1
|
Yeboah I, Dwomoh D, Ndejjo R, Kabwama SN, Ohemeng F, Takyi SA, Issah I, Bawuah SA, Wanyenze RK, Fobil J. Maintaining essential health services during COVID-19 in Ghana: a qualitative study. BMJ Glob Health 2024; 8:e013284. [PMID: 38490688 PMCID: PMC11148662 DOI: 10.1136/bmjgh-2023-013284] [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: 06/30/2023] [Accepted: 02/11/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Evidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers' and policy-makers' experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy. METHODS We used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study. RESULTS Participants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population-based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19. CONCLUSION Disruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations' continuous access to essential health services and strengthened health service delivery.
Collapse
Affiliation(s)
- Isaac Yeboah
- Employment and Society, University of Professional Studies, Legon, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, University of Ghana, Legon, Ghana
| | - Rawlance Ndejjo
- Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - Sylvia Akpene Takyi
- Department of Biological, Environmental, and Occupational Health, University of Ghana, Legon, Ghana
| | - Ibrahim Issah
- Department of Biological, Environmental, and Occupational Health, University of Ghana, Legon, Ghana
| | - Serwaa Akoto Bawuah
- Department of Biological, Environmental, and Occupational Health, University of Ghana, Legon, Ghana
| | | | - Julius Fobil
- Department of Biological, Environmental, and Occupational Health, University of Ghana, Legon, Ghana
| |
Collapse
|
2
|
İlaslan E, Adıbelli D. Exploring Disease Management Experiences of Individuals with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Study. Clin Nurs Res 2024; 33:51-59. [PMID: 37798953 DOI: 10.1177/10547738231201996] [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: 10/07/2023]
Abstract
The aim of this study was to investigate the impact of COVID-19 infection on disease management among individuals with type 2 diabetes and to explore their perspectives on COVID-19. This descriptive qualitative study included patients with diabetes, with a sample of 15 patients meeting the study criteria. The data were analyzed using code groups, which were then further categorized into main themes and subthemes. The main themes were: initial contact with the SARS-CoV-2 that is associated with COVID-19 illness changes in diabetes self-management behaviors; attempt at maintaining diabetes selfmanagement behaviors; and problems with accessing diabetes care. The study findings revealed several significant insights. Individuals with diabetes exhibited a fear of contracting SARS-CoV-2, which led to reduced levels of exercise and difficulties in managing blood sugar levels and insulin adjustments. Moreover, due to anxiety about COVID-19 infection, they postponed health check-ups, resulting in experiencing diabetes-related complications.
Collapse
Affiliation(s)
- Emine İlaslan
- Akdeniz University Kumluca Health Science Faculty, Antalya, Turkey
| | | |
Collapse
|
3
|
Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR. Impact of COVID-19 Pandemic on Healthcare Utilization among Patients with Type 2 Diabetes Mellitus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4577. [PMID: 36901588 PMCID: PMC10002238 DOI: 10.3390/ijerph20054577] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
Collapse
|
4
|
Alromaihi D, Asheer S, Hasan M, Faqihi F, Almannaei N, Alkowari S, Janahi D, Hasan M, Abraham A, Verma S. Evaluation of Patients' Satisfaction with the Transition of Internal Medicine Outpatient Clinics to Teleconsultation During COVID-19 Pandemic. Telemed J E Health 2023; 29:270-277. [PMID: 35704029 DOI: 10.1089/tmj.2021.0517] [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: 11/13/2022] Open
Abstract
Introduction: The utilization of telemedicine has been steadily rising and became more available during the coronavirus disease 2019 (COVID-19) pandemic to ensure the continuity of care and minimize the risk of exposure to the infection. The aim of this study was to evaluate patients' and caregivers' satisfaction to newly developed teleconsultation services at the internal medical outpatient clinics at a tertiary university hospital during the COVID-19 pandemic. Methods: A cross-sectional satisfaction evaluation was conducted between April 2020 and June 2020. Participants included patients or caregivers who were randomly selected to answer a multi-item questionnaire to measure satisfaction with the quality, effectiveness, and convenience of the service. Results: A total of 901 participants completed the satisfaction survey. Most of the patients were in the age group 45-64 years (43.7%). The main teleconsultation method was telephone call (99.2%) and 798 participants (88.6%) were satisfied with the quality of teleconsultation. There was no difference in satisfaction levels across the various specialty clinics or age groups. The service was viewed as convenient by 636 participants (70.5%) and 481 (56.6%) preferred to continue using telemedicine after the COVID-19 pandemic. Conclusion: The study revealed high level of satisfaction among patients and caregivers with the recently introduced teleconsultation services at internal medicine outpatient clinics during the COVID-19 pandemic, which is a relatively new concept in many countries. This opens the door to further utilize telemedicine as an integrated part to improve patient care beyond the pandemic.
Collapse
Affiliation(s)
- Dalal Alromaihi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain.,Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Kingdom of Bahrain
| | - Shaikha Asheer
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Mariam Hasan
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Fatima Faqihi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Noora Almannaei
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Shaikha Alkowari
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Duha Janahi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Mona Hasan
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Aneena Abraham
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Seema Verma
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| |
Collapse
|
5
|
Alzahrani AM, Magliah SF, Turkistani HA, Abulaban BA, Sabban MF, Mashat MA, Al Shaikh AM. Perception of primary caregiver toward virtual pediatric clinics for type 1 diabetes mellitus during COVID-19 pandemic in Jeddah, Saudi Arabia: A cross-sectional study. Ann Med Surg (Lond) 2022; 81:104550. [PMID: 36147155 PMCID: PMC9486846 DOI: 10.1016/j.amsu.2022.104550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/24/2022] [Accepted: 08/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background Virtual phone clinics were adopted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, as an alternative to in-person routine outpatient visits amid the COVID-19 pandemic. This study aimed to assess primary caregiver perceptions of the virtual phone clinics towards routine care of pediatric patients with type 1 diabetes mellitus (T1DM). Methods A cross-sectional research design was employed through a web-based research tool where the primary caregivers of pediatric patients with T1DM participated. Data were analyzed descriptively and statistically using independent t-tests and one-way analysis of variance. Results In total, 214 participants were included in this study. The average primary caregiver perception value towards virtual phone clinics was 66.71 ± 23.1%, which suggested a satisfactory perception of their experience. Statistically significant differences (p > 0.05) were not found between the mean perception values and demographic characteristics. Higher mean primary caregiver perception values were associated with those who: (1) agreed or strongly agreed to be contented with their current state of health, (2) did not ask their physicians to be physically seen during a virtual visit, (3) preferred having four virtual visits or more, and (4) preferred having single to no in-person visits at all. Conclusion This study revealed a generally acceptable primary caregiver perception regarding virtual clinics. Telemedicine is recommended for routine treatment alongside regular in-clinic appointments to improve the quality of care for pediatric patients with T1DM. Most subjects showed interest in having many as four or more virtual visits per year. Almost three-fourths of subjects demonstrated satisfaction with phone consultations. Virtual clinics may be implemented for diabetes care alongside regular in-clinic visits.
