Use of a Smartphone App to Explore Potential Underuse of Prophylactic Aspirin for Preeclampsia
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ABSTRACT:
SUBMITTER: Krishnamurti T
PROVIDER: S-EPMC8556626 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
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Project description:ImportanceIt is unclear whether a higher dose (150-160 mg) or a lower dose (75 mg) of aspirin should be used to prevent preeclampsia.ObjectivesTo compare the risk of preeclampsia and bleeding complications between women using 150 to 160 mg of aspirin and those using 75 mg of aspirin for preeclampsia prevention.Design, setting, and participantsThis nationwide cohort study included 13 828 women giving birth at 22 weeks' gestation or later in Sweden between January 2017 and December 2020 who used low dose aspirin (75-160 mg) during pregnancy. Data were analyzed from October to November 2023.ExposureThe use of 150 to 160 mg or 75 mg of aspirin in pregnancy.Main outcome and measuresThe main outcome was a preeclampsia diagnosis recorded in the maternal birth record at the time of hospital discharge. The main safety outcome was postpartum hemorrhage, defined as bleeding more than 1000 mL after delivery. Relative risks (RRs) and 95% CIs were estimated using a doubly robust inverse probability-weighted regression adjustment model controlling for background characteristics.ResultsIn the total cohort of 13 828 women, the mean (SD) age was 33.0 (5.5) years and 3003 women (21.7%) were nulliparous. Of the women, 4687 (33.9%) were prescribed 150 to 160 mg of aspirin, and 9141 (66.1%) were prescribed 75 mg of aspirin. A total of 10 635 women (76.9%) had at least 2 dispensed prescriptions of low-dose aspirin. Among women using 150 to 160 mg of aspirin, 443 (9.5%) developed preeclampsia compared with 812 (8.9%) of those using 75 mg of aspirin (adjusted RR [aRR], 1.07; 95% CI, 0.93-1.24). Additionally, the risk of postpartum hemorrhage between the groups was similar, with 326 women (6.9%) using 150 to 160 mg of aspirin experiencing a postpartum hemorrhage compared with 581 (6.4%) in the 75-mg group (aRR, 1.08; 95% CI, 0.90-1.30).Conclusions and relevanceIn this cohort study of 13 828 women, no difference was found in preeclampsia incidence or bleeding complications between those using 150 to 160 mg of aspirin vs 75 mg of aspirin during pregnancy for preeclampsia prevention. These findings suggest that either dose may be a reasonable choice when using aspirin to prevent preeclampsia. However, large randomized trials investigating aspirin dose in pregnancy are still needed.
| S-EPMC11791696 | biostudies-literature
Project description:Research suggests various associations of smartphone use with a range of physical, psychological, and performance dimensions. Here, we test one sec, a self-nudging app that is installed by the user in order to reduce the mindless use of selected target apps on the smartphone. When users attempt to open a target app of their choice, one sec interferes with a pop-up, which combines a deliberation message, friction by a short waiting time, and the option to dismiss opening the target app. In a field-experiment, we collected behavioral user data from 280 participants over 6 wk, and conducted two surveys before and after the intervention span. one sec reduced the usage of target apps in two ways. First, on average 36% of the times participants attempted opening a target app, they closed that app again after one sec interfered. Second, over the course of 6 wk, users attempted to open target apps 37% less than in the first week. In sum, one sec decreased users' actual opening of target apps by 57% after six consecutive weeks. Afterward, participants also reported spending less time with their apps and indicated increased satisfaction with their consumption. To disentangle one sec's effects, we tested its three psychological features in a preregistered online experiment (N = 500) that measured the consumption of real and viral social media video clips. We found that providing the additional option to dismiss the consumption attempt had the strongest effect. While the friction by time delay also reduced consumption instances, the deliberation message was not effective.
| S-EPMC9974409 | biostudies-literature
Project description:ImportanceOpioid use disorder continues to be a national crisis, contributing to substantial morbidity and mortality. Medication is the only evidence-based treatment for opioid use disorder; however, improving clinical outcomes may require augmenting it with psychosocial interventions, such as contingency management (CM), specifically, smartphone app-based CM.ObjectiveTo evaluate whether augmenting medication for opioid use disorder (MOUD) with app-based CM is associated with fewer days of opioid use at the end of treatment and greater retention than treatment with MOUD only.Design, setting, and participantsThis retrospective cohort study used data from November 1, 2020, to November 30, 2023, collected from opioid treatment programs and office-based opioid treatment programs across Texas. The cohort included individuals aged 18 years or older who were uninsured or underinsured and who chose to receive MOUD only or MOUD plus CM delivered via the WEconnect smartphone app. Participants who chose to receive app-based CM received monetary incentives upon achieving their self-chosen recovery goals.ExposureOpioid use disorder.Main outcomes and measuresPrimary analyses examined differences in treatment outcomes (self-reported days of opioid use at the end of treatment and retention) between patients who chose MOUD only and those who chose MOUD plus app-based CM. Linear regression analysis was used to examine days of opioid use at the end of treatment, and Cox proportional hazards regression analysis was used to examine retention.ResultsThe analytic sample comprised 600 individuals (mean [SD] age, 38.4 [8.6] years; 342 male [57.0%]), with 300 included in each treatment group. Those who chose to receive MOUD plus app-based CM reported significantly fewer days of opioid use at the end of treatment compared with those who chose to receive MOUD only (mean [SD] duration, 8.4 [12.9] vs 12.0 [13.5] days; β = -6.10; 95% CI, -8.09 to -4.10). Retention analysis showed that patients who chose to receive MOUD plus app-based CM were significantly more likely to stay in treatment longer compared with those who chose to receive MOUD only (mean [SD] duration, 290.2 [109.4] vs 236.1 [128.1] days; β = 51.91; 95% CI, 33.86 to 69.95).Conclusions and relevanceThese findings suggest that augmenting MOUD with app-based CM may provide clinical benefits for underserved patients. Expanding the availability of app-based CM may contribute to decreasing the societal, economic, and personal burden of opioid use.
