Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have fac...Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.展开更多
Introduction Percutaneous coronary intervention(PCI),as a primary treatment for coronary artery disease,has made significant strides in both technology and clinical practice since its inception.However,long-term manag...Introduction Percutaneous coronary intervention(PCI),as a primary treatment for coronary artery disease,has made significant strides in both technology and clinical practice since its inception.However,long-term management of post-PCI patients,particularly restenosis prevention and disease progression control,continues to face numerous challenges[1].Insufficient patient adherence to lifestyle interventions and secondary prevention,coupled with low utilization of cardiac rehabilitation,leads to a sustained increase in the risk of postoperative adverse cardiac events[2,3].The rapid development of digital health technologies(DHTs)offers opportunities to overcome these persistent difficulties.This editorial reviewed the latest applications and multiple challenges,and suggested future directions of DHTs in post-PCI patients(Figure 1).展开更多
Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently requ...Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently required.This article explores the potential of digital health technologies to address the challenge posed by climate change-related health issues.It discusses their dual functionality of diminishing the carbon footprint of healthcare services and increasing understanding and governance of climate-sensitive diseases.Notably,with advanced technologies such as Generative medical AI(GMAI)presenting environmental concerns like substantial energy consumption during data processing and the generation of electronic waste,it is essential to underscore the significance of their responsible development and implementation of these technologies.This will ensure that the benefits of digital health technologies can be maximized while minimizing their ecological drawbacks.This study,therefore propose,a framework for leveraging digital health technologies to support climate change adaptation,including disease surveillance,telemedicine,patient support systems,and public awareness campaigns.展开更多
Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the sta...Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth policy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.展开更多
Background:Maternal and child health(MCH)remains a significant public health concern globally despite previous efforts made to improve MCH services.Initiatives such as antenatal care,postnatal care services exclusive ...Background:Maternal and child health(MCH)remains a significant public health concern globally despite previous efforts made to improve MCH services.Initiatives such as antenatal care,postnatal care services exclusive breastfeeding,child vaccination and supplements have been rolled out to improve MCH outcomes.However,inadequate maternal healthcare,socioeconomic factors,obstetric haemorrhaging,complications of hypertension during pregnancy,lack of maternal information,poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates,especially in resource-constrained areas in many sub-Saharan African countries including South Africa.Objective:This study aimed to review mobile health(mHealth)interventions deployed to improve maternal and child health outcomes.Methods:The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable,prominent electronic databases(Google Scholar,Scopus,PubMed,Embase,CINAHL,Web of Science,etc.).A total of 26 papers were selected and analyzed.Results:The findings revealed several mHealth interventions such as MomConnect,Mobile Alliance for Maternal Action,NurseConnect,ChildConnect,CommCare,Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services.However,inadequate digital infrastructure,digital divide,resistance to change,inadequate funding,language barriers,short message service and data costs,lack of digital skills and support,compatibility,scalability and interoperability issues,legislative and policy compliance,lack of mHealth awareness,data security and privacy concerns hinder uptake and utilisation of mHealth interventions.There is a need to scale up and sustain mHealth interventions and update existing regulatory framework,policies and strategies.Conclusion:mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services.Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues.展开更多
Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is infl...Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.展开更多
Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this ...Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.展开更多
The healthcare systems in the Asia-Pacific region are confronted with immense challenges due to an aging population and its rising demand for medical services.Out-of-hospital care supported by digital medical technolo...The healthcare systems in the Asia-Pacific region are confronted with immense challenges due to an aging population and its rising demand for medical services.Out-of-hospital care supported by digital medical technology has emerged as a potential solution.Countries in the Asia-Pacific region are actively exploring the use of innovative digital technologies to develop out-of-hospital care programs tailored to each nation’s context.However,there are also many non-technical challenges like technology maturity,qualification of healthcare staff,incentives of physicians within hospitals,funding and reimbursement,which inhibit the adoption of out-of-hospital.This review examines the current state of out-of-hospital care in four countries in the Asia-Pacific region:the United States,Australia,Singapore,and China.It proposes a practical technical catalog of out-of-hospital care,analyzes existing development challenges,and offers recommendations based on international best practices.Moving forward,it’s urgent to further integrate technologies and the health system,and navigate multi-stakeholder collaboration in out-of-hospital care.展开更多
基金Supported by Post-Subsidy Funds from the National Clinical Research Center,Ministry of Science and Technology of China,No.303-01-001-0272-08Beijing Municipal Administration of Hospitals Incubating Program,No.PX2022032Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI),No.JYY2023-13.