Collapse
Affiliation(s)
- Abdullah M. Alzahrani
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Sultan F. Magliah
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- Corresponding author.
| | - Haneen A. Turkistani
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Bahaa A. Abulaban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Mahmoud F. Sabban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Manar A. Mashat
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Adnan M. Al Shaikh
- Department of Pediatrics, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| |
Collapse
|
6
|
Bouclaous C, Azar LJ, Barmo N, Daher R, Tabaja J, El Hout G, Berika L. Levels and Correlates of Numeracy Skills in Lebanese Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10557. [PMID: 36078271 PMCID: PMC9517913 DOI: 10.3390/ijerph191710557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Diabetes numeracy skills are required in the interpretation of food labels, insulin pump dosage, the interpretation of blood glucose meter data, and the determination of carbohydrate intake. This study assessed the levels and correlates of numeracy skills in Lebanese adults with diabetes to identify those most at risk of uncontrolled diabetes. In total, 299 adults with diabetes, mean age 47.4 ± 19.8 years, took the questionnaire. It consisted of self-developed items on sociodemographic and health-related factors, in addition to the Diabetes Numeracy Test-15 (DNT-15) and the Single Item Literacy Screener. Many participants (62%) scored < 10 on the DNT-15 indicating insufficient numeracy skills. DNT-15 scores were positively associated with literacy, exercise, healthy diet, perceived diabetes control, frequency of glycaemia measurement, ability to afford treatment, and ease of understanding information related to diabetes. Age, BMI, and complications were negatively correlated with DNT-15 score. Numeracy skills were higher in males, single individuals, and in people with type 1 diabetes, fewer complications, controlled HbA1c, higher income, higher education, a prior visit to a dietician, and ability to maintain personal care despite COVID-19. Interventions to strengthen numeracy skills would empower individuals with diabetes, lead to appropriate self-management behaviors, and prevent health complications in at-risk individuals.
Collapse
Affiliation(s)
- Carmel Bouclaous
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos P.O. Box 36, Lebanon
| | | | | | | | | | | | | |
Collapse
|
7
|
Patrascu R, Albai A, Braha A, Gaita L, Lazar S, Potre O, Timar B. Factors Influencing the Desirability, Acceptability, and Adherence of Patients with Diabetes to Telemedicine. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58080997. [PMID: 35893112 PMCID: PMC9331825 DOI: 10.3390/medicina58080997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Telemedicine solutions have proven their value and efficacy in augmenting diabetes care. In addition to the availability of tools needed to implement telemedicine solutions for patients with diabetes, the patients’ desirability, acceptance, and adherence represent major burdens in implementing them. The main aim of this research is to evaluate which factors are influencing the desirability, acceptance, and adherence of patients with diabetes to telemedicine interventions in diabetes care. Materials and Methods: QTelemeDiab, a previously validated instrument for assessing patients’ desirability, acceptance, and adherence to telemedicine in diabetes care, was used on 114 enrolled patients with diabetes mellitus, in parallel with demographic, socio-economic, disease history, and psychometric data from all patients. Results: Left-skewed score distributions were observed for the QTelemeDiab total score (median = 166; skewness = −1.738), as well as all its components, thus denoting a high desirability, acceptance, and adherence towards telemedicine use. The presence of severe depression was associated with significant decreases in the QTelemeDiab score (148 vs. 167; p < 0.001), as well as on the desirability sub-score (101 vs. 115; p < 0.001) and adherence sub-score (30 vs. 35; p < 0.001). The presence of severe anxiety was associated with significant decreases in QTelemeDiab score (150 vs. 166), as well as the desirability sub-score (104 vs. 114; p = 0.008) and adherence sub-score (30 vs. 34; p = 0.012). Conclusions: There is a high desirability, acceptance, and adherence to the use of telemedicine interventions in patients with diabetes, both in special and in normal epidemiological settings. The presence of severe anxiety decreases the patient’s desirability, acceptance, and adherence, while the presence of severe depression decreases the patient’s desirability and adherence to the use of telemedicine interventions in diabetes care.
Collapse
Affiliation(s)
- Raul Patrascu
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
| | - Alin Albai
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Correspondence: ; Tel.: +40-7214-35829
| | - Adina Braha
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Laura Gaita
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Sandra Lazar
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ovidiu Potre
- First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Bogdan Timar
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| |
Collapse
|
8
|
Ganjali R, Jajroudi M, Kheirdoust A, Darroudi A, Alnattah A. Telemedicine solutions for clinical care delivery during COVID-19 pandemic: A scoping review. Front Public Health 2022; 10:937207. [PMID: 35937265 PMCID: PMC9354887 DOI: 10.3389/fpubh.2022.937207] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/24/2022] [Indexed: 01/04/2023] Open
Abstract
Background: The unexpected emergence of coronavirus disease 2019 (COVID-19) has changed mindsets about the healthcare system and medical practice in many fields, forcing physicians to reconsider their approaches to healthcare provision. It is necessary to add new, unique, and efficient solutions to traditional methods to overcome this critical challenge. In this regard, telemedicine offers a solution to this problem. Remote medical activities could diminish unnecessary visits and provide prompt medical services in a timely manner. Objective This scoping review aimed to provide a map of the existing evidence on the use of telemedicine during the COVID-19 pandemic by focusing on delineation functions and technologies, analyzing settings, and identifying related outcomes. Methods This review was conducted following the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed and Scopus databases were systematically searched based on specific eligibility criteria. The English publications included in this study focused on telemedicine systems implemented during the COVID-19 pandemic to provide clinical care services. Two independent reviewers screened the articles based on predefined inclusion and exclusion criteria. The relevant features of telemedicine systems were summarized and presented into the following four domains and their subcategories, including functionality, technology, context, and outcomes. Results Out of a total of 1,602 retrieved papers, 66 studies met the inclusion criteria. The most common function implemented was counseling, and telemedicine was used for diagnosis in seven studies. In addition, in 12 studies, tele-monitoring of patients was performed by phone, designed platforms, social media, Bluetooth, and video calls. Telemedicine systems were predominantly implemented synchronously (50 studies). Moreover, 10 studies used both synchronous and asynchronous technologies. Although most studies were performed in outpatient clinics or centers, three studies implemented a system for hospitalized patients, and four studies applied telemedicine for emergency care. Telemedicine was effective in improving 87.5% of health resource utilization outcomes, 85% of patient outcomes, and 100% of provider outcomes. Conclusion The benefits of using telemedicine in medical care delivery systems in pandemic conditions have been well–documented, especially for outpatient care. It could potentially improve patient, provider, and healthcare outcomes. This review suggests that telemedicine could support outpatient and emergency care in pandemic situations. However, further studies using interventional methods are required to increase the generalizability of the findings.
