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Gualtierotti R, Giachi A, Suffritti C, Bedogni L, Franco F, Poggi F, Mascetti S, Colussi M, Ahmetovic D, Begnozzi V, Boccalandro EA, Solimeno LP, Peyvandi F. Optimizing long-term joint health in the treatment of hemophilia. Expert Rev Hematol 2024; 17:713-721. [PMID: 39245933 DOI: 10.1080/17474086.2024.2396617] [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: 04/13/2024] [Accepted: 08/21/2024] [Indexed: 09/10/2024]
Abstract
INTRODUCTION The improved quality of care and increased drug availability have shifted the goal of treating people with hemophilia from life-threatening bleeding prevention to joint health preservation and quality of life amelioration. Many tools are now available to the clinician in order to optimize the management of hemophilic arthropathy. AREAS COVERED This paper reviews the pivotal role of ultrasound evaluation in early detection of joint bleeding and differential diagnosis of joint pain, with a focus on the feasibility of a long-term monitoring of joint health through the use of artificial intelligence and telemedicine. The literature search methodology included using keywords to search in PubMed and Google Scholar, and articles used were screened by the coauthors of this review. EXPERT OPINION Joint ultrasound is a practical point-of-care tool with many advantages, including immediate correlation between imaging and clinical presentation, and dynamic evaluation of multiple joints. The potential of telemedicine care, coupled with a point-of-care detection device assisted by artificial intelligence, holds promises for even earlier diagnosis and treatment of joint bleeding. A multidisciplinary approach including early intervention by physical medicine and rehabilitation (PMR) physicians and physiotherapists is crucial to ensure the best possible quality of life for the patient.
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Affiliation(s)
- Roberta Gualtierotti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Andrea Giachi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Suffritti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Luca Bedogni
- Dipartimento di Scienze Fisiche, Informatiche e Matematiche, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Francesco Franco
- Dipartimento di Scienze Fisiche, Informatiche e Matematiche, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Francesco Poggi
- Institute for Cognitive Sciences and Technologies (ISTC), National Research Council (CNR), Bologna, Italy
| | - Sergio Mascetti
- Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Marco Colussi
- Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Dragan Ahmetovic
- Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Valentina Begnozzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Elena Anna Boccalandro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Luigi Piero Solimeno
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Orthopaedic Surgery and Traumatology, Milan, Italy
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Mathkor DM, Mathkor N, Bassfar Z, Bantun F, Slama P, Ahmad F, Haque S. Multirole of the internet of medical things (IoMT) in biomedical systems for managing smart healthcare systems: An overview of current and future innovative trends. J Infect Public Health 2024; 17:559-572. [PMID: 38367570 DOI: 10.1016/j.jiph.2024.01.013] [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: 04/06/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/19/2024] Open
Abstract
Internet of Medical Things (IoMT) is an emerging subset of Internet of Things (IoT), often called as IoT in healthcare, refers to medical devices and applications with internet connectivity, is exponentially gaining researchers' attention due to its wide-ranging applicability in biomedical systems for Smart Healthcare systems. IoMT facilitates remote health biomedical system and plays a crucial role within the healthcare industry to enhance precision, reliability, consistency and productivity of electronic devices used for various healthcare purposes. It comprises a conceptualized architecture for providing information retrieval strategies to extract the data from patient records using sensors for biomedical analysis and diagnostics against manifold diseases to provide cost-effective medical solutions, quick hospital treatments, and personalized healthcare. This article provides a comprehensive overview of IoMT with special emphasis on its current and future trends used in biomedical systems, such as deep learning, machine learning, blockchains, artificial intelligence, radio frequency identification, and industry 5.0.
