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Nieto-Martínez R, De Oliveira-Gomes D, Gonzalez-Rivas JP, Al-Rousan T, Mechanick JI, Danaei G. Telehealth and cardiometabolic-based chronic disease: optimizing preventive care in forcibly displaced migrant populations. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:93. [PMID: 37667387 PMCID: PMC10478318 DOI: 10.1186/s41043-023-00418-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/15/2023] [Indexed: 09/06/2023]
Abstract
The number of migrants, which includes forcibly displaced refugees, asylum seekers, and undocumented persons, is increasing worldwide. The global migrant population is heterogeneous in terms of medical conditions and vulnerability resulting from non-optimal metabolic risk factors in the country of origin (e.g., abnormal adiposity, dysglycemia, hypertension, and dyslipidemia), adverse travel conditions and the resulting stress, poverty, and anxiety, and varying effects of acculturation and access to healthcare services in the country of destination. Therefore, many of these migrants develop a high risk for cardiovascular disease and face the significant challenge of overcoming economic and health system barriers to accessing quality healthcare. In the host countries, healthcare professionals experience difficulties providing care to migrants, including cultural and language barriers, and limited institutional capacities, especially for those with non-legal status. Telehealth is an effective strategy to mitigate cardiometabolic risk factors primarily by promoting healthy lifestyle changes and pharmacotherapeutic adjustments. In this descriptive review, the role of telehealth in preventing the development and progression of cardiometabolic disease is explored with a specific focus on type 2 diabetes and hypertension in forcibly displaced migrants. Until now, there are few studies showing that culturally adapted telehealth services can decrease the burden of T2D and HTN. Despite study limitations, telehealth outcomes are comparable to those of traditional health care with the advantages of having better accessibility for difficult-to-reach populations such as forcibly displaced migrants and reducing healthcare associated costs. More prospective studies implementing telemedicine strategies to treat cardiometabolic disease burden in migrant populations are needed.
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Affiliation(s)
- Ramfis Nieto-Martínez
- Precision Care Clinic Corp., Saint Cloud, FL, USA.
- Departments of Global Health and Population and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela.
| | - Diana De Oliveira-Gomes
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Juan P Gonzalez-Rivas
- Departments of Global Health and Population and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Brno, Czech Republic
| | - Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Jeffrey I Mechanick
- The Marie-Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Goodarz Danaei
- Departments of Global Health and Population and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Mougey EB, Judy WC, Venkatesh RD, Berg E, Lee JA, Rosen JM, Li B, Koster A, Maiden K, Gao Z, Franciosi JP. Equity and Inclusion in Pediatric Gastroenterology Telehealth: A Study of Demographic, Socioeconomic, and Digital Disparities. J Pediatr Gastroenterol Nutr 2023; 77:319-326. [PMID: 37079871 PMCID: PMC10412077 DOI: 10.1097/mpg.0000000000003797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 03/14/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES The purpose of our study is to compare in-person and telehealth pediatric care ambulatory visits for gastroenterology (GI) at the Nemours Children's Health System in the Delaware Valley (NCH-DV) based on geospatial, demographic, socioeconomic, and digital disparities. METHODS Characteristics of 26,565 patient encounters from January 2019 to December 2020 were analyzed. U.S. Census Bureau geographic identifiers were assigned to each participant and aligned with the American Community Survey (2015-2019) socioeconomic and digital outcomes. Reported odds ratios (OR) are telehealth encounter/in-person encounter. RESULTS GI telehealth usage increased 145-fold in 2020 compared to 2019 for NCH-DV. Comparing telehealth to in-person usage in 2020 revealed that GI patients who required a language translator were 2.2-fold less likely to choose telehealth [individual level adjusted OR (I-OR a ) [95% confidence interval, CI], 0.45 [0.30-0.66], P < 0.001]. Individuals of Hispanic ethnicity or non-Hispanic Black or African American race are 1.3-1.4-fold less likely to utilize telehealth than non-Hispanic Whites (I-OR a [95% CI], 0.73 [0.59-0.89], P = 0.002 and 0.76 [0.60-0.95], P = 0.02, respectively). Households in census block groups (BG) that are more likely to utilize telehealth: have broadband access (BG-OR = 2.51 [1.22-5.31], P = 0.014); are above the poverty level (BG-OR = 4.44 [2.00-10.24], P < 0.001); own their own home (BG-OR = 1.79 [1.25-2.60], P = 0.002); and have a bachelor's degree or higher (BG-OR = 6.55 [3.25-13.80], P < 0.001). CONCLUSIONS Our study is the largest reported pediatric GI telehealth experience in North America that describes racial, ethnic, socioeconomic, and digital inequities. Advocacy and research for pediatric GI focused on telehealth equity and inclusion is urgently needed.
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Affiliation(s)
| | - Wesley C. Judy
- the Department of Pediatrics, Nemours Children’s Hospital, Orlando, FL
| | - Rajitha D. Venkatesh
- Nationwide Children’s Hospital, Columbus, OH
- The Ohio State University, Columbus, OH
| | | | - Jennifer A. Lee
- Nationwide Children’s Hospital, Columbus, OH
- The Ohio State University, Columbus, OH
| | - John M. Rosen
- the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Mercy Kansas City, Kansas City, MO
- the Department of Pediatrics, University of Missouri – Kansas City, Kansas City, MO
| | - B.U.K. Li
- Medical College of Wisconsin, Milwaukee, WI
| | - Alex Koster
- Nemours Value Based Services Organization, Jacksonville, FL
| | - Kristin Maiden
- Nemours Value Based Services Organization, Jacksonville, FL
| | - Zhongcui Gao
- Nemours Value Based Services Organization, Jacksonville, FL
| | - James P. Franciosi
- the Division of Gastroenterology, Nemours Children’s Hospital, Orlando, FL, and
- University of Central Florida – College of Medicine, Orlando, FL
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103
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Regragui S, Abou Malham S, Gaboury I, Bois C, Deville-Stoetzel N, Maillet L, Savoie A, Breton M. Nursing practice and teleconsultations in a pandemic context: A mixed-methods study. J Clin Nurs 2023; 32:6339-6353. [PMID: 37202866 DOI: 10.1111/jocn.16756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/03/2023] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
AIM To explore the use and implementation of teleconsultations by primary care nurses in the context of the COVID-19 pandemic. BACKGROUND Teleconsultation use increased rapidly during the COVID-19 pandemic. Its implementation has been documented for physicians and specialists, but knowledge is still limited in nursing practice. DESIGN A sequential mixed-methods study. METHODS Phase 1: A cross-sectional e-survey with 98 nurses (64 nurse clinicians [NCs] and 34 nurse practitioners [NPs]) was conducted in 2020 in 48 teaching primary care clinics in Quebec (Canada). Phase 2: Semi-structured interviews with four NCs and six NPs were conducted in 2021 in three primary care clinics. This study adheres to STROBE and COREQ guidelines. RESULTS During the pandemic, telephone was the principal teleconsultation modality used by NPs and NCs compared to other teleconsultation modalities (text messages, email and video). The only variable associated with a higher likelihood of using teleconsultations was type of professional (NCs). Video consultation was almost absent from the modalities used. The majority of participants reported several facilitators to using teleconsultations in their work (e.g. web platforms and work-family balance) and for patients (e.g. rapid access). Some barriers to utilisation were identified (e.g. lack of physical resources) for successful integration of teleconsultations at the organisational, technological and systemic levels. Participants also reported positive (e.g. assessment of cognitive deficiency) and negative (e.g. rural population) impacts of using teleconsultations during a pandemic that made the use of teleconsultations complex. CONCLUSION This study highlights the potential for nurses to use teleconsultations in primary care practice and suggests concrete solutions to encourage their implementation after the pandemic. RELEVANCE TO CLINICAL PRACTICE Findings emphasize the need for updated nursing education, easy-to-use technology and the strengthening of policies for the sustainable use of teleconsultations in primary health care. IMPLICATIONS FOR THE PROFESSION This study could promote the sustainable use of teleconsultations in nursing practice. REPORTING METHOD The study adhered to relevant EQUATOR guidelines; the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies were used for reporting. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution, as the study focused on the use of teleconsultation among health professionals, specifically primary care nurses.
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Affiliation(s)
- Safa Regragui
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sabina Abou Malham
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Isabelle Gaboury
- Département de médecine de famille, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Caroline Bois
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Nadia Deville-Stoetzel
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Lara Maillet
- École nationale d'administration publique, Montréal, Québec, Canada
| | - Annie Savoie
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Mylaine Breton
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Spiess ST, Gardner E, Turner C, Galt A, Fortenberry K, Ho T, Knox J, Ose D. We Cannot Put This Genie Back in the Bottle: Qualitative Interview Study Among Family Medicine Providers About Their Experiences With Virtual Visits During the COVID-19 Pandemic. J Med Internet Res 2023; 25:e43877. [PMID: 37651162 PMCID: PMC10502598 DOI: 10.2196/43877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/09/2023] [Accepted: 05/31/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND When a genie is freed from its bottle, things cannot be restored to the way they were before. At the beginning of the global COVID-19 pandemic, health care systems adjusted how they delivered care overnight. Primary care practices switched from seeing patients in person to virtual care applications, including video and phone visits, e-visits, e-consults, and messaging with clinicians. Prior to the pandemic, these applications were not as widely used, but discussions around their advantages and disadvantages in some settings were being explored. Emergency regulatory changes spurred by the pandemic freed this virtual care "genie" from its bottle. Wide-scale adoption of virtual care in family medicine has much potential, as primary care services are often a patient's first point of contact with the health care system. OBJECTIVE This study aims to analyze family medicine providers' experiences using virtual visits during the pandemic, perceived outcomes of the shift to virtual visits, and discusses its implications for the future of family medicine. METHODS This qualitative study took place at 3 academic primary care clinics between June and December 2020. Data were collected through one-on-one Zoom (version 5.2.1) interviews with family medicine clinical faculty who experienced the rapid transition of in-person visits to mostly "virtual" visits. The interviews were recorded, deidentified, and transcribed. We adopted a constructivist approach to qualitative content analysis to evaluate the results. RESULTS In total, 25 participants were eligible, and 20 individuals participated in this study (80% participation rate). The mean age was 43.4 years, and 85% (17/20) of the participants were female. We identified 3 main themes: the care process, patient engagement, and team-based care. CONCLUSIONS This study highlights the transition from in-person to virtual visits during the pandemic from the perspective of family medicine providers. Generally, family medicine providers' perceptions of the shift to virtual visits were positive, especially regarding team-based care. Challenges involved virtual inhibition, particularly for providers. Providers described ways they integrated virtual care with aspects of in-person care, creating a hybrid environment. The genie is out of the bottle-things will not be the same-but family medicine now has the opportunity to evolve.
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Affiliation(s)
- Saskia T Spiess
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Elena Gardner
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Cindy Turner
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Annie Galt
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Katherine Fortenberry
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Tiffany Ho
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Jordan Knox
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
| | - Dominik Ose
- Department of Family and Preventative Medicine, School of Medicine, University of Utah Health, Salt Lake City, UT, United States
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Neumann A, König HH, Bokermann J, Hajek A. Determinants of Patient Use and Satisfaction With Synchronous Telemental Health Services During the COVID-19 Pandemic: Systematic Review. JMIR Ment Health 2023; 10:e46148. [PMID: 37594785 PMCID: PMC10474517 DOI: 10.2196/46148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/03/2023] [Accepted: 05/31/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Several recent studies examined patient use and satisfaction with synchronous telemental health services in response to the widespread implementation during the COVID-19 pandemic. However, a systematic review of recent literature on the determinants of these outcomes is missing. OBJECTIVE The aim of this systematic review was to give an extensive overview of the literature on and highlight the influential determinants of patient use and satisfaction with synchronous telemental health services during the COVID-19 pandemic. METHODS This review satisfied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO. Peer-reviewed, quantitative studies that observed the determinants of patient use or satisfaction with synchronous telemental health services during the COVID-19 pandemic were included. PubMed, PsycInfo, and Web of Science database searches were conducted in August 2022 for English and German language studies published from 2020 onward. Key steps were performed by 2 reviewers. Determinants were synthesized into major categories informed by the dimensions of the widely used and established Unified Theory of Acceptance and Use of Technology. RESULTS Of the 20 included studies, 10 studies examined determinants of patient use, 7 examined determinants of patient satisfaction, and 3 observed both outcomes. The quality of the studies was mainly good or fair. There was substantial heterogeneity in the study designs, methods, and findings. Sociodemographic characteristics and health-related determinants were mostly considered. Some of the major dimensions of the Unified Theory of Acceptance and Use of Technology were neglected in recent studies. Although most findings were mixed or nonsignificant, some indications for potential relationships were found (eg, for sex, age, and symptom severity). CONCLUSIONS The findings revealed potential target groups (eg, female and young patients with mild symptoms) for future postpandemic telemental health interventions. However, they also identified patient groups that were harder to reach (eg, older patients with severe symptoms); efforts may be beneficial to address such groups. Future quantitative and qualitative research is needed to secure and expand on recent findings, which could help improve services. TRIAL REGISTRATION PROSPERO CRD42022351576; https://tinyurl.com/yr6zrva5.
