Dokument: PICASO: Eine individualisierte, patientenorientierte Plattform zur verbesserten Betreuung von Patienten mit rheumatoider Arthritis - Eine Betrachtung der Patientenseite

Titel:

PICASO: Eine individualisierte, patientenorientierte Plattform zur verbesserten Betreuung von Patienten mit rheumatoider Arthritis - Eine Betrachtung der Patientenseite

Weiterer Titel:

PICASO: The PICASO cloud platform for improved holistic care in rheumatoid arthritis treatment - experiences of patients

URL für Lesezeichen:

https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=63488

URN (NBN):

urn:nbn:de:hbz:061-20230904-162740-6

Kollektion:

Dissertationen

Sprache:

Deutsch

Dokumententyp:

Wissenschaftliche Abschlussarbeiten » Dissertation

Medientyp:

Text

Autor:

Schwartz, Catarina Renée [Autor]

Dateien:

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Dateien vom 28.08.2023 / geändert 28.08.2023

Beitragende:

Prof. Dr. Richter, Jutta [Gutachter]
PD. Dr. Kiltz, Uta [Gutachter]

Dewey Dezimal-Klassifikation:

600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit

Beschreibungen:

Die Versorgung chronisch erkrankter Patienten mit Komorbiditäten und stetig komplexer werdenden Behandlungskonzepten bedarf einer effizienten, sektorübergreifenden Koordination von Behandlungsplänen. Nur so ist eine (kosten-)effiziente Datennutzung, eine Optimierung von Managementprozessen und eine Vermeidung redundanter Diagnostik gewährleistet. Die Einbindung aller Beteiligten (Patienten/Behandler etc.) in die Koordination dieser Prozesse, wurde mit der Informations- und Kommunikations-Plattform (IKT) PICASO ermöglicht, entwickelt im Rahmen des Förderprogrammes der Europäischen Union „Horizon 2020“. Dieses IKT-Instrument mit aktiver Teilhabe am Behandlungs- und Genesungsprozess wird im Rahmen dieser Dissertationsschrift aus Sicht der Patienten evaluiert. Über einen Zeitraum von jeweils sechs Monaten waren 30 Patienten mit rheumatoider Arthritis (RA) und kardiovaskulärer/n Begleiterkrankung/en bzw. Risikofaktor/en in das PICASO Proof-of-concept Projekt eingeschlossen. Über Home-Monitoring-Geräte sowie individuelle Zugänge zu dem patientenspezifischen PICASO-Dashboard konnten die Patienten aktiv an ihrem Gesundheits- und Behandlungsprozess mitwirken. Die persönlichen Vorstellungen erfolgten zu planmäßig vorgesehenen Ambulanzterminen zum Einschluss-Zeitpunkt, nach drei und sechs Monaten. Als ein Teil des Projektes wurde ein umfangreiches Konzept zur Evaluation der Projektbestandteile durch die Patienten entwickelt. Dreißig RA-Patienten (80,0% weiblich) mit mittlerem Alter±Standardabweichung von 58,6±10,8 Jahren, einer Krankheitsdauer von 12,6±8,5 Jahren, einer milden Krankheitsaktivität (DAS28-CRP(4) 2,6±0,9) und 2,9±1,6 Komorbiditäten nahmen teil, sie waren IT-erfahren sowie Anfänger. Die Nutzungsadhärenz der Plattform durch die Patienten war hoch. Evaluationen des Dashboards zeigten insbesondere in den Bereichen Attraktivität, Durchschaubarkeit und Steuerbarkeit positive Bewertungen. Die meisten Teilnehmer (88,9%) waren mit dem Dashboard zufrieden und bewerteten die Nutzung als (eher) einfach. Es kam innerhalb des Untersuchungszeitraums zu einer Steigerung des Empowerments, bspw. setzten sich 48,3% der Patienten neue gesundheitsbezogene Ziele und 91,6% berichteten über eine erleichterte Arzt-Patienten-Kommunikation. Die PICASO-Plattform bietet eine moderne, IT-basierte Ergänzung zur aktuellen Regelversorgung von RA Patienten mit einem positiven Effekt auf das Empowerment und die Partizipation der Patienten am eigenen Behandlungsprozess. Die Integration der Anwendungen in den Alltag der Patienten konnten belegt werden. Die Effekte auf das Outcome der Patienten sowie die Anwendbarkeit der Plattform im klinischen Alltag über längere Zeiträume mit größeren Patientenkollektiven sind in Folgestudien zu prüfen.

The care of chronically ill patients with comorbidities and increasingly complex treatment concepts
requires efficient, cross-sectoral coordination of treatment plans. This is necessary to ensure (cost-)
efficient use of data, optimization of management processes and avoidance of redundant diagnostics.
The integration of all parties involved (patients/health care providers, etc.) in the coordination of these
processes was enabled with the information and communication platform (ICT) PICASO, developed as
part of the European Union's "Horizon 2020" funding program. The ICT tool with options for active
participation in the treatment and recovery process was evaluated from patients’ perspective.
Over a period of six months, 30 patients with rheumatoid arthritis (RA) and cardiovascular concomitant
disease(s) or risk factor(s) were included in the PICASO proof-of-concept project. Patients were able to
actively participate in their health and treatment process via home-monitoring devices and individual
access to their patient-specific PICASO dashboard. Face-to-face visits occurred during scheduled
outpatient appointments at inclusion, after three and six months. As a part of the project, a
comprehensive approach to patients’ evaluation of the project components was developed.
Thirty RA patients (80.0% female) with mean age±standard deviation of 58.6±10.8 years, disease
duration of 12.6±8.5 years, mild disease activity (DAS28-CRP(4) 2.6±0.9), and 2.9±1.6 comorbidities
participated; they were IT experienced as well as novice. Data collection showed high adherence.
Evaluations of the dashboard had positive ratings, especially in the areas of attractiveness, perspicuity
and dependability. Most participants (88.9%) were satisfied with the dashboard and rated its use as
(rather) easy. There was an increase in empowerment within the study period, for example, 48.3% of
patients set new health-related goals and 91.6% reported facilitated doctor-patient communication.
The PICASO platform offers a modern, IT-based supplement to the current standard care of RA patients
with a positive effect on patients' empowerment and participation in their own treatment process. The
integration of the applications into patients' everyday life could be proven. The effects on the outcome
of the patients as well as the applicability of the platform in the clinical routine care over longer periods
with larger patient collectives are to be examined in follow-up studies.

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Lizenz:

Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz

Fachbereich / Einrichtung:

Medizinische Fakultät

Dokument erstellt am:

04.09.2023

Dateien geändert am:

04.09.2023

Promotionsantrag am:

10.03.2023

Datum der Promotion:

24.08.2023

Heinrich-Heine-Universität Düsseldorf

Dokument: PICASO: Eine individualisierte, patientenorientierte Plattform zur verbesserten Betreuung von Patienten mit rheumatoider Arthritis - Eine Betrachtung der Patientenseite