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Affiliation(s)
- Darin Mansor Mathkor
- Research and Scientific Studies Unit, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Noof Mathkor
- Department of Pathology, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
| | - Zaid Bassfar
- Department of Information Technology, Faculty of Computers and Information Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Farkad Bantun
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Petr Slama
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Mendel University in Brno, 61300 Brno, Czech Republic
| | - Faraz Ahmad
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Shafiul Haque
- Research and Scientific Studies Unit, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan 45142, Saudi Arabia; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
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Russell S, Whitehart S, Mason J, Window P. Does the method of telehealth delivery affect the physiotherapy management of adults with bleeding disorders? A comparison of audioconferencing and videoconferencing. Haemophilia 2023; 29:1589-1596. [PMID: 37729471 DOI: 10.1111/hae.14869] [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: 07/04/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
AIM To determine whether the method of telehealth delivery (audioconferencing or videoconferencing) affects the physiotherapy management of adults with inherited bleeding disorders. METHODS A cross-sectional observational study was utilised involving 40 physiotherapy consultations (23 initial consultations and 17 follow-up consultations) of adults (>18) with a diagnosed bleeding disorder. Each consultation involved an initial audioconferencing component followed immediately by a separate videoconferencing component. Following each component, the physiotherapist utilised the clinical information gathered to formulate and record a management plan, and additionally recorded their confidence in this plan. Differences between the management plans and clinician confidence were recorded, including where applicable the visual information prompting a change in management plans. RESULTS Audioconferencing and videoconferencing management plans differed in 40% of all consultations, including 52.0% of initial consultations and 23.5% of follow-up consultations. Among consultations where management plans differed, this was prompted by visual information related to the anatomic location of symptoms (31.3%), the absence/presence of swelling (31.3%), joint range of movement (25.0%), and general appearance (12.5%). Median self-reported clinician confidence of management plans increased significantly from 70.0% following audioconferencing to 93.0% following videoconferencing. CONCLUSION When utilizing telehealth, the choice between audioconferencing or videoconferencing may affect physiotherapy management of adults with bleeding disorders, particularly with initial consultations. Videoconferencing potentially leads to more appropriate management plans, clinician confidence and utilization of healthcare resources. Further high-quality studies are required to confirm the findings of this study.
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Affiliation(s)
- Scott Russell
- Queensland Haemophilia Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Simon Whitehart
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Jane Mason
- Queensland Haemophilia Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Peter Window
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane, Australia
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Xu J, Qu M, Dong X, Chen Y, Yin H, Qu F, Zhang L. Tele-Instruction Tool for Multiple Lay Responders Providing Cardiopulmonary Resuscitation in Telehealth Emergency Dispatch Services: Mixed Methods Study. J Med Internet Res 2023; 25:e46092. [PMID: 37494107 PMCID: PMC10413244 DOI: 10.2196/46092] [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: 01/29/2023] [Revised: 05/07/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Telephone-assisted cardiopulmonary resuscitation (T-CPR) has proven to be a crucial intervention in enhancing the ability of lay responders to perform cardiopulmonary resuscitation (CPR) during telehealth emergency services. While the majority of established T-CPR protocols primarily focus on guiding individual rescuers, there is a lack of emphasis on instructing and coordinating multiple lay responders to perform resuscitation collaboratively. OBJECTIVE This study aimed to develop an innovative team-based tele-instruction tool to efficiently organize and instruct multiple lay responders on the CPR process and to evaluate the effectiveness and feasibility of the tool. METHODS We used a mixed methods design in this study. We conducted a randomized controlled simulation trial to conduct the quantitative analysis. The intervention groups used the team-based tele-instruction tool for team resuscitation, while the control groups did not have access to the tool. Baseline resuscitation was performed during the initial phase (phase I test). Subsequently, all teams watched a team-based CPR education training video and finished a 3-person practice session with teaching followed by a posttraining test (phase II test). In the qualitative analysis, we randomly selected an individual from each team and 4 experts in emergency medical services to conduct semistructured interviews. The purpose of these interviews was to evaluate the effectiveness and feasibility of this tool. RESULTS The team-based tele-instruction tool significantly improved the quality of chest compression in both phase I and phase II tests. The average compression rates were more appropriate in the intervention groups compared to the control groups (median 104.5, IQR 98.8-111.8 min-1 vs median 112, IQR 106-120.8 min-1; P=.04 in phase I and median 117.5, IQR 112.3-125 min-1 vs median 111, IQR 105.3-119 min-1; P=.03 in phase II). In the intervention group, there was a delay in the emergency response time compared to that in the control group (time to first chest compression: median 20, IQR 15-24.8 seconds vs median 25, IQR 20.5-40.3 seconds; P=.03; time to open the airway: median 48, IQR 36.3-62 seconds vs median 73.5, IQR 54.5-227.8 seconds; P=.01). However, this delay was partially mitigated after the phase II test. The qualitative results confirmed the compatibility and generalizability of the team-based tele-instruction tool, demonstrating its ability to effectively guide multiple lay responders through teamwork and effective communication with telecommunicators. CONCLUSIONS The use of the team-based tele-instruction tool offers an effective solution to enhance the quality of chest compression among multiple lay responders. This tool facilitated the organization of resuscitation teams by dispatchers and enabled efficient cooperation. Further assessment of the widespread adoption and practical application of the team-based tele-instruction tools in real-life rescue scenarios within the telehealth emergency services system is warranted.