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Affiliation(s)
- Ariana Neumann
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Josephine Bokermann
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Cacciatore S, Spadafora L, Bernardi M, Galli M, Betti M, Perone F, Nicolaio G, Marzetti E, Martone AM, Landi F, Asher E, Banach M, Hanon O, Biondi-Zoccai G, Sabouret P. Management of Coronary Artery Disease in Older Adults: Recent Advances and Gaps in Evidence. J Clin Med 2023; 12:5233. [PMID: 37629275 PMCID: PMC10455820 DOI: 10.3390/jcm12165233] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors. Recent randomized clinical trials and epidemiological studies have provided new data on optimal management of complex patients with CAD. However, frail older adults are still underrepresented in the literature. This narrative review aims to highlight the importance of assessing frailty as an aid to guide therapeutic decision-making and tailor CAD management to the specific needs of older adults, taking into account age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and potential drug interactions. We also discuss gaps in the evidence and offer perspectives on how best in the future to optimize the global strategy of CAD management in older adults.
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Affiliation(s)
- Stefano Cacciatore
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Luigi Spadafora
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00186 Rome, Italy
| | - Marco Bernardi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00186 Rome, Italy
| | - Mattia Galli
- Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy
| | - Matteo Betti
- University of Milan, 20122, Milan, Italy
- Monzino IRCCS Cardiological Center, 20137 Milan, Italy
| | - Francesco Perone
- Cardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, Caserta, Italy
| | - Giulia Nicolaio
- Department of Experimental and Clinical Medicine and Geriatrics, University of Florence, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla 3, 50134 Florence, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Elad Asher
- The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, P.O. Box 12271, Jerusalem 9112102, Israel
| | - Maciej Banach
- Department of Preventive Cardiology, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Medical University of Lodz (MUL), 93-338 Lodz, Poland
| | - Olivier Hanon
- Assistance Publique Hôpitaux de Paris, Geriatric Department, Broca Hospital, University of Paris Cité, 54–56 Rue Pascal, 75013 Paris, France
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy
- Mediterranea Cardiocentro, Via Orazio 2, 80122 Naples, Italy
| | - Pierre Sabouret
- Heart Institute, Pitié-Salpétrière Hospital, ACTION-Group, Sorbonne University, 47–83 Bd de l’Hôpital, 75013 Paris, France
- Department of Cardiology, National College of French Cardiologists, 13 Rue Niépce, 75014 Paris, France
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Zachrison KS, Yan Z, White BA, Park L, Schwamm LH. Factors Associated with the Digital Patient Experience of Virtual Care Across Specialties. TELEMEDICINE REPORTS 2023; 4:227-235. [PMID: 37637376 PMCID: PMC10457601 DOI: 10.1089/tmr.2023.0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/29/2023]
Abstract
Background We aimed to characterize patient experience with virtual care across medical specialties using validated survey data. Primary objective: to determine whether experience varied by visit modality (virtual vs. in-person) and whether relationships persisted after adjusting for patient and provider characteristics. Secondarily, among physicians with sufficient data, we compared virtual versus in-person patient experience scores at the physician level and identified characteristics associated with better experience scores for virtual care. Methods This was a retrospective analysis of administrative databases from a large New England health care system, including all ambulatory visits from October 1, 2020 to September 30, 2021 with patient experience scores recorded. We compared experience between virtual and in-person at the visit level (score: 0-10) and the physician level for likelihood of recommending the physician to friends or family. We used a series of cross-classified hierarchical models with visits grouped by patient and by physician to decompose sources of variation. Among physicians with sufficient data, we compared physicians with higher virtual versus higher in-person net promoter score (NPS). Results Of 378,472 visits performed by 3368 physicians, 86,878 (23%) were conducted virtually. Most scored ≥9 for either modality, with a small preference for virtual versus in-person care (9.6 vs. 9.5, p < 0.001). We found that more variation in scores was explained by patient than by physician (22.9% vs. 3%). Visit modality was of minimal explanatory value. Most physicians' virtual and in-person NPS were similar, and virtual visit volume was not associated. Conclusions We found robust evidence for the parity of patient experience between virtual and in-person modalities across specialties.
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Affiliation(s)
- Kori S. Zachrison
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Zhiyu Yan
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin A. White
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lee Park
- Department of Internal Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Mass General Brigham, Boston, Massachusetts, USA
| | - Lee H. Schwamm
- Mass General Brigham, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Corcorran MA, Thornton K, Struminger B, Easterbrook P, Scott JD. Training the healthcare workforce: the global experience with telementorship for hepatitis B and hepatitis C. BMC Health Serv Res 2023; 23:824. [PMID: 37533025 PMCID: PMC10394928 DOI: 10.1186/s12913-023-09849-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Telementorship has emerged as an innovative strategy to decentralise medical knowledge and increase healthcare capacity across a wide range of disease processes. We report the global experience with telementorship to support healthcare workers delivering hepatitis B virus (HBV) and hepatitis C virus (HCV) care and treatment. METHODS In early 2020, we conducted a survey of HBV and HCV telementorship programmes, followed by an in-depth interview with programme leads. Programmes were eligible to participate if they were located outside of the United States (U.S.), focused on support to healthcare workers in management of HBV and/or HCV, and were affiliated with or maintained adherence to the Project ECHO model, a telementorship programme pioneered at the University of New Mexico. One programme in the U.S., focused on HCV treatment in the Native American community, was purposively sampled and invited to participate. Surveys were administered online, and all qualitative interviews were performed remotely. Descriptive statistics were calculated for survey responses, and qualitative interviews were assessed for major themes. RESULTS Eleven of 18 eligible programmes completed the survey and follow up interview. Sixty-four percent of programmes were located at regional academic medical centers. The majority of programmes (64%) were led by hepatologists. Most programmes (82%) addressed both HBV and HCV, and the remainder focused on HCV only. The median number of participating clinical spoke sites per programme was 22, and most spoke site participants were primary care providers. Most ECHO sessions were held monthly (36%) or bimonthly (27%), with sessions ranging from 45 min to 2 h in length. Programme leaders identified collective learning, empowerment and collaboration to be key strengths of their telementorship programme, while insufficient funding and a lack of protected time for telementorship leaders and participants were identified as major barriers to success. CONCLUSION The Project ECHO model for telementorship can be successfully implemented across high and low-and-middle-income countries to improve provider knowledge and experience in management of viral hepatitis. There is a tremendous opportunity to further expand upon the existing experience with telementorship to support non-specialist healthcare workers and promote elimination of viral hepatitis.
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Affiliation(s)
- Maria A Corcorran
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Harborview Medical Center, 325 9th Ave, Box 359782, Seattle, WA, 98104, USA.
| | - Karla Thornton
- Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- Project ECHO, University of New Mexico, Albuquerque, NM, USA
| | - Bruce Struminger
- Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- Project ECHO, University of New Mexico, Albuquerque, NM, USA
| | - Philippa Easterbrook
- Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - John D Scott
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
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Barlow KJ, Fahey PP, Atlantis E. Glycaemic monitoring and control among high-risk patients with type 2 diabetes in Australian general practice during COVID-19. Fam Med Community Health 2023; 11:e002271. [PMID: 37567729 PMCID: PMC10423797 DOI: 10.1136/fmch-2023-002271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted general practice worldwide, primarily due to public health measures that restricted access to care for chronic diseases, such as type 2 diabetes. These measures disproportionately affected higher risk groups with type 2 diabetes, such as older people and those with obesity. This study aims to identify factors that may have influenced the rates of compliance with testing guidelines and target glycaemic control in Australian general practice settings during the COVID-19 pandemic. METHODS We used a serial cross-sectional study design of patient record data from general practices representative of the Nepean Blue Mountains Local Health District between 2020 and 2022. Aggregated patient records were analysed to determine percentages of subgroups with a blood glycaemic testing interval consistent with guidelines (≥1 within 15 months) and achieving target glycaemic control (by glycated haemoglobin of ≤7%). Linear regression models were used to test the association between independent and dependent variables, and to generate regression coefficients and 95% CI, corrected for time trends. RESULTS Of the average 14 356 patient records per month, 55% were male, 53% had a body mass index (BMI) <30 and 55% were aged 55-74 years. Compliance to testing guidelines slightly decreased (75-73%) but was positively associated with male sex (2.5%, 95% CI 1.7%, 3.4%), BMI≥30 (9.6%, 95% CI 8.8%, 10.4%) and 55-74 years (7.5%, 95% CI 6.6%, 8.5%) and 75 years and over age groups (7.1%, 95% CI 6.2%, 7.9%). Mean percentage of patient records achieving target glycaemic control slightly increased and was negatively associated with male sex (-3.7%, 95% CI -5.2%, -2.2%), but positively associated with 55-74 years (4.5%, 95% CI 3.8%, 5.1%) and 75 years and over age groups (12.2%, 95% CI 4.5%, 20.0%). Compliance to testing guidelines increased with each additional general practice per 10 000 persons (8.4%, 95% CI 4.9%, 11.8%). CONCLUSIONS During the COVID-19 pandemic, people with type 2 diabetes in Australia continued to follow glycaemic testing guidelines at the same rate. In fact, there was a slight improvement in glycaemic control among all subgroups of patients, including those at higher risk. These findings are encouraging, but the longer term impact of COVID-19 on type 2 diabetes care is still unclear.
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Affiliation(s)
- Kirrilee Jane Barlow
- School of Health Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Paul P Fahey
- School of Health Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Kingswood, New South Wales, Australia
- Discipline of Medicine, Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Nepean, New South Wales, Australia
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Gao J, Ma Q, Sun D, Yang Y, Ren M, Wang L, Fan C, Fan Z, Cao M, Zhao J. Telemedicine in the Battle with 2019 Novel Coronavirus Disease (COVID-19) in Henan Province, China: A Narrative Study. Telemed J E Health 2023; 29:1211-1223. [PMID: 36602780 DOI: 10.1089/tmj.2022.0247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background and Objectives: Based on practical services of the Henan Province Telemedicine Center (HTCC), the purpose of this study is to investigate the design, construction, implementation, and application effect of a specific telemedicine system in response to the coronavirus disease 2019 (COVID-19). Methods: Data on COVID-19 cases from December 31, 2019, through October 17, 2022, were collected from official websites. Data and information of telemedicine services related to COVID-19 in HTCC were collected and analyzed, and relevant graphical representations were plotted. Results: All the 147 COVID-19 designated hospitals in the Henan Province were covered by the specific telemedicine system. The cities near to the Hubei Province in the south of Henan tended to be with more COVID-19 cases, where more COVID-19-related telemedicine services were conducted. For the telemedicine system, function modules, including real-time monitoring, command and dispatch, intractable cases transfer, remote guidance, and data sharing, were designed and realized to deal with COVID-19. Through the system, telemedicine services involved COVID-19 such as epidemic surveillance, emergency rescue, case discussion, diagnosis and treatment, remote ward-round, and distance education were performed. During the period between February 2 and March 3, 2020, 646 COVID-19 patients were served by the telemedicine system, with an improvement rate of 73.2%. Conclusions: Telemedicine can improve the diagnosis and treatment of COVID-19 patients, which play a helpful role in curbing the COVID-19 epidemic. Given the current global COVID-19 pandemic and the potential re-emerge of novel zoonotic pathogens in the future, the use of telemedicine would be imperative to fight against the pandemic.
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Affiliation(s)
- Jinghong Gao
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Hospital Management of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianqian Ma
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongxu Sun
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiling Yang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingxing Ren
- Office of Academic Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Wang
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chaolin Fan
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaohan Fan
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingbo Cao
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Zhao
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Dodeja AK, Schreier M, Granger M, Mitchell D, Chumita R, Sisk T, Daniels CJ, Rajpal S. Patient Experience with Telemedicine in Adults with Congenital Heart Disease. Telemed J E Health 2023; 29:1261-1265. [PMID: 36656168 DOI: 10.1089/tmj.2022.0279] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction: The COVID-19 pandemic has resulted in increased use of telemedicine. There are limited data on patient experience with telemedicine in adults with congenital heart disease (ACHD). We hypothesized that due to their complex medical history, ACHD would prefer in-person clinic visits over telemedicine. Methods: We conducted a nurse-administered telephone survey based on Agency for Healthcare Research and Quality recommendations to assess patient experience after ACHD telemedicine visits in the early part of the pandemic from March 2020 to June 2020. Results: Of 216 ACHD who had telemedicine visits, 136 (63%) agreed to participate in the survey. Mean age was 45 ± 18 years, majority (65%) being video encounters. Most (98%) patients expressed that the telemedicine visit was successful in addressing their health care needs. Only 21 (15%) patients reported technical issues. Most patients (76%) preferred telemedicine given testing was provided separately, 25 (18%) preferred in-person clinic visits, and 8 (6%) had no preference. Of the 25 patients over 65 years, 19 (76%) would choose telemedicine over the in-person clinic, and only 1 patient reported technical difficulties. Conclusion: ACHD reported a positive experience with telemedicine. Technical limitations were infrequent even among the elderly. The majority of patients felt that their health care needs were addressed and would consider telemedicine over clinic visits. These data are important as payors move away from supporting telemedicine and hospitals restructure, with and without ongoing COVID-19 concerns.
