Neha Shah

All Publications

• Learnings in Digital Health Design: Insights From a Pilot Web App for Structured Note-Taking for Patients With Rheumatoid Arthritis. JMIR formative research Srivastava, U., Dasari, S., Shah, N. 2023; 7: e49358

  Abstract

  Patients fail to accurately remember 40% to 80% of medical information relayed during doctor appointments, and most standard after-visit summaries fail to effectively help patients comply with behaviors to manage their health conditions. The value of technology to empower and engage patients in their health management has been shown, and here we apply technology to help patients remember and act upon information communicated during their medical appointments.We describe the development of WellNote, a digital notebook designed for patients to create a customized plan to manage their condition, plan for their appointments, track important actions (eg, medications and labs), and receive reminders for appointments and labs.For this pilot, we chose to focus on rheumatoid arthritis, a chronic condition that relies on many of these features. The development of WellNote followed a structured method based on design thinking and co-design principles, with the app built in close collaboration with patients and a physician partner to ensure clinical relevance. Our design process consisted of 3 rounds: patient and physician interviews, visual prototypes, and a functional pilot app.Over the course of the design process, WellNote's features were refined, with the final version being a digital notebook designed for patients with rheumatoid arthritis to manage their health by helping them track medications and labs and plan for appointments. It features several pages, like a dashboard, patient profile, appointment notes, preplanning, medication management, lab tracking, appointment archives, reminders, and a pillbox for medication visualization.WellNote's active and structured note-taking features allow patients to clearly document the information from their physician without detracting from the conversation, helping the patient to become more empowered and engaged in their health management. The co-design process empowered these stakeholders to share their needs and participate in the development of a solution that truly solves pain points for these groups. This viewpoint highlights the role of digital health tools and the co-design of new health care innovations to empower patients and support clinicians.

  View details for DOI 10.2196/49358

  View details for PubMedID 38015609

• 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis & rheumatology (Hoboken, N.J.) England, B. R., Smith, B. J., Baker, N. A., Barton, J. L., Oatis, C. A., Guyatt, G., Anandarajah, A., Carandang, K., Chan, K. K., Constien, D., Davidson, E., Dodge, C. V., Bemis-Dougherty, A., Everett, S., Fisher, N., Fraenkel, L., Goodman, S. M., Lewis, J., Menzies, V., Moreland, L. W., Navarro-Millan, I., Patterson, S., Phillips, L. R., Shah, N., Singh, N., White, D., AlHeresh, R., Barbour, K. E., Bye, T., Guglielmo, D., Haberman, R., Johnson, T., Kleiner, A., Lane, C. Y., Li, L. C., Master, H., Pinto, D., Poole, J. L., Steinbarger, K., Sztubinski, D., Thoma, L., Tsaltskan, V., Turgunbaev, M., Wells, C., Turner, A. S., Treadwell, J. R. 2023

  Abstract

  OBJECTIVE: To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA).METHODS: An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n=20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.RESULTS: The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions.CONCLUSION: This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.

  View details for DOI 10.1002/art.42507

  View details for PubMedID 37227071