Collapse
Affiliation(s)
- Raheleh Ganjali
- Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- *Correspondence: Raheleh Ganjali
| | - Mahdie Jajroudi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Kheirdoust
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Darroudi
- Department of Health Information Technology, Faculty of Paramedicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ashraf Alnattah
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
9
|
Alzubaidi H, Hafidh K, Saidawi W, Othman AM, Khakpour MM, Zoghbor MM, Abu-Gharbieh E, Alzoubi KH, Shaw JE. Behavioral, psychological, and clinical outcomes of Arabic-speaking people with type 2 diabetes during COVID-19 pandemic. Prim Care Diabetes 2022; 16:355-360. [PMID: 35410850 PMCID: PMC8993045 DOI: 10.1016/j.pcd.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023]
Abstract
AIMS Assess self-care activities, health behaviors, self-efficacy, diabetes distress, challenges, and changes in diabetes treatment and clinical parameters among Arabic-speaking people with T2DM during the COVID-19 pandemic. METHODS A cross-sectional study was conducted at a tertiary hospital in the United Arab Emirates. The study instrument collected self-reported data using validated tools about health behaviors, self-efficacy, and diabetes distress, and challenges in accessing and using healthcare services during the pandemic and documented clinical data and treatment before and during the pandemic from medical records. RESULTS 206 patients participated with a mean age of 58.7 years and 15.7 years since diabetes diagnosis. Non-adherence to healthful eating and exercise was reported by 38.3% and 73.7%, respectively. Exercise was the self-care activity that decreased the most (36.8%). Most participants had low diabetes distress (85.9%). There were no significant differences in clinical parameters before and during the pandemic, and diabetes treatment was unchanged for 72.8% of participants. Having two or more challenges with accessing and using diabetes healthcare services was significantly associated with decreased adherence to healthy eating (p = 0.025) and exercise (p = 0.003). CONCLUSIONS Arabic-speaking people with T2DM appeared to maintain relatively similar self-care levels, except exercise, with no deterioration in clinical parameters compared to pre-pandemic.
Collapse
Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates; Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority UAE, Dubai Medical College, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Amna M Othman
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Mahta M Khakpour
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Malaka M Zoghbor
- Pharmacist, Fakeeh University Hospital, Dubai Silicon Oasis, Dubai, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Institute, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, PO Box 6492, Melbourne, VIC 3004, Australia.
| |
Collapse
|
10
|
Telehealth use in patients with type 2 diabetes in australian general practice during the COVID-19 pandemic. BJGP Open 2022; 6:BJGPO.2021.0200. [DOI: 10.3399/bjgpo.2021.0200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/01/2022] [Accepted: 04/04/2022] [Indexed: 10/31/2022] Open
Abstract
BackgroundThe Australian government introduced temporary government-subsidised telehealth service items (phone and video-conference) in mid-March 2020 in response to the COVID-19 pandemic. The uptake of telehealth by type 2 diabetes (T2DM) patients for consulting with General Practitioners (GPs) is unknown.AimTo evaluate the uptake of telehealth consultations and associated patient characteristics in Australian general practice, including the frequency of HbA1c tests and change in HbA1c levels by telehealth use, compared to guideline recommendations.Design & settingThis study used electronic patient data from approximately 800 general practices in Victoria and New South Wales, Australia. A pre-COVID-19 period from March 2019 to February 2020 was compared to a pandemic period from March 2020 to February 2021. Patients diagnosed with T2DM before March 2018 were included.MethodTelehealth uptake patterns were examined overall and by patient characteristics. Generalized estimating equation models were used to examine patient probability of 6-monthly HbA1c testing and change in HbA1c levels, comparing between patients who did and patients who did not use telehealth.ResultsOf 57,961 patients, 80.8% had telehealth consultations during the pandemic period. Telehealth consultations were positively associated with T2DM patients who were older, female, had chronic kidney disease, prescribed anti-diabetic medications, and living in remote areas. We found no significant difference in 6-monthly HbA1c testing and HbA1c levels between telehealth users and patients who had face-to-face consultations only.ConclusionTelehealth GP consultations were well utilised by T2DM patients. Diabetes monitoring care via telehealth may be utilised as effective measures as face-to-face consultations.
Collapse
|
11
|
Leong CM, Lee TI, Chien YM, Kuo LN, Kuo YF, Chen HY. Social Media-Delivered Patient Education to Enhance Self-management and Attitudes of Patients with Type 2 Diabetes During the COVID-19 Pandemic: Randomized Controlled Trial. J Med Internet Res 2022; 24:e31449. [PMID: 35319478 PMCID: PMC8987969 DOI: 10.2196/31449] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/03/2021] [Accepted: 02/04/2022] [Indexed: 12/17/2022] Open
Abstract
Background The use of mobile health technologies has been necessary to deliver patient education to patients with diabetes during the COVID-19 pandemic. Objective This open-label randomized controlled trial evaluated the effects of a diabetes educational platform—Taipei Medical University–LINE Oriented Video Education—delivered through a social media app. Methods Patients with type 2 diabetes were recruited from a clinic through physician referral. The social media–based program included 51 videos: 10 about understanding diabetes, 10 about daily care, 6 about nutrition care, 21 about diabetes drugs, and 4 containing quizzes. The intervention group received two or three videos every week and care messages every 2 weeks through the social media platform for 3 months, in addition to usual care. The control group only received usual care. Outcomes were measured at clinical visits through self-reported face-to-face questionnaires at baseline and at 3 months after the intervention, including the Simplified Diabetes Knowledge Scale (true/false version), the Diabetes Care Profile–Attitudes Toward Diabetes Scales, the Summary of Diabetes Self-Care Activities, and glycated hemoglobin (HbA1c) levels. Health literacy was measured at baseline using the Newest Vital Sign tool. Differences in HbA1c levels and questionnaire scores before and after the intervention were compared between groups. The associations of knowledge, attitudes, and self-care activities with health literacy were assessed. Results Patients with type 2 diabetes completed the 3-month study, with 91 out of 181 (50.3%) patients in the intervention group and 90 (49.7%) in the control group. The change in HbA1c did not significantly differ between groups (intervention group: mean 6.9%, SD 0.8% to mean 7.0%, SD 0.9%, P=.34; control group: mean 6.7%, SD 0.6% to mean 6.7%, SD 0.7%, P=.91). Both groups showed increased mean knowledge scores at 12 weeks, increasing from 68.3% (SD 16.4%) to 76.7% (SD 11.7%; P<.001) in the intervention group and from 64.8% (SD 18.2%) to 73.2% (SD 12.6%; P<.001) in the control group. Positive improvements in attitudes and self-care activities were only observed in the intervention group (attitudes: mean difference 0.2, SD 0.5, P=.001; self-care activities: mean difference 0.3, SD 1.2, P=.03). A 100% utility rate was achieved for 8 out of 21 (38%) medication-related videos. Low health literacy was a significant risk factor for baseline knowledge scores in the intervention group, with an odds ratio of 2.80 (95% CI 1.28-6.12; P=.01); this became insignificant after 3 months. Conclusions The social media–based program was effective at enhancing the knowledge, attitudes, and self-care activities of patients with diabetes. This intervention was also helpful for patients with low health literacy in diabetes knowledge. The program represents a potentially useful tool for delivering diabetes education to patients through social media, especially during the COVID-19 pandemic. Trial Registration ClinicalTrials.gov NCT04876274; https://clinicaltrials.gov/ct2/show/results/NCT04876274
Collapse
Affiliation(s)
- Cheng Man Leong
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Ting-I Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Mei Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Na Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Feng Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Hsiang-Yin Chen
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW In this review, we examine the expanding role of continuous glucose monitoring in glycaemic management in primary care. RECENT FINDINGS Improving technology and decreasing cost have increased the uptake of use of continuous glucose monitoring (CGM) for glycaemic management in primary care, wherein most diabetes is managed. Optimized use of this technology, however, will require a convergence of several factors. Availability of devices for people with diabetes, availability of data at the time of clinical interactions, and expertise in interpretation of CGM and ambulatory glucose profile (AGP) data, as well as optimization of therapies, will be required. Significant progress has been made in all three areas in recent years, yet creating systems of support for widespread use of CGM in primary care remains an area of active investigation. SUMMARY There has been significant uptake in the use of CGM in the management of diabetes in primary care. Optimized use, however, requires both access to CGM data and the expertise to use the data. Although promising strategies have emerged, the task of generalizing these strategies to the broad population of primary care in America is ongoing. CGM technology holds significant potential for improving glycaemic management in primary care, yet important work remains to leverage the full potential of this promising technology.