| S-EPMC11612830 | biostudies-literature
Project description:BackgroundAccumulating evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. We reviewed current data and assessed the benefits and harms of prophylactic use of aspirin in the general population.MethodsThe effect of aspirin for site-specific cancer incidence and mortality, cardiovascular events was collated from the most recent systematic reviews. Studies identified through systematic Medline search provided data regarding harmful effects of aspirin and baseline rates of harms like gastrointestinal bleeding and peptic ulcer.ResultsThe effects of aspirin on cancer are not apparent until at least 3 years after the start of use, and some benefits are sustained for several years after cessation in long-term users. No differences between low and standard doses of aspirin are observed, but there were no direct comparisons. Higher doses do not appear to confer additional benefit but increase toxicities. Excess bleeding is the most important harm associated with aspirin use, and its risk and fatality rate increases with age. For average-risk individuals aged 50-65 years taking aspirin for 10 years, there would be a relative reduction of between 7% (women) and 9% (men) in the number of cancer, myocardial infarction or stroke events over a 15-year period and an overall 4% relative reduction in all deaths over a 20-year period.ConclusionsProphylactic aspirin use for a minimum of 5 years at doses between 75 and 325 mg/day appears to have favourable benefit-harm profile; longer use is likely to have greater benefits. Further research is needed to determine the optimum dose and duration of use, to identify individuals at increased risk of bleeding, and to test effectiveness of Helicobacter pylori screening-eradication before starting aspirin prophylaxis.
| S-EPMC4269341 | biostudies-literature
Project description:BackgroundHealth care professionals are increasingly using smartphones in clinical care. Smartphone use can affect patient quality of care and clinical outcomes.ObjectiveThis scoping review aimed to describe how physicians use smartphones and mobile apps in clinical settings.MethodsWe conducted a scoping review using the Joanna Briggs Institute methodology and reported the results according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We used the following databases in our literature search: MEDLINE, Embase, Cochrane Library, Web of Science, Google Scholar, and gray literature for studies published since 2010. An additional search was also performed by scanning the reference lists of included studies. A narrative synthesis approach was used.ResultsA total of 10 studies, published between 2016 and 2021, were included in this review. Of these studies, 8 used surveys and 2 used surveys with focus group study designs to explore smartphone use, its adoption, experience of using it, and views on the use of smartphones among physicians. There were studies with only general practitioners (n=3), studies with only specialists (n=3), and studies with both general practitioners and specialists (n=4). Physicians use smartphones and mobile apps for communication (n=9), clinical decision-making (n=7), drug compendium (n=7), medical education and training (n=7), maintaining health records (n=4), managing time (n=4), and monitoring patients (n=2) in clinical practice. The Medscape medical app was frequently used for information gathering. WhatsApp, a nonmedical app, was commonly used for physician-patient communication. The commonly reported barriers were lack of regulatory oversight, privacy concerns, and limited Wi-Fi or internet access. The commonly reported facilitator was convenience and having access to evidence-based medicine, clinical decision-making support, and a wide array of apps.ConclusionsSmartphones and mobile apps were used for communication, medical education and training, clinical decision-making, and drug compendia in most studies. Although the benefits of smartphones and mobile apps for physicians at work were promising, there were concerns about patient privacy and confidentiality. Legislation is urgently needed to protect the liability of health care professionals using smartphones.
