Demonstrating the feasibility of digital health to support pediatric patients in South Africa

Abstract Objective Resources for management of epilepsy in Africa are extremely limited reinforcing the need to develop innovative strategies for optimizing care. Studies have shown that the prevalence of epilepsy in low‐ and middle‐income countries is substantially greater than in more resourced co...

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Autores principales: Elin Haf Davies, Karen Fieggen, Jo Wilmshurst, Obuchinezia Anyanwu, Richard Joseph Burman, Sandra Komarzynski
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Lenguaje:EN
Publicado: Wiley 2021
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Acceso en línea:https://doaj.org/article/c5dd67cb6da64877a94548fe1a940ae4
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spelling oai:doaj.org-article:c5dd67cb6da64877a94548fe1a940ae42021-12-01T06:09:19ZDemonstrating the feasibility of digital health to support pediatric patients in South Africa2470-923910.1002/epi4.12527https://doaj.org/article/c5dd67cb6da64877a94548fe1a940ae42021-12-01T00:00:00Zhttps://doi.org/10.1002/epi4.12527https://doaj.org/toc/2470-9239Abstract Objective Resources for management of epilepsy in Africa are extremely limited reinforcing the need to develop innovative strategies for optimizing care. Studies have shown that the prevalence of epilepsy in low‐ and middle‐income countries is substantially greater than in more resourced countries. The objective of this report was to demonstrate that mobile Health (mHealth) technologies have the potential to improve the management of epilepsy in Africa. Methods The feasibility of technology‐based home monitoring was investigated in an observational study of 40 children with refractory epilepsy or epilepsy associated with intellectual disability and/or behavior difficulties in South Africa. Technology‐based home monitoring was implemented for six months. Physical activity, sleep, and heart rate were continuously monitored with a wearable device. Caregivers completed regular mobile Patient Reported Outcomes (mPROs) and reported seizures and ad hoc events using a dedicated app. Feasibility was assessed and descriptively measured for recruitment, retention, and engagement of the participants. Results The mHealth technology was able to capture important information that gives an impression of the overall experience of the children and their caregivers. Thirty‐seven participants (94.9%) reported at least one clinical event. Seventy‐nine percent of caregivers reported seizure events in their children, which were the primary event anticipated. Median engagement with the wearable device and monthly mPROs was 30.8% and 57.1%, respectively. However, most participants (87%) had to be given smartphones for them to have Bluetooth capabilities and access to the study app. Tolerability to the device was impacted by the difficult living circumstances of caregivers that induced fear of loss or theft. Significance The study showed how the use of remote patient monitoring in the form of mHealth can benefit epilepsy patients, despite highly variable engagement with the technology. The combination of mPROs and wearable devices generated informative datasets that will allow clinicians but also the children and their caregivers to better understand and manage the disease.Elin Haf DaviesKaren FieggenJo WilmshurstObuchinezia AnyanwuRichard Joseph BurmanSandra KomarzynskiWileyarticlefeasibilitymobile healthrefractory epilepsywearable technologyNeurology. Diseases of the nervous systemRC346-429ENEpilepsia Open, Vol 6, Iss 4, Pp 653-662 (2021)
institution DOAJ
collection DOAJ
language EN
topic feasibility
mobile health
refractory epilepsy
wearable technology
Neurology. Diseases of the nervous system
RC346-429
spellingShingle feasibility
mobile health
refractory epilepsy
wearable technology
Neurology. Diseases of the nervous system
RC346-429
Elin Haf Davies
Karen Fieggen
Jo Wilmshurst
Obuchinezia Anyanwu
Richard Joseph Burman
Sandra Komarzynski
Demonstrating the feasibility of digital health to support pediatric patients in South Africa
description Abstract Objective Resources for management of epilepsy in Africa are extremely limited reinforcing the need to develop innovative strategies for optimizing care. Studies have shown that the prevalence of epilepsy in low‐ and middle‐income countries is substantially greater than in more resourced countries. The objective of this report was to demonstrate that mobile Health (mHealth) technologies have the potential to improve the management of epilepsy in Africa. Methods The feasibility of technology‐based home monitoring was investigated in an observational study of 40 children with refractory epilepsy or epilepsy associated with intellectual disability and/or behavior difficulties in South Africa. Technology‐based home monitoring was implemented for six months. Physical activity, sleep, and heart rate were continuously monitored with a wearable device. Caregivers completed regular mobile Patient Reported Outcomes (mPROs) and reported seizures and ad hoc events using a dedicated app. Feasibility was assessed and descriptively measured for recruitment, retention, and engagement of the participants. Results The mHealth technology was able to capture important information that gives an impression of the overall experience of the children and their caregivers. Thirty‐seven participants (94.9%) reported at least one clinical event. Seventy‐nine percent of caregivers reported seizure events in their children, which were the primary event anticipated. Median engagement with the wearable device and monthly mPROs was 30.8% and 57.1%, respectively. However, most participants (87%) had to be given smartphones for them to have Bluetooth capabilities and access to the study app. Tolerability to the device was impacted by the difficult living circumstances of caregivers that induced fear of loss or theft. Significance The study showed how the use of remote patient monitoring in the form of mHealth can benefit epilepsy patients, despite highly variable engagement with the technology. The combination of mPROs and wearable devices generated informative datasets that will allow clinicians but also the children and their caregivers to better understand and manage the disease.
format article
author Elin Haf Davies
Karen Fieggen
Jo Wilmshurst
Obuchinezia Anyanwu
Richard Joseph Burman
Sandra Komarzynski
author_facet Elin Haf Davies
Karen Fieggen
Jo Wilmshurst
Obuchinezia Anyanwu
Richard Joseph Burman
Sandra Komarzynski
author_sort Elin Haf Davies
title Demonstrating the feasibility of digital health to support pediatric patients in South Africa
title_short Demonstrating the feasibility of digital health to support pediatric patients in South Africa
title_full Demonstrating the feasibility of digital health to support pediatric patients in South Africa
title_fullStr Demonstrating the feasibility of digital health to support pediatric patients in South Africa
title_full_unstemmed Demonstrating the feasibility of digital health to support pediatric patients in South Africa
title_sort demonstrating the feasibility of digital health to support pediatric patients in south africa
publisher Wiley
publishDate 2021
url https://doaj.org/article/c5dd67cb6da64877a94548fe1a940ae4
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