Saudi Cultural Missions Theses & Dissertations
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Item Restricted Healthcare in Crisis: Assessing Medication Adherence, Health Care Access, Telehealth Utilization, and Variations of Depression Treatment in the Era of COVID-19 for US Hypertensive Patients(Howard University, 2025) alharbi, Rehab; La’Marcus, WingateBackground: Coronaviruses (CoVs) are highly contagious viruses that cause respiratory and gastrointestinal illnesses. It disrupted global healthcare systems and affected access to care for chronic conditions like hypertension. It is a major risk factor for cardiovascular disease and a leading cause of death in the U.S. However, the pandemic shifted healthcare focus to COVID-19. Telehealth emerged as a critical tool for maintaining continuity of care. The pandemic also intensified mental health issues, such as depression. This study explores medication adherence, healthcare access, telehealth utilization, and depression treatment patterns among U.S. hypertensive patients during COVID 19. Methods: This cross-sectional analysis used secondary data from the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS).Outcomes included medication adherence among hypertensive patients, telehealth use, healthcare delay during the pandemic, and depression treatment variations in adults with both hypertension and depression. Descriptive statistics were utilized to describe patients’ characteristics, while logistic regression identified predictors of outcomes. Results: Medication adherence varied across antihypertensive classes, with ARBs having the lowest (53.4%) and beta-blockers having the highest (60.6%) levels of adherence. Older adults had lower adherence (adjusted odds ratio (AOR) = 0.87, p < 0.05) compared to younger adults (18-34). Whites were more likely to utilize telehealth than Blacks (AOR = 1.13, P = 0.05). Older individuals faced higher odds of delayed care, with those aged 50–64 having an (AOR = 1.19 ,p = 0.02), and v those aged 65 and above having an (AOR=1.29,p < 0.001). Additionally, Older adults aged 50–64 were more likely to receive depression treatment (AOR: 2.81, p < 0.001), and whites had 2 times higher odds of receiving depression treatment compared to blacks, with a p-value of 0.05. Those with poor physical health had the highest odds of receiving treatment (AOR = 5.99, p < 0.001), compared to those with excellent physical health status. Conclusions: The study highlights disparities in medication adherence, healthcare access, telehealth use, and depression treatment among hypertensive patients during COVID-19. Influenced by age, race, physical health, and gender. These findings highlight the need for policy interventions to improve access to chronic disease care.5 0Item Restricted Evaluating Reported Patient Perspectives of Teledentistry Use for Dental Care Provision During the COVID-19 Pandemic in Saudi Arabia: A Scoping Review(University of Exeter, 2024) Althabit, Thabet; Carrieri, DanieleBackground: The COVID-19 pandemic significantly impacted dental services, increasing interest in teledentistry as an alternative. In Saudi Arabia, dental clinics' temporary closure in March 2020 made teledentistry crucial for maintaining dental care. Despite advanced technology, teledentistry use was low. Understanding patient perspectives is key to improving its adoption. Objective: This review synthesizes evidence on patient perspectives, satisfaction, and perceived outcomes of teledentistry during the COVID-19 pandemic in Saudi Arabia to guide future strategies and research. Methods: Following a scoping review methodology, we searched multiple databases from 2020 to 2024, identifying studies involving Saudi patients using teledentistry during the pandemic. Data were extracted and analyzed thematically. Results: Eleven studies from 2020 to 2023 were included. Key themes were accessibility, convenience, patient satisfaction, and security concerns. Teledentistry improved access and reduced costs, with high satisfaction for minor issues. However, data privacy concerns and limitations in handling complex cases were noted. Conclusion: Teledentistry offered significant benefits during the pandemic, enhancing accessibility and patient satisfaction for minor issues. Yet, managing complex cases and ensuring data security remain challenges. A hybrid model of teledentistry and in-person visits is recommended. Further research on long-term effects, cost-effectiveness, and data security is needed.41 0Item Restricted AI in Telehealth for Cardiac Care: A Literature Review(University of technology sydney, 2024-03) Alzahrani, Amwaj; Li, lifuThis literature review investigates the integration of artificial intelligence (AI) in telehealth, with a specific focus on its applications in cardiac care. The review explores how AI enhances remote patient monitoring, facilitates personalized treatment plans, and improves healthcare accessibility for patients with cardiac conditions. AI-driven tools, such as wearable devices and implantable medical devices, have demonstrated significant potential in tracking critical health parameters, enabling timely interventions, and fostering proactive patient care. Additionally, AI-powered chatbots and telehealth platforms provide patients with real-time support and guidance, enhancing engagement and adherence to treatment regimens. The findings reveal that AI contributes to improving healthcare outcomes by enabling early detection of cardiac events, tailoring treatment plans to individual patient needs, and expanding access to care for underserved populations. However, the integration of AI in telehealth is not without challenges. Ethical considerations, such as ensuring data privacy, managing biases