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Affiliation(s)
- Jianing Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Mingyu Qu
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Yihe Chen
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hongfan Yin
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Fangge Qu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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DeFilippo EMM, Talwalkar JS, Harris ZM, Butcher J, Nasr SZ. Transitions of Care in Cystic Fibrosis. Clin Chest Med 2022; 43:757-771. [PMID: 36344079 DOI: 10.1016/j.ccm.2022.06.016] [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: 11/06/2022]
Abstract
The development of formal transition models emerged to reduce variability in care, including cystic fibrosis (CF) responsibility, independence, self-care, and education (RISE), which provides a standardized transition program, including knowledge assessments, self-management checklists, and milestones for people with CF. Despite these interventions, the current landscape of health care transition (HCT) remains suboptimal, and additional focused attention on HCT is necessary. Standardization of assessment tools to gauge the efficacy of transfer from pediatric to adult care is a high priority. Such tools should incorporate both clinical and patient-centered outcomes to provide a comprehensive picture of progress and deficiencies of the HCT process.
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Affiliation(s)
| | - Jaideep S Talwalkar
- Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT, USA; Yale Adult Cystic Fibrosis Program, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Zachary M Harris
- Yale Adult Cystic Fibrosis Program, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Butcher
- Department of Pediatrics, Division of Pediatric Psychology, Mott Children's Hospital, University of Michigan Health, Ann Arbor, MI, USA
| | - Samya Z Nasr
- Department of Pediatrics, Division of Pediatric Pulmonology, Mott Children's Hospital, University of Michigan Health, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5212, USA.
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Aliaga-Castillo V, Horment-Lara G, Contreras-Sepúlveda F, Cruz-Montecinos C. Safety and effectiveness of telerehabilitation program in people with severe haemophilia in Chile. A qualitative study. Musculoskelet Sci Pract 2022; 60:102565. [PMID: 35462316 DOI: 10.1016/j.msksp.2022.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Little is known about how people with haemophilia (PWH) perceive and assess the usefulness, safety and effectiveness of telerehabilitation. OBJECTIVE To describe usefulness, safety, effectiveness and limitations of a telerehabilitation program applied in people with severe haemophilia implemented during the COVID-19 pandemic in Chile. DESIGN AND METHODS A qualitative study was conducted based on a focus group. Four analytical categories were predefined, three of which involved elements of Donabedian's model for quality assessment in health care (structure, process and results). RESULTS One of the most important aspects according to all of the participants is the sense of safety they experienced while being taken care of by a physiotherapist specializing in PWH rehabilitation. This facilitated trust in the professional and adherence to treatment. All participants reported improvements in their physical condition and sense of well-being. The lack of adequate equipment at home, the limited length of the sessions, the perception that the physiotherapist may not be able to perform an appropriate physical examination and the lack of direct supervision were described as disadvantages. CONCLUSIONS The findings underscored that telerehabilitation had high satisfaction among PWH. Telerehabilitation was perceived by PWH as a safe and effective intervention to improve physical condition. Telerehabilitation could be further supported and improved, and coverage could be enhanced, including rural and remote areas, which suffer from chronic inequalities in access to rehabilitation. The lack of face-to-face supervision and physical examination were perceived as the principal disadvantages. These results may help to improve telerehabilitation programs in PWH elsewhere.
