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      Using Self-Study and Peer-to-Peer Support to Change “Sick” Care to “Health” Care: The Patient Perspective

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          Abstract

          Background: Access to digital health technologies is contributing to a paradigm shift where sickcare may become authentic healthcare. Individuals can now access personal health data through wearable sensors, affordable lab screenings, genetic and genomic sequencing, and real-time health tracking apps. Personal health data access creates opportunities to study health indicators 24/7 and in real time. This is especially useful for patients with hard-to-diagnose or treat diseases, which led to a self-formed patient group called Project Apollo. Project Apollo is composed of highly motivated patients with common experiences of undiagnosed conditions, a lack of clear treatment options, and shared frustrations with navigating the U.S. healthcare system. These experiences have led the Apollo cohort to supplement their health knowledge through self-study research.

          Objective: To qualify the experience and expectations of patients affiliated with Project Apollo.

          Methods: A qualitative approach involved record review and semi-structured interviews. One-hour semi-structured interviews were conducted to solicit motivations, expectations, and potential barriers and facilitators to self-study followed by a brief survey on digital tool use. Interviews were digitally recorded, transcribed, and analyzed to identify themes and patterns.

          Results: Participants included six females and three males ranging in age from 30 to 70+ years. Responses were organized under five key themes including: frustration with healthcare system; community support; self-study/N-of-1 research; access to experts; moving from sick to healthcare. Facilitators include motivation, albeit stemming from frustration, a safe community where patients derive support, and access to experts for guidance. Increasing awareness of clinicians about the potential value of partnering with patients who are advancing health knowledge through self-study is critical.

          Conclusions: N-of-1 self-study research, coupled with community support and digital health tools, appears to be one plausible pathway to shifting the paradigm from sickcare toward patient-partnered healthcare.

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          Most cited references29

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          Evidence based medicine: what it is and what it isn't

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            Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies

            Burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.
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              Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction

              Physician burnout has taken the form of an epidemic that may affect core domains of health care delivery, including patient safety, quality of care, and patient satisfaction. However, this evidence has not been systematically quantified.
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                Author and article information

                Contributors
                Journal
                Front Digit Health
                Front Digit Health
                Front. Digit. Health
                Frontiers in Digital Health
                Frontiers Media S.A.
                2673-253X
                04 June 2020
                2020
                : 2
                : 2
                Affiliations
                [1] 1Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego , La Jolla, CA, United States
                [2] 2Center for Wireless and Population Health Systems, UC San Diego , La Jolla, CA, United States
                [3] 3The Design Lab, UC San Diego , La Jolla, CA, United States
                Author notes

                Edited by: Constantinos S. Pattichis, University of Cyprus, Cyprus

                Reviewed by: Elena Cardillo, National Research Council (Cnr), Italy; Abu Saleh Mohammad Mosa, University of Missouri, United States

                *Correspondence: Camille Nebeker nebeker@ 123456eng.ucsd.edu

                This article was submitted to Connected Health, a section of the journal Frontiers in Digital Health

                Article
                10.3389/fdgth.2020.00002
                8522003
                34713016
                4e5401d6-71be-4fde-b135-df06af6d2c63
                Copyright © 2020 Nebeker, Weisberg, Hekler and Kurisu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 December 2019
                : 21 April 2020
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 33, Pages: 12, Words: 9826
                Funding
                Funded by: Walton Family Foundation, doi 10.13039/100010536;
                Funded by: University of California, San Diego, doi 10.13039/100007911;
                Categories
                Digital Health
                Original Research

                citizen science,n-of-1,digital health,self-tracking,participant-led research,peer-to-peer support,research ethics

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