in AI algorithms, and addressing regulatory complexities, emerge as critical areas requiring attention. Furthermore, technological limitations, including the need for robust validation and patient acceptance of AI technologies, underscore the importance of bridging the gap between research and real-world implementation. This review also examines future trends, including the integration of blockchain technology with AI to enhance data security and privacy in telehealth systems. Advancements in machine learning and the Internet of Things (IoT) are paving the way for innovative solutions, such as secure remote monitoring and personalized rehabilitation programs. While AI holds transformative potential in revolutionizing telehealth services for cardiac patients, addressing these challenges is imperative to ensure equitable, effective, and patient-centered care. This review underscores the need for interdisciplinary collaboration and regulatory oversight to unlock the full potential of AI in telehealth and improve outcomes for cardiac patients globally.30 0Item Restricted The Role of Pharmacists on Virtual Wards : A Focus Group Study(University of Brighton, 2024) Alahmari, Ahmed; Jeffs, SimonAbstract Objectives: This study explores the constantly changing role of pharmacists in virtual wards. Its main objective is to identify the precise challenges faced by pharmacists and pharmacy technicians. It also seeks to explore the manner in which these professionals can improve patient care by improving operational efficiency in digital care settings. Methods: The study employs a qualitative design, using focus group discussions with a sample of pharmacists and pharmacy technicians from Sussex Community NHS Foundation Trust. The data was analysed using thematic analysis, which helped extract key themes, including changing clinical roles, adaptation of technology, gaps in training, operational barriers, concerns about data security, and the impact of policy and workload in service delivery. Results: It was concluded that pharmacists are increasingly playing an active role in multidisciplinary teams (MDTs), taking up responsibilities in making clinical decisions, including patient management and independent prescribing. Specifically, pharmacists expressed concern in relation to the need for more advanced training on digital health technologies, including systems that monitor patients remotely. Furthermore, data security management was noted as an important matter, particularly in settings where digital tools were changing at a fast pace. Findings also show that operational inefficiencies, worsened by poor communication and geographic dispersion, obstruct the delivery of care. Conclusion: Integrating pharmacists into VWs is changing the character of their roles, calling for a higher degree of clinical independence and proficiency in digital health tools. Even though pharmacists are becoming more involved in direct patient care, there are still gaps in technological infrastructure and inadequate specialised training, which limits their effectiveness. Dealing with these issues using targeted interventions, such as enhanced training programs, better integration of technology, and more equitable distribution of workloads, is needed to optimise the contributions of pharmacists. Ultimately, it is assumed that overcoming these barriers will result in a more efficient healthcare system that improves patient outcomes.12 0Item Restricted Home Monitoring in Interstitial Lung Disease(University College London, 2024) Althobiani, Malik Abdulmalik; Hurst, John R; Porter, Joanna; Russell, Anne-Marie; Folarin, AmosIntroduction: Interstitial lung disease (ILD) comprises a variety of conditions affecting the parenchyma of the lung, with a diverse incidence. Some patients are prone to rapid progression, while others are susceptible to exacerbations. Forced vital capacity (FVC) is used as an endpoint in clinical trials for novel idiopathic pulmonary fibrosis (IPF) therapies. However, it is often measured every three months, resulting in lengthy monitoring periods to identify meaningful treatment responses or disease trajectories. Home spirometry may enable more regular monitoring, potentially allowing for faster detection of ineffective treatment and reductions in clinical trial size, duration, and cost. Individuals with ILD often experience cough, shortness of breath, anxiety, exercise limitation, and fatigue, impacting their quality-of-life (QoL). Conventional indicators of disease progression, such as pulmonary function tests (PFT), may not completely capture the severity of symptoms experienced by patients. Continuous remote patient monitoring involving more than FVC may provide a more complete and real-time assessment of physiological parameters and symptoms. However, the views of clinicians and patients are poorly understood, as is the feasibility and utility of delivering such an approach. Aim: To systematically gather, summarise and evaluate the evidence from clinical trials for feasibility, reliability, and detection of exacerbations and/or disease progression in patients with ILD. To understand the views of clinicians and patients about home monitoring in patients with ILD. To investigate the feasibility and utility of a 4 contemporary approach to patient care using commercially available technology to detect disease progression in patients with ILD through continuous monitoring of physiological parameters and symptoms. Methods: A systematic review was conducted assessing studies on home monitoring of physiological parameters and symptoms to detect ILD exacerbations and progression. This was followed by an international survey of clinicians to explore their perspectives on using telehealth for