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Canal-Pérez A, Navas-Otero A, Ortiz-Rubio A, Heredia-Ciuró A, Raya-Benítez J, Martín-Núñez J, Valenza MC. E-Health Interventions to Improve Health Outcomes in Patients with Systemic Lupus Erythematosus: A Systematic Review. Healthcare (Basel) 2024; 12:1603. [PMID: 39201161 PMCID: PMC11353259 DOI: 10.3390/healthcare12161603] [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: 05/27/2024] [Revised: 07/30/2024] [Accepted: 08/09/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that involves damage to one or more organs and systems. E-Health technologies have been used to improve the quality of care and to minimize the cost of rehabilitation services. This study aimed to provide the most recent and convincing evidence on the rehabilitation effects of e-Health interventions compared to conventional treatments. METHODS A systematic review was conducted. Inclusion criteria were defined following PICO recommendations (i.e., populations, intervention, comparison and outcome measures). Methodological quality and risk-of-bias were assessed for each study. RESULTS Six studies met the inclusion criteria, providing data on 743 individuals with SLE. Results indicated that e-Health interventions improved health outcomes, such as disease management or emotional status. Methodological quality was moderate and low risk-of-bias was found in the majority of the studies included. CONCLUSIONS For patients with SLE, e-Health interventions are a safe rehabilitation intervention to improve health outcomes. However, more high-quality studies with large samples are needed, with a focus on the long-term outcomes of e-Health interventions for patients with SLE.
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Affiliation(s)
- Ana Canal-Pérez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Alba Navas-Otero
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Alejandro Heredia-Ciuró
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Julia Raya-Benítez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain;
| | - Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.C.-P.); (A.H.-C.); (J.M.-N.); (M.C.V.)
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Hormaza-Jaramillo A, Arredondo A, Forero E, Herrera S, Ochoa C, Arbeláez-Cortés Á, Fernandez Aldana AR, Rodriguez A, Amador L, Castaño N, Reyes J. Effectiveness of Telemedicine Compared with Standard Care for Patients with Rheumatic Diseases: A Systematic Review. Telemed J E Health 2022; 28:1852-1860. [PMID: 35834601 DOI: 10.1089/tmj.2022.0098] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: The aim of this study was to systematically review the evidence on the effectiveness of telemedicine compared to standard care for patients with rheumatic diseases. Methods: A search was performed in MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews; for the gray literature, GREYNET databases and a snowball search were used. MeSH or Emtree terms. Three authors independently selected systematic reviews, randomized controlled trail (RCTs), or non-RCTs with patients with autoimmune or inflammatory rheumatic diseases, where telemedicine was compared with standard care. Effectiveness was measured in terms of disease activity, quality of life, and functional activity. The patients' satisfaction was also measured. The risk of bias was assessed by the Cochrane collaboration tool for RCTs and AMSTAR II for systematic reviews. Results: Four RCTs, one cross-out study, and five systematic reviews were included. The studies were conducted with rheumatoid arthritis patients, and one study involved patients with systematic lupus erythematosus. The interventions mainly involved teleconsultation and telemonitoring, with patient-reported outcomes (PROs) being compared with standard care. Four studies measured the effectiveness of telemedicine using PROs, in which three of the RCTs did not find differences in the clinical outcomes, and one found that telemedicine improved the remission of diseases, functional impairment, and radiographic joint damage progression. Two studies measured patient satisfaction with telemedicine and standard care without a significant difference between the groups. Conclusions: Despite heterogeneity between studies, the findings were remarkably consistent in demonstrating that there was no significant difference between the telemedicine group and the control group in terms of PROs and patient satisfaction. Patients should be offered the option of telemedicine to manage their diseases as part of health-care support. Further research is needed on the effectiveness of telemedicine in the long term for patients with rheumatic diseases.
