Digital Patient Care: Bridging Technology and Clinical Practice

Background/Objectives: The study primarily examined whether an IoT-based medication assistance system enhances ART adherence relative to standard care, and secondarily evaluated device feasibility and error patterns over time. Methods: This prospective study was conducted between June 2022 and October 2023 at a tertiary hospital in South Korea. Adults (≥19 years) living with HIV and prescribed ART were included; those with comorbid hepatitis B or C were excluded. People living with HIV who agreed to use the IoT-based InPHRPILL system (Sofnet Inc., Seoul, Republic of Korea) were assigned to the intervention group, whereas those who declined were assigned to the control group. Viral suppression, CD4⁺ cell counts, and adherence rates were measured. Additional analyses evaluated 12-month longitudinal adherence using pill-count data in both groups, and device-measured adherence and device-associated error rates in the intervention group. Results: Thirty-five participants (12 in the intervention group and 23 in the control group) were included. The intervention group demonstrated marginally shorter durations since HIV diagnosis and ART initiation at study enrollment, as well as slightly higher baseline HIV-RNA levels; however, these differences did not reach statistical significance. The median pill-counting and IoT device adherence rates were 100% and 87.4%, respectively (median deviation error rate = 4.4%). Poisson regression revealed significantly reduced error rates over time (β = −0.06493, p < 0.01), suggesting improved device use proficiency. Conclusions: IoT-based medication assistance systems may provide objective, real-time monitoring of ART adherence and facilitate identification of discrepancies between clinical evaluations and actual adherence patterns. Larger studies targeting individuals with suboptimal adherence are warranted to determine whether such systems can enhance adherence outcomes. Full article

Background: Cancer patients admitted to the bone marrow transplant (BMT) unit face life-threatening medical conditions. Consequently, their family members experience uncertainty, resulting in high levels of anxiety and depression (AD). Limited updates and communication from medical staff exacerbate these emotional burdens. To address these challenges, we developed a mobile health (mHealth) intervention, FamCarePlus, and evaluated its feasibility, usability, and efficacy. We hypothesized that the FamCarePlus application would demonstrate a high degree of feasibility and usability and would reduce AD compared to a control group relying solely on traditional communication through the nurses’ station. Methods: We employed a quasi-experimental pretest/posttest non-randomized, non-blinded self-report design over 3 weeks, with an experimental group (n = 10) using FamCarePlus and a control group (n = 9). We selected participants via convenience sampling using the electronic medical record to identify eligible patients and families, guided by inclusion and exclusion criteria. We used descriptive statistics and the Hospital Anxiety and Depression Scale (HADS) guidelines to analyze the data. Feasibility was defined by a retention rate > 80%, with usability testing using the System Usability Scale (SUS) and NASA Task Load Index (NASA-TLX) surveys. The HADS measured AD, comparing baseline to Week 3. Results: We met our feasibility criteria of >80%. All SUS and NASA scores were in the higher index, suggesting a significant degree of usability and low workload demand on participants. For efficacy, we compared baseline mean scores, with the experimental group reporting lower AD levels at Week 1 (41.9% and 27.8%, respectively) than the control group (55.2% and 34.2%, respectively). From Week 1 to Week 3, the percentage change showed an 8.6% decrease in anxiety in the experimental group, compared to a 12.8% decrease in anxiety in the control group. These results were consistent when analyzed according to HADS guidelines. Conclusions: The findings of this study provide preliminary evidence that the FamCarePlus intervention is feasible and usable, while also demonstrating that its use may be associated with a sustained reduction in AD levels among family members of patients admitted to the BMT unit. These outcomes underscore the potential of digital interventions to address disparities in patient health information access and psychosocial support. Full article

Background/Objectives: Mobile health (mHealth) technologies are increasingly used to support preventive oral care and patient self-management. CarieCheck is a Portuguese app intended to improve oral health literacy and support caries-risk self-assessment. This prospective pilot study focused on users’ perceived app quality and usability, assessed with uMARS-PT. Methods: Thirty participants from the academic community of Egas Moniz School of Health and Science used the app for 30 days and completed the uMARS-PT questionnaire. Descriptive statistics were used to calculate mean scores for Engagement, Functionality, Aesthetics, Information Quality, Subjective Quality, and Perceived Impact. Results: The overall mean uMARS-PT score was 4.22, indicating excellent perceived quality. The highest domain scores were Functionality (4.51), Aesthetics (4.45), and Information Quality (4.22). Engagement (3.71) and Subjective Quality (3.05) were moderate. Perceived Impact (3.85) reflected self-reported perception of increased awareness and motivation regarding oral health behaviors. Conclusions: CarieCheck was rated highly in usability, aesthetics, and information quality. These findings suggest that CarieCheck may be considered as a digital tool for preventive education and user-supported caries-risk self-assessment. Larger, longer-term studies in diverse populations using objective behavioral and clinical outcomes are warranted. Full article

