Name: the dyspepsia educational tool as a novel aid in dyspepsia management
Uploaded: 2019-06-29T13:00:00
Description: Watch this Scientific Journal Video about The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management at JoVE.com

Development of the dyspepsia educational tool was funded by a grant received from The Netherlands Organization for Health Research and Development (ZonMw), in the context of the &#39;to do or not to do&#39; program by the Netherlands Federation of University Medical Centers (NFU). We also would like to thank all the staff from Medify bv. for support, equipment, and expertise. In addition we would like to thank all our participants.

All procedures described in this protocol were approved by the Radboud university medical center Institutional Review Board (file no. 2016-3074).
1. Preliminary research
<ol>
	<li>Focus groups to assess unmet needs in dyspepsia management
	<ol>
		<li>Create a structure for a focus group with dyspeptic patients and with general practitioners.</li>
		<li>Conduct a focus group. Keep conducting additional focus groups until saturation of information is reached. 
		NOTE: For this study two f...

<ol>
	<li>Barello, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=eHealth+for+Patient+Engagement:+A+Systematic+Review.">eHealth for Patient Engagement: A Systematic Review.</a> Frontiers in Psychology. 6, 2013 (2015).</li><li>Halpert, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Irritable+Bowel+Syndrome:+Patient-Provider+Interaction+and+Patient+Education.">Irritable Bowel Syndrome: Patient-Provider Interaction and Patient Education.</a> Journal of Clinical Medicine. 7 (1), (2018).</li><li>Schulz, P. J., Rubinelli, S., Zufferey, M. C., Hartung, U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Coping+With+Chronic+Lower+Back+Pain:+Designing+and+Testing+the+Online+Tool+ONESELF.">Coping With Chronic Lower Back Pain: Designing and Testing the Online Tool ONESELF.</a> Journal of Computer-Mediated Communication. 15 (4), 625-645 (2010).</li><li>Tack, J., Bisschops, R., Sarnelli, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathophysiology+and+treatment+of+functional+dyspepsia.">Pathophysiology and treatment of functional dyspepsia.</a> Gastroenterology. 127 (4), 1239-1255 (2004).</li><li>Talley, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+dyspepsia:+new+insights+into+pathogenesis+and+therapy.">Functional dyspepsia: new insights into pathogenesis and therapy.</a> Korean Journal of Internal Medicine. 31 (3), 444-456 (2016).</li><li>Chiarioni, G., Pesce, M., Fantin, A., Sarnelli, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complementary+and+alternative+treatment+in+functional+dyspepsia.">Complementary and alternative treatment in functional dyspepsia.</a> United European Gastroenterology Journal. 6 (1), 5-12 (2018).</li><li>Ford, A. C., Marwaha, A., Lim, A., Moayyedi, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+the+prevalence+of+clinically+significant+endoscopic+findings+in+subjects+with+dyspepsia?+Systematic+review+and+meta-analysis.">What is the prevalence of clinically significant endoscopic findings in subjects with dyspepsia? Systematic review and meta-analysis.</a> Clinical Gastroenterology and Hepatology. 8 (10), 830-837 (2010).</li><li>Matsuzaki, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Burden+of+impaired+sleep+quality+on+work+productivity+in+functional+dyspepsia.">Burden of impaired sleep quality on work productivity in functional dyspepsia.</a> United European Gastroenterology Journal. 6 (3), 398-406 (2018).</li><li>Keefer, L., Palsson, O. S., Pandolfino, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Best+Practice+Update:+Incorporating+Psychogastroenterology+Into+Management+of+Digestive+Disorders.">Best Practice Update: Incorporating Psychogastroenterology Into Management of Digestive Disorders.</a> Gastroenterology. 154 (5), 1249-1257 (2018).</li><li>Feinle-Bisset, C., Azpiroz, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dietary+and+lifestyle+factors+in+functional+dyspepsia.">Dietary and lifestyle factors in functional dyspepsia.</a> Nature Reviews Gastroenterology &amp; Hepatology. 10 (3), 150-157 (2013).</li><li>Manes, G., Balzano, A., Marone, P., Lioniello, M., Mosca, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Appropriateness+and+diagnostic+yield+of+upper+gastrointestinal+endoscopy+in+an+open-access+endoscopy+system:+a+prospective+observational+study+based+on+the+Maastricht+guidelines.">Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy system: a prospective observational study based on the Maastricht guidelines.</a> Alimentary Pharmacology &amp; Therapeutics. 16 (1), 105-110 (2002).</li><li>de Jong, J. J., Lantinga, M. A., Drenth, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevention+of+overuse:+A+view+on+upper+gastrointestinal+endoscopy.">Prevention of overuse: A view on upper gastrointestinal endoscopy.</a> World Journal of Gastroenterology. 25 (2), 178-189 (2019).</li><li>Baldwin, J. L., Singh, H., Sittig, D. F., Giardina, T. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient+portals+and+health+apps:+Pitfalls,+promises,+and+what+one+might+learn+from+the+other.">Patient portals and health apps: Pitfalls, promises, and what one might learn from the other.</a> Healthcare (Amsterdam). 5 (3), 81-85 (2017).</li><li>Sleurs, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mobile+health+tools+for+the+management+of+chronic+respiratory+diseases.">Mobile health tools for the management of chronic respiratory diseases.</a> Allergy. , (2019).</li><li>Yuan, S. L. K., Marques, A. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+ProFibro+-+a+mobile+application+to+promote+self-care+in+patients+with+fibromyalgia.">Development of ProFibro - a mobile application to promote self-care in patients with fibromyalgia.</a> Physiotherapy. 104 (3), 311-317 (2018).</li><li>Huckvale, K., Morrison, C., Ouyang, J., Ghaghda, A., Car, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+evolution+of+mobile+apps+for+asthma:+an+updated+systematic+assessment+of+content+and+tools.">The evolution of mobile apps for asthma: an updated systematic assessment of content and tools.</a> BMC Medicine. 13, 58 (2015).</li><li>Mayer, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Applying+the+science+of+learning:+evidence-based+principles+for+the+design+of+multimedia+instruction.">Applying the science of learning: evidence-based principles for the design of multimedia instruction.</a> American Psychologist. 63 (8), 760-769 (2008).</li><li>Zhang, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interactive+Multimedia-Based+E-Learning:+A+Study+of+Effectiveness.">Interactive Multimedia-Based E-Learning: A Study of Effectiveness.</a> American Journal of Distance Education. 19 (3), 149-162 (2005).</li><li>Northrup, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+framework+for+designing+interactivity+intoWeb-based+instruction.">A framework for designing interactivity intoWeb-based instruction.</a> Educational Technology. 41 (2), 31-39 (2001).</li><li>Stalmeijer, R. E., McNaughton, N., Van Mook, W. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+focus+groups+in+medical+education+research:+AMEE+Guide+No.+91.">Using focus groups in medical education research: AMEE Guide No. 91.</a> Medical Teacher. 36 (11), 923-939 (2014).</li></ol>