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Affiliation(s)
| | | | | | - Carlos Cruz-Montecinos
- Department of Physical Therapy, University of Chile, Santiago, Chile; Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
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Cheung YT, Lam PH, Lam HHW, Ma CT, Leung AWK, Wong RSM, Li CK. Treatment Adherence and Health-Related Quality of Life in Patients with Hemophilia in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116496. [PMID: 35682087 PMCID: PMC9180237 DOI: 10.3390/ijerph19116496] [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: 03/29/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Background: This study aims to identify factors affecting health-related quality of life (HRQoL) in Chinese patients with hemophilia in Hong Kong, and to examine the association between treatment adherence and HRQoL outcomes. Methods: Patients with hemophilia A or B from a non-governmental organization reported their HRQoL and treatment adherence to prophylactic therapy using validated tools. Univariate tests and multivariable regression analysis were used to compare differences in outcomes across clinically relevant subgroups. Results: Fifty-six patients were recruited (mean age 30.4 [17.4] years; majority hemophilia A: 75%; moderate-to-severe severity: 88%). Patients who received prophylactic treatment reported fewer work/school problems (25.8 [18.9] versus 51.5 [26.3]; p = 0.001) than those who received on-demand therapy. The multivariable model showed that older age (B = 0.42, 95% CI = 0.093−0.75) and living in public housing (B = 10.24, 95% CI = 0.70−19.77) were associated with worse HRQoL. Older age was associated with treatment non-adherence (r = 0.66, p < 0.0001). Patients with poor adherence tended to report worse functioning in sports/leisure (r = 0.31, p = 0.033). Conclusions: Our results suggest that patients who were older, had lower education attainment and received on-demand treatment had poorer perception of their health. Improving adherence may lead to better HRQoL. Future work includes evaluating the occupational needs prospectively in this population.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- Correspondence: ; Tel.: +852-3943-6833; Fax: +852-2603-5295
| | - Pok Hong Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
| | | | - Chung-Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Alex Wing Kwan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Raymond Siu Ming Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
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Recht M, He C, Chen E, Cheng D, Solari P, Hinds D. Resource utilization and treatment costs of patients with severe hemophilia A: Real-world data from the ATHNdataset. EJHAEM 2022; 3:341-352. [PMID: 35846041 PMCID: PMC9176109 DOI: 10.1002/jha2.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 01/19/2023]
Abstract
Hemophilia A is characterized by unpredictable spontaneous bleeds and chronic comorbidities. However, limited data exists at the national level into detailed management patterns related to patient clinical characteristics, representative real-world dosing and treatment frequency, and costs. To assess and characterize the US severe hemophilia A (SHA) population, including subgroups of patients, in terms of clinical and demographic characteristics, healthcare resource utilization received at hemophilia treatment centers (HTCs), and projected annual costs of treatment utilizing data from the ATHNdataset of the American Thrombosis and Hemostasis Network (ATHN). Adult male people with SHA (PwSHA) (FVIII < 1%) were identified in the ATHNdataset between January 2013 and September 2019. This retrospective cohort study described patients' demographic and clinical characteristics, clinical history, as well as the HTC-related health resource utilization (HRU), treatment utilization, and projected annual treatment costs of US PwSHA received over the most recent year. Results are reported for the overall population and for three mutually exclusive subpopulations of patients: PwSHA with a history of and/or current inhibitors, PwSHA without a history of inhibitors but with (or a history of) one or more transfusion-transmitted infections (hepatitis B virus [HBV], hepatitis C virus [HCV], or human immunodeficiency virus [HIV]), and PwSHA without a history of inhibitors or of transfusion-transmitted infections (HBV, HCV, or HIV). Of the overall PwSHA cohort (N = 3677), there was a high prevalence of HCV (24.1%) and HIV (13.7%), while the prevalence of HBV (4.9%) was lower. Note that 20.5% of PwSHA overall currently or ever had FVIII inhibitors. On average, PwSHA had 2.8 total HTC visits per year, including 0.9 comprehensive care visits, 1.1 telephone contact visits, 0.5 office visits, and 0.1 surgeries or other procedures. However, 23.3% of PwSHA were not seen at an HTC, and 33.8% of PwSHA did not have a comprehensive care visit during their most recent year of data. HTC-related HRU was similar between the overall cohort and across the patient subpopulations, although PwSHA and inhibitors had more frequent HTC visits (a mean of 3.6 visits annually vs. 2.5-2.8 in the other groups). Using reported treatment frequency and dosing, estimated mean annual hemophilia treatment costs varied by treatment and across the three subpopulations: extended half-life factor product ($893,609-934,301 by subpopulation), standard half-life factor product ($798,700-930,812), plasma-derived factor product ($613,220-801,061), and non-factor product treatment ($765,289-833,240). This study summarized recent sociodemographic and clinical characteristics, HTC-related HRU, and HA treatments and projected costs among adult PwSHA, including among key subpopulations of PwSHA. PwSHA experience substantial clinical and resource burden on a chronic basis, despite the care coordination efforts of ATHN-affiliated HTCs. These findings motivate further exploration of the drivers of resource utilization, observed differences across subpopulations and other disparities, and ongoing monitoring of clinical and treatment burden in the face of an evolving care landscape.
