Dataset Information

Capacity and willingness to use information technology for managing chronic diseases among patients: A cross-sectional study in Lahore, Pakistan.

ABSTRACT:

Background and objectives

The information technology is a pivotal source of communication between patients and healthcare providers for managing chronic diseases. The objective of this study is to assess the capacity and willingness of patients to use information technology for managing chronic diseases.

Methods

A descriptive, cross-sectional study design was employed. Study was conducted in six tertiary care hospitals of Lahore, Pakistan. The study population consisted of patients aged ?18 years and diagnosed with a minimum of one chronic non-communicable disease. A structured questionnaire was administered to the study participants for data collection. SPSS was used for data analysis.

Results

Among the 400 respondents, hypertension (39.5%) was the leading chronic condition followed by diabetes (27.5%). Majority of the patients owned a cell phone (90.7%) and had internet access (66.2%). Almost half of the respondents (51.0%) were willing to use text messages; whereas 78.5% and 75.7% of the respondents were reluctant to use video conference and e-mail as a source of communication with healthcare providers. Reason for unwillingness to use e-mail was the patients' desire to be directly examined by the doctor; whereas unfamiliarity with the use of text message and video conference was the major reason for not using these technologies. Logistic regression analysis revealed that interest in using e-mail to interact with specialist was more among those participants who had good self-reported health (OR = 2.579, 95%CI = 1.276-5.212, p = .008), access to internet (OR = 5.416, 95%CI = 2.777-10.564, p < .001), and those who owned a cell phone (OR = 12.944, 95%CI = 1.751-95.704, p = .012). Interest in using text messages to interact with specialist was more among participants with middle-income group (OR = 2.303, 95%CI = 1.389-3.818, p < .001), residency in close proximity to healthcare professional (OR = 3.529, 95%CI = 2.333-5.339, p < .001), access to internet (OR = 3.253, 95%CI = 2.102-5.033, p < .001) and among those who owned a cell phone (OR = 46.709, 95%CI = 6.335-344.377, p < .001). Interest in using video conference to interact with specialist was more among those participants who had access to internet (OR = 5.840, 95%CI = 2.825-12.069, p < .001) and among those who owned a cell phone (OR = 11.177, 95%CI = 1.510-82.725, p = .018).

Conclusion

This study concluded that nearly half of the respondents were willing to use text messages; whereas, majority was reluctant in using video conference and e-mail as a source of communication with healthcare providers. Most of the respondents who were located farther from the health care provider were willing to use video conferencing in case it could save more than 60 minutes of their time.

SUBMITTER: Iftikhar S

PROVIDER: S-EPMC6328230 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Capacity and willingness to use information technology for managing chronic diseases among patients: A cross-sectional study in Lahore, Pakistan.

Iftikhar Sadia S Saqib Anum A Sarwar Muhammad Rehan MR Sarfraz Muhammad M Arafat Mosab M Shoaib Qurat-Ul-Ain QU

PloS one 20190110 1

<h4>Background and objectives</h4>The information technology is a pivotal source of communication between patients and healthcare providers for managing chronic diseases. The objective of this study is to assess the capacity and willingness of patients to use information technology for managing chronic diseases.<h4>Methods</h4>A descriptive, cross-sectional study design was employed. Study was conducted in six tertiary care hospitals of Lahore, Pakistan. The study population consisted of patient ...[more]