Collapse
Affiliation(s)
- Thomas W Martens
- International Diabetes Center, HealthPartners Institute and Park Nicollet Department of Internal Medicine, Minneapolis, Minnesota, USA
| |
Collapse
|
13
|
Doctor-Patient Relationship in Synchronous/Real-time Video-Consultations and In-Person Visits: An Investigation of the Perceptions of Young People with Type 1 Diabetes and Their Parents During the COVID-19 Pandemic. Int J Behav Med 2022; 29:638-647. [PMID: 35076861 PMCID: PMC8788397 DOI: 10.1007/s12529-021-10047-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/21/2022]
Abstract
Background Given that the widely acknowledged influence of the doctor-patient relationship on objective health parameters and treatment adherence in chronic illnesses, this study sought to explore how patients perceived the patient-doctor relationship across virtual and in-person contexts. Methods Parents’ and patients’ perceptions of doctor-patient relationship were evaluated in 610 children and adolescents (12.17 ± 4.19 years, 50.9% girls) with type 1 diabetes who visited via video-conferencing or in person during the COVID-19 pandemic. Results No differences were found between video consultations and in-person visits in terms of care satisfaction (p > .05), doctor-patient relationship—for the dimensions agreement on tasks (p = .506) and bond (p = .828)—as perceived by parents and physician empathy as perceived by patients (p = .096). Parents rated patient-doctor agreement on explicit goals of treatment higher in video consultation than in person (p = .009, d = .211). Agreement on goals (β = − .180, p = .016) and bond with doctor (β = − .160, p = .034) were negatively and significantly associated with HbA1c values, but only in participants who visited in person. Conclusions Parents’ care satisfaction and perceptions of doctor-patient relationship, along with patients’ perceptions of physician empathy, did not substantially differ between visits carried out in person or via video consultations. Given the high risk of psychological problems described in young people with diabetes, video consultation can be considered a useful opportunity to maintain access to a healthcare provider in a challenging time, such as the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10047-5.
Collapse
|
14
|
Asheq A, Ashames A, Al-Tabakha M, Hassan N, Jairoun A. Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates. F1000Res 2021; 10:435. [PMID: 34925767 PMCID: PMC8649966 DOI: 10.12688/f1000research.51729.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions: Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.
Collapse
Affiliation(s)
- Ameena Asheq
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Akram Ashames
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Moawia Al-Tabakha
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Nageeb Hassan
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Ammar Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
| |
Collapse
|
15
|
Silverii GA, Delli Poggi C, Dicembrini I, Monami M, Mannucci E. Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies. Acta Diabetol 2021; 58:1603-1611. [PMID: 34159476 PMCID: PMC8219181 DOI: 10.1007/s00592-021-01754-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/29/2021] [Indexed: 02/06/2023]
Abstract
AIM To assess the effect on glycaemic control of confinement due to lockdown measures, during COVID-19 pandemic, in people with type 1 (T1DM) and type 2 (T2DM) diabetes. METHODS Meta-analysis of observational studies reporting measures of glucose control and variability before and during and/or after periods of confinement caused by COVID-19 in 2020 and/or 2021. RESULTS We included 27 studies on T1DM. No significant change in Hba1c was observed after lockdown (WMD - 1.474 [- 3.26; 0.31] mmol/mol, I2 = 93.9). TIR significantly increased during and after lockdown (WMD: 2.73 1.47; 4.23 %, I2 = 81% and 3.73 [1.13; 5.33] %, I2 = 85%, respectively).We retrieved nine studies on T2DM patients. No significant variation in HbA1c was detected (WMD - 1.257 - 3.91; 1.39 mmol/mol, I2 = 98.3%). HbA1c had a more favourable trend in studies performed in Asia than in Europe (p = 0.022 between groups). CONCLUSION Lockdown showed no significant detrimental effect on HbA1c in either T1DM or T2DM. Conversely, home confinement led to a reduction in mean glucose and glucose variability in T1DM, although with a high heterogeneity of results.
Collapse
Affiliation(s)
- Giovanni Antonio Silverii
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | - Chiara Delli Poggi
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Ilaria Dicembrini
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Matteo Monami
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Edoardo Mannucci
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| |
Collapse
|
16
|
Coma E, Miró Q, Medina M, Marin-Gomez FX, Cos X, Benítez M, Mas A, Fàbregas M, Fina F, Lejardi Y, Vidal-Alaball J. Association between the reduction of face-to-face appointments and the control of patients with type 2 diabetes mellitus during the Covid-19 pandemic in Catalonia. Diabetes Res Clin Pract 2021; 182:109127. [PMID: 34752800 PMCID: PMC8592525 DOI: 10.1016/j.diabres.2021.109127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/20/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022]
Abstract
AIM To analyse the relation between face-to-face appointments and management of patients with type 2 diabetes mellitus (T2DM) visited in primary care practices (PCP). METHODS Retrospective study in 287 primary care practices (PCPs) attending>300,000 patients with T2DM. We analysed the results of 9 diabetes-related indicators of the Healthcare quality standard, comprising foot and retinopathy screening, blood pressure (BP) and glycemic control; and the incidence of T2DM. We calculated each indicator's percentage of change in 2020 with respect to the results of 2019. RESULTS Indicators' results were reduced in 2020 compared to 2019, highlighting the indicators of foot and retinopathy screening (-51.6% and -25.7%, respectively); the glycemic control indicator (-21.2%); the BP control indicator (-33.7%) and the incidence of T2DM (-25.6%). Conversely, the percentage of type 2 diabetes patients with HbA1c > 10% increased by 34%. PCPs with<11 weekly face-to-face appointments offered per professional had greater reductions than those PCPs with more than 40. For instance, a reduction of -60.7% vs -38.2% (p-value < 0.001) in the foot screening's indicator; -27.5% vs -12.5% (p-value < 0.001) in glycemic control and -40.2 vs -24.3% (p-value < 0.001) in BP control. CONCLUSIONS Reducing face-to-face visits offered may impact T2DM patients' follow-up and thus worsen their control.