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Affiliation(s)
- Anudeep K Dodeja
- Division of Pediatric Cardiology, Connecticut Children's, Hartford, Connecticut, USA
| | - Matthew Schreier
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Matthew Granger
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Deborah Mitchell
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rosemary Chumita
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tracey Sisk
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Curt J Daniels
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Saurabh Rajpal
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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Rettinger L, Kuhn S. Barriers to Video Call-Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process. J Med Internet Res 2023; 25:e46715. [PMID: 37526957 PMCID: PMC10427933 DOI: 10.2196/46715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/01/2023] [Accepted: 05/17/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Telehealth interventions have become increasingly important in health care provision, particularly during the COVID-19 pandemic. Video calls have emerged as a popular and effective method for delivering telehealth services; however, barriers limit the adoption among allied health professionals and nurses. OBJECTIVE This review aimed to identify and map the perceived barriers to the use of video call-based telehealth interventions among allied health professionals and nurses. METHODS A comprehensive literature search was conducted in the PubMed and CINAHL databases on June 22, 2022, and updated on January 3, 2023, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Only original studies published in English or German since June 2017 that reported barriers to the use of video call-based telehealth interventions were eligible for inclusion. The studies had to involve interviews, focus groups, or questionnaires with physical therapists, occupational therapists, speech and language therapists, audiologists, orthoptists, dieticians, midwives, or nurses. Each publication was coded for basic characteristics, including country, health profession, and target group. Inductive coding was used to identify the patterns, themes, and categories in the data. Individual codings were analyzed and summarized narratively, with similarities and differences in barriers identified across health professions and target groups. RESULTS A total of 56 publications were included in the review, with barriers identified and categorized into 8 main categories and 23 subcategories. The studies were conducted in various countries, predominantly the United States, Australia, the United Kingdom, Canada, Israel, and India. Questionnaires were the most commonly used evaluation method, with 10,245 health professionals involved. Interviews or focus groups were conducted with 288 health professionals. Most of the included publications focused on specific health care professions, with the highest number addressing barriers for physical therapists, speech and language therapists, and audiologists. The barriers were related to technology issues, practice issues, patient issues, environmental issues, attributions, interpersonal issues, policies and regulations, and administration issues. The most reported barriers included the lack of hands-on experience, unreliable network connection, the lack of technology access, diminished fidelity of observations and poor conditions for visual instructions, the lack of technology skills, and diminished client-practitioner interaction and communication. CONCLUSIONS This review identified key barriers to video call-based telehealth use by allied health professionals and nurses, which can foster the development of stable infrastructure, education, training, guidelines, policies, and support systems to improve telehealth services. Further research is necessary to identify potential solutions to the identified barriers.
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Affiliation(s)
- Lena Rettinger
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
- Institute of Digital Medicine, University Hospital of Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Sebastian Kuhn
- Institute of Digital Medicine, University Hospital of Giessen and Marburg, Philipps University Marburg, Marburg, Germany
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Tjeertes J, Bacino CA, Bichell TJ, Bird LM, Bustamante M, Crean R, Jeste S, Komorowski RW, Krishnan ML, Miller MT, Nobbs D, Ochoa-Lubinoff C, Parkerson KA, Rotenberg A, Sadhwani A, Shen MD, Squassante L, Tan WH, Vincenzi B, Wheeler AC, Hipp JF, Berry-Kravis E. Enabling endpoint development for interventional clinical trials in individuals with Angelman syndrome: a prospective, longitudinal, observational clinical study (FREESIAS). J Neurodev Disord 2023; 15:22. [PMID: 37495977 PMCID: PMC10373389 DOI: 10.1186/s11689-023-09494-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by the absence of a functional UBE3A gene, which causes developmental, behavioral, and medical challenges. While currently untreatable, comprehensive data could help identify appropriate endpoints assessing meaningful improvements in clinical trials. Herein are reported the results from the FREESIAS study assessing the feasibility and utility of in-clinic and at-home measures of key AS symptoms. METHODS Fifty-five individuals with AS (aged < 5 years: n = 16, 5-12 years: n = 27, ≥ 18 years: n = 12; deletion genotype: n = 40, nondeletion genotype: n = 15) and 20 typically developing children (aged 1-12 years) were enrolled across six USA sites. Several clinical outcome assessments and digital health technologies were tested, together with overnight 19-lead electroencephalography (EEG) and additional polysomnography (PSG) sensors. Participants were assessed at baseline (Clinic Visit 1), 12 months later (Clinic Visit 2), and during intermittent home visits. RESULTS The participants achieved high completion rates for the clinical outcome assessments (adherence: 89-100% [Clinic Visit 1]; 76-91% [Clinic Visit 2]) and varied feasibility of and adherence to digital health technologies. The coronavirus disease 2019 (COVID-19) pandemic impacted participants' uptake of and/or adherence to some measures. It also potentially impacted the at-home PSG/EEG recordings, which were otherwise feasible. Participants achieved Bayley-III results comparable to the available natural history data, showing similar scores between individuals aged ≥ 18 and 5-12 years. Also, participants without a deletion generally scored higher on most clinical outcome assessments than participants with a deletion. Furthermore, the observed AS EEG phenotype of excess delta-band power was consistent with prior reports. CONCLUSIONS Although feasible clinical outcome assessments and digital health technologies are reported herein, further improved assessments of meaningful AS change are needed. Despite the COVID-19 pandemic, remote assessments facilitated high adherence levels and the results suggested that at-home PSG/EEG might be a feasible alternative to the in-clinic EEG assessments. Taken altogether, the combination of in-clinic/at-home clinical outcome assessments, digital health technologies, and PSG/EEG may improve protocol adherence, reduce patient burden, and optimize study outcomes in AS and other rare disease populations.
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Affiliation(s)
- Jorrit Tjeertes
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland.
| | - Carlos A Bacino
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
| | | | - Lynne M Bird
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Dysmorphology/Genetics, Rady Children's Hospital, San Diego, CA, USA
| | - Mariana Bustamante
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | | | - Shafali Jeste
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | | | - Meghan T Miller
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - David Nobbs
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Cesar Ochoa-Lubinoff
- Departments of Pediatrics, Division of Developmental-Behavioral Pediatrics, Rush University Medical Center, Chicago, IL, USA
| | | | - Alexander Rotenberg
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anjali Sadhwani
- Department of Psychiatry and Behavioral Services, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities & UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Lisa Squassante
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brenda Vincenzi
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Anne C Wheeler
- Carolina Institute for Developmental Disabilities, Carrboro, NC, USA
- RTI International, Durham, NC, USA
| | - Joerg F Hipp
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Anatomy and Cell Biology, Rush University Medical Center, 1725 W Harrison St, Suite 718, Chicago, IL, 60612, USA.
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Deshpande N, Wu M, Kelly C, Woodrick N, Werner DA, Volerman A, Press VG. Video-Based Educational Interventions for Patients With Chronic Illnesses: Systematic Review. J Med Internet Res 2023; 25:e41092. [PMID: 37467015 PMCID: PMC10398560 DOI: 10.2196/41092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/30/2023] [Accepted: 03/21/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND With rising time constraints, health care professionals increasingly depend on technology to provide health advice and teach patients how to manage chronic disease. The effectiveness of video-based tools in improving knowledge, health behaviors, disease severity, and health care use for patients with major chronic illnesses is not well understood. OBJECTIVE The aim of this study was to assess the current literature regarding the efficacy of video-based educational tools for patients in improving process and outcome measures across several chronic illnesses. METHODS A systematic review was conducted using CINAHL and PubMed with predefined search terms. The search included studies published through October 2021. The eligible studies were intervention studies of video-based self-management patient education for an adult patient population with the following chronic health conditions: asthma, chronic kidney disease, chronic obstructive pulmonary disease, chronic pain syndromes, diabetes, heart failure, HIV infection, hypertension, inflammatory bowel disease, and rheumatologic disorders. The eligible papers underwent full extraction of study characteristics, study design, sample demographics, and results. Bias was assessed with the Cochrane risk-of-bias tools. Summary statistics were synthesized in Stata SE (StataCorp LLC). Data reporting was conducted per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. RESULTS Of the 112 studies fully extracted, 59 (52.7%) were deemed eligible for inclusion in this review. The majority of the included papers were superiority randomized controlled trials (RCTs; 39/59, 66%), with fewer pre-post studies (13/59, 22%) and noninferiority RCTs (7/59, 12%). The most represented conditions of interest were obstructive lung disease (18/59, 31%), diabetes (11/59, 19%), and heart failure (9/59, 15%). The plurality (28/59, 47%) of video-based interventions only occurred once and occurred alongside adjunct interventions that included printed materials, in-person counseling, and interactive modules. The most frequently studied outcomes were disease severity, health behavior, and patient knowledge. Video-based tools were the most effective in improving patient knowledge (30/40, 75%). Approximately half reported health behavior (21/38, 56%) and patient self-efficacy (12/23, 52%) outcomes were improved by video-based tools, and a minority of health care use (11/28, 39%) and disease severity (23/69, 33%) outcomes were improved by video-based tools. In total, 48% (22/46) of the superiority and noninferiority RCTs and 54% (7/13) of the pre-post trials had moderate or high risk of bias. CONCLUSIONS There is robust evidence that video-based tools can improve patient knowledge across several chronic illnesses. These tools less consistently improve disease severity and health care use outcomes. Additional study is needed to identify features that maximize the efficacy of video-based interventions for patients across the spectrum of digital competencies to ensure optimized and equitable patient education and outcomes.
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Affiliation(s)
- Nikita Deshpande
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Meng Wu
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Colleen Kelly
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
| | - Nicole Woodrick
- Corporate Engagement & Strategic Partnerships, Arizona State University, Tempe, AZ, United States
| | - Debra A Werner
- The University of Chicago Library, Chicago, IL, United States
| | - Anna Volerman
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Valerie G Press
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, United States
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Cioboata R, Biciusca V, Olteanu M, Vasile CM. COVID-19 and Tuberculosis: Unveiling the Dual Threat and Shared Solutions Perspective. J Clin Med 2023; 12:4784. [PMID: 37510899 PMCID: PMC10381217 DOI: 10.3390/jcm12144784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The year 2020 will likely be remembered as the year dominated by COVID-19, or coronavirus disease. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for this pandemic, can be traced back to late 2019 in China. The COVID-19 pandemic has significantly impacted the tuberculosis (TB) care system, reducing TB testing and reporting. This can be attributed to the disruption of TB services and restrictions on patient movement, consequently increasing TB-related deaths. This perspective review aims to highlight the intersection between COVID-19 and TB, highlighting their dual threat and identifying shared solutions to address these two infectious diseases effectively. There are several shared commonalities between COVID-19 and tuberculosis, particularly the transmission of their causative agents, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mycobacterium tuberculosis. Both pathogens are transmitted via respiratory tract secretions. TB and COVID-19 are diseases that can be transmitted through droplets and airborne particles, and their primary target is typically the lungs. Regarding COVID-19 diagnostics, several methods are available for rapid and accurate detection. These include RT-PCR, which can provide results within two hours, and rapid antigen test kits that offer results in just a few minutes. The availability of point-of-care self-testing further enhances convenience. On the other hand, various approaches are employed for TB diagnostics to swiftly identify active TB. These include sputum microscopy, sputum for reverse transcription polymerase chain reaction (RT-PCR), and chest X-rays. These methods enable the rapid detection of active TB on the same day, while culture-based testing may take significantly longer, ranging from 2 to 8 weeks. The utilization of diverse diagnostic tools helps ensure the timely identification and management of COVID-19 and TB cases. The quality of life of patients affected by COVID-19 and tuberculosis (TB) can be significantly impacted due to the nature of these diseases and their associated challenges. In conclusion, it is crucial to emphasize the urgent need to address the dual threat of COVID-19 and TB. Both diseases have devastated global health, and their convergence poses an even greater challenge. Collaborative efforts, research investments, and policy reforms are essential to tackle this dual threat effectively.
