Special Issue "e-Health in Cardiovascular Medicine"

A special issue of Medical Sciences (ISSN 2076-3271). This special issue belongs to the section "Cardiovascular Disease".

Deadline for manuscript submissions: closed (15 January 2019)

Special Issue Editors

Guest Editor
Prof. Julie Redfern

The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia; The George Institute for Global Health Australia, Sydney, Australia
Website | E-Mail
Interests: Chronic disease; primary healthcare; e-health; cardiovascular disease self-management; telehealth interventions
Guest Editor
Prof. Lis Neubeck

School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
Website | E-Mail
Interests: cardiovascular disease; health improvement; preventive cardiology; e-health

Special Issue Information

Dear Colleagues,

Cardiovascular disease is the leading cause of morbidity and mortality globally. There are significant challenges in delivering better preventive and management strategies. In recent years, we have seen the world undergo a technological revolution. Today, almost half of the world's population is connected to the Internet and almost one-quarter own a smartphone. Further, the United Nations has set the goal of connecting all the world's inhabitants to affordable Internet by 2020. This will increase access to information, education and will empower many people to improve their living conditions and escape poverty. As a result, there is a rapidly expanding area of research and development that is transforming the way healthcare can be delivered. This provides new possibilities, and new challenges, for cardiovascular disease management, which often requires complex and multidimensional strategies for improving prevention and management.

In light of this, we are pleased to invite you to contribute to this Special Issue, "e-Health in Cardiovascular Medicine", which will be published in the international journal Medical Sciences. Medical Sciences is an international open access scientific journal, providing a platform for advances in basic, translational and clinical research. Citations are available in PubMed and full-text are archived in PubMed Central. The journal aims is to publish original research, review articles and short communications in order to increase understanding of the fundamental principles and fundamental questions in medicine and healthcare. The objectives of this Special Issue on "e-Health in Cardiovascular Medicine" are to publish and collect both clinical research, public health and other research contributions from original and high-quality research articles and encourage researchers to investigate topics in the field. The overall goal is to expand our understanding of digital health interventions and how they may transform the prevention and management of cardiovascular disease.

A/Prof. Julie Redfern
Lead Guest Editor

Prof. Lis Neubeck
Co-Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medical Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mhealth
  • telehealth
  • cardiovascular disease
  • health services
  • prevention
  • management
  • technology

Published Papers (6 papers)

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Editorial

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Open AccessEditorial
e-Health in Cardiovascular Medicine
Med. Sci. 2019, 7(6), 72; https://doi.org/10.3390/medsci7060072
Received: 7 June 2019 / Accepted: 11 June 2019 / Published: 20 June 2019
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Abstract
Cardiovascular disease (CVD), including coronary artery disease (CHD) and stroke, is the leading cause of death and disease burden globally [...] Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)

