Digital health in stroke medicine: what are the opportunities for stroke patients?

Antonenko, Kateryna; Paciaroni, Maurizio; Соколова, Л. И.; Pezzella, Francesca Romana

doi:10.1097/wco.0000000000000891

Cited by 9 publications

(6 citation statements)

References 45 publications

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“…The randomisation and group allocation of participants was conducted by a researcher who was not involved in the assessment or intervention procedures (BS). Randomisation was based on a single sequence of random allocation using a table of random numbers ( https://www.randomizer.org/ ) 15 .…”

Section: Methodsmentioning

confidence: 99%

Managing Post-Stroke Fatigue Using a Mobile Health Called iHealth After Intracerebral Hemorrhage

Jin,

Zhu,

Zhou

et al. 2024

JMDH

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Background Post-stroke Fatigue (PSF) after Intracerebral Hemorrhage (ICH) is a long-term symptom in stroke survivors. However, the pathogenesis of PSF remains inadequately understood and sufficient evidence-based treatments are lacking. Mobile health (mHealth) technology offers a promising approach to expanding access to high-quality and culturally tailored evidence-based mental care. Aim This study examined the role of mHealth called iHealth in the management of PSF after ICH. Methods A total of 225 patients diagnosed with intracerebral hemorrhage (ICH) were included in the study and randomly assigned to either the Mobile Health Intervention Group (mHI Group) or the non-Mobile Health Intervention Group (non-mHI). The management involved the utilization of a digital healthcare application named iHealth, which incorporated digital questionnaires, fatigue scale tests, and online videos for the purpose of administering the Patient Fatigue Reporting Measurement Information System (PFRMIS) short form as part of the initial patient assessment following ICH. The study was conducted remotely via video conferencing over a 12-week period in mHI Group, with fatigue assessments being conducted 3 months post-ICH onset in two groups. Results Following the administration of PSF by iHealth, Univariate Logistic analyses indicated a significant association between fatigue and the type of activity, with patients who were sedentary or did nothing experiencing higher levels of fatigue (β=2.332, p<0.001; β=2.517, p<0.001). Multivariate Logistic analyses demonstrated a positive association between the intensity of physical activity and decreased emotional well-being and family support, as well as increased fatigue. (p=0.001, p=0.002, p=0.001). The FSS results demonstrated a significantly reduced incidence of PSF in the MHI group in comparison to non-mHI group following the conclusion of the programme. (13.1% vs 40%, p<0.001). Conclusion This study explored the effectiveness of the iHealth app for PSF following ICH, indicating that iHealth is a clinically valuable tool that warrants further dissemination.

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Section: Methodsmentioning

confidence: 99%

Managing Post-Stroke Fatigue Using a Mobile Health Called iHealth After Intracerebral Hemorrhage

Jin,

Zhu,

Zhou

et al. 2024

JMDH

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“…Digitizing has already been shown to speed up the redesign of health care [ 3 ] and potentially foster access to health care services [ 7 , 11 ]. In Sweden, the digital platform Healthcare Guide 1177 [ 12 ], accessible to registered individuals, is widely used.…”

Section: Introductionmentioning

confidence: 99%

“…People with long-term conditions need digital tools designed to cover a range of health problems and related information. Although previsit digital tools have been designed for people with various conditions [ 2 , 16 , 17 , 25 ], tools related to organized follow-up after stroke are scarce [ 11 ]. Furthermore, when digital elements are used, they are commonly part of a comprehensive and complex approach to poststroke follow-up [ 26 , 27 ] and lack a thorough description of the development process including user experiences [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Digital Tool for People With a Long-Term Condition Using Stroke as a Case Example: Participatory Design Approach

