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Foglia E, Ferrario L, Garagiola E, Asperti F, Mazzone A, Gatti F, Varalli L, Ponsiglione C, Cannavacciuolo L. The role of INTERCheckWEB digital innovation in supporting polytherapy management. Sci Rep 2023; 13:5544. [PMID: 37016155 PMCID: PMC10072813 DOI: 10.1038/s41598-023-32844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/03/2023] [Indexed: 04/06/2023] Open
Abstract
The study aims at defining the factors affecting the clinicians' decision of changing or confirming the treatment options for frail patients in polytherapy, supporting prescribing patterns, thus also figuring out if the inclination of the clinicians towards digital solutions (INTERCheckWEB) and specific guidelines, could play a role in their decision. A literature review was performed, revealing the main individual, organizational and decisional factors, impacting on the clinicians' propensity to change the current patients' therapy: the clinician perceptions of support in case of clinical guidelines use or INTERCheckWEB use were studied. A qualitative approach was implemented, and thirty-five clinicians completed a questionnaire, aimed at evaluating fifteen different clinical cases, defining if they would change the patient's current therapy depending on the level of information received. Three methodological approaches were implemented. (1) Bivariate correlations to test the relationships between variables. (2) Hierarchical sequential linear regression model to define the predictors of the clinician propensity to change therapy. (3) Fuzzy Qualitative Comparative Analysis-fsQCA, to figure out the combination of variables leading to the outcome. Patient's age and autonomy (p value = 0.000), as well as clinician's perception regarding IT ease of use (p value = 0.043) and seniority (p value = 0.009), number of drugs assumed by the patients (p value = 0.000) and number of concomitant diseases (p value = 0.000) are factors influencing a potential change in the current therapy. The fsQCA-crisp confirms that the clinical conditions of the patients are the driving factors that prompt the clinicians towards a therapy change.
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Affiliation(s)
- Emanuela Foglia
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | - Lucrezia Ferrario
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy.
| | - Elisabetta Garagiola
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | - Federica Asperti
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | | | | | - Luca Varalli
- ASST Ovest Milanese Hospital, Legnano, Milano, Italy
| | - Cristina Ponsiglione
- Department of Industrial Engineering, University of Naples Federico II, Naples, Italy
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Abstract
PURPOSE OF REVIEW Despite advances in infection prevention and control and breakthroughs in vaccination development, challenges remain for long-term care facilities (LTCFs) as they face a likely future of emerging infectious diseases. To ensure the safety of LTCF residents from the current and future pandemics, we identify lessons learned from the coronavirus disease 2019 (COVID-19) experience for improving future prevention and response efforts. RECENT FINDINGS In addition to high disease susceptibility among LTCF residents, LTCF vulnerabilities include a lack of pandemic preparedness, a lack of surge capacity in human, material and testing resources, and poorly designed buildings. External sources of vulnerability include staff working in multiple LTCFs and high COVID-19 rates in surrounding communities. Other challenges include poor cooperation between LTCFs and the other components of health systems, inadequately enforced regulations, and the sometimes contradictory interests for-profit LTCFs face between protecting their residents and turning a profit. SUMMARY These challenges can be addressed in the post-COVID-19 period through systemic reforms. Governments should establish comprehensive health networks that normalize mechanisms for prediction/preparedness and response/recovery from disruptive events including pandemics. In addition, governments should facilitate cooperation among public and private sector health systems and institutions while utilizing advanced digital communication technologies. These steps will greatly reduce the threat to LTCFs posed by emerging infectious diseases in future.
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Huang JH, Chang HT, Liao CH, Chiu KM. Rapid response of a medical center upon the surge of COVID-19 epidemic in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1-5. [PMID: 34866013 PMCID: PMC8609672 DOI: 10.1016/j.jmii.2021.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/04/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022]
Abstract
A surge of coronavirus disease (COVID-19) cases emerged in northern Taiwan in mid-May 2021. In spite of over one-year preparedness, the medical system in this area suffered from the crisis. Far Eastern Memorial Hospital (FEMH) responded quickly with decreased total hospitalization cases (about 50%) to free manpower and space. With simple construction work, the in-hospital service capacity increases from 11 negative-pressure ward (1 unit) and 2 negative-pressure ICU (1 unit) beds to over 130 ward (5 units) and 58 ICU beds (4 units) without negative-pressure design within 3 weeks. For a period of time, FEMH takes care of 10% of all intensive care services in Taiwan. The vaccination rate of workers reaches 90% since mid-May. The amount of testing performed during the period, including PCR and rapid tests, comprised of more than 20% of tests performed in New Taipei City. Two hotels for mild/asymptomatic COVID patients were handled by FEMH workers. By mid-July, about one-fifth of COVID-19 cases in New Taipei City received services from the FEMH system. With determined leadership and concerted efforts, combined interventions can increase the capacity of medical care within weeks and help society against the COVID-19 epidemic.