Research

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Open AccessArticle
Evaluating Reach, Acceptability, Utility, and Engagement with An App-Based Intervention to Improve Medication Adherence in Patients with Coronary Heart Disease in the MedApp-CHD Study: A Mixed-Methods Evaluation
Med. Sci. 2019, 7(6), 68; https://doi.org/10.3390/medsci7060068 (registering DOI)
Received: 18 February 2019 / Revised: 27 May 2019 / Accepted: 31 May 2019 / Published: 4 June 2019
Cited by 1 | PDF Full-text (1769 KB) | HTML Full-text | XML Full-text
Abstract
Objective: The aim of this study was to assess the reach, acceptability, utility, and engagement with the apps that were used in the MEDication reminder APPlications (apps) to improve medication adherence in Coronary Heart Disease (MedApp-CHD) study, a randomised clinical trial to improve [...] Read more.
Objective: The aim of this study was to assess the reach, acceptability, utility, and engagement with the apps that were used in the MEDication reminder APPlications (apps) to improve medication adherence in Coronary Heart Disease (MedApp-CHD) study, a randomised clinical trial to improve medication adherence, using a mixed-methods approach. Methods: The MedApp-CHD study randomised 163 patients with coronary heart disease (CHD) to one of three groups: (i) usual care (n = 56), (ii) a basic medication reminder app (n = 54), or (iii) an advanced medication reminder app (n = 53). For this mixed-methods evaluation, the data sources included patient screening logs, feedback questionnaires collected at three-month follow-up, focus groups discussions, and analytical data from the app software. Results: Ninety-four percent (98/104) of participants who received a medication reminder app completed the three-month feedback questionnaire and 15 participated in the focus group discussions. The themes that were identified included that participants (i) found the medication reminders useful in reminding them to take the medications on the correct time every day, (ii) liked having the medication list as an easily-accessible record of medications’ names and dosages, (iii) reported being likely to continue to use the apps after the study completion, (iv) would be likely to recommend the apps to their family and friends, and (v) those who used the clinical measurements feature found it useful as a tool to track and graph the blood pressure and glucose levels over time (especially those with diabetes and/or hypertension). In addition, analytical data from the app software demonstrated that the participants used the medication-related features more than the clinical measurements feature. Furthermore, data from the patient screening logs showed that the main reason for exclusion, other than not meeting the CHD criteria, was not having a suitable smartphone, and those that were excluded for this reason were older and had a higher proportion of females than those enrolled in the study. Conclusion: This study provides important insights regarding the features that are most useful in apps that aim to improve medication adherence. This mixed-methods evaluation suggests that, currently, young male patients with CHD are more likely to use such apps, that the apps were well-accepted and useful in reminding the patients to take the medications, and that the patients were engaged in regularly using the apps. Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)
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Open AccessArticle
The Keeping on Track Study: Exploring the Activity Levels and Utilization of Healthcare Services of Acute Coronary Syndrome (ACS) Patients in the First 30-Days after Discharge from Hospital
Med. Sci. 2019, 7(4), 61; https://doi.org/10.3390/medsci7040061
Received: 27 February 2019 / Revised: 7 April 2019 / Accepted: 10 April 2019 / Published: 19 April 2019
Cited by 1 | PDF Full-text (1293 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected [...] Read more.
The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30–90 days. Eighteen participants were recruited (6 metropolitan 12 rural) 61% ST elevation myocardial infarction (STEMI), mean age 55 years, 83% male. Recall of discharge education included knowledge of diagnosis (recall = 100%), procedures (e.g., angiogram = 40%), and comorbidities (e.g., hypertension = 60%, diabetes = 100%). In the first 30 days post-discharge, median steps per day was 2506 (standard deviation (SD) ± 369) steps (one participant completed 10,000 steps), 62% visited a general practitioner (GP) 16% attended cardiac rehabilitation, 16% visited a cardiologist, 72% a pharmacist, 27% visited the emergency department for cardiac event, and 61% a pathology service (blood tests). Adherence to using the activity tracking apps was 87%. Managing Big Data from the GPS and physical activity tracking apps was a challenge with over 300,000 lines of raw data cleaned to 90,000 data points for analysis. This study was an example of the application of objective data from the real world to help understand post-ACS discharge patient activity. Rates of access to services in the first 30 days continue to be of concern. Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)
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Open AccessArticle
Development of a Low-Cost Wireless Phonocardiograph With a Bluetooth Headset under Resource-Limited Conditions
Med. Sci. 2018, 6(4), 117; https://doi.org/10.3390/medsci6040117
Received: 26 November 2018 / Revised: 11 December 2018 / Accepted: 11 December 2018 / Published: 17 December 2018
Cited by 1 | PDF Full-text (2673 KB) | HTML Full-text | XML Full-text
Abstract
Commercially available digital stethoscopes can be used as a phonocardiograph to record heart sounds. However, procuring a costly digital stethoscope may not be possible under resource-limited conditions. A low-cost, wire connected, and mobile phone-assisted phonocardiograph has been reported previously. The aim of this [...] Read more.
Commercially available digital stethoscopes can be used as a phonocardiograph to record heart sounds. However, procuring a costly digital stethoscope may not be possible under resource-limited conditions. A low-cost, wire connected, and mobile phone-assisted phonocardiograph has been reported previously. The aim of this study was to develop a low-cost and wireless phonocardiograph for resource-limited settings. A Bluetooth headset was dismantled to find its microphone. A stethoscope ear knob was cut to make a small bell and it was attached to the microphone. This modified Bluetooth headset was capable of recording sounds while connected to a mobile device with audio recording application. The modified Bluetooth headset, mobile phone, and audio recording software can serve as a wireless phonocardiograph (WiPCGh). Heart sounds were successfully recorded with the help of the newly developed WiPCGh. The audio files were shared with a personal computer (PC) via Bluetooth. The wave form was analyzed in a PC-based audio editing application. First and second heart sounds with systolic and diastolic murmur were identified. WiPCGh can be utilized in recording heart sounds for academic and telemedicine purposes. However, the capability of WiPCGh in the diagnosis of cardiac diseases is yet to be explored in future studies. Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)
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Review