remote ILD health care support. A patient survey was then conducted to quantify patients’ use of and experiences with digital devices. These preliminary studies informed the development of the research question and main PhD hypotheses. To test these hypothesis, two subsequent studies were conducted. Firstly, a feasibility study that assessed the feasibility, acceptability, and value of remote monitoring using commercially available technologies over 6 months period. Secondly, a prospective observational cohort study that evaluated a real-time multimodal program using commercially available technology to detect disease progression in patients with ILD through continuous monitoring of physiological parameters and symptoms. Results: The systematic review provided supportive evidence for the feasibility and acceptability of home monitoring in patients with ILD and identified priorities for future research. The findings of the follow-up studies indicated that although health care professionals recognised the potential benefits of home monitoring, their adoption rate was low due to barriers like lack of organisational support, technical issues, and 5 workload constraints. Although the findings of the mixed-methods study have demonstrated that digital devices are widely used among patients with ILD, the views and perspectives regarding the use of these devices is varied. The prospective multi- centre observational cohort study provided evidence supporting the feasibility and acceptability of remote monitoring to capture both subjective and objective data from varied sources in patients with respiratory diseases. The high engagement level observed from the passively collected data suggests the potential value of wearables for long-term, user-friendly remote monitoring in chronic respiratory disease management. The main study is one of the first to employ a comprehensive multimodal remote monitoring system to investigate the potential of home-monitoring to detect progression in patients with ILD. The results demonstrate the potential of multimodal home-monitoring to assess associations between physiological parameters and symptoms with disease progression, and to detect disease progression in patients with ILD. Moreover, the results suggest a strong correlation between hospital and home measurements of forced vital capacity in patients with ILD. Conclusion: Taken collectively, the findings presented in this thesis supports the use of a multimodal home-monitoring system, and the potential role for physiological parameters and symptoms to detect ILD progression. It provides a contemporary, personalised approach to patient management. These results provide a critical initial step towards further evaluating the value of home-monitoring for ILD management. However, larger, longitudinal validation studies are required. Future research could explore the potential of machine learning algorithms on this data for real-time detection of ILD disease progression. Machine learning models could provide early detection of changes in lung function and alert patients and healthcare providers to acute and chronic changes and empower patients to better self-manage their disease. This could allow for timely interventions and more personalised management of ILD.23 0Item Restricted An exploration of the perceptions and experiences of adult heart failure patients utilizing telehealth monitoring in their homes: A Qualitative Systematic Review(Saudi Digital library, 2023-12-13) Alhazmi, Raneem Mohammed Ahmed; Whittingham, Katharine; Brindley, Allison; Gee, GarethAbstract Background Heart failure (HF) is a significant health issue since affected individuals endure a substantial load of symptoms and restrictions in their physical functioning, with implications on their mental and behavioural welfare. The implementation of a telemonitoring system promises to enhance the treatment of the disease by facilitating prompt medication adjustments, early identification of signs and symptoms indicating illness progression, and fostering the adoption of self-care practices. This qualitative systematic review examines the overall experiences of adult heart failure patients who used telemonitoring equipment inside their homes as a component of follow-up treatment and self-management. Objective To identify and explore the experiences and perceptions of adult HF using TM in their homes. Methods A qualitative systematic review was performed using the JBI framework, studies released between 2010 and 2022 and the search was implemented from three central databases that have been carefully searched (CINHAL full text, MEDLINE and PUBMED). Results Seven qualitative investigations, for a total of more than one hundred patients diagnosed with heart failure using telemonitoring tools. A total of forty-nine results were identified and eight categories derive. Four synthesised results were obtained: awareness and knowledge about their condition promote reassurance and self-empowerment, continuity in care facilitates adherence to habits and self-management, patients value in-person interactions with healthcare practitioners and perceive telemonitoring systems as lacking personalized touch, patients find value in the time efficiency and user-friendliness of telemonitoring systems, but technical and economic barriers often outweigh these benefits. Conclusion TM can enhance patients' disease awareness, knowledge, and self-care competence. Patients generally reported feeling reassured and empowered through daily self-monitoring, which helped establish their healthy routines. However, the qualitative evidence indicates that patients still highly value human connection and in-person support from healthcare professionals, seeing TM as