The digital dyspepsia educational tool, developed using the abovementioned protocol, is a novel multimedia educational tool to assist patients and physicians in management of dyspepsia. This tool may be deployed to stimulate patient engagement, and improve health outcomes while curtailing inappropriate use of medical resources.
A similar procedure has been described for development of a fibromyalgia app15. As with dyspepsia, management of fibromyalgia focuses initially ...

Patient education is an important component of healthcare, enabling active engagement of patients in responsible management of their health1. To improve efficacy and appropriate use of healthcare resources, contemporary and disease-specific measures are needed to facilitate patient engagement. 
Nowadays, digital tools increasingly replace paper versions of patient education, benefiting from their sustainability, effective distribution, and potential to visualize information. For chronic illnesses that lack curative treatment and biological substrate, education is essential for motivation of patients to engage in self-management2,3. Dyspepsia is a condition that often causes long-term complaints. Exact origin of symptoms remains unclear, although evidence indicates three main pathophysiological mechanisms, including 1) hypersensitivity to gastric distension, 2) impaired gastric accommodation, causing inadequate distension in reaction to a meal, and 3) delayed gastric emptying4. Additionally, duodenal perturbations, brain-gut disturbances, and dietary factors have been suggested to play a role5. Main symptoms comprise post-prandial fullness, epigastric pain, early satiety, and epigastric burning. Upper gastrointestinal (GI) endoscopy in dyspeptic patients reveals no cause of symptoms in over 70%; these cases are referred to as functional dyspepsia. Pharmacological treatment options for dyspepsia are limited, often inciting patients to resolve to complementary and alternative therapies6,7. Quality of life in dyspepsia patients is often reduced as dyspepsia is associated with concomitant issues, such as impaired sleep quality and loss of work productivity8. Dyspepsia management benefits from active patient engagement, as behavioral interventions are a main component of dyspepsia treatment9,10. These interventions require a significant effort from patients, which may be facilitated by personalized and interactive support. 
Correct management of dyspepsia is essential to improve healthcare outcomes and prevent overuse of medical resources. Upper gastrointestinal (GI) endoscopy for dyspepsia is a well-known form of overuse as its diagnostic yield is limited11. Several methods have been proposed to reduce the number of upper GI endoscopies, mostly focused on physician education or drug-based symptom reduction12. Uncertainty about the cause of dyspepsia is often unsatisfactory for patients, and diagnostic tests may be performed in excess as a consequence. Consequently, education of patients about pathogenesis, treatment options, and conservative management would be an effective strategy to reduce the number of upper GI endoscopies. 
While digital tools potentially provide an excellent platform for patient education, several functionalities of a digital tool are required, in order to maximize patient adoption and subsequent patient engagement in disease management13. The expected success of digital education mainly depends on its development process and measures taken to optimize information transfer. However, development processes of digital educational tools are infrequently published, impairing reproduction, progression, and evaluation of the validity and safety1,14.
There is need for a detailed description and evaluation of development of a patient-centered digital educational tool. We describe the development of our dyspepsia educational tool, to serve as a template for future educational tool development.