PMID: 30629632

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Project description:BackgroundHealth care providers have shown considerable interest in using information technologies such as email, text messages and video conferencing to facilitate the management of chronic noncommunicable diseases such as hypertension, diabetes mellitus and vascular disease. We sought to determine whether these technologies are available and appealing to the target population.MethodsWe analyzed cross-sectional data from a computer-assisted telephone survey, conducted by Statistics Canada in February and March 2012, of western Canadian adults with at least 1 chronic condition. Survey respondents were asked about their capacity (e.g., "Do you own a mobile phone?") and willingness to use each of 3 information technologies (email, text messages and video conferencing) to interact with health care providers. For all analyses, Statistics Canada's calibrated design weights and bootstrap weights were used to obtain population-level point estimates for proportions and odds ratios.ResultsIn total, 1849 (79.8%) of 2316 eligible people participated. Of the 1849 participants, 81.9% had hypertension, 26.2% had diabetes, 21.4% had heart disease, and 7.9% had stroke; 32.2% had more than 1 of the 4 chronic conditions of interest. High proportions of respondents owned a computer with Internet access (76.4%, 95% confidence interval [CI] 73.3%-79.3%) or a mobile phone (73.9%, 95% CI 70.7%-76.8%). About two-thirds of respondents were interested in using email to interact with a specialist (66.3%, 95% CI 63.0%-69.5%); respondents were less enthusiastic about using text messages (44.9%, 95% CI 41.2%-48.7%). Enthusiasm for video conferencing was more pronounced among those residing further from medical specialists than among those living closer. Among respondents who were potentially interested in video conferencing, almost 50% of remote dwellers would use this technology if it saved more than 60 minutes of travel time.InterpretationMany people were interested in using electronic technologies, especially video conferencing and email-based methods, to help manage their chronic condition. The effectiveness and cost implications of using email and video conferencing in the management of chronic disease deserve further consideration.

Project description:Background and objectivesPractice-based research (PBR) is of pivotal importance for hospital pharmacists which not only up-grades the profession but also improves the patient care. This study aimed to evaluate the attitude, perception, willingness, motivation and barriers to PBR among hospital pharmacists in Pakistan.MethodsA descriptive, cross sectional study design was employed. Data were collected between 1st December, 2017 and 1st March, 2018 from 130 hospital pharmacists employed in 41 hospitals of Lahore, Pakistan. A survey instrument comprising of six sections was designed to determine the attitude, perception, willingness, motivation and barriers to PBR. Data were analyzed by using Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, version 21.0, Armonk, NY: IBM Corp.). The normality of the data was determined through Shapiro-Wilks and Kolmogorov-Smirnov tests. Independent Samples Mann-Whitney U Test and Independent Samples Kruskal-Wallis Test were carried out to test if there were differences among the characteristics of the hospital pharmacists. Logistic regression analysis was used to figure out the factors associated with attitude, perceptions, willingness and motivation towards PBR. A p-value <0.05 was used for statistical significance of differences.ResultsA total of 141 pharmacists were approached. Among them, 130 responded to the survey (response rate 92%). Out of a maximum score i.e., 5 (100%) the respondents obtained a median score of 4 (IQR = 0) for attitude, perception and motivation towards PBR; whereas, a median score of 4 (IQR = 1) was obtained for willingness thus demonstrating fair positive attitude, good perceptions, increased motivation and willingness towards PBR. The most common barrier limiting the pharmacists' participation in PBR was lack of time (23.8%) followed by lack of incentives (16.2%) and lack of support (14.6%). Results of the logistic regression analysis revealed that hospital pharmacists practicing in the inpatient settings had 4.56 times more positive attitude towards PBR (OR = 4.56, 95%CI = 1.07─19.42, p-value = 0.040) as compared to those practicing in the outpatient settings. The male hospital pharmacists (OR = 8.86, 95%CI = 1.15-53.74, p-value = 0.017), those practicing in the outpatient (OR = 23.51, 95%CI = 2.04─271.53, p-value = 0.011) and inpatient settings had increased motivation towards PBR (OR = 12.24, 95%CI = 1.61─94.66, p-value = 0.016).ConclusionDespite the presence of several barriers, the respondents had fair positive attitude, good perceptions, increased motivation and willingness towards PBR which is a promising finding.