Collapse
Affiliation(s)
- Ermengol Coma
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain.
| | - Queralt Miró
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain
| | - Manuel Medina
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | - Francesc X Marin-Gomez
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain; Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Spain; Faculty of Medicine. University of Vic - Central University of Catalonia, Vic, Spain
| | - Xavier Cos
- DAP_Cat Research Group, Gerencia Territorial Barcelona Ciutat, Institut Català de la Salut, Spain; Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autonoma de Barcelona, Spain; Institut Català de la Salut, Spain
| | - Mència Benítez
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain; Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | | | - Mireia Fàbregas
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | | | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain; Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Spain; Faculty of Medicine. University of Vic - Central University of Catalonia, Vic, Spain
| |
Collapse
|
17
|
Al Harthi T, Anwar H, Al Lawati A, Al Shuriqi F, Al Rashdi F, Al Mahrouqi A, Al Ismaili M, Al Syiabi R, Al Azri H, Meah UH, Al Ghafri T. The Impact of Covid-19 on Diabetes Care in Muscat Governorate: A Retrospective Cohort Study in Primary Care. J Prim Care Community Health 2021; 12:21501327211051930. [PMID: 34719302 PMCID: PMC8558604 DOI: 10.1177/21501327211051930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 pandemic has led to health service modification and temporary disruption of the routine care provided to patients with diabetes mellitus (DM) in primary care. This was done to minimize outpatient visits, permit physical distancing, and ensure patients’ and healthcare providers safety. There is no evidence that explored or measured the impact of COVID-19 pandemic on diabetes services and patients’ glycemic outcome in Oman. Aim and Objectives To explore the accessibility of DM services in primary care after COVID-19 pandemic announcement, and measure patients’ glycemic outcome. Methods Before and after, retrospective cohort study using Al-Shifa healthcare database in primary care. One thousand adult patients with diabetes who attended DM clinic before pandemic announcement in 2019 were randomly selected and followed up until end of 2020. Patients aged ≥18 years and had at least 2 visits in 2019 were included. Access to DM services was identified by number of patients received care, frequency of consultations, mode of consultation, and type of intervention given to patients. Patients’ glycated hemoglobin (HbA1c), and other glycemic parameters after pandemic announcement in 2020 were determined and compared with the same parameters before pandemic in 2019. Association between patients’ HbA1c and mode of consultation was measured using multivariable regression analysis. Results A total of 937 patients continued to follow and received DM care after pandemic announcement. Median number of consultations was 2 with interquartile range (IQR): 3-2. 57.4% had face-to-face alone, 32.4% had combined face to face and telephone consultation, and 10% had telephone consultation alone. Mean difference in HbA1c (%) before and after pandemic announcement was 0.2 ± 1.4 (95% CI: 0.1 to 0.3), P = .002. With multivariable linear regression, the mean difference in HbA1c was −0.3 (−2.3 to 1.5), P = .734 for telephone consultation alone, −0.5 (−2.4 to 1.4), P = .613 for face-to-face alone, and −0.5 (−2.4 to 1.3), P = .636 for combined consultations, compared to those who did not receive any formal consultation. Conclusion Despite service modification and disruption of comprehensive care in primary care after COVID-19 pandemic announcement, DM services were accessible as majority of patients maintained follow up. There was an overall increase in mean glycated hemoglobin, however, it was a less than 1 unit increase. After adjusting for multivariable, glycated hemoglobin was reduced among those who received consultation including telephone consultation compared to those who did not, however evidence was unconvincing.
Collapse
Affiliation(s)
| | - Huda Anwar
- Ministry of Health, Al Khuwair, Muscat, Oman
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Novi Sulistia Wati, Pokkate Wongsasuluk, Pradana Soewondo. A cross-sectional study on the telemedicine usage and glycemic status of diabetic patients during the COVID-19 pandemic. MEDICAL JOURNAL OF INDONESIA 2021. [DOI: 10.13181/mji.oa.215558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts selfmanagement in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic.
METHODS A cross-sectional study was conducted in T2DM patients aged 25–54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbA1c) levels, which was categorized into poor (HbA1c≥7%) and good glycemic control (HbA1c<7%). Data were analyzed using chi-square and binary logistic regression.
RESULTS Of 264 patients, only 19.2% used telemedicine and 60.2% had poor glycemic control during the pandemic. Overweight or obesity (odds ratio [OR] = 5.740 [95% confidence interval [CI] = 2.554–12.899]; p<0.001), insulin injection (OR = 3.083 [95% CI = 1.238–7.677]; p = 0.016), and frequent fried food consumption (OR = 5.204 [95% CI = 1.631–16.606]; p = 0.005) were the factors contributing to poor glycemic control. The risk is lower if exercised regularly (OR = 0.036 [95% CI = 0.007–0.195]; p<0.001) and consulted with a doctor using telemedicine (OR = 0.193 [95% CI = 0.044–0.846]; p = 0.029) or in-person visits (OR = 0.065 [95% CI = 0.016–0.260]; p<0.001).
CONCLUSIONS Glycemic control was not optimal during the COVID-19 pandemic. Therefore, keeping a healthy lifestyle and staying connected with a doctor are important to ensure optimal blood glucose control and reduce the risk of diabetesrelated complications.
Collapse
|
19
|
Kshanti IA, Epriliawati M, Mokoagow MI, Nasarudin J, Magfira N. The Impact of COVID-19 Lockdown on Diabetes Complication and Diabetes Management in People With Diabetes in Indonesia. J Prim Care Community Health 2021; 12:21501327211044888. [PMID: 34541963 PMCID: PMC8461120 DOI: 10.1177/21501327211044888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aims: As the country with the seventh largest number of People with Diabetes (PWD) in the world, the Coronavirus disease 2019 (COVID-19) pandemic, and the Large Social Scale Restriction (LSSR) policy taken by the Indonesian government to reduce the number of COVID-19 transmissions is estimated to interfere diabetes management and will increase the incidence of diabetes complications. This study aims to determine the difficulties of diabetes management and its impact on diabetes morbidity during the COVID-19 pandemic in Indonesia. Methods: This study is a cross-sectional study using a national scale web survey. This research was conducted in Indonesia enrolling 1124 PWD aged 18 years or older. Diabetes complications are defined as self-assessed incidence of hypoglycemia, or Diabetic Foot Ulcer (DFU), or hospital admission experienced by PWD in Indonesia during the COVID-19 pandemic. The correlation between diabetes management difficulties and diabetes-related complications was measured using a modified cox regression test. Results: Diabetes management difficulties were experienced by 69.8% of PWD in Indonesia. The difficulties include attending diabetes consultation 30.1%, access to diabetes medication 12.4%, checking blood glucose levels 9.5%, controlling diet 23.8%, and performing regular exercise 36.5%. Diabetes-related complications occurred in 24.6% of subjects. Those who had diabetes management difficulties during the COVID-19 pandemic are prone to have diabetes complications by 1.4 times greater (PR: 1.41, 95% CI: 1.09-1.83) than those who did not. Conclusion: The COVID-19 pandemic and LSSR have impact on diabetes management and diabetes-related complications as assessed by PWD in Indonesia.
Collapse
Affiliation(s)
| | | | | | | | - Nadya Magfira
- Fatmawati General Hospital, Jakarta Selatan, Indonesia
| |
Collapse
|
20
|
Abd-Alrazaq A, Hassan A, Abuelezz I, Ahmed A, Alzubaidi MS, Shah U, Alhuwail D, Giannicchi A, Househ M. Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review. J Med Internet Res 2021; 23:e29136. [PMID: 34406962 PMCID: PMC8767979 DOI: 10.2196/29136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/28/2021] [Accepted: 06/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies. OBJECTIVE This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic. METHODS We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data. RESULTS Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%). CONCLUSIONS Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.
