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The editorial in "Frontiers in Pharmacology" discusses recent advances in improving medication adherence, emphasizing the challenges faced in achieving optimal adherence to long-term therapies. The text highlights the importance of collaboration among stakeholders to support adherence and improve patient outcomes. Various studies presented in the editorial address medication adherence in different contexts, such as chronic conditions, mental health, and cancer treatment, offering insights into interventions and strategies to enhance adherence. The editorial underscores the need for a system-level approach to address adherence challenges and promote resource-efficient strategies. [Extracted from the article]

Telemedicine (TM) has emerged as a valuable tool in managing pediatric type 1 diabetes (T1D), particularly during the COVID-19 pandemic when traditional in-person visits were limited. This narrative review examines the impact of TM on patient-provider relationships, glycemic control, and overall diabetes management in children and adolescents with T1D. Studies consistently demonstrate high levels of patient and provider satisfaction with TM, citing increased consultation frequency, reduced travel burdens, and lower associated costs. However, results regarding the effect of TM on glycemic control, as measured by HbA1c levels, are inconsistent. Some studies show significant reductions in HbA1c levels with TM use, while others report outcomes comparable to or less effective than traditional care. The effectiveness of TM also appears to be influenced by the concurrent use of advanced diabetes technologies, such as continuous glucose monitors and automated insulin delivery systems. Furthermore, TM’s impact on quality of life and other clinical outcomes beyond glucose management remains underexplored. Methodological limitations, including inconsistent randomization strategies and lack of long-term follow-up, hinder definitive conclusions. Despite these uncertainties, TM offers several advantages, such as improved accessibility and patient engagement, which may justify its broader implementation. Future research should focus on optimizing TM approaches to enhance glycemic control and quality of life, identifying the most effective strategies for specific patient groups, and addressing technological and economic barriers. This review highlights the need for comprehensive, long-term studies to fully understand TM’s potential in pediatric T1D management and its integration into standard care practices.

Introduction: Digital health services and technology are rapidly developing following the COVID-19 pandemic. This study aimed to reveal the differences between users of digital health technology (DHT) and the general population with regard to cancer prevention. Materials and Methods: This was an observational study on a conventional sample of 270 DHT users with completed data, performed in September 2021. Results: A significant difference was observed in the proportion of DHT users and the general population reporting the screening test results, which was 2-6 times higher in the DHT group. Digital technologies applied to the "self-care" model were more suitable for internet-literate populations. Discussion: Including digital technologies in a self-care model may be more suitable for internet-literate individuals. Thus, in a preventative health organizational framework, DHT should be integrated and used at the primary care level in the general population to improve disparities in the preventative health domain. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) and other neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD) are associated with progressive cognitive, motor, affective and consequently functional decline considerably affecting Activities of Daily Living (ADL) and quality of life. Standard assessments, such as questionnaires and interviews, cognitive testing, and mobility assessments, lack sensitivity, especially in early stages of neurodegenerative diseases and in the disease progression, and have therefore a limited utility as outcome measurements in clinical trials. Major advances in the last decade in digital technologies have opened a window of opportunity to introduce digital endpoints into clinical trials that can reform the assessment and tracking of neurodegenerative symptoms. The Innovative Health Initiative (IMI)-funded projects RADAR-AD (Remote assessment of disease and relapse--Alzheimer's disease), IDEA-FAST (Identifying digital endpoints to assess fatigue, sleep and ADL in neurodegenerative disorders and immune-mediated inflammatory diseases) and Mobilise-D (Connecting digital mobility assessment to clinical outcomes for regulatory and clinical endorsement) aim to identify digital endpoints relevant for neurodegenerative diseases that provide reliable, objective, and sensitive evaluation of disability and health-related quality of life. In this article, we will draw from the findings and experiences of the different IMI projects in discussing (1) the value of remote technologies to assess neurodegenerative diseases; (2) feasibility, acceptability and usability of digital assessments; (3) challenges related to the use of digital tools; (4) public involvement and the implementation of patient advisory boards; (5) regulatory learnings; and (6) the significance of inter-project exchange and data- and algorithm-sharing. [ABSTRACT FROM AUTHOR]