Project description:BackgroundWell-timed initiation of HIV therapy enhances life expectancy, decreases mortality and morbidity, and inhibits the transmission of HIV and complications related to it. The purpose of the present survey is to investigate the frequency and reasons for delayed initiation of anti-retroviral therapy (ART) and to determine its relationship with various socio-demographic variables and HIV-related characteristics.MethodsThe analysis is based on a cross-sectional study involving 355 people living with HIV (diagnosed by PCR) who were more than 18 years of age and not receiving HIV therapy before enrolment at the HIV clinics of two selected tertiary-care teaching hospitals in Lahore, Pakistan. In this study, delayed initiation of ART was defined as not attending the HIV management centre or a clinic for ART within 3 months of a confirmed diagnosis. The participants were selected using a systematic probability sampling technique. Bivariate logistic regression was performed using a backward stepwise technique to establish the variables related to delayed onset of HIV therapy. Factors significant at p ≤ 0.20 were considered for multivariate analysis, which was used to describe the association between independent factors and delayed initiation of treatment.ResultsDelayed onset of ART was observed in 28.5% of individuals. Factors such as no schooling (AOR = 5.92; 95% CI: 1.38-25.41; p = 0.017) and occasional household income (AOR = 3.88; 95% CI: 1.01-14.89; p = 0.048) were significantly associated with late onset of ART. Our research findings also indicated that the main reasons for late beginning of HIV therapy were: feeling healthy (45.5%), did not have time to go to the HIV treatment centre (42.6%), did not want to discuss HIV test result (37.6%), and fear of stigma and discrimination within their community (35.6%).ConclusionsLate commencement of HIV therapy in Pakistan is common, and an improved connection is needed between identification of HIV and beginning of therapy. HIV management centres should counsel and monitor patients from the time of a positive HIV test result until they initiate therapy.

Project description:BackgroundThe internet has become the most widely used medium among teenagers, who spend much of their time online, which raises parental concerns. Notwithstanding teens' increased internet use and exposure to online risks, little is yet known about parental internet mediation in local settings. The present research aimed to assess the various dimensions of parental mediation to regulate teens' use of the internet and their predictors.MethodsA cross-sectional survey was conducted in the district of Lahore, Pakistan, among mothers/female caregivers of teens (aged 13-19 years). Only women were interviewed because they are more frequently engaged as primary caregivers than fathers or male caregivers. Furthermore, only qualified and working mothers from the top two professions among women, i.e. academia and medicine, were interviewed. A stratified random sampling technique was adopted, and 347 mothers were interviewed using face-to-face interviews at 11 universities and 11 hospitals/medical colleges. Data were entered and analysed using descriptive, bivariate and multivariate logistic regression analyses.ResultsThe findings highlighted that more than 65% of respondents applied highly active mediation of internet safety, around 60% used highly active co-use mediation and more than 56% applied restrictive mediation. In addition, 36% of respondents monitored and 15.3% technically mediated to regulate their teens' use of the internet. The results of the multivariate logistic regression revealed that the majority of respondents were more inclined to adopt active internet safety mediation if they had teens aged 16-19 years, with medium internet addiction, possessed good digital skills, felt confident about their teens' coping appraisal to perform online protection, and considered their teens to have high self-esteem and resilience.ConclusionsThis research found that parental internet mediation is a multifaceted concept used to regulate teens' online activity and enhance a resilient approach to reduce the risks associated with use of the internet. The researchers recommend developing parental guidelines, e-safety resource material, local support networks and community programmes to educate parents, teachers and teens in order to raise awareness and promote resilient pathways amongst teens.

Project description:OBJECTIVE:To check if mobile health (m-Health) short message service (SMS) can improve the knowledge and practice of the American Diabetic Association preventive care guidelines (ADA guidelines) recommendations among physicians. METHODOLOGY:Quasi-experimental pre-post study design with a control group. PARTICIPANTS:The participants of the study were 62 medical officers/medical postgraduate trainees from two hospitals in Lahore, Pakistan. Pretested questionnaire was used to collect baseline information about physicians' knowledge and adherence according to the ADA guidelines. All the respondents attended 1-day workshop about the guidelines. The intervention group received regular reminders by SMS about the ADA guidelines for the next 5 months. Postintervention knowledge and practice scores of 13 variables were checked again using the same questionnaire. Statistical analysis included χ2 and McNemar's tests for categorical variables and t-test for continuous variables. Pearson's correlation analysis was done to check correlation between knowledge and practice scores in the intervention group. P values of <0.05 were considered statistically significant. RESULTS:The total number of participating physicians was 62. Fifty-three (85.5%) respondents completed the study. Composite scores within the intervention group showed statistically significant improvement in knowledge (p<0.001) and practice (p<0.001) postintervention. The overall composite scores preintervention and postintervention also showed statistically significant difference of improvement in knowledge (p=0.002) and practice (p=0.001) between non-intervention and intervention groups. Adherence to individual 13 ADA preventive care guidelines level was noted to be suboptimal at baseline. Statistically significant improvement in the intervention group was seen in the following individual variables: review of symptoms of hypoglycaemia and hyperglycaemia, eye examination, neurological examination, lipid examination, referral to ophthalmologist, and counselling about non-smoking. CONCLUSION:m-Health technology can be a useful educational tool to help with improving knowledge and practice of diabetic guidelines. Future multicentre trials will help to scale this intervention for wider use in resource-limited countries.