an adjunct instead of serving as a substitute for in-person interactions46 0Item Restricted Assess Perspective and Knowledge of Healthcare Providers Towards Telehealth in Saudi Arabia: A Systematic Review(Saudi Digital Library, 2023-11-28) Mulayhi, Badriah Mousa; George, JominBackground and Objective: Telehealth has become a well-known tool for the delivery of health care in Saudi Arabia, and the perspective and knowledge of healthcare providers are influential in the implementation, adoption and advancement of the method. This systematic review was conducted to examine the current literature base regarding telehealth and the related healthcare professional perspective and knowledge in the Kingdom of Saudi Arabia. Materials and Methods: This systematic review was conducted by searching seven databases, including MEDLINE, CINHAL, Web of Science, Scopus, PubMed, PsycINFO and ProQuest Central. Inclusion criteria designated studies that were published in the English language from 2000 to 2023 in Saudi Arabia, full-text available and assessed the perspective or knowledge of healthcare providers towards telehealth. This systematic review was guided by Boland's guidance. All related studies were individually assessed by the researcher using the AXIS tool, which assesses the quality of cross-sectional studies in a systematic review. Data were extracted into a table, and a narrative synthesis was carried out to summarise and report the findings. Results: Ten studies met the inclusion criteria out of the 1840 search results. Positive perspective and low levels of knowledge among providers were observed across the studies. Frequent reasons for a positive attitude toward telehealth among healthcare providers were improving healthcare quality, access and delivery, saving time and money and its effective use. In addition, age, gender, profession and work experience were identified as factors associated with health professionals' knowledge level. The major challenges facing healthcare providers in practicing telehealth in Saudi Arabia are insufficient expert support, patient privacy, internet connection issues, lack of training courses, lack of knowledge of telehealth usage and high cost. Conclusions: This systematic review highlighted the existing perception and knowledge of health care providers towards telehealth. As a compilation of the varied personal attitude and knowledge of concerned professionals, it will assist in the better implementation of telehealth in Saudi Arabia, improve its advancement as a health care delivery option and reduced common challenges to its use.21 0Item Restricted The Role of an online health forum for Women with Breast Cancer Treated by Chemotherapy(Saudi Digital Library, 2023-11-03) Aljehani, Shroog; Bath, PeterBreast cancer, which affects more women than men, is among the global death-leading chronic conditions that have triggered the need for online health forums as interventions to help meet various healthcare goals. Women with breast cancer treated with chemotherapy have diverse needs, some of which can be met through these forums. Therefore, this dissertation is a systematic review that evaluates evidence from different journal publications to investigate the role of an online health forum for women with breast cancer treated by chemotherapy. The PICO framework was the preferred method for developing the study’s research question, while the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was the selected methodology for presenting results for this systematic review. This study is important because the findings will inform the relevance and usage of online health forums, informational needs, and the perceptions and information-seeking behaviours of women with breast cancer treated by chemotherapy.10 0Item Restricted Exploring medical staff ‘s attitudes, towards the using of Telehealth during the COVID 19 pandemic, with in Al Thager General Hospital, Jeddah, Saudi Arabia.(Saudi Digital Library, 2023-09-26) Albaqami, Waleed; Jenkins, JudyBackground: Despite the extensive research on the utilisation of Telehealth during COVID-19, no review has attempted to summarise the findings for a better understanding of how the global event has affected healthcare professionals’ attitudes toward Telehealth. This study presents a systematic review of medical staff attitudes toward the utilisation of Telehealth during COVID-19. Methods: Utilising the PRISMA guideline, a comprehensive literature search was performed in three electronic databases: PubMed, Google Scholar and ScienceDirect. All the retrieved articles were screened according to specific inclusion criteria to select relevant articles published between 2014 and 2022. Results: Fifteen relevant articles were included in the systematic review. Thematic analyses of the retrieved data led to the synthesis of four themes: (1) Positive attitudes, (2) facilitators and enablers, (3) negative attitudes, and (4) barriers. Participants generally reflected positive attitudes toward telehealth utilisation during the pandemic, as evidenced by their positive feedback on actual usage and suggestions for improved telehealth modalities. Specific factors such as ease of use, effort expectancy, performance expectancy, and facilitating conditions were identified as facilitators of positive attitudes. However, negative attitudes such as underutilisation, a higher risk of misdiagnosis, and data privacy and security issues were reported. Conclusion: These findings assist relevant bodies and policymakers in developing strategies to improve the utilisation of Telehealth in the COVID-19 period, as well as balancing the frequency of in-person and Telehealth sessions without compromising the quality of healthcare services.38 0