Information Technology-Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study.
health information technologies
health planning
patient outcome assessment
β-thalassemia major
Journal
JMIR medical informatics
ISSN: 2291-9694
Titre abrégé: JMIR Med Inform
Pays: Canada
ID NLM: 101645109
Informations de publication
Date de publication:
23 Jan 2019
23 Jan 2019
Historique:
received:
27
10
2017
accepted:
19
07
2018
revised:
26
01
2018
entrez:
24
1
2019
pubmed:
24
1
2019
medline:
24
1
2019
Statut:
epublish
Résumé
Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed. Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12). Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.
Sections du résumé
BACKGROUND
BACKGROUND
Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally.
OBJECTIVE
OBJECTIVE
The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC.
METHODS
METHODS
A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed.
RESULTS
RESULTS
Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12).
CONCLUSIONS
CONCLUSIONS
Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.
Identifiants
pubmed: 30672740
pii: v7i1e9291
doi: 10.2196/medinform.9291
pmc: PMC6364210
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e9291Informations de copyright
©Rajat Kumar Agarwal, Amit Sedai, Kumari Ankita, Lalith Parmar, Rakesh Dhanya, Sunil Dhimal, Reshma Sriniwas, Ashwini Gowda, Pooja Gujjal, Pushpa H, Suman Jain, J Dasaratha Ramaiah, Sujata Jali, Neelavva Rayappa Tallur, Stalin Ramprakash, Lawrence Faulkner. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 23.01.2019.
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