IntroductionIncreasingly, people are turning toward digital health technologies to support their care management, communication with health professionals, and performing activities of daily living. Digital health technologies may be well implemented in clinical practices in several jurisdictions, but the influence of sociocultural factors may sometimes be neglected. To increase use and sustainability of these innovative solutions in health care, we need to understand acceptability among diverse groups of the population such as linguistically diverse populations. Francophone-speaking populations in Canada, for example, are known to endure challenges with income, health and difficulties associated with living in rural areas which impede on their likelihood to use digital health technologies. As part of the University of Ottawa International Francophonie Research Chair on Digital Health Technologies, this study aimed to understand the conditions that make digital health technologies acceptable among francophone-speaking communities.MethodsUsing a meta-ethnography methodology, this study synthesizes international qualitative research on social acceptability of digital health technology among francophone-speaking communities. We focused on four types of digital health technologies: telemedicine, mobile technologies, wearable technologies, and robotic technologies. Using Noblit and Hare's 7 phase approach to conducting a meta-ethnography, we were able to get a comprehensive synthesis and understanding of the research landscape on the issue. Studies published between 2010 and 2020 were included and synthesized using NVivo, excel and a mind mapping technique.ResultsOur coding revealed that factors of social acceptability for digital health technologies could be grouped into the following categories: care organization, self-care support, communication with care team, relational and technical risks, organizational factors, social and ethical values. Our paper discusses the themes evoked in each category and their relevance for the included digital health technologies.DiscussionIn discussing the results, we present commonalities and differences in the social acceptability factors of the different digital health technologies. In addition, we demonstrate the importance of considering sociocultural diversity in the study of social acceptability for digital health technologies.ImplicationsThe results of this study have implications for practitioners who are the instigators of digital health technology implementation with healthcare service users. By understanding factors of social acceptability among francophone-speaking communities, practitioners will be better suited to propose and support the implementation of technologies in ways that are suitable for these individuals. For policymakers, this knowledge could be used for developing policy actions based on consideration for diversity.

BackgroundEvaluating and integrating digital health technologies is a critical component of a national healthcare ecosystem in the 2020s and is expected to even increase in significance.DesignThe paper gives an overview of international practices on public financing and health technology assessment of digital health technologies (DHTs) in five European Union (EU) countries and outlines recommendations for country-level action that relevant stakeholders can consider in order to support uptake of digital health solutions in Hungary. A scoping review was carried out to identify and gather country-specific classifications and international practices on the financing DHTs in five pioneering EU countries: Germany, France, Belgium, the United Kingdom and Finland.ResultsSeveral frameworks have been developed for DHTs, however there is no single, unified framework or method for classification, evaluation, and financing of digital health technologies in European context. European countries apply different taxonomy, use different assessment domains and regulations for the reimbursement of DHTs. The Working Group of the Hungarian Health Economic Society recommends eight specific points for stakeholders, importantly taking active role in shaping common clinical evidence standards and technical quality criteria across in order for common standards to be developed in the European Union single market.ConclusionSpecificities of national healthcare contexts must be taken into account in decisions to allocate public funds to certain therapies rather than others.

IntroductionDigital health services and technology are rapidly developing following the COVID-19 pandemic. This study aimed to reveal the differences between users of digital health technology (DHT) and the general population with regard to cancer prevention.Materials and MethodsThis was an observational study on a conventional sample of 270 DHT users with completed data, performed in September 2021.ResultsA significant difference was observed in the proportion of DHT users and the general population reporting the screening test results, which was 2–6 times higher in the DHT group. Digital technologies applied to the “self-care” model were more suitable for internet-literate populations.DiscussionIncluding digital technologies in a self-care model may be more suitable for internet-literate individuals. Thus, in a preventative health organizational framework, DHT should be integrated and used at the primary care level in the general population to improve disparities in the preventative health domain.