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Affiliation(s)
- Ramona Cioboata
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
- Department of Pneumology, Victor Babes Clinical Hospital, 030303 Craiova, Romania
| | - Viorel Biciusca
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
- Department of Internal Medicine, Filantropia Hospital, 050474 Craiova, Romania
| | - Mihai Olteanu
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
- Department of Pneumology, Victor Babes Clinical Hospital, 030303 Craiova, Romania
| | - Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 33600 Pessac, France
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Woods L, Dendere R, Eden R, Grantham B, Krivit J, Pearce A, McNeil K, Green D, Sullivan C. Perceived Impact of Digital Health Maturity on Patient Experience, Population Health, Health Care Costs, and Provider Experience: Mixed Methods Case Study. J Med Internet Res 2023; 25:e45868. [PMID: 37463008 PMCID: PMC10394505 DOI: 10.2196/45868] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/05/2023] [Accepted: 05/26/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Health care organizations understand the importance of new technology implementations; however, the best strategy for implementing successful digital transformations is often unclear. Digital health maturity assessments allow providers to understand the progress made toward technology-enhanced health service delivery. Existing models have been criticized for their lack of depth and breadth because of their technology focus and neglect of meaningful outcomes. OBJECTIVE We aimed to examine the perceived impacts of digital health reported by health care staff employed in health care organizations across a spectrum of digital health maturity. METHODS A mixed methods case study was conducted. The digital health maturity of public health care systems (n=16) in Queensland, Australia, was examined using the quantitative Digital Health Indicator (DHI) self-assessment survey. The lower and upper quartiles of DHI scores were calculated and used to stratify sites into 3 groups. Using qualitative methods, health care staff (n=154) participated in interviews and focus groups. Transcripts were analyzed assisted by automated text-mining software. Impacts were grouped according to the digital maturity of the health care worker's facility and mapped to the quadruple aims of health care: improved patient experience, improved population health, reduced health care cost, and enhanced provider experience. RESULTS DHI scores ranged between 78 and 193 for the 16 health care systems. Health care systems in the high-maturity category (n=4, 25%) had a DHI score of ≥166.75 (the upper quartile); low-maturity sites (n=4, 25%) had a DHI score of ≤116.75 (the lower quartile); and intermediate-maturity sites (n=8, 50%) had a DHI score ranging from 116.75 to 166.75 (IQR). Overall, 18 perceived impacts were identified. Generally, a greater number of positive impacts were reported in health care systems of higher digital health maturity. For patient experiences, higher maturity was associated with maintaining a patient health record and tracking patient experience data, while telehealth enabled access and flexibility across all digital health maturity categories. For population health, patient journey tracking and clinical risk mitigation were reported as positive impacts at higher-maturity sites, and telehealth enabled health care access and efficiencies across all maturity categories. Limited interoperability and organizational factors (eg, strategy, policy, and vision) were universally negative impacts affecting health service delivery. For health care costs, the resource burden of ongoing investments in digital health and a sustainable skilled workforce was reported. For provider experiences, the negative impacts of poor usability and change fatigue were universal, while network and infrastructure issues were negative impacts at low-maturity sites. CONCLUSIONS This is one of the first studies to show differences in the perceived impacts of digital maturity of health care systems at scale. Higher digital health maturity was associated with more positive reported impacts, most notably in achieving outcomes for the population health aim.
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Affiliation(s)
- Leanna Woods
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
- Digital Health Cooperative Research Centre, Sydney, Australia
| | - Ronald Dendere
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Rebekah Eden
- UQ Business School, The University of Queensland, Brisbane, Australia
| | - Brittany Grantham
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Jenna Krivit
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Andrew Pearce
- Healthcare Information and Management Systems Society, Singapore, Singapore
| | - Keith McNeil
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
| | | | - Clair Sullivan
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
- Metro North Hospital and Health Service, Brisbane, Australia
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Sahu S, Dora SS, Singh AK, Mishra A, Patro BK, Subba SH. Spectrum of Population Availing COVID-19 Teleconsultation Services during COVID-19 Pandemic: A Cross-Sectional Study in a Tertiary Care Center of Eastern India. Indian J Community Med 2023; 48:623-626. [PMID: 37662133 PMCID: PMC10470563 DOI: 10.4103/ijcm.ijcm_783_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/12/2023] [Indexed: 09/05/2023] Open
Abstract
The COVID-19 pandemic has created a defining situation globally, and the outpatient services were also affected due to the closure of many healthcare facilities. The study was conducted to know the spectrum of the population availing teleconsultation and their needs for consultation. A cross-sectional study conducted in AIIMS Bhubaneswar, India, from May 2021 to June 2021in which the beneficiaries availing of the COVID-19 teleconsultation service were taken as study was participants and a total of 423 participants participated in the study. The proportion of participants who availed of the services in the age group 20-39 years was 67.8%. The participants from the urban area were 81%. Very few or almost nil participation were observed in the category of semiskilled, unskilled, and unemployed occupations. The reasons for availing of teleconsultation services were, for the treatment of COVID-19 disease (45%), distressed consultation for the medication (21%), and seeking advice for testing (13%), related to COVID-19 vaccination (6%) and 9% consulted to know the prognosis of the disease. Steps should be taken to expand the teleconsultation services to the underserved rural community and the people with lower educational status.
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Affiliation(s)
- Subhakanta Sahu
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Susmita S. Dora
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Arvind K. Singh
- Regional Institute of HIV Surveillance and Epidemiology, AIIMS, Bhubaneswar, Odisha, India
| | - Abhisek Mishra
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Binod K. Patro
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Sonu H. Subba
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
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Isakari M, Sanchez A, Conic R, Peretti J, Saito K, Sitapati AM, Millen M, Longhurst C. Benefits and Challenges of Transitioning Occupational Health to an Enterprise Electronic Health Record. J Occup Environ Med 2023; 65:615-620. [PMID: 37043385 PMCID: PMC10332650 DOI: 10.1097/jom.0000000000002864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVE Occupational health (OH) documentation has traditionally been separate from health system electronic health records (EHRs), but this can create patient safety and care continuity challenges. Herein, we describe outcomes and challenges of such integration including how one health system managed compliance with laws, regulations, and ethical principles concerning digital privacy. METHODS Occupational health integration with the enterprise EHR at the University of California San Diego Health was started in June 2021 and completed in December 2021. RESULTS Integrating with the enterprise EHR allowed for a secure telehealth system, faster visit times, digitization of questionnaires medical clearance forms, and improved reporting capabilities. CONCLUSIONS Integration and interoperability are fundamental building blocks to any OH EHR solution and will allow for evaluation of worker population trends, and targeted interventions to improve worker health status.
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Duffy LV, Evans R, Bennett V, Hady JM, Palaniappan P. Therapeutic Relational Connection in Telehealth: Concept Analysis. J Med Internet Res 2023; 25:e43303. [PMID: 37347526 PMCID: PMC10337293 DOI: 10.2196/43303] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/28/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Therapeutic relational connection (TRC) in telehealth is a new concept that refers to the intentional use of relationship connection between health care providers and their patients as both parties work toward a therapeutic aim. It has been demonstrated that TRC positively affects patient-centered outcomes including adherence, self-management, and satisfaction with care. What is not known are best practices for establishing TRC during telehealth visits. The rapid emergence of telehealth during the COVID-19 pandemic has identified a number of challenges. These challenges include lack of human contact, distance creating mistrust, the inability to rely on nonverbal communication, and a sense of depersonalization. Training for health care providers in these interpersonal communication skills needed to establish TRC during telehealth visits is needed. OBJECTIVE This paper aims to explore the evolutionary concept of TRC in telehealth. The purpose of this paper is to provide a concept analysis of TRC during telehealth interactions between providers and patients through a comprehensive review of the existing published literature. METHODS Rodgers' evolutionary concept analysis method was used to guide this study. PubMed, Embase, PsycINFO, and CINAHL were used to search for relevant publications. An integrative review strategy aided by Rayyan software was used to identify a final sample of 13 papers for analysis. RESULTS The proposed definition of TRC in telehealth is the experience of a mutually responsive patient-provider relationship that is built on mutual respect and understanding and informed by cultural humility, presence, empathy, and the ability to effectively evaluate patient concerns to work toward a therapeutic aim. The key attributes of TRC in telehealth are the provider's ability to evaluate patient concerns, interpersonal communication, cultural humility, mutual trust and respect, presence, empathy, and building relationships. Clinical presence, proper environment, knowledge about the use of technology (both patient and provider), use of verbal and nonverbal communication, and knowledge about community and culture are important antecedents of TRC. Consequences of TRC include improved communication resulting in mutual respect and caring, adherence to follow-up recommendations, increased coping, collaborative decision-making, and satisfaction with care. CONCLUSIONS Telehealth visits necessitate alternative approaches to establishing TRC as compared to in-person clinic visits. With the rapid expansion of telehealth platforms and a heightened acceptance of the technology, there is a need to integrate knowledge and provide a clear conceptualization of TRC in telehealth as TRC has been demonstrated to result in positive patient-centered outcomes. Identifying the attributes and antecedents of TRC in telehealth allows us the opportunity to develop guidelines and educational interventions aimed at training health care providers in the skills needed to establish TRC during telehealth visits.
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Affiliation(s)
- Lisa V Duffy
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Rebecka Evans
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Veronica Bennett
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Joan Marie Hady
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Priya Palaniappan
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
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Zapata JP, Petroll AE, Quinn KG, Zamantakis A, John SA. Implementation determinants of HIV Self-Testing among young sexual minority men. Arch Public Health 2023; 81:113. [PMID: 37344899 DOI: 10.1186/s13690-023-01126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND HIV self-testing (HIVST) has shown the potential for reaching people with heightened vulnerability to HIV, including young sexual minority men (YSMM), yet implementation of HIVST among YSMM aged 17-24 is scarce as a prevention method. Moreover, despite the consistent finding that offering HIVST increases HIV testing rates, barriers remain that need to be reduced in order to maximize the potential of this biomedical technology. Such information is necessary to direct implementation efforts to increase HIVST among YSMM, including HIV counseling and linkage to care. The current study was therefore intended to investigate perspectives for HIVST among YSMM and how HIVST can be marketed to increase implementation. METHODS Between March and September 2020, we enrolled 41 YSMM to participate in one of nine online synchronous focus group discussions about their general experience with HIV preventive services. Guided by the Consolidated Framework (CFIR) for Implementation Research, we explored YSMM perspectives on facilitators and barriers to HIVST implementation. Data were analyzed using a deductive thematic content analysis approach. RESULTS Many participants had never used HIVST before their participation in this study (n = 30; 73.2%). Qualitative results exhibited a variety of implementation determinants across the five CFIR 2.0 domains. Barriers included concerns about the format in which the testing materials would be provided (i.e., nature of packaging) and about the method in which the sample would need to be collected, particularly for those who had the testing kit mailed to their home address. These reservations were nested in the fear of unwanted disclosure of their sexual behavior, namely among the respondents who had to cohabitate with family due to the COVID-19 pandemic. Participants also discussed the limited local resources for HIVST. Many participants suggested programs that could be implemented to support HIVST, such as collaborations with trusted community agencies. CONCLUSIONS Understanding YSMM' perspectives of HIVST may help identify implementation deficiencies within the delivery system and aid the development of implementation strategies to promote reach of HIVST.
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Affiliation(s)
- Juan Pablo Zapata
- Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave 14th Floor, Chicago, IL, 60611, USA.
| | - Andrew E Petroll
- Health Intervention Sciences Group, Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katherine G Quinn
- Health Intervention Sciences Group, Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alithia Zamantakis
- Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave 14th Floor, Chicago, IL, 60611, USA
| | - Steven A John
- Health Intervention Sciences Group, Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Gómez-Palacio Schjetnan M, Perrusquia-Ortiz LE, Cruz-Maycott R, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Mental health and adherence to antiretroviral therapy among Mexican people living with HIV during the COVID-19 pandemic. AIDS Res Ther 2023; 20:34. [PMID: 37287023 PMCID: PMC10245356 DOI: 10.1186/s12981-023-00532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - María Gómez-Palacio Schjetnan
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México.
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Kaul V, Chahal J, Schrarstzhaupt IN, Geduld H, Shen Y, Cecconi M, Siqueira AM, Markoski MM, Kawano-Dourado L. Lessons Learned from a Global Perspective of Coronavirus Disease-2019. Clin Chest Med 2023; 44:435-449. [PMID: 37085231 PMCID: PMC9684102 DOI: 10.1016/j.ccm.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coronavirus disease-2019 has impacted the world globally. Countries and health care organizations across the globe responded to this unprecedented public health crisis in a varied manner in terms of public health and social measures, vaccination development and rollout, the conduct of research, developments of therapeutics, sharing of information, and in how they continue to deal with the widespread aftermath. This article reviews the various elements of the global response to the pandemic, focusing on the lessons learned and strategies to consider during future pandemics.
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Affiliation(s)
- Viren Kaul
- Department of Pulmonary and Critical Care Medicine, Crouse Health/Upstate Medical University, 736 Irving Avenue, Syracuse, NY, 13210, USA
| | - Japjot Chahal
- Department of Pulmonary and Critical Care Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Isaac N Schrarstzhaupt
- Capixaba Institute of Health Education, Research and Innovation (ICEPi), Rua Duque de Caxias, 267 - Centro, Vitória/ES, 29010-120, Brazil
| | - Heike Geduld
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Room 5006 Clinical Building, Stellenbosch University Tygerberg Campus, Cape Town 7505, South Africa
| | - Yinzhong Shen
- Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, China
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care, IRCCS Instituto Clinico Humanitas, Via Manzoni 56, Rozzano (Milano), Italy
| | - Andre M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, CEP 21040-900, Rio de Janeiro RJ Brazil
| | - Melissa M Markoski
- UFCSPA - Federal University of Health Sciences of Porto Alegre. Sarmento Leite, 245 - Centro Histórico, Porto Alegre - RS, 90050-170, Brazil
| | - Leticia Kawano-Dourado
- Hcor Research Institute, Hospital do Coracao, R. Des Eliseu Guilherme, 200, 8o andar, Sao Paulo, SP 04004-030, Brazil; Pulmonary Division, InCor, University of Sao Paulo.
