Background: Asthma is an important public health issue in the United States. eHealth technology offers a potential solution to asthma treatment adherence, but the relative effect of various types of eHealth interventions has not been systematically studied. Objectives: To systematically review the effectiveness of eHealth in improving adherence to inhaled corticosteroids (ICS) among patients with persistent asthma, as well as the satisfaction of patients undergoing eHealth interventions. Methods: Literature searches were conducted in five databases in August 2018. Included studies were randomized controlled trials comparing eHealth interventions versus usual care in improving adherence among patients prescribed ICS for persistent asthma. Quantitative synthesis was performed using a random effects model. Results: Eighty records were identified after removal of duplicates. Fifteen trials were eligible for qualitative synthesis. Included trials utilized: social media (n = 1), electronic health records (n = 1), telehealth (n = 6), and mHealth (n = 7). Twelve trials were eligible for quantitative synthesis. Results show a small but significant overall effect of eHealth interventions on adherence to ICS (Standardized Mean Difference (SMD) = 0.41, 95%CI = 0.02-0.79). Among the different types of eHealth interventions, a significant improvement in adherence was observed for mHealth interventions compared to usual care in a pooled analysis of 4 trials (SMD = 0.96, 95%CI = 0.28-1.64). However, there was considerable heterogeneity among studies. Patient satisfaction was evaluated in 5 trials comparing telehealth (n = 2) and mHealth (n = 3) with usual care. Participants found the interventions to be helpful and satisfactory. Conclusion: eHealth interventions, especially mHealth interventions, are effective and acceptable in improving patient adherence to ICS.

Objective. To implement and assess the effectiveness of using Twitter to encourage interaction between faculty members, guests, and students in a pharmacy management course taught simultaneously on 2 campuses. Design. Students were required to tweet a minimum of 10 times over several class sessions. The course instructor and guest professionals also participated. Assessment. More than eighteen hundred tweets were made by students, guests, and the instructor. Students tweeted most frequently with each other and found value in reading each others' tweets. One hundred thirty-one students completed an optional evaluation survey. Seventy-one percent indicated that Twitter was distracting, 69% believed it prevented note taking, and more than 80% indicated that it facilitated class participation and allowed an opportunity to voice opinions. Conclusion. Educators who wish to use Twitter in pharmacy courses must balance the potentially positive aspects of the technology, such as increased interaction among students, with potentially negative aspects, such as the interruptive nature of Twitter use and the large volume of tweets generated by a class assignment.

Surgical site infections (SSI) cause substantial morbidity and pose a burden to acute healthcare services after surgery. We aimed to investigate whether a smartphone-delivered wound assessment tool can expedite diagnosis and treatment of SSI after emergency abdominal surgery. This single-blinded randomised control trial (NCT02704897) enroled adult emergency abdominal surgery patients in two tertiary care hospitals. Patients were randomised (1:1) to routine postoperative care or additional access to a smartphone-delivered wound assessment tool for 30-days postoperatively. Patient-reported SSI symptoms and wound photographs were requested on postoperative days 3, 7, and 15. The primary outcome was time-to-diagnosis of SSI (Centers for Disease Control definition). 492 patients were randomised (smartphone intervention: 223; routine care: 269). There was no significant difference in the 30-day SSI rate between trial arms: 21 (9.4%) in smartphone vs 20 (7.4%, p = 0.513) in routine care. Among the smartphone group, 32.3% (n = 72) did not utilise the tool. There was no significant difference in time-to-diagnosis of SSI for patients receiving the intervention (−2.5 days, 95% CI: −6.6−1.6, p = 0.225). However, patients in the smartphone group had 3.7-times higher odds of diagnosis within 7 postoperative days (95% CI: 1.02−13.51, p = 0.043). The smartphone group had significantly reduced community care attendance (OR: 0.57, 95% CI: 0.34−0.94, p = 0.030), similar hospital attendance (OR: 0.76, 95% CI: 0.28−1.96, p = 0.577), and significantly better experiences in accessing care (OR: 2.02, 95% CI: 1.17−3.53, p = 0.013). Smartphone-delivered wound follow-up is feasible following emergency abdominal surgery. This can facilitate triage to the appropriate level of assessment required, allowing earlier postoperative diagnosis of SSI.

New types of social Internet applications (often referred to as Web 2.0) are becoming increasingly popular within higher education environments. Although developed primarily for entertainment and social communication within the general population, applications such as blogs, social video sites, and virtual worlds are being adopted by higher education institutions. These newer applications differ from standard Web sites in that they involve the users in creating and distributing information, hence effectively changing how the Web is used for knowledge generation and dispersion. Although Web 2.0 applications offer exciting new ways to teach, they should not be the core of instructional planning, but rather selected only after learning objectives and instructional strategies have been identified. This paper provides an overview of prominent Web 2.0 applications, explains how they are being used within education environments, and elaborates on some of the potential opportunities and challenges that these applications present.

OBJECTIVE To assess adolescents' preferred mobile app features and to propose a framework for evaluating health-related mobile apps for adolescents. METHODS PubMed, CINAHL, PsycINFO, ERIC, HealthIT.gov , and ClinicalTrials.gov were systematically searched in August 2017. Studies pertaining to app development, feasibility, or usability that reported preferred app features and rating criteria on mHealth (mobile health) apps intended for adolescents were included. Quality assessment was performed using the Mixed Methods Appraisal Tool. Qualitative synthesis was performed to develop themes reflecting best practices for evaluating the quality of mHealth apps for adolescents. Using a grounded theory approach, we constructed a theoretical framework of rating criteria that can be used to inform development of an evaluation tool for mHealth apps targeted to adolescents. RESULTS Thirteen articles were included. Most commonly preferred features include ability to track test results or self-management progress, connect to social media, and gain points or prizes through app gamification. Common rating criteria include degree of app customizability, ease of use, visual appeal, and interactivity. Five emerging dimensions were used in the theoretical framework: Technical Quality; Engagement; Support System; Autonomy; and Safety, Privacy, and Trust. CONCLUSIONS We found that adolescents prefer mHealth apps that are customizable, offer peer support through social media, sustain engagement via gamification, and support the ability to visualize health trends via simplified graphs. Findings may help in the development of mHealth apps that are preferred by adolescents, as well as the development of a quality evaluation tool for mHealth apps targeted to this population.