文摘Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.
文摘Introduction Percutaneous coronary intervention(PCI),as a primary treatment for coronary artery disease,has made significant strides in both technology and clinical practice since its inception.However,long-term management of post-PCI patients,particularly restenosis prevention and disease progression control,continues to face numerous challenges[1].Insufficient patient adherence to lifestyle interventions and secondary prevention,coupled with low utilization of cardiac rehabilitation,leads to a sustained increase in the risk of postoperative adverse cardiac events[2,3].The rapid development of digital health technologies(DHTs)offers opportunities to overcome these persistent difficulties.This editorial reviewed the latest applications and multiple challenges,and suggested future directions of DHTs in post-PCI patients(Figure 1).
基金supported by the Science and Technology Innovation 2030 Major Project(2023ZD0508506)National Key Research and Development Program of China(2022YFC2305104).
文摘Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently required.This article explores the potential of digital health technologies to address the challenge posed by climate change-related health issues.It discusses their dual functionality of diminishing the carbon footprint of healthcare services and increasing understanding and governance of climate-sensitive diseases.Notably,with advanced technologies such as Generative medical AI(GMAI)presenting environmental concerns like substantial energy consumption during data processing and the generation of electronic waste,it is essential to underscore the significance of their responsible development and implementation of these technologies.This will ensure that the benefits of digital health technologies can be maximized while minimizing their ecological drawbacks.This study,therefore propose,a framework for leveraging digital health technologies to support climate change adaptation,including disease surveillance,telemedicine,patient support systems,and public awareness campaigns.
文摘Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth policy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.
文摘Background:Maternal and child health(MCH)remains a significant public health concern globally despite previous efforts made to improve MCH services.Initiatives such as antenatal care,postnatal care services exclusive breastfeeding,child vaccination and supplements have been rolled out to improve MCH outcomes.However,inadequate maternal healthcare,socioeconomic factors,obstetric haemorrhaging,complications of hypertension during pregnancy,lack of maternal information,poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates,especially in resource-constrained areas in many sub-Saharan African countries including South Africa.Objective:This study aimed to review mobile health(mHealth)interventions deployed to improve maternal and child health outcomes.Methods:The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable,prominent electronic databases(Google Scholar,Scopus,PubMed,Embase,CINAHL,Web of Science,etc.).A total of 26 papers were selected and analyzed.Results:The findings revealed several mHealth interventions such as MomConnect,Mobile Alliance for Maternal Action,NurseConnect,ChildConnect,CommCare,Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services.However,inadequate digital infrastructure,digital divide,resistance to change,inadequate funding,language barriers,short message service and data costs,lack of digital skills and support,compatibility,scalability and interoperability issues,legislative and policy compliance,lack of mHealth awareness,data security and privacy concerns hinder uptake and utilisation of mHealth interventions.There is a need to scale up and sustain mHealth interventions and update existing regulatory framework,policies and strategies.Conclusion:mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services.Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues.
文摘Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.
文摘Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.
文摘The healthcare systems in the Asia-Pacific region are confronted with immense challenges due to an aging population and its rising demand for medical services.Out-of-hospital care supported by digital medical technology has emerged as a potential solution.Countries in the Asia-Pacific region are actively exploring the use of innovative digital technologies to develop out-of-hospital care programs tailored to each nation’s context.However,there are also many non-technical challenges like technology maturity,qualification of healthcare staff,incentives of physicians within hospitals,funding and reimbursement,which inhibit the adoption of out-of-hospital.This review examines the current state of out-of-hospital care in four countries in the Asia-Pacific region:the United States,Australia,Singapore,and China.It proposes a practical technical catalog of out-of-hospital care,analyzes existing development challenges,and offers recommendations based on international best practices.Moving forward,it’s urgent to further integrate technologies and the health system,and navigate multi-stakeholder collaboration in out-of-hospital care.