| S-EPMC10131676 | biostudies-literature
Project description:BackgroundDespite high rates of smartphone ownership in psychiatric populations, there are very little data available characterizing smartphone use in individuals with mental illness. In particular, few studies have examined the interest and use of smartphones to support mental health.ObjectiveThis study aimed to (1) characterize general smartphone app and social media usage in an acute transdiagnostic psychiatric sample with high smartphone ownership, (2) characterize current engagement and interest in the use of smartphone apps to support mental health, and (3) test demographic and clinical predictors of smartphone use.MethodsThe survey was completed by all patients attending an adult partial hospital program, with no exclusion criteria. The primary outcomes were frequency of use of general and mental health smartphone apps (smartphone use survey) and the frequency of social media use and phone-checking behavior (mobile technology engagement scale).ResultsOverall, 322 patients (aged mean 33.49, SD 13.87 years; 57% female) reported that their most frequently used app functions were texting, email, and social media. Younger individuals reported more frequent use across most types of apps. Baseline depression and anxiety symptoms were not associated with the frequency of app use. Participants reported health care, calendar, and texting apps as most supportive of their mental health and social media apps as most negatively affecting their mental health. Most patients reported an interest in (73.9% [238/322]) and willingness to use (81.3% [262/322]) a smartphone app to monitor their mental health condition. Less than half (44%) of the patients currently had a mental health app downloaded on their smartphone, with mindfulness and meditation apps being the most common type.ConclusionsThe high interest in and willingness to use mental health apps, paired with the only moderate current reported usage, indicate a potential unmet treatment opportunity in psychiatric populations. There is potential to optimize non-mental health-specific apps to better support the needs of those with mental illness and to design a new wave of mental health apps that match the needs of these populations as well as the way they use smartphones in daily life.
| S-EPMC6592519 | biostudies-literature
Project description: Not available
| S-EPMC10694474 | biostudies-literature
Project description:ObjectiveSmartphone apps have the potential to be accessible tools to provide psychoeducation for adults with Attention-Deficit/Hyperactivity Disorder (ADHD). The Adult ADHD App aims to provide psychoeducation about ADHD and supports available in Ireland. The present study aimed to investigate acceptability and user engagement of the Adult ADHD App by auditing real-world use data and gaining qualitative feedback from app users.MethodsApp analytical data was audited from the Google Analytics platform. Fourteen app-users, nine of whom identified as women and five as men, with an age range of 26-65 (M = 40.29, SD = 11.14), participated in semi-structured interviews. Reflexive thematic analysis was employed to develop themes on app-users' experiences.ResultsThe audit of app analytics indicated that over a period of one year, 12,000 people actively used the app and 6400 users returned after their initial use. We developed four themes from the interviews: 'An evidence-based tool for understanding adult ADHD' highlighted that the Adult ADHD App provides trustworthy psychoeducation on ADHD. 'Recommendations for ADHD-friendly adaptations' identified modifications to improve usability of the app. 'Meeting the needs of different stages in the ADHD journey' showed that while the app significantly benefitted adults new to their ADHD, adults who were familiar with their ADHD sought an app that would help them in moments of challenge. 'Perception of public services impacts app experience' suggested that people's attitudes and experiences of the public health system in Ireland affected their views of app content.ConclusionThe Adult ADHD App appears to meet its aims of providing psychoeducation on adult ADHD. Elements can be modified to improve usability. Digital health tools created by public health organisations should consider how people's previous experiences with healthcare services can impact how they perceive the information in the tools.
| S-EPMC11847728 | biostudies-literature
Project description:BackgroundThe Striving to be Strong study tested the efficacy of a multifaceted, theory-based, complex osteoporosis prevention smartphone application (app). We hypothesized use of the app would improve bone mineral density and trabecular bone scores.MethodsThe study was a three-group, prospective, repeated-measure, longitudinal randomized trial. Baseline sample consisted of 290 healthy women between 40 and 60 years of age. Participants were randomly assigned to one of three groups: "Striving," a dynamically tailored, person-centered app; "Boning Up," a standardized osteoporosis-education e-book; and "Wait List," a participant's choice of intervention in the final 3 months of the 12-month study. Participants had or were provided a smart phone. Bone mineral density and trabecular bone scores were measured using dual-energy X-ray absorptiometry at baseline and 12 months. To assess engagement in health behavior change processes, ecological momentary assessments were administered via text messaging during the 12 months participants actively used the app.ResultsThe final sample reflects an 89.6% retention rate. There were decreases in bone mineral density over time but not among the three groups. The percentage of bone density lost over 12 months was lower than expected. Trabecular bone scores were not different over time or by group but improved across all three groups.DiscussionSmall but positive results were observed across all groups, suggesting one or more aspects of participation might have affected outcomes, including dissemination of the intervention across groups, retention without participation, ecological momentary assessments functioning as both an intervention and measure, and selective engagement in research-based recommendations.
| S-EPMC7105101 | biostudies-literature
Project description:Fear conditioning models key processes related to the development, maintenance and treatment of anxiety disorders and is associated with group differences in anxiety. However, laboratory administration of tasks is time and cost intensive, precluding assessment in large samplesnecessary for the analysis of individual differences. This study introduces a newly developed smartphone app that delivers a fear conditioning paradigm remotely using a loud human scream as an aversive stimulus. Three groups of participants (total n = 152) took part in three studies involving a differential fear conditioning experiment to assess the reliability and validity of a smartphone administered fear conditioning paradigm. This comprised of fear acquisition, generalisation, extinction, and renewal phases during which online US-expectancy ratings were collected during every trial with evaluative ratings of negative affect at three time points. We show that smartphone app delivery of a fear conditioning paradigm results in a pattern of fear learning comparable to traditional laboratory delivery and is able to detect individual differences in performance that show comparable associations with anxiety to the prior group differences literature.
| S-EPMC6891256 | biostudies-literature