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Yang Y, Li S, Cai Y, Zhang Q, Ge P, Shang S, Han H. Effectiveness of telehealth-based exercise interventions on pain, physical function and quality of life in patients with knee osteoarthritis: A meta-analysis. J Clin Nurs 2023; 32:2505-2520. [PMID: 35872635 DOI: 10.1111/jocn.16388] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of the study was to evaluate the effectiveness of telehealth-based exercise intervention on pain, physical function and quality of life in patients with knee osteoarthritis. DESIGN A systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS Six databases (PubMed, Embase, Cochrane Library, CINAHL, PEDro and Web of Science Core Collection) were searched for relevant randomised controlled trials published from database inception to 3 June 2021. Reviewers independently screened the literature, extracted data and used the Cochrane Collaboration Risk of Bias Tool for quality assessment. A meta-analysis and subgroup analyses, stratified by control condition, intervention duration and delivery type, were conducted by Revman 5.4. The study was reported in compliance with PRISMA statement. RESULTS A total of 9 independent RCTs with 861 participants were included. The meta-analysis showed that the telehealth-based exercise interventions significantly reduced pain in KOA patients (SMD = -0.28, 95% CI [-0.49, -0.08], p < .01) and produced similar effects to controls in terms of physical function and quality of life. Subgroup analysis revealed that telehealth-based exercise interventions were superior to the use of exercise booklet and usual care in terms of pain and physical function and were similar to face-to-face exercise treatment; a long-term (>3 months) intervention and the use of web and smartphone APPs to deliver exercise interventions were associated with better pain relief and physical function. CONCLUSIONS Telehealth-based exercise intervention is an effective strategy for KOA management during the COVID-19 epidemic, and it is significantly better than usual care in reducing knee pain and improving physical function and was able to achieve the effects of traditional face-to-face exercise treatment. Although the duration and type of delivery associated with the effect of the intervention have been identified, patient preference and acceptability need to be considered in practice.
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Affiliation(s)
- Yajie Yang
- School of Nursing, Peking University, Beijing, China
| | - Sitian Li
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Shanxi, China
| | - Ying Cai
- School of Nursing, Peking University, Beijing, China
| | - Qi Zhang
- School of Nursing, Peking University, Beijing, China
| | - Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Shaomei Shang
- School of Nursing, Peking University, Beijing, China
| | - Hongbin Han
- Department of Radiology, Peking University Third Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging Technology, Beijing, China
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Li X, Zhou Y, Liu Y, Wang X, Yuen KF. Psychological antecedents of telehealth acceptance: A technology readiness perspective. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 91:103688. [PMID: 37089615 PMCID: PMC10110278 DOI: 10.1016/j.ijdrr.2023.103688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/11/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
The ongoing coronavirus pandemic has been threatening the healthcare system. In this context, telehealth is a potential solution to deliver effective and safe health care to the public. To facilitate the application and acceptance of telehealth, a good understanding of psychological determinants is of great importance. Therefore, this study aims to examine the public's positive and negative mindsets towards telehealth. A theoretical model was established by employing the technology readiness model and perceived value theory. To empirically test the relationships between constructs, a total of 500 responses from residents in Singapore were collected; thereafter, structural equation modeling was performed. The results indicate that discomfort negatively impacts perceived value whereas optimism and innovativeness positively impact users' perceived value. Further, perceived value positively impacts the acceptance of telehealth via attitude. Demographic factors (i.e. internet literacy, age, education) can also influence certain aspects of technology readiness (e.g. innovativeness, optimism). Moreover, social influence is an important moderator between perceived value and the acceptance of telehealth. The empirical findings enhance the understanding of users' psychology concerning telehealth and provide policy recommendations regarding the development of telehealth to improve public health.
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Affiliation(s)
- Xue Li
- School of Civil and Environmental Engineering, Nanyang Technological University, Singapore
| | - Yusheng Zhou
- School of Civil and Environmental Engineering, Nanyang Technological University, Singapore
| | - Yanfeng Liu
- Graduate School of Management of Technology, Pukyong National University, South Korea
| | - Xueqin Wang
- Department of International Logistics, Chung-Ang University, South Korea
| | - Kum Fai Yuen
- School of Civil and Environmental Engineering, Nanyang Technological University, Singapore
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Minerva F, Giubilini A. Is AI the Future of Mental Healthcare? TOPOI : AN INTERNATIONAL REVIEW OF PHILOSOPHY 2023:1-9. [PMID: 37361723 PMCID: PMC10230127 DOI: 10.1007/s11245-023-09932-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Affiliation(s)
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, England
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Poot CC, Meijer E, Fokkema M, Chavannes NH, Osborne RH, Kayser L. Translation, cultural adaptation and validity assessment of the Dutch version of the eHealth Literacy Questionnaire: a mixed-method approach. BMC Public Health 2023; 23:1006. [PMID: 37254148 DOI: 10.1186/s12889-023-15869-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND The digitalization of healthcare requires users to have sufficient competence in using digital health technologies. In the Netherlands, as well as in other countries, there is a need for a comprehensive, person-centered assessment of eHealth literacy to understand and address eHealth literacy related needs, to improve equitable uptake and use of digital health technologies. OBJECTIVE We aimed to translate and culturally adapt the original eHealth Literacy Questionnaire (eHLQ) to Dutch and to collect initial validity evidence. METHODS The eHLQ was translated using a systematic approach with forward translation, an item intent matrix, back translation, and consensus meetings with the developer. A validity-driven and multi-study approach was used to collect validity evidence on 1) test content, 2) response processes and 3) internal structure. Cognitive interviews (n = 14) were held to assess test content and response processes (Study 1). A pre-final eHLQ version was completed by 1650 people participating in an eHealth study (Study 2). A seven-factor Confirmatory Factor Analysis (CFA) model was fitted to the data to assess the internal structure of the eHLQ. Invariance testing was performed across gender, age, education and current diagnosis. RESULTS Cognitive interviews showed some problems in wording, phrasing and resonance with individual's world views. CFA demonstrated an equivalent internal structure to the hypothesized (original) eHLQ with acceptable fit indices. All items loaded substantially on their corresponding latent factors (range 0.51-0.81). The model was partially metric invariant across all subgroups. Comparison of scores between groups showed that people who were younger, higher educated and who had a current diagnosis generally scored higher across domains, however effect sizes were small. Data from both studies were triangulated, resulting in minor refinements to eight items and recommendations on use, score interpretation and reporting. CONCLUSION The Dutch version of the eHLQ showed strong properties for assessing eHealth literacy in the Dutch context. While ongoing collection of validity evidence is recommended, the evidence presented indicate that the eHLQ can be used by researchers, eHealth developers and policy makers to identify eHealth literacy needs and inform the development of eHealth interventions to ensure that people with limited digital access and skills are not left behind.
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Affiliation(s)
- Charlotte C Poot
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
- National eHealth Living Lab (NeLL), Leiden University Medical Centre, The Netherlands, Leiden, The Netherlands.
| | - Eline Meijer
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
- National eHealth Living Lab (NeLL), Leiden University Medical Centre, The Netherlands, Leiden, The Netherlands
| | - Marjolein Fokkema
- Methodology and Statistics Research Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
- National eHealth Living Lab (NeLL), Leiden University Medical Centre, The Netherlands, Leiden, The Netherlands
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Portz JD, Schmid A, Fruhauf C, Fox A, Van Puymbroeck M, Sharp J, Leach H. Acceptability of Online Yoga Among Individuals With Chronic Conditions and Their Caregivers: Qualitative Study. JMIR Form Res 2023; 7:e39158. [PMID: 37223971 DOI: 10.2196/39158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The online delivery of yoga interventions rapidly expanded during the COVID-19 pandemic, and preliminary studies indicate that online yoga is feasible across multiple chronic conditions. However, few yoga studies provide synchronous online yoga sessions and rarely target the caregiving dyad. Online chronic disease management interventions have been evaluated across conditions, life spans, and diverse samples. However, the perceived acceptability of online yoga, including self-reported satisfaction and online delivery preferences, is underexplored among individuals with chronic conditions and their caregivers. Understanding user preferences is essential for successful and safe online yoga implementation. OBJECTIVE We aimed to qualitatively examine the perceived acceptability of online yoga among individuals with chronic conditions and their caregivers who participated in an online dyadic intervention that merged yoga and self-management education to develop skills (MY-Skills) to manage persistent pain. METHODS We conducted a qualitative study among 9 dyads (>18 years of age; individuals experiencing persistent moderate pain) who participated in MY-Skills online during the COVID-19 pandemic. The intervention consisted of 16 online, synchronous yoga sessions over 8 weeks for both dyad members. After the completion of the intervention, participants (N=18) participated in semistructured telephone interviews for around 20 minutes, discussing their preferences, challenges, and recommendations for improved online delivery. Interviews were analyzed by using a rapid analytic approach. RESULTS MY-Skills participants were, on average, aged 62.7 (SD 19) years; were primarily women; were primarily White; and had a mean of 5.5 (SD 3) chronic conditions. Both participants and caregivers reported moderate pain severity scores (mean 6.02, SD 1.3) on the Brief Pain Inventory. The following three themes were identified related to online delivery: (1) participants indicated a preference for the intervention to be in person rather than online because they were distracted in the home setting, because they felt that in-person yoga would be more engaging, because the yoga therapist could physically correct positions, and because of safety concerns (eg, fear of falling); (2) participants indicated good acceptability of online MY-Skills delivery due to convenience, access, and comfort with being in their home; and (3) recommendations for improving online delivery highlighted a need for additional and accessible technical support. CONCLUSIONS Both individuals with chronic conditions and their caregivers find online yoga to be an acceptable intervention. Participants who preferred in-person yoga did so due to distractions in the home and group dynamics. Some participants preferred in-person corrections to ensure correct positioning, while others felt safe with verbal modifications in their homes. Convenience and access were the primary reasons for preferring online delivery. To improve online delivery, future yoga studies should include specific activities for fostering group engagement, enhancing safety protocols, and increasing technical support. TRIAL REGISTRATION ClinicalTrials.gov NCT03440320; https://clinicaltrials.gov/ct2/show/NCT03440320.
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Affiliation(s)
| | - Arlene Schmid
- Colorado State University, Fort Collins, CO, United States
| | | | - Aimee Fox
- Kansas State University, Manhattan, KS, United States
| | | | - Julia Sharp
- Colorado State University, Fort Collins, CO, United States
| | - Heather Leach
- Colorado State University, Fort Collins, CO, United States
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128
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Adepoju OE, Dang P, Valdez MR. Comparing In-Person Only, Telemedicine Only, and Hybrid Health Care Visits Among Older Adults in Safety-Net Clinics. TELEMEDICINE REPORTS 2023; 4:93-99. [PMID: 37283857 PMCID: PMC10240331 DOI: 10.1089/tmr.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 06/08/2023]
Abstract
Introduction Older adults face challenges in seeking health care. This study examined factors associated with in-person only versus telemedicine only versus hybrid health care visits among adults 65+ in safety-net clinics. Methods Data were obtained from a large Texas-based Federally Qualified Health Center (FQHC) network. The dataset included 12,279 appointments for 3914 unique older adults between March and November 2020. The outcome of interest was a 3-level indicator of telemedicine visits: in-person visits only, telemedicine visits only, and hybrid (in person + telemedicine) visits during the study period. We used a multinomial logit model adjusting for patient level characteristics to assess the strength of the relationships. Results Compared to their white counterparts, black and Hispanic older adults were significantly likely to have telemedicine only visits versus in-person only visits (black RRR: 0.59, 95% confidence interval [CI]: 0.41-0.86; Hispanic RRR: 0.46, 95% CI: 0.36-0.60). However, there were no significant racial and ethnic differences in hybrid utilization (black RRR: 0.91, 95% CI: 0.67-1.23; Hispanic RRR: 0.86, 95% CI: 0.70-1.07). Discussion Our findings suggest that hybrid opportunities may bridge racial and ethnic disparities in access to care. Clinics should consider building capacity for both in-person and telemedicine opportunities as complementary strategies.