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Affiliation(s)
| | - Ana Arredondo
- Internal Medicine and Rheumatology Fundacion Universitaria de Ciencias de la Salud, Bogota, Colombia
- Rheumatology, Hospital de San Jose, Bogota, Colombia
- Rheumatology, Clinicos IPS, Bogota, Colombia
| | - Elias Forero
- Rheumatology, Universidad del Norte, Barranquilla, Colombia
| | - Sebastian Herrera
- Rheumatology, ARTMEDICA, Medellin, Colombia
- Rheumatology, Clinica Las Americas, Medellin, Colombia
| | - Carlos Ochoa
- Rheumatology, Centro de Reumatologia, Bogota, Colombia
| | - Álvaro Arbeláez-Cortés
- Rheumatology, Clinica Imbanaco Grupo Quiron salud, Cali, Colombia
- Internal Medicine, Universidad Libre, Cali, Colombia
| | | | - Andrea Rodriguez
- Clinical Epidemiology, National University of Colombia, Bogota, Colombia
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Knitza J, Callhoff J, Chehab G, Hueber A, Kiltz U, Kleyer A, Krusche M, Simon D, Specker C, Schneider M, Voormann A, Welcker M, Richter JG. [Position paper of the commission on digital rheumatology of the German Society of Rheumatology: tasks, targets and perspectives for a modern rheumatology]. Z Rheumatol 2020; 79:562-569. [PMID: 32651681 DOI: 10.1007/s00393-020-00834-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Digitalization in the healthcare system is a great challenge for rheumatology as for other medical disciplines. The German Society for Rheumatology (DGRh) wants to actively participate in this process and benefit from it. By founding the commission on digital rheumatology, the DGRh has created a committee that deals with the associated tasks, advises the DGRh on questions and positions associated with digital health. For the DGRh, this affects the most diverse areas of digitalization in medicine and rheumatology. This position paper presents the topics and developments currently handled by the commission and the tasks identified.
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Affiliation(s)
- J Knitza
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland.
| | - J Callhoff
- Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland
| | - G Chehab
- Poliklinik und Funktionsbereich Rheumatologie & Hiller-Forschungszentrum Rheumatologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - A Hueber
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland.,Sektion Rheumatologie, Sozialstiftung Bamberg, Klinikum Bamberg, Bamberg, Deutschland
| | - U Kiltz
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - A Kleyer
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland
| | - M Krusche
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin, Berlin, Deutschland
| | - D Simon
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland
| | - C Specker
- Klinik für Rheumatologie & Klinische Immunologie, Evangelisches Krankenhaus, Kliniken Essen-Mitte, Essen, Deutschland
| | - M Schneider
- Poliklinik und Funktionsbereich Rheumatologie & Hiller-Forschungszentrum Rheumatologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - A Voormann
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
| | - M Welcker
- Geschäftsführung, MVZ für Rheumatologie Dr. Martin Welcker GmbH & RheumaDatenRhePort (rhadar), Planegg, Deutschland
| | - J G Richter
- Poliklinik und Funktionsbereich Rheumatologie & Hiller-Forschungszentrum Rheumatologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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Haun JN, Alman AC, Melillo C, Standifer M, McMahon-Grenz J, Shin M, Lapcevic WA, Patel N, Elwy AR. Using Electronic Data Collection Platforms to Assess Complementary and Integrative Health Patient-Reported Outcomes: Feasibility Project. JMIR Med Inform 2020; 8:e15609. [PMID: 32589163 PMCID: PMC7381258 DOI: 10.2196/15609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/06/2019] [Accepted: 04/27/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The Veteran Administration (VA) Office of Patient-Centered Care and Cultural Transformation is invested in improving veteran health through a whole-person approach while taking advantage of the electronic resources suite available through the VA. Currently, there is no standardized process to collect and integrate electronic patient-reported outcomes (ePROs) of complementary and integrative health (CIH) into clinical care using a web-based survey platform. This quality improvement project enrolled veterans attending CIH appointments within a VA facility and used web-based technologies to collect ePROs. OBJECTIVE This study aimed to (1) determine a practical process for collecting ePROs using patient email services and a web-based survey platform and (2) conduct analyses of survey data using repeated measures to estimate the effects of CIH on patient outcomes. METHODS In total, 100 veterans from one VA facility, comprising 11 cohorts, agreed to participate. The VA patient email services (Secure Messaging) were used to manually send links to a 16-item web-based survey stored on a secure web-based survey storage platform (Qualtrics). Each survey included questions about patient outcomes from CIH programs. Each cohort was sent survey links via Secure Messaging (SM) at 6 time points: weeks 1 through 4, week 8, and week 12. Process evaluation interviews were conducted with five primary care providers to assess barriers and facilitators to using the patient-reported outcome survey in usual care. RESULTS This quality improvement project demonstrated the usability of SM and Qualtrics for ePRO collection. However, SM for ePROs was labor intensive for providers. Descriptive statistics on health competence (2-item Perceived Health Competence Scale), physical and mental health (Patient-Reported Outcomes Measurement Information System Global-10), and stress (4-item Perceived Stress Scale) indicated that scores did not significantly change over time. Survey response rates varied (18/100, 18.0%-42/100, 42.0%) across each of the 12 weekly survey periods. In total, 74 of 100 participants provided ≥1 survey, and 90% (66/74) were female. The majority, 62% (33/53) of participants, who reported the use of any CIH modality, reported the use of two or more unique modalities. Primary care providers highlighted specific challenges with SM and offered solutions regarding staff involvement in survey implementation. CONCLUSIONS This quality improvement project informs our understanding of the processes currently available for using SM and web-based data platforms to collect ePROs. The study results indicate that although it is possible to use SM and web-based survey platforms for ePROs, automating scheduled administration will be necessary to reduce provider burden. The lack of significant change in ePROs may be due to standard measures taking a biomedical approach to wellness. Future work should focus on identifying ideal ePRO processes that would include standardized, whole-person measures of wellness.