Collapse
Affiliation(s)
- Alaa Abd-Alrazaq
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Asmaa Hassan
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Israa Abuelezz
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Arfan Ahmed
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mahmood Saleh Alzubaidi
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Uzair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Anna Giannicchi
- School of Professional Studies, Berkeley College, New York, NY, United States
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| |
Collapse
|
21
|
Abstract
OBJECTIVE The first wave of the COVID-19 pandemic had a major impact on healthcare utilisation. The aim of this retrospective review was to quantify how utilisation of non-COVID care changed during this time so as to gain insight and inform planning of future services during potential second and subsequent waves. METHODS AND ANALYSIS A longitudinal design was used to analyse anonymous private UK health insurer datasets covering the period of January 2018 to August 2020. Taken as a measure of healthcare utilisation in the UK, incidence rates of claims broken down by service area and condition were calculated alongside overall monthly totals and costs. Pre-COVID-19 years were compared with the current year. RESULTS Healthcare utilisation during the first wave of COVID-19 decreased by as much as 70% immediately after lockdown measures were implemented. After 2 months, the trend reversed and claims steadily began to increase, but did not reach rates seen from previous years by the end of August 2020. Assessment by service and diagnostic category showed that most areas, especially those highly reliant on in-person treatment, reflected the same pattern (ie, rapid drop followed by a steady recovery). The provision of mental health services differed from this observed trend, where utilisation increased by 20% during the first wave of COVID-19, in comparison to pre-COVID-19 years. The utilisation of maternity services and the treatment of existing cancers also stayed stable, or increased slightly, during this time. CONCLUSIONS Healthcare utilisation in a UK-based privately insured population decreased dramatically during the first wave of the COVID-19 pandemic, being over 70% lower at its height. However, mental health services remained resilient during this time, possibly due to greater virtualisation of diagnostics and care.
Collapse
Affiliation(s)
- Ana Howarth
- Cigna Europe, Greenock, UK
- Population Health Research Institute, St George's University of London, London, UK
| | | | - Alf Theodorou
- Cigna Europe, Greenock, UK
- NewCourse, West Down Farm, Corton Denham, Sherborne, UK
| | - Peter R Mills
- Cigna Europe, Greenock, UK
- Department of Respiratory Medicine, Whittington Hospital, London, London, UK
| |
Collapse
|
22
|
Kong Q, Riedewald D, Askari M. Factors Affecting Portal Usage Among Chronically Ill Patients During the COVID-19 Pandemic in the Netherlands: Cross-sectional Study. JMIR Hum Factors 2021; 8:e26003. [PMID: 34003762 PMCID: PMC8291139 DOI: 10.2196/26003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/01/2021] [Accepted: 05/03/2021] [Indexed: 01/07/2023] Open
Abstract
Background The COVID-19 pandemic has impacted the capacity of the regular health care system, which is reflected in limited access to nonurgent care for patients who are chronically ill in the Dutch health care system. Nevertheless, many of them still depend on health care assistance to manage their illnesses. Patient portals are used to provide continued health care (remotely) and offer self-management tools during COVID-19 and potentially after. However, little is known about the factors influencing portal use and users’ satisfaction among patients who are chronically ill during the COVID-19 pandemic. Objective This study aims to examine predictors of patient portal use among patients who are chronically ill, the willingness to recommend the portal to others, and the likelihood of future use among portal nonusers. Methods An online self-administered questionnaire was distributed among patients who are chronically ill via social media in May 2020. The questionnaire consisted of four parts: (1) demographics including age and hours of daily internet use; (2) physical health status including COVID-19 infection, perceived level of control, and hospital visits; (3) mental health status including depression and life satisfaction; and (4) portal use including response waiting time and awareness. Descriptive, correlation, univariate, and multivariate analyses were conducted to identify factors that affect portal use, users’ willingness to recommend, and nonusers’ likelihood of future portal use. Results A total of 652 patients responded, and 461 valid questionnaires were included. Among the 461 patients, 67% (n=307) were identified as patient portal users. Of the nonusers, 55% (85/154) reported not being aware of the existence of a patient portal at their hospital. Significant predictors of portal use include level of control (P=.04), hospital visit time (P=.03), depression scale (P=.03), and status of life satisfaction (P=.02). Among portal users, waiting time to get a response via the portal (P<.001) and maximum acceptable waiting time (P<.001) were the strongest predictors for willingness to recommend the portal; among nonusers, the model predicted that those who were not aware of patient portals (P<.001) and were willing to wait moderately long (P<.001) were most likely to use the portal in the future. Conclusions This study provides insights into factors that influence portal use and willingness to recommend, based on which health care providers can improve the adoption of patient portals and their services. It suggests that health care providers should leverage efficient operations management to improve responsiveness and reduce waiting time to enhance user satisfaction and willingness to recommend use. Health care organizations need to increase portal awareness among nonusers and train their patients to increase both use and longer adoption of patient portals. Factors including depression and life satisfaction can influence portal use; therefore, future studies on determinants of portal use and nonuse in this specific population are needed.
Collapse
Affiliation(s)
- Qingxia Kong
- Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
| | - Danique Riedewald
- Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
| | - Marjan Askari
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| |
Collapse
|
23
|
Magliah SF, Alsabban AS, Turkistani HA, Abulaban BA, Alsharif AH, Alsharif SS, Zarif HA. Perception of virtual clinics among Saudi adults with type 1 diabetes during the COVID-19 pandemic. Diabetes Metab Syndr 2021; 15:102175. [PMID: 34186374 PMCID: PMC8744414 DOI: 10.1016/j.dsx.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS We aimed to assess patient perception toward the rapid implementation of virtual phone clinics among Saudi adult patients with type 1 diabetes mellitus (T1DM) during the coronavirus disease (COVID-19) pandemic. METHODS This cross-sectional, web-based study included Saudi adult patients with T1DM who attended at least one virtual phone visit with the diabetes clinic at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between August 1 and December 31, 2020. Patients anonymously answered a Google form-created Arabic questionnaire. Information about patient characteristics, outcome, and perception of the virtual phone visit were obtained. Data were presented using descriptive statistics, chi-square, one-way ANOVA, independent t-, and Welch's t-tests. RESULTS The questionnaire was sent to 281 patients, of whom 201 completed it. 59.2% patients were satisfied with their overall virtual phone clinic experience, and 75.6% preferred to continue attending the virtual phone clinics in the future. The average perception value of patients toward virtual phone clinics was 67.76 ± 19.9, suggesting good perception among the majority. Negative or neutral views of current health, asking to be physically seen, and missing a virtual appointment were associated with significantly lower average patient perception value (p < 0.001). CONCLUSIONS Most Saudi patients with T1DM have adapted to virtual phone consultations, exhibiting good satisfaction and perception, and high preference to continue using this system in the future. The utilization of the service to assist patients with diabetes is highly encouraged, especially during the COVID-19 pandemic. Strategies need to be developed to further enhance the patient experience.
Collapse
Affiliation(s)
- Sultan F Magliah
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia.
| | - Ahmad S Alsabban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia; King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Haneen A Turkistani
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Bahaa A Abulaban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Abdulaziz H Alsharif
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Sarah S Alsharif
- Department of Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Hawazen A Zarif
- Department of Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia; King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| |
Collapse
|
24
|
Asheq A, Ashames A, Al-Tabakha M, Hassan N, Jairoun A. Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates. F1000Res 2021; 10:435. [PMID: 34925767 PMCID: PMC8649966 DOI: 10.12688/f1000research.51729.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 02/11/2024] Open
Abstract
Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions : Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.
