TY  - JOUR
AU  - Agarwal, Rajat Kumar
AU  - Sedai, Amit
AU  - Ankita, Kumari
AU  - Parmar, Lalith
AU  - Dhanya, Rakesh
AU  - Dhimal, Sunil
AU  - Sriniwas, Reshma
AU  - Gowda, Ashwini
AU  - Gujjal, Pooja
AU  - H, Pushpa
AU  - Jain, Suman
AU  - Ramaiah, J Dasaratha
AU  - Jali, Sujata
AU  - Tallur, Neelavva Rayappa
AU  - Ramprakash, Stalin
AU  - Faulkner, Lawrence
PY  - 2019
DA  - 2019/01/23
TI  - Information Technology–Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study
JO  - JMIR Med Inform
SP  - e9291
VL  - 7
IS  - 1
KW  - β-thalassemia major
KW  - health information technologies
KW  - health planning
KW  - patient outcome assessment
AB  - Background: Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. Objective: The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. Methods: A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed. Results: Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12). Conclusions: Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC. 
SN  - 2291-9694
UR  - http://medinform.jmir.org/2019/1/e9291/
UR  - https://doi.org/10.2196/medinform.9291
UR  - http://www.ncbi.nlm.nih.gov/pubmed/30672740
DO  - 10.2196/medinform.9291
ID  - info:doi/10.2196/medinform.9291
ER  -