Dependence on Digital Medicine in Resource-Limited Settings.
Dependence on Digital Medicine in Resource-Limited Settings.
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资源有限环境中对数字医学的依赖。
DOI：
10.1080/15265161.2018.1498949
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Eyal,Nir
中科院分区：
文献类型：
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作者：
Campbell,JeffreyI;Haberer,Jessica;Musiimenta,Angella;Eyal,Nir
随着技术几乎渗透到日常生活的各个方面，数字医学在医疗保健中发挥越来越重要的作用也就不足为奇了。Klugman及其同事（2018）在对使用数字医疗所产生的伦理问题进行全面分析时，简要提到了对数字医疗设备的依赖性。一种广泛使用的数字医疗技术是电子依从性监测器（EAM），其已在全球范围内用于测量从吸入沙丁胺醇到脊柱侧凸矫正器的药物依从性和行为。在过去十年中，我们使用越来越复杂的EAM来衡量和试图改善撒哈拉以南非洲艾滋病毒感染者的抗逆转录病毒治疗依从性，我们对乌干达EAM用户的体验进行了定性研究。在对乌干达EAM用户进行的一系列定性研究中，一些受访者描述了依赖EAM进行抗逆转录病毒治疗，这是使用该设备数月至数年的意外后果（坎贝尔等人，2016年，Musiimenta 2018年）。依赖数字医疗技术，我们将其定义为对技术的身体或心理依赖以维持健康，可能会因不同原因而存在风险。例如，Klugman和他的同事强调了健康风险和对数字医疗的潜在信任丧失，如果患者依赖数字医疗技术，然后出现故障并停止运作，可能会发生这种情况。事实上，我们都不得不在不合时宜的时候重启手机;想象一下，如果我们的手机被连接到控制我们的心脏起搏器或胰岛素泵。但这一评论描述了对医疗技术的另一种形式的依赖。
With technology permeating nearly every aspect of daily life, it is no surprise that digital medicine is taking on an increasingly important role in medical care. In their sweeping analysis of ethical considerations arising from use of digital medicine, Klugman and colleagues (2018) make a brief mention of dependence upon digital medical devices as one such consideration. One type of widely used digital medical technology is electronic adherence monitors (EAMs), which have been used worldwide to measure adherence to medications and behaviors ranging from inhaled albuterol to scoliosis braces. Over the past decade, we have used increasingly sophisticated EAMs to measure and attempt to improve antiretroviral therapy adherence among people living with HIV in sub-Saharan Africa, and we have conducted qualitative research on EAM users' experiences in Uganda. In a series of qualitative studies with EAM users in Uganda, some interviewees have described becoming dependent upon EAMs to take antiretroviral therapy, an unintended consequence of using the device for months to years (Campbell et al. 2016, Musiimenta 2018).Dependence upon digital medical technologywhich we define as physical or psychological reliance upon a technology to maintain health-may prove risky for different reasons. For instance, Klugman and colleagues highlight the risks to health and potential loss of trust in digital medicine that may occur if patients become dependent upon digital medical technology that then experiences a glitch and stops functioning. Indeed, we have all had to reboot our cellphones at inopportune times; imagine if our phones were wired to control our pacemakers or insulin pumps. But this commentary characterizes another form of dependence on medical technology.