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Affiliation(s)
- Omolola E. Adepoju
- Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, Texas, USA
- Humana Integrated Health Systems Sciences Institute, Houston, Texas, USA
| | - Patrick Dang
- Humana Integrated Health Systems Sciences Institute, Houston, Texas, USA
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Nguyen J, Takesh T, Parsangi N, Song B, Liang R, Wilder-Smith P. Compliance with Specialist Referral for Increased Cancer Risk in Low-Resource Settings: In-Person vs. Telehealth Options. Cancers (Basel) 2023; 15:2775. [PMID: 37345112 DOI: 10.3390/cancers15102775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/13/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023] Open
Abstract
Efforts are underway to improve the accuracy of non-specialist screening for oral cancer (OC) risk, yet better screening will only translate into improved outcomes if at-risk individuals comply with specialist referral. Most individuals from low-resource, minority, and underserved (LRMU) populations fail to complete a specialist referral for OC risk. The goal was to evaluate the impact of a novel approach on specialist referral compliance in individuals with a positive OC risk screening outcome. A total of 60 LRMU subjects who had screened positive for increased OC risk were recruited and given the choice of referral for an in-person (20 subjects) or a telehealth (40 subjects) specialist visit. Referral compliance was tracked weekly over 6 months. Compliance was 30% in the in-person group, and 83% in the telehealth group. Approximately 83-85% of subjects from both groups who had complied with the first specialist referral complied with a second follow-up in-person specialist visit. Overall, 72.5% of subjects who had chosen a remote first specialist visit had entered into the continuum of care by the study end, vs. 25% of individuals in the in-person specialist group. A two-step approach that uses telehealth to overcome barriers may improve specialist referral compliance in LRMU individuals with increased OC risk.
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Affiliation(s)
- James Nguyen
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Thair Takesh
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Negah Parsangi
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Bofan Song
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Rongguang Liang
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Petra Wilder-Smith
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
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Thomas A, Edwards KJ, Bradwell HL, Chatterjee A, Jones RB. E-nursing homes: transforming access to nurses in nursing homes in response to the staffing crisis. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:428-432. [PMID: 37173078 DOI: 10.12968/bjon.2023.32.9.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The UK is facing a nationwide staffing crisis within adult social care, due to difficulties in recruiting and retaining registered nurses. Current interpretation of legislation means nursing homes must always have the physical presence of a registered nurse on duty within the home. With the shortage of registered nurses increasing, reliance on agency workers is commonplace, a practice impacting service cost and continuity of care. Lack of innovation to tackle this issue means the question of how to transform service delivery to combat staffing shortages is open for debate. The potential for technology to augment the provision of care was highlighted during the COVID-19 pandemic. In this article the authors present one possible solution focused on the provision of digital nursing care within nursing homes. Anticipated benefits include enhanced accessibility of nursing roles, reduced risk of viral spread and opportunities for upskilling staff. However, challenges include the current interpretation of legislation.
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Affiliation(s)
- Anne Thomas
- Chief Executive Officer, Cornwall Care, Truro
| | - Katie J Edwards
- Research Associate, Centre for Health Technology, University of Plymouth, Plymouth
| | - Hannah L Bradwell
- Research Fellow, Centre for Health Technology, University of Plymouth, Plymouth
| | - Arunangsu Chatterjee
- Professor of Digital Health and Education, Faculty of Medicine and Health, University of Leeds, Leeds
| | - Ray B Jones
- Professor of Health Informatics, Centre for Health Technology, University of Plymouth, Plymouth
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131
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Natkin LW, van den Broek-Altenburg E, Benson JS, Atherly A. Community Health Teams: a qualitative study about the factors influencing the decision-making process. BMC Health Serv Res 2023; 23:466. [PMID: 37165389 PMCID: PMC10170420 DOI: 10.1186/s12913-023-09423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/19/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND The purpose of this study was to explore the factors influencing how individual Community Health Teams (CHTs) make decisions about what services to offer and how to allocate their resources. METHODS We conducted thirteen semi-structured interviews with all 13 CHTs program managers between January and March, 2021. We analyzed interviewees descriptions of their service offerings, resources allocation, and decision-making process to identify themes. RESULTS Four major themes emerged from the interview data as factors influencing community health team program managers' decision-making process: commitment to offering high-quality care coordination, Blueprint's stable and flexible structure, use of data in priority setting, and leveraging community partnerships and local resources. CONCLUSIONS Community-based CHTs with flexible funding allowed programs to tailor service offerings in response to community needs. It is important for teams to have access to community-level data. Teams are cultivating and leveraging community partners to increase their care coordination capacity, which is focus of their work. CHTs are a model for leveraging community partnerships to increase service capacity and pubic engagement in health services for other states to replicate.
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Affiliation(s)
- Lisa W Natkin
- University of Vermont, The Robert Larner College of Medicine, Burlington, VT, 05405, United States.
| | | | - Jamie S Benson
- University of Vermont, The Robert Larner College of Medicine, Burlington, VT, 05405, United States
| | - Adam Atherly
- Department of Health Administration, Virginia Commonwealth University, Richmond, VA, 23284, United States
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132
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Fisher M, Aher A, Araga M, Franks B. Patient Factors in the Dose Selection of Oral Sumatriptan for Acute Migraine: A Post Hoc Analysis of Two Randomized Controlled Studies. Pain Ther 2023; 12:853-861. [PMID: 37103731 PMCID: PMC10134697 DOI: 10.1007/s40122-023-00511-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/30/2023] [Indexed: 04/28/2023] Open
Abstract
INTRODUCTION Patients are seeking greater involvement in their healthcare. It therefore may be beneficial to provide guidance on initial oral sumatriptan dose selection for the treatment of acute migraine in nontraditional settings, such as telehealth and other remote forms of medical care. We sought to determine whether clinical or demographic factors are predictive of oral sumatriptan dose preference. METHODS This was a post hoc analysis of two clinical studies designed to determine preference for 25, 50, or 100 mg oral sumatriptan. Patients were aged 18-65 years with at least a 1 year history of migraine and experienced, on average, between one and six severe or moderately severe migraine attacks per month, with or without aura. Predictive factors were demographic measures, medical history, and migraine characteristics. Possibly predictive factors were identified using three analyses: classification and regression tree analysis, marginal significance (P < 0.1) within a full-model logistic regression, and/or selection within a forward-selection procedure in a logistic regression. A reduced model containing the variables identified in the preliminary analyses was developed. Due to differences in study design, data were not combined. RESULTS A dose preference was expressed by 167 patients in Study 1 and 222 patients in Study 2. Gender and medical history of urologic and/or psychological conditions in Study 1 and duration of migraine history, height, and medical history of endocrine or neurologic disease and headache severity in Study 2 were identified as possibly predictive. The predictive model showed low positive predictive value (PPV; 23.8%) and low sensitivity (21.7%) for Study 1. For Study 2, the model showed moderate PPV (60.0%) but low sensitivity (10.9%). CONCLUSIONS No clinical or demographic characteristics alone or in combination were consistently or strongly associated with preference for oral sumatriptan dose level. TRIAL REGISTRATION The studies on which this paper is based were conducted before trial registration indexes were introduced.
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Affiliation(s)
- Matt Fisher
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA.
| | - Abhay Aher
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA
| | - Mako Araga
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA
| | - Billy Franks
- GlaxoSmithKline Consumer Healthcare B.V., Amersfoort, Netherlands
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133
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Yang C, Kessler M, Taebi N, Hetjens M, Reissfelder C, Otto M, Vassilev G. Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial. Obes Surg 2023:10.1007/s11695-023-06587-2. [PMID: 37081252 PMCID: PMC10119000 DOI: 10.1007/s11695-023-06587-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE Medical follow-up after bariatric surgery is recommended. However, the compliance was poor. This study aimed to evaluate the feasibility of a smartphone-based fully remote follow-up (FU) program for patients after bariatric surgery. METHODS In the interventional group, patients were followed up using a smartphone application (app), through which questionnaires were sent regularly. Participants in the control group underwent standard FU at the outpatient clinic every three months. After 12 months, all the participants were evaluated at an outpatient clinic. RESULTS Between August 2020 and March 2021, 44 and 43 patients in the interventional and control groups, respectively, were included in the analysis after three patients were lost to FU, and three withdrew their informed consent because they wished for more personal contact with medical caregivers. After 12 months, total weight loss (TWL), %TWL, and percentage of excess weight loss (%EWL) did not differ between groups. There were no significant differences in the complication rates, including surgical complications, malnutrition, and micronutrition deficiency. The parameters of bioelectrical impedance analysis and quality of life did not differ between the groups. Vitamins and minerals in serum were similar in both groups except for calcium, which was significantly higher in the interventional group (2.52 mmol/L vs. 2.35 mmol/L, p = 0.038). CONCLUSION Fully remote FU with a smartphone application is at least as effective as traditional in-person FU in an outpatient clinic after bariatric surgery. Through remote FU, patients can save time and medical professionals may have more resources for patients with more severe problems.
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Affiliation(s)
- Cui Yang
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Mia Kessler
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Niki Taebi
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Michael Hetjens
- Department of Biomedical Informatics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Reissfelder
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Mirko Otto
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Georgi Vassilev
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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134
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Hui S, Sane N, Wang A, Wan L, Bell S, Le S, Dev A. Hepatocellular carcinoma surveillance in the telehealth era: A single-centre review. J Telemed Telecare 2023:1357633X231166032. [PMID: 37032467 DOI: 10.1177/1357633x231166032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
BACKGROUND Real-world hepatocellular carcinoma (HCC) surveillance uptake remains suboptimal, despite evidence that surveillance is associated with lower cancer-related mortality in patients with cirrhosis and chronic hepatitis B. We aimed to examine the impact of telehealth consultations on HCC surveillance rates within a specialist liver clinic. METHODS We conducted a retrospective observational study within an Australian outreach liver clinic within a culturally diverse community, comparing standard consultations before the COVID-19 pandemic to telehealth consultations during the pandemic. The primary outcome was surveillance uptake defined as the percentage of time up-to-date with surveillance (PTUDS) with the 6-month interval following each scan considered up-to-date. RESULTS Over 18 months of follow-up for each cohort, the median PTUDS was 86.5% in the standard consultation cohort and 85.5% in the telehealth consultation cohort (p = 0.12). HCC diagnoses did not differ between groups and hospitalisation and mortality rates were low. Using multivariate regression, increasing age, the need for an interpreter and being born in South-East Asia independently predicted PTUDS in the standard consultation cohort, whereas being born in Australia or New Zealand was predictive of a lower PTUDS. Current alcohol use and distance from the clinic predicted a lower PTUDS in the telehealth consultation cohort. In both groups, missed clinic attendances were strongly predictive of a lower PTUDS. CONCLUSION Telehealth hepatology consultations effectively coordinate HCC surveillance and are associated with similar outcomes to standard consultations. Its implementation should be widely considered given its advantages with regards to accessibility for patients.
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Affiliation(s)
- Samuel Hui
- School of Clinical Sciences at Monash Health, 2541Monash University, Melbourne, Victoria, Australia
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
| | - Nikhita Sane
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
| | - Andrew Wang
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
| | - Leo Wan
- School of Clinical Sciences at Monash Health, 2541Monash University, Melbourne, Victoria, Australia
| | - Sally Bell
- School of Clinical Sciences at Monash Health, 2541Monash University, Melbourne, Victoria, Australia
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
| | - Suong Le
- School of Clinical Sciences at Monash Health, 2541Monash University, Melbourne, Victoria, Australia
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
| | - Anouk Dev
- School of Clinical Sciences at Monash Health, 2541Monash University, Melbourne, Victoria, Australia
- Department of Gastroenterology and Hepatology, 2538Monash Health, Melbourne, Victoria, Australia
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135
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Davis AJ, Greene M, Walker J, Erlandson KM. Perspectives of people living with HIV age 50 and over regarding barriers and resources for care. AIDS Care 2023; 35:581-590. [PMID: 36736330 PMCID: PMC10121861 DOI: 10.1080/09540121.2022.2162840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
ABSTRACTWith early and effective antiretroviral therapy leading to improved life expectancy in people with HIV (PWH), PWH aged 50 or older face concerns and issues related to aging. Providers at the University of Colorado identified a need to assess the healthcare needs of PWH aged 50 and older at the UCHealth Infectious Diseases/Travel (TEAM) Clinic in Aurora, Colorado. A survey was developed to illuminate participants' general rating of their health, factors that made it challenging to get the healthcare needed prior to COVID-19 and during COVID-19, and types of healthcare appointments and providers that would make a difference in healthcare experience. Descriptive statistics and brief thematic analysis of open-ended questions found that most participants rated their current health as very good or good. Participants noted that connecting to resources and appointment scheduling were the top challenges prior to the COVID-19 pandemic, and during the COVID-19 pandemic, participants described challenges with resource connection, communication with providers, and wait times. To reduce these barriers, telehealth video appointments, healthcare visits with a provider who specializes in aging, and healthcare visits with providers who specialize in aging if co-located in the HIV clinic were recognized as beneficial resources from the perspectives of participants.
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Affiliation(s)
- Amelia J Davis
- School of Medicine, University of Colorado, Aurora, CO, USA
| | - Meredith Greene
- Department of Medicine, Division of Geriatrics, University of California, San Francisco, CA, USA
| | - Jacob Walker
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL, USA
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Coats H, Doyon K, Isaacson MJ, Tay D, Rosa WE, Mayahara M, Kates J, Frechman E, Wright PM, Boyden JY, Broden EG, Hinds PS, James R, Keller S, Thrane SE, Mooney-Doyle K, Sullivan SS, Xu J, Tanner J, Natal M. The 2023-2026 Hospice and Palliative Nurses Association Research Agenda. J Hosp Palliat Nurs 2023; 25:55-74. [PMID: 36843048 DOI: 10.1097/njh.0000000000000935] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The Hospice and Palliative Nursing Association established the triannual research agenda to ( a ) provide focus for researchers to conduct meaningful scientific and quality improvement initiatives and inform evidence-based practice, ( b ) guide organizational funding, and ( c ) illustrate to other stakeholders the importance of nursing research foci. HPNA Research Agendas are developed to give direction for future research to continue advancing expert care in serious illness and ensure equitable delivery of hospice and palliative care.