IntroductionNigeria faces enormous challenges to meet the growing demands for maternal healthcare. This has necessitated the need for digital technologies such as mobile health, to supplement existing maternal healthcare services. However, mobile health programs are tempered with gender blind spots that continue to push women and girls to the margins of society. Failure to address underlying gender inequalities and unintended consequences of mobile health programs limits its benefits and ultimately its sustainability. The importance of understanding existing gender dynamics in mobile health interventions for maternal health cannot be overstated.ObjectiveThis study explores the gender dimensions of Text4Life, a mobile health intervention for maternal healthcare in Edo State, Nigeria by capturing the unique perspectives of women who are the primary beneficiaries, their spouses who are all men, and community leaders who oversaw the implementation and delivery of the intervention.MethodThis qualitative study used criterion-based purposive sampling to recruit a total of 66 participants: 39 women, 25 men, and two ward development committee chairpersons. Data collection involved 8 age and sex desegregated focus group discussions with women and men and in-depth interviews with ward development committee chairpersons in English or Pidgin English. Translated and transcribed data were exported to NVivo 1.6 and data analysis followed a conventional approach to thematic analysis.ResultsWomen had some of the necessary resources to participate in the Text4Life program, but they were generally insufficient thereby derailing their participation. The program enhanced women's status and decision-making capacity but with men positioned as heads of households and major decision-makers in maternal healthcare, there remained the possibility of deprioritizing maternal healthcare. Finally, while Text4Life prioritized women's safety in various contexts, it entrenched systems of power that allow men's control over women's reproductive lives.ConclusionAs communities across sub-Saharan Africa continue to leverage the use of mHealth for maternal health, this study provides insights into the gender implications of women's use of mHealth technologies. While mHealth programs are helpful to women in many ways, they are not enough on their own to undo entrenched systems of power through which men control women's access to resources and their reproductive and social lives.

In Germany, some digital health applications (DiHA) became reimbursable through the statutory health insurance system with the adoption of the Digital Healthcare Act in 2019. Approaches and concepts for the German care context were developed in an iterative process, based on existing concepts from international experience. A DiHA categorization was developed that could be used as a basis to enable the creation of a reimbursed DiHA repository, and to derive evidence requirements for coverage and reimbursement for each DiHA. The results provide an overview of a possible classification of DiHA as well as approaches to assessment and evaluation. The structure of remuneration and pricing in connection with the formation of groups is demonstrated.

Companion technologies, such as social robots and conversational chatbots, take increasing responsibility for daily tasks and support our physical and mental health. Especially in the domain of healthcare, where technologies are often applied for long-term use, our experience with and relationship to such technologies become ever more relevant. Based on a 2-week interaction period with a conversational chatbot, our study (N = 58) explores the relationship between humans and technology. In particular, our study focuses on felt social connectedness of participants to the technology, possibly related characteristics of technology and users (e.g., individual tendency to anthropomorphize, individual need to belong), as well as possibly affected outcome variables (e.g., desire to socialize with other humans). The participants filled in short daily and 3 weekly questionnaires. Results showed that interaction duration and intensity positively predicted social connectedness to the chatbot. Thereby, perceiving the chatbot as anthropomorphic mediated the interrelation of interaction intensity and social connectedness to the chatbot. Also, the perceived social presence of the chatbot mediated the relationship between interaction duration as well as interaction intensity and social connectedness to the chatbot. Characteristics of the user did not affect the interrelations of chatbot interaction duration or intensity and perceived anthropomorphism or social presence. Furthermore, we did not find a negative correlation between felt social connectedness of users to the technology and their desire to socialize with other humans. In sum, our findings provide both theoretical and practical contributions. Our study suggests that regular interaction with a technology can foster feelings of social connectedness, implying transferability of dynamics known from interpersonal interaction. Moreover, social connectedness could be supported by technology design that facilitates perceptions of anthropomorphism and social presence. While such means could help to establish an intense relationship between users and technology and long-term engagement, the contexts in which anthropomorphic design is, actually, the means of choice should be carefully reflected. Future research should examine individual and societal consequences to foster responsible technology development in healthcare and beyond.