1. Dunleavy G1, Posadzki PP1, Kyaw BM2, Car J 1, 3.
Digital health education in low and middle-income countries: An inquiry from 22 studies across
Dunleavy G1, Posadzki PP1, Kyaw BM2, Car J 1, 3.
1Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
2Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
3Global eHealth Unit, School of Public Health, Imperial College London, UK.
In this study we will be collecting data on wound characteristics, HRQoL, health service utilisation and other cost-consequences from a societal perspective at multiple sites (polyclinics, hospitals, elderly homes) in Singapore. The study is a cross-sectional study with a recruitment target of 1,000 adult patients.
The obtained data on healthcare utilisation and other cost items will be linked with corresponding unit costs from collaborating healthcare providers, the ministry of health in Singapore or other sources. This data will be merged with already published national and international data on e.g. prevalence to enable calculations to estimate the humanistic and economic burden of wounds in Singapore.
Using a COI methodology for our study will be useful in terms of policy decision making and prioritisation as it tells us how much society spends on chronic wounds and what could potentially be saved if the disease were to decrease or eradicated. The identification of different cost-driving components will also be important information when it comes to prioritisation e.g. what interventions that should be introduced for chronic wound patients and which subgroup that most likely need and will benefit more from being targeted related to ethnicity, age etc. In our analyses we will aim to explore HRQoL and costs for different
subgroups to gain an deeper understanding on how the humanistic and economic burden of chronic wounds in Singapore is related to wounds of different aetiologies, wounds of various severity, patients sociodemographic/clinical characteristics, diagnostic procedures and treatments.
Our analyses will be conducted by exploring HRQoL and costs for different subgroups such as various ethnicities, wound aetiologies and other sociodemographic and clinical characteristics. This data will be able to:
Background
The WHO estimates that there is a shortage of approximately 17.4 million healthcare workers globally, of which, almost 2.6 million are doctors and over 9 million are nurses and midwives.
The most critical shortage of healthcare professionals (HCP) is experienced in low and middle-income countries (LMIC), adversely affecting people’s health and health outcomes.
Digital health education (DHE) might be one solution to tackle these problems
Objectives
The objective of this study is to assess the effectiveness of DHE interventions in HCP education in LMICs, in terms of (i) knowledge, skills, attitude and satisfaction; (ii) costs, safety, patient-centred outcomes.
Methods
Results
Electronic searches ( )
MEDLINE(Ovid)
Embase (Elsevier)
CENTRAL (Wiley)
PsychINFO (Ovid)
ERIC (Ovid)
CINAHL (Ebsco)
Web of Science Core Collection (Thomson Reuters)
Trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies
The search strategy yielded a total of 25,739 records with 22 RCTs/cRCTs and 1896 participants included for the analyses.
19 studies were conducted in upper-middle income countries, with only two studies conducted in LIMCs (India, The Philippines) and one study conducted in a low income country (Kenya).
The results were mixed and inconclusive for all four primary outcomes, i.e., some studies favouring DHE whereas others traditional learning.
We identified poor reporting or under-reporting of mainly secondary outcomes, e.g., none of the studies reported any patient-centred outcomes or adverse effects of DHE, and only one study evaluated costs of DHE.
Results
Conclusions
We were unable to conclude whether DHE is effective in improving knowledge, skills, attitudes and satisfaction of HCPs when compared with traditional learning due to the overall very low quality of evidence. More research is needed in LIMC to inform policy makers.
Acknowledgement
We would like to acknowledge the contribution of colleagues from Karolinska Institutet, Sweden and Imperial College London, UK.