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137
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Beaulieu-Jones BR, de Geus SWL, Rasic G, Woods AP, Papageorge MV, Sachs TE. COVID-19 Did Not Stop the Rising Tide: Trends in Case Volume Logged by Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2023; 80:499-510. [PMID: 36528544 PMCID: PMC9682049 DOI: 10.1016/j.jsurg.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The coronavirus pandemic has profoundly impacted all facets of surgical care, including surgical residency training. The objective of this study was to assess the operative experience and overall case volume of surgery residents before and during the pandemic. METHODS Using data from the Accreditation Council for Graduate Medical Education annual operative log reports, operative volume for 2015 to 2021 graduates of Accreditation Council for Graduate Medical Education -accredited general, orthopedic, neuro- and plastic surgery residency programs was analyzed using nonparametric Kendall-tau correlation analysis. The period before the pandemic was defined as AY14-15 to AY18-19, and the pandemic period was defined as AY19-20 to AY20-21. RESULTS Operative data for 8556 general, 5113 orthopedic, 736 plastic, and 1278 neurosurgery residency graduates were included. Between 2015 and 2021, total case volume increased significantly for general surgery graduates (Kendall's tau-b: 0.905, p = 0.007), orthopedic surgery graduates (Kendall's tau-b: 1.000, p = 0.003), neurosurgery graduates (Kendall's tau-b: 0.905, p = 0.007), and plastic surgery graduates (Kendall's tau-b: 0.810, p = 0.016). Across all specialties, the mean total number of cases performed by residents graduating during the pandemic was higher than among residents graduating before the pandemic, though no formal significance testing was performed. Among general surgery residents, the number of cases performed as surgeon chief among residents graduating in AY19-20 decreased for the first time in 5 years, though the overall volume remained higher than the prior year, and returned to prepandemic trends in AY20-21. CONCLUSIONS Over the past 7 years, the case volume of surgical residents steadily increased. Surgical trainees who graduated during the coronavirus pandemic have equal or greater total operative experience compared to trainees who graduated prior to the pandemic.
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Affiliation(s)
- Brendin R Beaulieu-Jones
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Susanna W L de Geus
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Alison P Woods
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marianna V Papageorge
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Teviah E Sachs
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
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138
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Kim E, Yoon JY, Kim H. Community Health Nursing During the COVID-19 Pandemic in Korea: Consequences, Challenges, and Directions. J Community Health Nurs 2023; 40:79-93. [PMID: 36920111 DOI: 10.1080/07370016.2022.2163850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
PURPOSE To explore the consequences, challenges, and future directions based on community health nurses' experiences during COVID-19. DESIGN Qualitative study. Four focus group interviews were conducted with 27 community health nurses. FINDINGS Three major themes emerged: 1) Coordination of roles and duties, 2) Identifying deterioration of patients' health and increasing demand for visits, and 3) Changing service delivery strategies: a testing ground for new services. CONCLUSIONS Community health nurses were essential public healthcare providers during the pandemic. The findings are informative for nurses and policy makers who can develop and suggest different services in the post-COVID era.
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Affiliation(s)
- Eunjoo Kim
- College of Nursing, Health and Nursing Research Institute, Jeju National University, Jeju, Republic of Korea
| | - Ju Young Yoon
- The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.,College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hyori Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
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139
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Raes S, Annemans L, Willems R, Trybou J. Physicians' views on optimal use and payment system for telemedicine: a qualitative study. BMC Health Serv Res 2023; 23:292. [PMID: 36978073 PMCID: PMC10043843 DOI: 10.1186/s12913-023-09314-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Telemedicine is already in use in daily practice, but appropriate reimbursement and physician payment is falling behind in many countries. One reason is the limited availability of research on the matter. This research therefore examined physicians' views on the optimal use and payment modalities for telemedicine. METHODS Sixty-one semi-structured interviews were conducted with physicians from 19 medical disciplines. Interviews were encoded using thematic analysis. RESULTS Telephone and video televisits tend not to be used as a first patient contact, except for triage of patients in urgency situations. Several minimum required modalities for the payment system of televisits and telemonitoring were identified. For televisits these were: (i) remuneration of both telephone- and videovisits to increase healthcare equity, (ii) little or no differentiation between videovisit and in-person visit fee to make videovisits financially attractive and sustainable for physicians, (iii) differentiation of televisit fee per medical discipline, and (iv) quality requirements such as mandatory reporting in the patient's medical file. The identified minimum required modalities for telemonitoring were: (i) an alternative payment scheme than fee-for-service, (ii) remunerating not only physicians but also other involved health professionals, (iii) designating and remunerating a coordinator, and (iv) distinguishing sporadic vs. continuously follow-up. CONCLUSIONS This research investigated the telemedicine usage behavior of physicians. Moreover, several minimum required modalities were identified for a physician-supported payment system of telemedicine, as these innovations necessitate challenging and innovation of the healthcare payment systems as well.
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Affiliation(s)
- Sarah Raes
- Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium.
| | - Lieven Annemans
- Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium
| | - Jeroen Trybou
- Department of Public Health and Primary Care, Ghent University, Ghent, 9000, Belgium
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Kodjebacheva GD, Culinski T, Kawser B, Coffer K. Satisfaction with telehealth compared to non-telehealth services among pediatric patients and their caregivers: A systematic review of the literature. JMIR Pediatr Parent 2023; 6:e41554. [PMID: 37000504 PMCID: PMC10176140 DOI: 10.2196/41554] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/10/2022] [Accepted: 03/27/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Telehealth is the use of technology to deliver healthcare in a virtual format. The COVID-19 pandemic prompted an increase in the use of telehealth. OBJECTIVE To review satisfaction with pediatric care only in studies that have at least one group of pediatric patients and/or their caregivers receiving telehealth during the COVID-19 pandemic and at least one comparison group of those receiving non-telehealth services. METHODS We searched for peer-reviewed studies published in English that compared satisfaction with pediatric care between pediatric patients and/or their caregivers receiving telehealth services during the COVID-19 pandemic and those receiving non-telehealth services. Because of stay-at-home orders, studies with comparison groups for non-telehealth services that took place either before or during the pandemic were eligible. We conducted the search on January 5, 2023, in the PubMed, EMBASE, CINAHL, and PsycInfo databases. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently screened titles and abstracts prior to reviewing the full-text of remaining articles. The following information from each eligible study was extracted: country, participant characteristics by comparison group, study design, telehealth approach, measurement tools to assess satisfaction, and findings by comparison group. RESULTS All eligible 14 studies assessed satisfaction among caregivers and/or pediatric patients participating in video and/or telephone visits during the COVID-19 pandemic compared to those having in-person appointments either prior to or during the pandemic. In 5 of the 14 studies, comparison non-telehealth services took place before the pandemic, and in the remaining 9 investigations, non-telehealth services took place during the pandemic. Thirteen studies were observational investigations with different designs and one study was a quasi-experimental intervention with 3 comparison groups for video, in-person, and hybrid visits. In 9 out of the 14 studies, satisfaction with telehealth services was higher compared to that during in-person visits. Reasons caregivers were satisfied with video visits were the ease of use and the reduced need for transportation. Reasons caregivers were not satisfied with remote care included limited personal interaction with the provider and technological challenges. Caregivers participating in telehealth expressed concerns about the lack of a physical examination. Those participating in non-telehealth services expressed that in-person interactions promoted treatment adherence. Only 1 study assessed satisfaction among patients where adolescents completed their own surveys; a higher percentage of adolescents using telehealth reported effective communication with the provider compared to patients using in-person visits. CONCLUSIONS Telehealth services tended to receive more favorable or comparable satisfaction ratings than in-person visits in most studies. Needed improvements in telehealth included strategies to address technological challenges and develop better rapport between the patient/caregiver and medical provider. Interventions on the effectiveness of pediatric telehealth compared to pediatric non-telehealth services on improving satisfaction and health outcomes will be valuable. CLINICALTRIAL
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Affiliation(s)
- Gergana Damianova Kodjebacheva
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
- International Institute, University of Michigan, Ann Arbor, US
| | - Taylor Culinski
- Department of Behavioral Sciences, College of Arts and Sciences, University of Michigan-Flint, Fint, US
| | - Bushra Kawser
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
| | - Katelynn Coffer
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
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141
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Dumbrell J, Daneshvar H, Oteo A, Baldacchino A, Matheson C. The acceptability of overdose alert and response technologies: introducing the TPOM-ODART framework. Harm Reduct J 2023; 20:40. [PMID: 36967388 PMCID: PMC10040083 DOI: 10.1186/s12954-023-00763-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/03/2023] [Indexed: 03/28/2023] Open
Abstract
Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern.
Methods Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group methodology was conducted. The participant groups were people with lived experience of problem opioid use, affected family members and service providers. Data analysis followed a multi-stage approach to thematic analysis and utilised both inductive and deductive methods.
Results Thirty individuals participated in one of six focus groups between November 2021 and September 2022. The analysis generated six major themes, three of which are reported in this article—selected for their close relevance to PWUO and their importance to developers of digital technologies for this group. ‘Trust—in technologies, systems and people’ was a major theme and was closely linked to data security, privacy and confidentiality. ‘Balancing harm reduction, safety and ambivalence’ reflects the delicate balance technological solutions must achieve to be acceptable to PWUO. Lastly, ‘readiness—a double bind’ encapsulates the perception shared across participant groups, that those at the highest risk, may be the least able to engage with interventions. Conclusion Effective digital strategies to prevent fatal OD must be sensitive to the complex relationships between technological, social/human, organisational and wider macroenvironmental factors which can enable or impede intervention delivery. Trust, readiness and performance are central to technology acceptability for PWUO. An augmented TPOM was developed (the TPOM-ODART). Supplementary Information The online version contains supplementary material available at 10.1186/s12954-023-00763-4.
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Affiliation(s)
- Josh Dumbrell
- grid.11918.300000 0001 2248 4331Drugs Research Network Scotland, University of Stirling, Stirling, UK
| | - Hadi Daneshvar
- grid.11918.300000 0001 2248 4331Faculty of Social Science, University of Stirling, Stirling, UK
| | - Alberto Oteo
- grid.11914.3c0000 0001 0721 1626University of St Andrews Medical School, University of St Andrews, St Andrews, UK
| | - Alexander Baldacchino
- grid.11914.3c0000 0001 0721 1626University of St Andrews Medical School, University of St Andrews, St Andrews, UK
| | - Catriona Matheson
- grid.11918.300000 0001 2248 4331Faculty of Social Science, University of Stirling, Stirling, UK
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Groom HC, Crawford P, Azziz-Baumgartner E, Henninger ML, Smith N, Salas B, Donald J, Naleway AL. Care trajectories for patients utilizing electronic visits for COVID-like symptoms in a large healthcare delivery system: May 2020-December 2021. J Telemed Telecare 2023:1357633X231162874. [PMID: 36945878 DOI: 10.1177/1357633x231162874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND There is limited information about how on-line screening tools developed by integrated systems facilitated management of COVID-like illness patients. METHODS Using the Kaiser Permanente Northwest (KPNW) Electronic Health Record, we identified adult plan members who accessed online COVID-19 screening e-visits and enumerated their subsequent medical encounters, tests for SARS-CoV-2, and test outcomes. RESULTS Between May 2020 and December 2021, members completed 55,139 e-visits, with disproportionate representation among females (65% vs. 53% in the overall membership) and members aged <45 years (61% vs. 39%). Thirty percent of patients (16,953) were managed entirely through e-visits and 70% received subsequent in-person care. The percent of SARS-CoV-2 positive individuals was highest among the 1055 individuals triaged to inpatient care (17.9%), compared to 9.5% among those escalated to additional ambulatory care. CONCLUSIONS The e-visit on-line screening tool helped KPNW assist thousands of patients with COVID-19 symptoms, avoid unnecessary in-person patient encounters, and preserved KPNW infection control and pandemic surge capacity.