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Open AccessReview
Cardiovascular Disease Prevention in Adolescents: eHealth, Co-Creation, and Advocacy
Med. Sci. 2019, 7(2), 34; https://doi.org/10.3390/medsci7020034
Received: 18 January 2019 / Revised: 20 February 2019 / Accepted: 20 February 2019 / Published: 24 February 2019
Cited by 1 | PDF Full-text (1012 KB) | HTML Full-text | XML Full-text
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and [...] Read more.
Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and obesity can exacerbate the early onset of atherosclerosis. There is a need to improve modifiable risk factors during adolescence to prevent progression to CVD in later life. Electronic health (eHealth) behaviour change interventions are a potential solution for adolescents to improve CVD risk factors, given adolescents are digital frontrunners and digital technology is wide-reaching. The process of co-creating eHealth behaviour change interventions with adolescents is a promising strategy to improve intervention effectiveness and engagement. Additionally, effective youth advocacy is an emerging strategy for CVD prevention in adolescents. This narrative review evaluates published eHealth behaviour change interventions targeting cardiovascular disease risk factors in adolescents, which utilize a co-creation process, describe the emerging role of advocacy in CVD prevention for adolescents and provide recommendations for future interventions. Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)
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Other

Open AccessPerspective
From Rapid Recommendation to Online Preference-Sensitive Decision Support: The Case of Severe Aortic Stenosis
Med. Sci. 2018, 6(4), 109; https://doi.org/10.3390/medsci6040109
Received: 7 September 2018 / Revised: 22 November 2018 / Accepted: 27 November 2018 / Published: 29 November 2018
Cited by 1 | PDF Full-text (5111 KB) | HTML Full-text | XML Full-text
Abstract
The launch of ‘Rapid Recommendations’ by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) group, in collaboration with Making GRADE the Irresistible Choice (MAGIC) and the British Medical Journal (BMJ), is a very interesting recent development in e-healthcare. Designed to respond quickly [...] Read more.
The launch of ‘Rapid Recommendations’ by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) group, in collaboration with Making GRADE the Irresistible Choice (MAGIC) and the British Medical Journal (BMJ), is a very interesting recent development in e-healthcare. Designed to respond quickly to developments that have created new decision situations, their first project resulted from the arrival of minimally invasive Transcatheter Aortic Valve Implantation (TAVI) as an alternative to Surgical Aortic Valve Replacement (SAVR), for patients with symptomatic severe aortic stenosis. The interactive MAGIC decision aid that accompanies a Rapid Recommendation and is the main route to its clinical implementation, represents a major advance in e-health, for a cardiovascular decision in this case. However, it needs to go further in order to facilitate fully person-centred care, where the weighted preferences of the individual person are elicited at the point of decision, and transparently integrated with the best (most personalised) estimates of option performances, to produce personalised, preference-sensitive option evaluations. This can be achieved by inputting the collated GRADE evidence on the criteria relevant in the TAVI/SAVR choice into a Multi-Criteria Decision Analysis-based decision support tool, generating a personalised, preference-sensitive opinion. A demonstration version of this add-on to the MAGIC aid, divested of recommendations, is available online as proof of method. Full article
(This article belongs to the Special Issue e-Health in Cardiovascular Medicine)
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