Background: Digital technologies can contribute to healthcare democratization in an ethical, safe, and sustainable context. The remote monitoring of implantable cardiac devices enables the follow-up of patients from a distance. Patients with anti-bradycardia pacemakers represent the largest group and have the least access to this technology due to the controversial cost–benefit ratio and barriers to its widespread implementation, such as equipment costs and organizational challenges. In contrast, reimbursed transportation in Portugal reached approximately 82 million euros in 2024. Objectives: The aim of the present study was to assess the financial viability of remote pacemaker follow-up in a Portuguese district hospital, comparing the non-urgent transportation costs and the investment in remote monitoring equipment while measuring user acceptance and satisfaction. Methods: A total of 41 surveys were conducted with patients who received a pacemaker and used publicly reimbursed transportation. The projected costs were calculated for two simulated protocols: the first involved in-person visits every six months, while the second involved in-person visits every two years with remote consultations every six months, over the expected lifespan of the devices. EZR, version 1.61, was used. Results: Our data showed a 74% overall reduction in face-to-face visits. The implementation of remote follow-up would result in a cost saving of EUR 373/patient (21.2%), with total reimbursement (p = 0.01151). The savings increased to 33.3%, reaching EUR 764/patient (p = 0.0002742) for distances greater than 60 km (round trip) for ambulance users with total reimbursement. Acceptance and satisfaction achieved 88%. Conclusions: Remote monitoring of pacemakers can be a financially viable alternative with high acceptance and satisfaction. Full article

Background: Primary Sclerosing Cholangitis (PSC), Primary Biliary Cholangitis (PBC), and Autoimmune Hepatitis (AIH) are rare immune-mediated liver conditions that significantly affect patients’ quality of life. In Romania, access to specialized information and patient support resources is limited, underscoring the need for tailored educational tools. The aim was to describe the methodology for developing, implementing, and conducting a feasibility study of an online platform for patients with PSC, PBC, and AIH, as a pilot study, providing early insights. Methods: The platform offers educational materials, registration, a discussion forum, and digital tools for quality-of-life assessment. Data on demographics, usage, and quality of life were collected using standardized questionnaires (CLDQ-PSC, PBC-10) and non-standardized questionnaires, and analyzed with Microsoft Office Excel and DATATab. Results: The website was created using an online platform requiring no advanced IT skills. Content was developed in accordance with international guidelines (EASL, AASLD) and translated and adapted for Romanian patients. As of 15 July 2025, 81 patients had been registered (26% PSC, 68% PBC, 6% AIH), with a predominance of urban participants (all patients: 87% female, mean age at diagnosis = 44.5 years). Most participants used mobile devices and reported improved understanding and engagement with their health after using the platform. Conclusions: The first dedicated digital platform has been established in Romania to address the health literacy needs of patients with PSC, PBC, and AIH. The study offers insights into future directions and a replicable model for similar initiatives. The pilot evaluation of the platform faced several limitations, including self-selection bias, non-standardized assessments, and a small sample size. Full article

Background and Objectives: Falls are a leading cause of morbidity and mortality among older adults in hospitals and long-term care facilities (LTCFs). Digital healthcare approaches are increasingly being applied to fall detection and prevention; however, their effectiveness remains uncertain. This review evaluated the effectiveness, usability, and clinical applicability of detection- and prediction-based systems in institutional settings. Materials and Methods: We systematically searched major international and Korean databases—PubMed, Embase, Ovid-MEDLINE, CINAHL, the Cochrane Library, IEEE, KMbase, KISS, KoreaMed, and RISS—for studies published up to December 2024. The eligible studies included randomized controlled trials, quasi-experimental, and observational studies involving older adults in hospitals or LTCFs. Two reviewers independently screened the studies, extracted data, and assessed their quality using standardized tools. Results: Thirty-three studies comprising 20 fall detection systems and 13 fall prediction models were included. Detection systems using inertial, pressure, radar, or multimodal sensors have improved monitoring and achieved high usability (>80% acceptance); however, they did not consistently reduce fall incidence or the occurrence of injurious falls. For instance, one trial reported a nonsignificant reduction in injurious falls (aRR 0.56, 95% CI 0.17–1.79), whereas another trial observed a nonsignificant increase (aIRR 1.60, 95% CI 0.83–3.08). Frequent false alarms contribute to alarm fatigue. The prediction models showed moderate-to-strong discrimination. Gradient boosting and neural networks performed best for continuous gait features, while regression and boosting approaches were effective for categorical EHR data. Most models lacked external validation and were not linked to clinical care pathways. Conclusions: Digital approaches show potential for fall prevention in hospitals and LTCFs; however, current evidence remains inconsistent and limited. Detection systems improve surveillance but offer limited preventive effects, whereas prediction models demonstrate technical promise without establishing clinical benefits. Future research should refine the technology, validate models externally, and integrate them into patient-centered workflows. Full article

Objective: To explore the lived experiences of type 2 diabetes mellitus (T2DM) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD) using continuous glucose monitoring (CGM). Research Design and Methods: A qualitative phenomenological study was conducted with 50 adult T2DM patients on PD or HD who used CGM for at least 14 days. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis framework was applied to identify major themes regarding insulin management, CGM utilization, and emotional and social dimensions. Results: Four main themes emerged, each with multiple subthemes. PD patients emphasized enhanced autonomy and frequent insulin adjustments due to dialysate glucose absorption. Conversely, HD patients reported severe post-dialysis fatigue, emotional distress, and limited social engagement often associated with intra-dialytic hypoglycemia. CGM was valued by 85% of participants for improving metabolic awareness and self-management. However, 15% reported barriers such as device cost and technical difficulties. The insights clearly distinguish the differential impact of dialysis modality on daily glucose control and patient well-being. Conclusions: These findings underscore the critical need for patient-centered care incorporating access to CGM and tailored insulin regimens. Equitable implementation of CGM in dialysis settings could significantly enhance glycemic control, emotional resilience, and overall quality of life. Full article