusion Using co-design methodology resulted in the INTERCEPT mHealth app responding to the end users’ needs and preferences including desired content and features. The next step in the development process is to trial the feasibility and usage of the I-App in the real-world clinical setting.

Increasing patient advocacy: The development of patient guidelines for cardio-oncology

Abstract Funding Acknowledgements Type of funding sources: None. Background As people live longer, many are living with two conditions- cardiovascular disease and cancer. With advancements in treatment in cancer including surgery and immunotherapy and, a relatively new specialty- cardio-oncology- has evolved. As patients can either have a pre-existing cardiovascular condition or present with a cardiac complication such as Acute Coronary Syndrome or Atrial Fibrillation during cancer treatment, there is a need for cardiovascular assessment prior to, during and after cancer treatment. The first cardio-oncology guidelines were released in 2022 for use in clinical practice that is aimed at clinicians. Despite increased involvement of patients in the research process, the evidenced-based results are not always written in ‘patient’ friendly language. Often lay summaries and thus the practical aspects of the condition or treatment are not available to patients and their families. Purpose Given the need to be more inclusive and make research findings and guidelines more patient friendly, the aim was to develop patient guidelines for Methods The ESC clinical practice guidelines on cardio-oncology for patients were written by a multidisciplinary team of healthcare professionals, including doctors, nurses, scientists and patients, and are intended mainly for use in clinics and hospitals with the aim of ensuring the language was inclusive and non-technical. Results Guidelines are useful in making diagnoses and deciding on treatment using the most up-to-date medical and scientific evidence to ensure that patients receive the most appropriate care. The guidelines outline recommendations on (i) Being treated by a multidisciplinary cardio-oncology team, (ii) Looking after your heart health, during and after cancer treatment, (iii) Paying particular attention to your heart health if you have previously had a heart attack, a stroke, an arrhythmia (irregular heartbeat) or you have high blood pressure, diabetes or high cholesterol and (iv) Making appropriate healthy lifestyle choices. A final version was published in late 2022 and the plan is to translate thee guidelines into several languages so they can be widely used and disseminated. Conclusion These guidelines demonstrate how clinicians and patients can work collaboratively to develop patient-friendly guidelines that can be used in practice and potentially optimise the shared-decision making process between patients and their healthcare team.

De American Diabetes Association/European Association for the Study of Diabetes-consensus van 2022 en de implicaties voor België

The ADA/EASD consensus 2022 and its implications for Belgium During the European Association for the Study of Diabetes (EASD) congress in Stockholm, the new consensus guideline for the treatment of hyperglycemia in type 2 diabetes was presented. The American Diabetes Association (ADA) and the EASD plead for a holistic, patient-centered approach surrounded by a team of healthcare professionals. The consensus focuses on a patient-tailored pharmacological and non-pharmacological approach taking into account patient-specific comorbidities. Striving for sustainable weight reduction should be the cornerstone of any therapeutic intervention in type 2 diabetes. The early initiation of combination therapy is recommended to avoid therapeutic inertia and to increase the time to therapeutic failure. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA) remain the first choice for patients with established cardiorenal disease or high-risk patients, possibly in combination with metformin. In the absence of cardiovascular or renal disease, the medication selection should be driven by weight control, obtaining glycemic control and the avoidance of hypoglycemia. Here again, SGLT2i and GLP1-RA shine because of their good safety profile and highly favorable effects on weight, glucose and blood pressure. Thanks to the b(l)ooming development of new antidiabetic medication for type 2 diabetes, adding insulin to the treatment plan can often be postponed to later stages of the disease. When insulin is required, the combined initiation with a GLP1-RA should be considered as they allow lower glycemic targets to be reached with a lower injection burden, a lower risk of hypoglycemia and lower weight gain than with insulin alone.