Kjörk¹,

Sunnerhagen²,

Lundgren‐Nilsson³

et al. 2022

JMIR Hum Factors

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Background In patient care, demand is growing for digital health tools to enable remote services and enhance patient involvement. People with chronic conditions often have multiple health problems, and long-term follow-up is recommended to meet their needs and enable access to appropriate support. A digital tool for previsit preparation could enhance time efficiency and guide the conversation during the visit toward the patient’s priorities. Objective This study aims to develop a digital previsit tool and explore potential end user’s perceptions, using a participatory approach with stroke as a case example. Methods The digital tool was developed and prototyped according to service design principles, informed by qualitative participant data and feedback from an expert panel. All features were processed in workshops with a team that included a patient partner. The resulting tool presented questions about health problems and health information. Study participants were people with stroke recruited from an outpatient clinic and patient organizations in Sweden. Development and data collection were conducted in parallel. For conceptualization, the initial prototype was based on the Post-Stroke Checklist and research. Needs and relevance were explored in focus groups, and we used a web survey and individual interviews to explore perceived utility, ease of use, and acceptance. Data were thematically analyzed following the Framework Method. Results The development process included 22 participants (9 women) with a median age of 59 (range 42-83) years and a median of 51 (range 4-228) months since stroke. Participants were satisfied or very satisfied with using the tool and recommended its use in clinical practice. Three main themes were constructed based on focus group data (n=12) and interviews (n=10). First, valuable accessible information illuminated the need for information to confirm experiences, facilitate responses, and invite engagement in their care. Amendments to the information in turn reconfigured their expectations. Second, utility and complexity in answering confirmed that the questions were relevant and comprehensible. Some participants perceived the answer options as limiting and suggested additional space for free text. Third, capturing needs and value of the tool highlighted the tool’s potential to identify health problems and the importance of encouraging further dialog. The resulting digital tool, Strokehälsa [Strokehealth] version 1.0, is now incorporated into a national health platform. Conclusions The participatory approach to tool development yielded a previsit digital tool that the study group perceived as useful. The holistic development process used here, which integrated health information, validated questions, and digital functionality, offers an example that could be applicable in the context of other long-term conditions. Beyond its potential to identify care needs, the tool offers information that confirms experiences and supports answering the questions in the tool. The tool is freely shared for adaptation in different contexts. Trial Registration researchweb 236341; https://www.researchweb.org/is/vgr/project/236341

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“…As a first attempt to incorporate technological innovations in post stroke management, digital elements have been implemented in pilot projects as documentation tools for stroke pilots [ 20 ] or patients [ 15 ], and a communication tool between treatment sectors [ 21 ]. The beneficial effects of more complex digital interventions in other conditions [ 22 , 23 ] suggest that such technology could also be a powerful tool for post stroke management [ 24 ]. Against this background, we designed the PostStroke-Manager as a novel concept combining multiple innovations based on digital and personal assistance.…”

Section: Introductionmentioning

confidence: 99%

The PostStroke-Manager – combining mobile, digital and sensor-based technology with personal assistance: protocol of the feasibility study

Michalski

Prost

Handel³

et al. 2021

Neurol. Res. Pract.

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Introduction Post stroke management has moved into the focus as it represents the only way to secure acute treatment effects in the long term. Due to individual courses, post stroke management appears rather challenging and is hindered by existing barriers between treatment sectors. As a novel concept, the PostStroke-Manager combines digital and sensor-based technology with personal assistance to enable intersectoral cooperation, best possible reduction of stroke-related disability, optimal secondary prevention, and detection of physical and psychological comorbidities. Methods This prospective single-center observational study aims to investigate the feasibility of the PostStroke-Manager concept in an outpatient setting. Ninety patients who have suffered an ischemic or hemorrhagic stroke or transient ischemic attack will be equipped with a tablet and mobile devices recording physical activity, blood pressure, and electrocardiographic signals. Through a server-based platform, patients will be connected with the primary care physician, a stroke pilot and, if necessary, other specialists who will use web-based platforms. Via the tablet, patients will have access to an application with 10 newly designed components including, for instance, a communication tool, medication schedule, medical records platform, and psychometric screenings (e.g., depression, anxiety symptoms, quality of life, adherence, cognitive impairment). During the 1-year follow-up period, clinical visits are scheduled at three-month intervals. In the interim, communication will be secured by an appropriate tool that includes text messenger, audio, and video telephony. As the primary endpoint, feasibility will be measured by a 14-item questionnaire that addresses digital components, technical support, and personal assistance. The PostStroke-Manager will be judged feasible if at least 50% of these aspects are rated positively by at least 75% of patients. Secondary endpoints include feedback from professionals and longitudinal analyses on clinical and psychometric parameters. Perspective This study will answer the question of whether combined digital and personal support is a feasible approach to post stroke management. Furthermore, the patient perspective gained regarding digital support may help to specify future applications. This study will also provide information regarding the potential use of remote therapies and mobile devices in situations with limited face-to-face contacts. Trial registration German Register for Clinical Trials (DRKS00023213.), registered 27 April 2021.

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Digital health in stroke medicine: what are the opportunities for stroke patients?

Cited by 9 publications

References 45 publications

Managing Post-Stroke Fatigue Using a Mobile Health Called iHealth After Intracerebral Hemorrhage

Managing Post-Stroke Fatigue Using a Mobile Health Called iHealth After Intracerebral Hemorrhage

Development of a Digital Tool for People With a Long-Term Condition Using Stroke as a Case Example: Participatory Design Approach

The PostStroke-Manager – combining mobile, digital and sensor-based technology with personal assistance: protocol of the feasibility study

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