Collapse
Affiliation(s)
- Ameena Asheq
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Akram Ashames
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Moawia Al-Tabakha
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Nageeb Hassan
- College of Pharmacy and Health Sciences, Ajman University, 346 Ajman, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, 346 Ajman, Ajman, United Arab Emirates
| | - Ammar Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
| |
Collapse
|
25
|
What’s the Name of the Game? The Impact of eHealth on Productive Interactions in Chronic Care Management. SUSTAINABILITY 2021. [DOI: 10.3390/su13095221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Chronic care management is dependent on productive interactions between patients and healthcare professionals. Digital health technologies (eHealth) open up new possibilities for improving the quality of care, but there is a limited understanding of what productive interactions entail. This study explores characteristics of productive interactions to support self-care and healthcare in the context of eHealth use in diabetes care. We collected qualitative data based on interviews with nurses and responses to open-ended survey questions from patients, prior to and post using an eHealth service for self-monitoring and digital communication. We found that eHealth’s influence on productive interactions was characterized by unconstrained access, health parameter surveillance, and data-driven feedback, with implications for self-care and healthcare. Our findings indicate that eHealth perforates the boundaries that define interactions under traditional, non-digital care. This was manifested in expressions of uncertainty and in blurred boundaries between self-care and healthcare. We conclude that the attainment of a sustainable eHealth ecosystem will require healthcare to acknowledge eHealth as a disruptive change that may require re-organization to optimally support the productive use of eHealth services for both patients and staff, which includes agreement on new routines, as well as social interaction rules.
Collapse
|
26
|
Abd-alrazaq A, Hassan A, Abuelezz I, Ahmed A, Alzubaidi MS, Shah U, Alhuwail D, Giannicchi A, Househ M. Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review (Preprint).. [DOI: 10.2196/preprints.29136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies.
OBJECTIVE
This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic.
METHODS
We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data.
RESULTS
Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%).
CONCLUSIONS
Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.
Collapse
|
27
|
Jones A, Bardram JE, Bækgaard P, Cramer-Petersen CL, Skinner T, Vrangbæk K, Starr L, Nørgaard K, Lind N, Bechmann Christensen M, Glümer C, Wang-Sattler R, Laxy M, Brander E, Heinemann L, Heise T, Schliess F, Ladewig K, Kownatka D. Integrated personalized diabetes management goes Europe: A multi-disciplinary approach to innovating type 2 diabetes care in Europe. Prim Care Diabetes 2021; 15:360-364. [PMID: 33184011 DOI: 10.1016/j.pcd.2020.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/15/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
Type 2 diabetes mellitus represents a multi-dimensional challenge for European and global societies alike. Building on an iterative six-step disease management process that leverages feedback loops and utilizes commodity digital tools, the PDM-ProValue study program demonstrated that integrated personalized diabetes management, or iPDM, can improve the standard of care for persons living with diabetes in a sustainable way. The novel "iPDM Goes Europe" consortium strives to advance iPDM adoption by (1) implementing the concept in a value-based healthcare setting for the treatment of persons living with type 2 diabetes, (2) providing tools to assess the patient's physical and mental health status, and (3) exploring new avenues to take advantage of emerging big data resources.
Collapse
Affiliation(s)
- Allan Jones
- Roche Diabetes Care GmbH, Mannheim, Germany.
| | | | - Per Bækgaard
- Technical University of Denmark, Lyngby, Denmark
| | | | | | | | - Laila Starr
- University of Copenhagen, Copenhagen, Denmark
| | | | - Nanna Lind
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | | | - Rui Wang-Sattler
- German Research Centre for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research, Germany
| | - Michael Laxy
- German Research Centre for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research, Germany
| | | | | | | | | | | | | |
Collapse
|
28
|
Chan CB, Popeski N, Hassanabad MF, Sigal RJ, O'Connell P, Sargious P. Use of Virtual Care for Glycemic Management in People With Types 1 and 2 Diabetes and Diabetes in Pregnancy: A Rapid Review. Can J Diabetes 2021; 45:677-688.e2. [PMID: 34045146 DOI: 10.1016/j.jcjd.2021.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/18/2021] [Accepted: 02/28/2021] [Indexed: 11/26/2022]
Abstract
Our objective in this study was to answer the main research question: In patients with diabetes, does virtual care vs face-to-face care provide different clinical, patient and practitioner experience or quality outcomes? Articles (2012 to 2020) describing interventions using virtual care with the capability for 2-way, individualized interactions compared with usual care were included. Studies involving any patients with diabetes and outcomes of glycated hemoglobin (A1C), quality of care and/or patient or health-care practitioner experience were included. Systematic reviews, randomized controlled studies, quasi-experimental trials, implementation trials, observational studies and qualitative analyses were reviewed. MEDLINE and McMaster Health Evidence databases searched in June 2020 identified 59 articles. Virtual care, in particular telemonitoring, combined with a means of 2-way communications provided improvement in A1C similar or superior to usual care, with the strongest evidence for type 2 diabetes. Virtual care was generally acceptable to patients, who expressed satisfaction with their care. Health-care providers recognized benefits but raised issues of technical support, workflow and compensation.
Collapse
Affiliation(s)
- Catherine B Chan
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Agricultural, Food and Nutritional Sciences, Li Ka Shing Centre for Health Innovation Research, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.
| | - Naomi Popeski
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mortaza Fatehi Hassanabad
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Petra O'Connell
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Peter Sargious
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Medicine, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
29
|
Mekonnen CK, Ferede YM, Abate HK. Determinants of Dietary Adherence Among Type 2 Diabetes Patients Aimed COVID-19 at the University of Gondar Comprehensive Specialized Hospital. Diabetes Metab Syndr Obes 2021; 14:917-927. [PMID: 33688226 PMCID: PMC7936688 DOI: 10.2147/dmso.s297582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/19/2021] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND People with diabetes are proving to be at higher risk of severe coronavirus infection than the general population. Non-adherence to dietary recommendation is a critical problem in individuals with type 2 diabetes; particularly, in the era of coronavirus. This study aimed to explore determinants that affect adherence to the recommendations of diet during coronavirus pandemic. OBJECTIVE This study aimed to determine dietary adherence among diabetes type 2 patients aimed at coronavirus pandemic and its associated factors. METHODS An institutional-based cross-sectional study was conducted among type 2 diabetes patients on follow-up. Systematic random sampling was employed to get representative study participants. Dietary adherence was dichotomized and with logistic regression analysis to assess the association between dependent and explanatory variables. The degree of association was interpreted by using both crude odds ratios and adjusted odds ratios with 95% confidence intervals and P-values <0.05 were considered statistically significant. RESULTS In this study, 576 participants took part with a 99.3% response rate. The dietary adherence was found to be 48.3% with [95% CI (44.1-52.4)]. The educational level of College and above was [AOR=3.64, 95% CI (1.59-8.34)], being a government-employed [AOR=2.38, 95% CI (1.13-4.99)], being urban [AOR=1.30, 95% CI (1.09-2.42)], family size of less than five [AOR=1.27, 95% CI (1.08-1.97)], medium level of wealth-status[AOR=2.26, 95% CI (1.67-4.54)], family history of diabetes [AOR=2.18, 95% CI (1.14-4.19)], duration of diabetes more than 15 years [AOR=5.39, 95% CI (1.57-18.52)], and knowledge related to coronavirus [AOR=4.33,95% CI (2.71-6.92)] were significantly associated with adherence to the dietary recommendation. CONCLUSION The dietary adherence was relatively low aimed at coronavirus pandemic. Knowledge about COVID-19 was found significantly associated with dietary adherence. RECOMMENDATIONS There has to be a strong commitment to aware the community to minimize the risk of coronavirus severity among diabetes patients. This could be through adherence to dietary recommendations of particularly in the era of coronavirus pandemic.