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Affiliation(s)
- Holly C Groom
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Phil Crawford
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Eduardo Azziz-Baumgartner
- 1242Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA
| | - Michelle L Henninger
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Ning Smith
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Bianca Salas
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Judy Donald
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
| | - Allison L Naleway
- Kaiser Permanente Center for Health Research, Science Programs Department, Portland, OR, USA
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A comparative analysis of outpatient nutrition clinic scheduling outcomes based on in-person and telehealth patient care delivery modalities ☆. HEALTHCARE ANALYTICS (NEW YORK, N.Y.) 2023; 3:100163. [PMID: 36999092 PMCID: PMC10032049 DOI: 10.1016/j.health.2023.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023]
Abstract
During the start of the global COVID-19 pandemic in March 2020, patient care modalities changed from in-person to telehealth to comply with physical distancing guidelines. Our study uniquely examines operations data from three distinct periods: before the transition to telehealth, early transition from in-person care to telehealth, and the eventual adoption of telehealth. We present a comparative analysis of outpatient nutrition clinic scheduling outcomes based on care delivery modality. We used descriptive statistics to report means and variance and frequencies. We used inferential statistics to make comparisons: categorical data were compared using chi- square analysis with post-hoc comparisons using a z-test with alpha at 0.05. Means of continuous variables were compared using ANOVA with Tukey HSD post-hoc analysis. We found patient demographics remained widely unchanged across the three distinct periods as the demand for telehealth visits increased, with a notable rise in return patient visits, signaling both adaptability across the patient population and acceptance of the telehealth modality. These analyses along with evidence from the included literature review point to many the benefits of telehealth, thus telehealth as a healthcare delivery modality is here to stay. Our work serves as a foundation for future studies in this field, provides information for decision-makers in telehealth-related strategic planning, and can be utilized in advocacy for the extension of telehealth coverage.
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Xiao Y, Chen TT, Zhou YL, Zhu SY. Challenges in establishing a strong telemedicine system in China. Postgrad Med J 2023; 99:1-3. [PMID: 36947420 DOI: 10.1093/postmj/qgac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/22/2022] [Accepted: 11/05/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Yu Xiao
- Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610036, China
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu 610036, China
| | - Ting-Ting Chen
- Nursing School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Ya-Ling Zhou
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu 610036, China
| | - Shao-Yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou 515065, China
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145
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Eslami Jahromi M, Ayatollahi H. Utilization of telehealth to manage the Covid-19 pandemic in low- and middle-income countries: a scoping review. J Am Med Inform Assoc 2023; 30:738-751. [PMID: 36565464 PMCID: PMC10018263 DOI: 10.1093/jamia/ocac250] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/04/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Recently, the coronavirus disease 2019 (Covid-19) pandemic has led to an increase in the use of telehealth technology. It seems that the application of this technology in low- and middle-income countries (LMICs) has been limited, and few studies have been undertaken to review the current state of knowledge in this area. The aim of the present study was to explore the utilization of telehealth to manage the Covid-19 pandemic in LMICs. MATERIALS AND METHODS This scoping review was conducted in 2022. PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest were searched, and all quantitative research, qualitative studies, case reports, and case studies related to the use of telehealth to manage Covid-19 in LMICs and published since 2020 were included in the study. The findings were analyzed and reported narratively. RESULTS In total, 18 articles were included in the research. These studies were conducted in South Asia, sub-Saharan Africa, the Middle East and North Africa, and East Asia and Oceania. Telehealth interventions included teleconsultation, telecoaching, teledermatology, televisit, mhealth applications, telerehabilitation, telepharmacy, and telepsychiatry. WhatsApp was the most common way for service delivery and in most studies, patients and health care providers were satisfied with services. CONCLUSION Although the use of telehealth interventions was limited in LMICs during the Covid-19 pandemic, in most cases, it was an effective solution to combat the outbreak of Covid-19 and had positive outcomes. A comparison between the characteristics and clinical effectiveness of similar interventions in different countries including LMICs are worth investigation in the future studies.
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Affiliation(s)
- Maryam Eslami Jahromi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Suliman S, Akbar R, Yousaf Z, Ghazouani H, Al-Mohanadi D, Al-Mohammed A, Alkhal A. The Pros and Cons of Use of Handheld Electronic Devices During Ward Rounds and the Impact of the COVID-19 Pandemic. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:245-255. [PMID: 36960386 PMCID: PMC10028557 DOI: 10.2147/amep.s395501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The exponential use of handheld electronic devices (HEDs) among healthcare providers has shown the potential to enhance clinical workflows and improve patient care. However, the challenges and risks of carrying these devices during ward rounds and their impact on postgraduate trainees' (PGTs') training in general and more specifically during the COVID-19 pandemic need to be explored. METHODS A cross-sectional mixed-methods online survey was conducted to evaluate the perceptions of trainees and faculty at Accreditation Council for Graduate Medical Education International accredited residency and fellowships programs in Qatar on the use of HEDs on clinical workflow, trainees' education, and the impact of the COVID-19 pandemic. One hundred and fifty-eight participants were enrolled in the study (87 postgraduate trainees and 71 faculty). Exploratory data analysis and descriptive statistics were performed using STATA version 12 and thematic analysis of 301 qualitative responses to the survey open-ended questions using Atlas. ti qualitative software, version 9.4.0. RESULTS Almost all PGTs, 83 (95.4%), and faculty 43 (62.3%) use HEDs during ward rounds. Accessibility of patient information by PGTs 73 (94.8%) and faculty 46 (84.4%) and work efficiency were the main perceived benefits. Hindering communication between team members, disruption of interaction with patients, increased risk of infection and breach of patient confidentiality were among the challenges associated with their use. Carrying devices reduced the frequency of hand hygiene practices and physical examinations of patients by trainees. The COVID-19 pandemic led to a decrease in the use of HEDs by both faculty [38(64%)] and PGTs [42(60%)]. CONCLUSION HEDs' use is valued by both faculty and PGTs in enhancing workflow, trainees' education, patient experience, and patient care during the COVID-19 pandemic. Graduate medical education leaders should adopt measures to monitor their use during ward rounds as they can negatively impact trainees' education, reduce interaction with patients, increase the risk of infection, and breach patient confidentiality.
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Affiliation(s)
- Shireen Suliman
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Raza Akbar
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Zohaib Yousaf
- Internal Medicine, Tower Health, West Reading, PA, USA
| | | | - Dabia Al-Mohanadi
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Medical Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Al-Mohammed
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Abdullatif Alkhal
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Medical Education Department, Hamad Medical Corporation, Doha, Qatar
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Gonçalves RL, Pagano AS, Reis ZSN, Brackstone K, Lopes TCP, Cordeiro SA, Nunes JM, Afagbedzi SK, Head M, Meira W, Batchelor J, Ribeiro ALP. Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review. J Med Internet Res 2023; 25:e44209. [PMID: 36787223 PMCID: PMC10022651 DOI: 10.2196/44209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, telehealth was expanded without the opportunity to extensively evaluate the adopted technology's usability. OBJECTIVE We aimed to synthesize evidence on health professionals' perceptions regarding the usability of telehealth systems in the primary care of individuals with noncommunicable diseases (NCDs; hypertension and diabetes) from the COVID-19 pandemic onward. METHODS A systematic review was performed of clinical trials, prospective cohort studies, retrospective observational studies, and studies that used qualitative data collection and analysis methods published in English, Spanish, and Portuguese from March 2020 onward. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Studies involving health professionals who used telehealth systems in primary care and managed patients with NCDs from the COVID-19 pandemic onward were considered eligible. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles. The risk of bias and methodological quality of the included studies were analyzed. The primary outcome was the usability of telehealth systems, while the secondary outcomes were satisfaction and the contexts in which the telehealth system was used. RESULTS We included 11 of 417 retrieved studies, which had data from 248 health care professionals. These health care professionals were mostly doctors and nurses with prior experience in telehealth in high- and middle-income countries. Overall, 9 studies (82%) were qualitative studies and 2 (18%) were quasiexperimental or multisite trial studies. Moreover, 7 studies (64%) addressed diabetes, 1 (9%) addressed diabetes and hypertension, and 3 (27%) addressed chronic diseases. Most studies used a survey to assess usability. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems to be good and felt comfortable and satisfied. Patients felt satisfied using telehealth. The most important predictor for using digital health technologies was ease of use. The main barriers were technological challenges, connectivity issues, low computer literacy, inability to perform complete physical examination, and lack of training. Although the usability of telehealth systems was considered good, there is a need for research that investigates factors that may influence the perceptions of telehealth usability, such as differences between private and public services; differences in the level of experience of professionals, including professional experience and experience with digital tools; and differences in gender, age groups, occupations, and settings. CONCLUSIONS The COVID-19 pandemic has generated incredible demand for virtual care. Professionals' favorable perceptions of the usability of telehealth indicate that it can facilitate access to quality care. Although there are still challenges to telehealth, more than infrastructure challenges, the most reported challenges were related to empowering people for digital health. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021296887; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=296887. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.21801/ppcrj.2022.82.6.
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Affiliation(s)
- Roberta Lins Gonçalves
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Manaus, Brazil
| | | | | | | | | | - Sarah Almeida Cordeiro
- Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Manaus, Brazil
| | - Julia Macedo Nunes
- Department of Linguistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Michael Head
- University of Southampton, Southampton, United Kingdom
| | - Wagner Meira
- Department of Linguistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Construction and Validation of an Image Discrimination Algorithm to Discriminate Necrosis from Wounds in Pressure Ulcers. J Clin Med 2023; 12:jcm12062194. [PMID: 36983198 PMCID: PMC10057569 DOI: 10.3390/jcm12062194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
Artificial intelligence (AI) in medical care can raise diagnosis accuracy and improve its uniformity. This study developed a diagnostic imaging system for chronic wounds that can be used in medically underpopulated areas. The image identification algorithm searches for patterns and makes decisions based on information obtained from pixels rather than images. Images of 50 patients with pressure sores treated at Kobe University Hospital were examined. The algorithm determined the presence of necrosis with a significant difference (p = 3.39 × 10−5). A threshold value was created with a luminance difference of 50 for the group with necrosis of 5% or more black pixels. In the no-necrosis group with less than 5% black pixels, the threshold value was created with a brightness difference of 100. The “shallow wounds” were distributed below 100, whereas the “deep wounds” were distributed above 100. When the algorithm was applied to 24 images of 23 new cases, there was 100% agreement between the specialist and the algorithm regarding the presence of necrotic tissue and wound depth evaluation. The algorithm identifies the necrotic tissue and wound depth without requiring a large amount of data, making it suitable for application to future AI diagnosis systems for chronic wounds.
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Schladen MM, Kuo HH, Tran T, Ofonedu A, Hoang H, Jett R, Gu M, Liu K, Mohammed K, Mohammed Y, Lum PS, Koumpouros Y. Evolution of a System to Monitor Infant Neuromotor Development in the Home: Lessons from COVID-19. Healthcare (Basel) 2023; 11:healthcare11060784. [PMID: 36981440 PMCID: PMC10048217 DOI: 10.3390/healthcare11060784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
In the nine months leading up to COVID-19, our biomedical engineering research group was in the very early stages of development and in-home testing of HUGS, the Hand Use and Grasp Sensor (HUGS) system. HUGS was conceived as a tool to allay parents' anxiety by empowering them to monitor their infants' neuromotor development at home. System focus was on the evolving patterns of hand grasp and general upper extremity movement, over time, in the naturalistic environment of the home, through analysis of data captured from force-sensor-embedded toys and 3D video as the baby played. By the end of March, 2020, as the COVID-19 pandemic accelerated and global lockdown ensued, home visits were no longer possible and HUGS system testing ground to an abrupt halt. In the spring of 2021, still under lockdown, we were able to resume recruitment and in-home testing with HUGS-2, a system whose key requirement was that it be contactless. Participating families managed the set up and use of HUGS-2, supported by a detailed library of video materials and virtual interaction with the HUGS team for training and troubleshooting over Zoom. Like the positive/negative poles of experience reported by new parents under the isolation mandated to combat the pandemic, HUGS research was both impeded and accelerated by having to rely solely on distance interactions to support parents, troubleshoot equipment, and securely transmit data. The objective of this current report is to chronicle the evolution of HUGS. We describe a system whose design and development straddle the pre- and post-pandemic worlds of family-centered health technology design. We identify and classify the clinical approaches to infant screening that predominated in the pre-COVID-19 milieu and describe how these procedural frameworks relate to the family-centered conceptualization of HUGS. We describe how working exclusively through the proxy of parents revealed the family's priorities and goals for child interaction and surfaced HUGS design shortcomings that were not evident in researcher-managed, in-home testing prior to the pandemic.
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Affiliation(s)
- Manon Maitland Schladen
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Hsin-Hung Kuo
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Tan Tran
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Achuna Ofonedu
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Hanh Hoang
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Robert Jett
- Department of Mechanical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Megan Gu
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Kimberly Liu
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Kai'lyn Mohammed
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Yas'lyn Mohammed
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Peter S Lum
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Yiannis Koumpouros
- Department of Public and Community Health, University of West Attica, 12243 Aigaleo, Greece
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Tumosa N. Using the Age-Friendly Health Systems Framework to Track Wellness and Health Promotion Priorities of Older Adults in the Global Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4617. [PMID: 36901627 PMCID: PMC10001799 DOI: 10.3390/ijerph20054617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The promotion of health and wellness interventions for older adults is important in controlling the onset and progression of disabilities as well as disease in these individuals [...].
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Affiliation(s)
- Nina Tumosa
- Senior Public Health Advisor-Geriatrics, Division of Medicine and Dentistry, Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS), Rockville, MD 20857, USA
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