<table border="0" cellpadding="0" cellspacing="0" style="width:591px;" width="589">
	<tbody>
		<tr height="62">
			<td height="62" style="height:63px;width:223px;">Dyspepsia e-learning</td>
			<td style="width:73px;">Dyspepsia e-learning</td>
			<td style="width:123px;"></td>
			<td style="width:172px;">Digital educational tool for dyspepsia management</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:223px;">Paper Food Diary</td>
			<td style="width:73px;">Any</td>
			<td style="width:123px;"></td>
			<td>Schedule to record food consumption and symptoms</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:223px;">Computer</td>
			<td style="width:73px;">Any</td>
			<td style="width:123px;"></td>
			<td>A computer or tablet should be used to complete the e-learning</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:223px;">Medify Content Management System</td>
			<td style="width:73px;">Medify BV</td>
			<td style="width:123px;"></td>
			<td>A content management system to process the e-learning content</td>
		</tr>
	</tbody>
</table>

the dyspepsia educational tool as a novel aid in dyspepsia management

Digital educational tools have a well-established role in current healthcare. In particular, disorders that are managed non-pharmacologically benefit from this development, as it enables patient engagement in self-management. Dyspepsia is a condition thought to arise from gastric and duodenal perturbations, brain-gut axis disturbances, and dietary factors. Behavioral interventions are a major part of dyspepsia treatment, hence patient engagement and motivation through education is essential. Protocols that describe the development process of such educational tools are scarce. We provide a methodology describing development of a dyspepsia educational tool. Assessment of users' needs is the first step, followed by a literature search. The content is developed based on the main themes and entered into a content management system, to build the program. Final adjustments are made after a pilot test of the tool. The presented protocol can be used as a guide for development of a digital dyspepsia educational tool or as a tool for similar situations.

Results of focus groups
Five patients, recruited through patient networks (n = 2) or at the outpatient clinic (n = 3), were invited to join a focus group. All focus group patients were diagnosed with dyspepsia based on the opinion of a gastroenterologist. Characteristics of included patients are presented in Table 1.
Most participants ...

Watch this Scientific Journal Video about The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management at JoVE.com

The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management

This protocol describes the development process of a digital dyspepsia educational tool. Assessment of unmet needs and literature, content development, and building of the tool are presented. The methodology can be used as a guide for future development of digital educational tools.

Digital educational tools have a well-established role in current healthcare. In particular, disorders that are managed non-pharmacologically benefit from ...

Research

JoVE Journal

Medicine

A Strategy to Identify de Novo Mutations in Common Disorders such as Autism and Schizophrenia

There are several lines of evidence supporting the role of de novo mutations as a mechanism for common disorders, such as autism and schizophrenia. First, ...

Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia

Pneumonia, the inflammatory state of lung tissue primarily due to microbial infection, claimed 52,306 lives in the United States in 20071 and resulted in ...

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

Examining molecular mechanisms involved in neuropathological conditions, such as ischemic stroke, can be difficult when using whole animal systems. As ...

Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies

The microcirculation consists of blood vessels with diameters less than 150 &#181;m. It makes up a large part of the circulatory system and plays an ...

Using Adeno-associated Virus as a Tool to Study Retinal Barriers in Disease

M&#252;ller cells are the principal glial cells of the retina. Their end-feet form the limits of the retina at the outer and inner limiting membranes ...

Evaluation of the Efficacy of the H. pylori Protein HP-NAP as a Therapeutic Tool for Treatment of Bladder Cancer in an Orthotopic Murine Model

Evaluation of the Efficacy of the H. pylori Protein HP-NAP as a Therapeutic Tool for Treatment of Bladder Cancer in an Orthotopic Murine Model

Bladder cancer is one of the most common malignancies of the urogenital tract. Intravesical injection of Bacillus Calmette-Gu&#233;rin (BCG) is the gold ...

Neonatal Murine Cochlear Explant Technique as an In Vitro Screening Tool in Hearing Research

Neonatal Murine Cochlear Explant Technique as an In Vitro Screening Tool in Hearing Research

While there have been remarkable advances in hearing research over the past few decades, there is still no cure for Sensorineural Hearing Loss (SNHL), a ...

Tubal Cytology of the Fallopian Tube as a Promising Tool for Ovarian Cancer Early Detection

Currently, it is widely accepted that the vast majority of ovarian high-grade serous carcinoma (HGSC) originate from the fallopian tube. However, due to ...

Ultrahigh Resolution Mouse Optical Coherence Tomography to Aid Intraocular Injection in Retinal Gene Therapy Research

HR-SD-OCT is utilized to monitor the progression of photoreceptor degeneration in live mouse models, assess the delivery of therapeutic agents into the ...

Contractility Measurements of Human Uterine Smooth Muscle to Aid Drug Development

Discovery and characterization of novel pharmaceutical compounds or biochemical probes rely on robust and physiologically relevant assay systems. We ...