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Affiliation(s)
- Jolie N Haun
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States.,Department of Community & Family Health, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Amy C Alman
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States.,Department of Public Health, University of South Florida, Tampa, FL, United States
| | - Christine Melillo
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States
| | - Maisha Standifer
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States.,Department of Pharmacy Practice, College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Julie McMahon-Grenz
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States
| | - Marlena Shin
- Center for Healthcare Organization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, MA, United States
| | - W A Lapcevic
- Research Service, James A. Haley VA Medical Center, Tampa, FL, United States
| | - Nitin Patel
- Performance Improvement and Reporting, VHA Office of Community Care, Department of Veteran Affairs, Washington, DC, United States
| | - A Rani Elwy
- Center for Healthcare Organization and Implementation Research, Bedford Veterans Affairs Medical Center, Bedford, MA, United States.,Brown University, Providence, RI, United States
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Gandrup J, Yazdany J. Using Health Information Technology to Support Use of Patient-Reported Outcomes in Rheumatology. Rheum Dis Clin North Am 2019; 45:257-273. [PMID: 30952397 DOI: 10.1016/j.rdc.2019.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Technology can help health care providers understand their patients' experience of illness in a way that was previously impossible. Experience in using health information technology (IT) to capture this information through PROs within rheumatology suggests that careful attention to human centered design, including detailed workflow planning, consideration of patient and physician burden, integration into the health IT ecosystem, and delivering information to the right person at the right time are all important. Technology applications must be tested in diverse health systems and populations to ensure they are simple to interpret, useful for clinical decision making and effective in impacting outcomes.
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Affiliation(s)
- Julie Gandrup
- Division of Rheumatology, University of California, San Francisco, San Francisco, CA, USA
| | - Jinoos Yazdany
- Division of Rheumatology, University of California, San Francisco, San Francisco, CA, USA.
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Adane K, Gizachew M, Kendie S. The role of medical data in efficient patient care delivery: a review. Risk Manag Healthc Policy 2019; 12:67-73. [PMID: 31114410 PMCID: PMC6486797 DOI: 10.2147/rmhp.s179259] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Implementing accurate data management systems ensure safe and efficient transfer of confidential health care data. However, health care professionals overlooked their important tasks of medical data processing. Hence, using high-quality electronic health record (EHR) applications in health care is important to minimize medical errors. Therefore, this review tries to indicate the roles of EHR in advancing quality health care service provisions. Methods The keywords identified were EHR, EMR, medical data processing, medical data retention, medical data destruction, health care, and patient care, and a few related terms with different combinations. PubMed (National Library of Medicine), Google Scholar, and Google search engine were used to search for articles from those databases. Searching was done using boolean words “AND”, “OR”, and “NOT” using all [All fields] and [MeSH Terms] searching strategies. Results Articles were screened using the title, checked by their abstract, and the remaining related full-text materials were included or excluded by two individuals deciding its eligibility. Finally, 73 materials issued from 2013–2018 were used for qualitatively synthesizing and reconciling the idea to produce this review article. Conclusion Poor medical data processing systems are the key reasons for medical errors. Employing standardized data management systems reduce errors and associated sufferings. Therefore, using electronic tools in the health care institution ensures safe and efficient data management. Therefore, it is important to establish appropriate medical data management systems for efficient health care delivery.
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Affiliation(s)
- Kasaw Adane
- Unit of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia,
| | - Mucheye Gizachew
- School of Biomedical and Laboratory Sciences, Department of Medical Microbiology, University of Gondar, Gondar, Ethiopia
| | - Semalegne Kendie
- School of Sociology and Social Work, Department of Social Work, University of Gondar, Gondar, Ethiopia
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