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Affiliation(s)
- Jih-Hsin Huang
- Department of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hou-Tai Chang
- Department of Critical Care Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Chun-Hsing Liao
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taiwan.
| | - Kuan-Ming Chiu
- Department of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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Learning from the past: Taiwan's responses to COVID-19 versus SARS. Int J Infect Dis 2021; 110:469-478. [PMID: 34098099 PMCID: PMC8178059 DOI: 10.1016/j.ijid.2021.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To evaluate the prevalence of infection prevention behaviors in Taiwan-wearing facemasks and alcohol-based hand hygiene (AHH)-and compare their practice rates during SARS and COVID-19. METHODS We surveyed 2328 Taiwanese from July 29 to August 6, 2020, assessing demographics, information sources, and preventive behaviors during the 2003 SARS outbreaks, 2009 pandemic influenza H1N1, COVID-19, and with post-survey intentions. Characteristics associated with the practice of preventive behaviors in 2020 were identified through logistic regression. RESULTS Preventive behaviors were conscientiously practiced by 70.2% of participants. Compared with 2003 SARS/2009 H1N1, the percentages of facemask use (66.6% vs 99.2% [indoors], P < 0.001) and on-person AHH (44.2% vs 65.4% [hand sanitizers], P < 0.001) significantly increasedduring 2020 COVID-19. Highest adherence to preventive behaviors in 2020 was among females (adjusted odds ratio [aOR], 1.72), those receiving government COVID-19 information (aOR, 1.52), participants recruited from primary-care clinics (aOR, 1.43), and those who practiced AHH during 2003 SARS/2009 H1N1 (aOR, 1.37). CONCLUSIONS Government leadership, healthcare providers risk communication, and public cooperation rapidly mitigated the spread of COVID-19 in Taiwan even before vaccination. Future global efforts must implement such population-based preventive behaviors at a level above the viral-transmission-threshold, particularly in areas with fast-spreading SARS-CoV-2 variants.
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Chen CL, Lai CC, Luh DL, Chuang SY, Yang KC, Yeh YP, Ming-Fang Yen A, Chang KJ, Chang RE, Li-Sheng Chen S. Review of epidemic, containment strategies, clinical management, and economic evaluation of COVID-19 pandemic. J Formos Med Assoc 2021; 120 Suppl 1:S6-S18. [PMID: 34116896 PMCID: PMC8156902 DOI: 10.1016/j.jfma.2021.05.022] [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] [Received: 05/09/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
The spread of the emerging pathogen, named as SARS-CoV-2, has led to an unprecedented COVID-19 pandemic since 1918 influenza pandemic. This review first sheds light on the similarity on global transmission, surges of pandemics, and the disparity of prevention between two pandemics. Such a brief comparison also provides an insight into the potential sequelae of COVID-19 based on the inference drawn from the fact that a cascade of successive influenza pandemic occurred after 1918 and also the previous experience on the epidemic of SARS and MERS occurring in 2003 and 2015, respectively. We then propose a systematic framework for elucidating emerging infectious disease (EID) such as COVID-19 with a panorama viewpoint from natural infection and disease process, public health interventions (non-pharmaceutical interventions (NPIs) and vaccine), clinical treatments and therapies (antivirals), until global aspects of health and economic loss, and economic evaluation of interventions with emphasis on mass vaccination. This review not only concisely delves for evidence-based scientific literatures from the origin of outbreak, the spread of SARS-CoV-2 to three surges of pandemic, and NPIs and vaccine uptakes but also provides a new insight into how to apply big data analytics to identify unprecedented discoveries through COVID-19 pandemic scenario embracing from biomedical to economic viewpoints.
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Affiliation(s)
- Chi-Ling Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chao-Chih Lai
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Emergency Department of Taipei City Hospital, Ren-Ai Branch, Taiwan
| | - Dih-Ling Luh
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Kuen-Cheh Yang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Po Yeh
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Changhua County Public Health Bureau, Changhua, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - King-Jen Chang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ray-E Chang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
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Tsai YF, Chen SY, Yen YF, Huang TC. Taiwan can help-Community protection net: preventive effects of the Northern Taiwan Centralized Quarantine Center against SARS-CoV-2. Public Health 2021; 198:e7-e8. [PMID: 34099319 PMCID: PMC8078902 DOI: 10.1016/j.puhe.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/20/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Y-F Tsai
- Department of Nung, Taipei City Hospital, YangMing Branch, Taipei, Taiwan; School of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - S-Y Chen
- Department of Nung, Taipei City Hospital, YangMing Branch, Taipei, Taiwan; School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Y-F Yen
- Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei City, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; University of Taipei, Taipei, Taiwan
| | - T-C Huang
- Superintendent Office, Taipei City Hospital, Taipei, Taiwan.
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