Collapse
Affiliation(s)
- Chilot Kassa Mekonnen
- Department of Medical, Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Chilot Kassa Mekonnen Email
| | - Yohannes Mulu Ferede
- Department of Medical, Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailemichael Kindie Abate
- Department of Medical, Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
30
|
Barone MTU, Ngongo B, Harnik SB, Oliveira LXD, Végh D, de Luca PV, Pedrosa HC, Giraudo F, Cardona-Hernandez R, Chaudhury N, Menna-Barreto L. COVID-19 associated with diabetes and other noncommunicable diseases led to a global health crisis. Diabetes Res Clin Pract 2021; 171:108587. [PMID: 33307134 PMCID: PMC7724978 DOI: 10.1016/j.diabres.2020.108587] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/03/2020] [Accepted: 11/26/2020] [Indexed: 01/08/2023]
Abstract
COVID-19 has gravely threatened high-risk populations, such as people with diabetes and other noncommunicable diseases, leading to disproportionate hospitalizations and deaths worldwide. It is well documented from previous outbreaks that diabetes increases the risk for poor outcomes due to SARS infection. In the present review, we bring evidence that the country and global level health crisis caused by COVID-19 could have been avoided or extremely minimized if measures to protect high-risk populations were implemented timely. In addition to general lockdowns, testing, tracing, isolation and hygiene measures, other specific interventions for diabetes and comorbidities management were shown crucial to allow the continuation of care services during the pandemic. These interventions included: teleconsultation, digital remote education andmonitoring, e-prescriptions, medicine delivery options, mobile clinics, and home point-of-care tests. In conclusion, we recommend prompt actions to protect the most vulnerable groups, valuing knowledge and experiences from previous outbreaks and lessons learned during the COVID-19 pandemic, in order to shield communities, health systems and the global economy.
Collapse
Affiliation(s)
- Mark Thomaz Ugliara Barone
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova Conceição, Zip Code 04511-011, São Paulo, SP, Brazil.
| | - Belinda Ngongo
- Pan African Women in Health (PAWH), P.O. Box 95535, Grant Park, 2051, South Africa
| | - Simone Bega Harnik
- Universidade de São Paulo (USP), Instituto de Matemática e Estatística, Departamento de Estatística, Rua do Matão 1010, Cidade Universitária, Zip Code 05508-090, São Paulo, SP, Brazil
| | - Lucas Xavier de Oliveira
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Liga de Enfermagem na Atenção ao Diabetes da Escola de Enfermagem da Universidade de São Paulo (LEAD-EE-USP), Av. Dr. Enéas Carvalho de Aguiar, 419, Zip Code 05403-000, Cerqueira César, São Paulo, SP, Brazil
| | - Dániel Végh
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; Semmelweis University, Faculty of Dentistry, Department of Prosthodontics, Budapest, Hungary
| | - Patrícia Vieira de Luca
- Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Associação Brasileira de Hipercolesterolemia Familiar (AHF), Rua Machado Bittencourt 190, Vila Clementino, Zip Code 04044-000, São Paulo, Brazil
| | - Hermelinda Cordeiro Pedrosa
- Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova Conceição, Zip Code 04511-011, São Paulo, SP, Brazil; Research Centre, Endocrinology Unit, Regional Taguatinga Hospital, Secretary of Health, Brasilia, Federal District, Brazil
| | - Franco Giraudo
- Institute Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile; Juvenile Diabetes Foundation of Chile (FDJ), Santiago, Chile
| | | | - Nayanjeet Chaudhury
- Public Health Institute, Oakland, CA, 555 12th Street, Suite 215, Oakland, CA, 94607; Ramaiah International Centre for Public Health Innovations, MS Ramaiah Nagar, MSRIT Post, Bangalore 560097, India
| | - Luiz Menna-Barreto
- Grupo Multidisciplinar de Desenvolvimento e Ritmos Biológicos (GMDRB), Escola de Artes, Ciências eHumanidades da Universidade de São Paulo (EACH-USP), Rua Arlindo Béttio, 1000 - Ermelino Matarazzo, São Paulo, SP 03828-000, Brazil
| |
Collapse
|
31
|
Bari B, Corbeil MA, Farooqui H, Menzies S, Pflug B, Smith BK, Vasquez A, Berard L. Insulin Injection Practices in a Population of Canadians with Diabetes: An Observational Study. Diabetes Ther 2020; 11:2595-2609. [PMID: 32893337 PMCID: PMC7475025 DOI: 10.1007/s13300-020-00913-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Proper insulin injection technique has demonstrated positive clinical outcomes in patients with diabetes. A Canadian-based practice reflective was undertaken to evaluate the current state of understanding of injection technique practices by patients administering insulin, and the importance physicians place on proper injection technique. METHODS Twenty-four sites across Canada completed a practice profile survey and enrolled adult non-pregnant patients with either type 1 or type 2 diabetes injecting insulin using an insulin pen. Seven areas of proper injection technique to be evaluated were identified by the study steering committee: size of injection site, use of a skin lift, needle reuse, length of the needle, duration of the needle in the skin, injection into lipohypertrophic tissue, and applied injection force. During a scheduled visit, each patient filled out the Injection Technique Survey and the physician documented the answers via an electronic database. RESULTS Almost all physicians surveyed agreed (96%) that proper insulin injection technique is important or very important and 80% indicated they were either completely confident or fairly confident in discussing overall insulin injection technique. All patients surveyed were making at least one insulin injection technique error within the following categories: applied injection force (76%), area size of injection site (64%), duration of pen needle in skin (61%), pen needle reuse (39%), performs a skin lift with a 4 or 5 mm needle (38%), uses a longer pen needle than required (34%), and injection of insulin into lipohypertrophic tissue (37%). CONCLUSION Patients commonly make insulin injection errors. Patient and physician education on optimal insulin injection technique continues to be an unmet medical need for the treatment of patients with diabetes. Prospective trials examining the impact of new technology, diabetes educational teams, and e-learning as educational interventions are potential avenues to explore in future studies to support improved insulin injection technique.
Collapse
Affiliation(s)
- Basel Bari
- Markham HealthPlex Medical Centre, Markham, ON, Canada
| | | | - Hena Farooqui
- Medical Division, CTC Communications, Mississauga, ON, Canada
| | - Stuart Menzies
- Medical Division, CTC Communications, Mississauga, ON, Canada
| | - Brian Pflug
- Becton, Dickinson and Company, Franklin Lakes, NJ, USA
| | - Brennan K Smith
- Medical Division, CTC Communications, Mississauga, ON, Canada
| | | | | |
Collapse
|
32
|
Ceriello A. "Diabetes as a case study of chronic disease management": Eight years later. The opportunity learned from the COVID-19 pandemic. Diabetes Res Clin Pract 2020; 167:108384. [PMID: 32853689 PMCID: PMC7445126 DOI: 10.1016/j.diabres.2020.108384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Antonio Ceriello
- IRCCS MultiMedica, Sesto San Giovanni, Via Gaudenzio Fantoli, 16/15, 20138 Milan, Italy.
| |
Collapse
|