Project description:Inadequate access to medicines affected by un-controlled prices is a major concern in developing countries, including Pakistan, which lacks comprehensive data on medicine prices. Thus, the objective of this study was to evaluate the prices, availability and affordability of essential medicines in Lahore division, Pakistan. The survey was undertaken from November, 2016 till March, 2017 by including 50 medicines, 14 from the WHO/HAI core list and 36 supplementary medicines from national essential medicine list (NEML) at public (n = 16) and private (n = 16) health facilities. The prices, availability and affordability of selected medicines were measured using a variant of the WHO/HAI standard methodology available on HAI website and WHO/HAI manual. A questionnaire was used for data collection from Lahore division. The prices were compared to International reference prices (IRPs) and the daily wage of a lowest paid unskilled government worker was used to calculate medicine affordability. Data suggested poor availability of originator brands (OB) in public and private sector facilities, i.e., 6.8% and 55.0%, respectively. Similarly, low availability was observed for lowest price generics (LPGs), both in public (35.3%) and private sector (20.3%) facilities-far below the WHO global action plan targets of 80% availability of essential medicines by 2025. In private sector, 53% OB and 38% LPG medicines were found excessively priced. The cost of standard treatment with OBs was unaffordable, i.e., above a single daily wage (1.4 day's wages) was demanded to purchase the standard treatment for the selected diseases in case of OBs medicines. Whereas, the cost of LPGs medicine required to purchase the standard treatment of the selected diseases was 0.6 day's wage (median), below a single daily wage. In conclusion, access to essential medicines, especially at public sector facilities was affected by low availability, particularly of OBs in comparison to LPGs. Thus, the better availability of LPGs might be a rational basis of transition into a generic system of prescribing that may improve the availability and accessibility of essential medicines in Lahore division. Medicine prices in Lahore division were found higher in comparison to IRPs. Thus, the efforts must be made to formulate patient's pocket friendly drug pricing policy that favors price cuts and improves affordability.

Project description:BackgroundThe clinical application of voice technology provides novel opportunities in the field of telehealth. However, patients' readiness for this solution has not been investigated among patients with cardiovascular diseases (CVD).ObjectiveThis paper aims to evaluate patients' anticipated experiences regarding telemedicine, including voice conversational agents combined with provider-driven support delivered by phone.MethodsA cross-sectional study enrolled patients with chronic CVD who were surveyed using a validated investigator-designed questionnaire combining 19 questions (eg, demographic data, medical history, preferences for using telehealth services). Prior to the survey, respondents were educated on the telemedicine services presented in the questionnaire while being assisted by a medical doctor. Responses were then collected and analyzed, and multivariate logistic regression was used to identify predictors of willingness to use voice technology.ResultsIn total, 249 patients (mean age 65.3, SD 13.8 years; 158 [63.5%] men) completed the questionnaire, which showed good repeatability in the validation procedure. Of the 249 total participants, 209 (83.9%) reported high readiness to receive services allowing for remote contact with a cardiologist (176/249, 70.7%) and telemonitoring of vital signs (168/249, 67.5%). The voice conversational agents combined with provider-driven support delivered by phone were shown to be highly anticipated by patients with CVD. The readiness to use telehealth was statistically higher in people with previous difficulties accessing health care (OR 2.920, 95% CI 1.377-6.192) and was most frequent in city residents and individuals reporting a higher education level. The age and sex of the respondents did not impact the intention to use voice technology (P=.20 and P=.50, respectively).ConclusionsPatients with cardiovascular diseases, including both younger and older individuals, declared high readiness for voice technology.

Dataset Information

Capacity and willingness to use information technology for managing chronic diseases among patients: A cross-sectional study in Lahore, Pakistan.

Background and objectives

Methods

Results

Conclusion

Publications

Capacity and willingness to use information technology for managing chronic diseases among patients: A cross-sectional study in Lahore, Pakistan.

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