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Affiliation(s)
- Michael Recht
- American Thrombosis and Hemostasis Network (ATHN)RochesterNew YorkUSA
| | - Chunla He
- American Thrombosis and Hemostasis Network (ATHN)RochesterNew YorkUSA
| | - Er. Chen
- BioMarin Pharmaceutical, Inc. (BioMarin)NovatoCAUSA
| | - Dunlei Cheng
- American Thrombosis and Hemostasis Network (ATHN)RochesterNew YorkUSA
| | - Paul Solari
- BioMarin Pharmaceutical, Inc. (BioMarin)NovatoCAUSA
| | - David Hinds
- BioMarin Pharmaceutical, Inc. (BioMarin)NovatoCAUSA
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Cheung YT, Lam PH, Lam TTN, Lam HHW, Li CK. Technology Acceptance Among Patients With Hemophilia in Hong Kong and Their Expectations of a Mobile Health App to Promote Self-management: Survey Study. JMIR Form Res 2021; 5:e27985. [PMID: 34499034 PMCID: PMC8461536 DOI: 10.2196/27985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/02/2021] [Accepted: 08/16/2021] [Indexed: 01/05/2023] Open
Abstract
Background The lifelong management of hemophilia is demanding and complex. In July 2019, we published a review in the Journal of Medical Internet Research, summarizing telehealth interventions that facilitate monitoring of bleeding events and promoting the appropriate use of clotting factors among patients with hemophilia. This work has led to the development of a community program that aims to harness technology to promote self-management among patients with hemophilia in Hong Kong. Objective Before the inception of this program, we conducted a cross-sectional survey to evaluate the patients’ level of technology acceptance and identify their expectations of the use of mobile technology for self-management of hemophilia. Methods In total, 56 participants (75% adult patients and 25% parents of pediatric patients; 87.5% with moderate to severe disease) were recruited from a local nongovernmental organization that serves patients with hemophilia. They rated their perceived confidence and acceptance in using the new mobile technology (score 1 to 5 for each item, with a higher score indicating better acceptance) using a structured questionnaire (adapted from the Technology Acceptance Model). They also identified the top features that they perceived to be the most important components of a mobile app for the self-management of hemophilia. The Mann–Whitney U test was used to compare technology acceptance scores across subgroups of different clinical and socioeconomic characteristics. Results In general, the participants considered themselves skilled in using mobile apps (mean 4.3, 95% CI 4.1-4.5). They were willing to learn to use the new mobile app to organize their bleeding records (mean 4.0, 95% CI 3.7-4.3) and to manage their health (mean 4.2, 95% CI 4.1-4.5). Participants who lived in public housing (a surrogate marker for lower socioeconomic status in Hong Kong) reported lower technology acceptance than those who lived in private housing (P=.04). The most important features identified by the participants concerned documenting of infusion logs (n=49, 87.5%), bleeding events (n=48, 85.7%), and the secure delivery of the bleeding information to health care professionals (n=40, 71.4%). Conclusions It is encouraging to infer that patients with hemophilia in Hong Kong are receptive to the use of mobile health technology. The findings of this survey are applicable in designing the key features of a patient-centered, multimodal program harnessing mobile technology to promote self-management among patients with hemophilia. Future studies should evaluate participants’ acceptability and perceived usability of the mobile app via user metrics and assess clinical and humanistic outcomes of this program.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Pok Hong Lam
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Teddy Tai-Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | | | - Chi Kong Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.,Department of Paediatrics & Adolescent Medicine, Hong Kong SAR, Hong Kong.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
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Considerations for Home-Based Treatment of Fabry Disease in Poland during the COVID-19 Pandemic and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168242. [PMID: 34443990 PMCID: PMC8394954 DOI: 10.3390/ijerph18168242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/30/2023]
Abstract
Current therapy for Anderson–Fabry disease in Poland includes hospital or clinic-based intravenous enzyme replacement therapy with recombinant agalsidase alpha or beta, or oral pharmacological chaperone therapy with migalastat. Some countries around the world offer such treatment to patients in the comfort of their own homes. The 2020–2021 COVID-19 pandemic has pushed global healthcare providers to evolve their services so as to minimize the risk of COVID-19 exposure to both patients and providers; this has led to advances in telemedicine services and the increasing availability of at-home treatment for various procedures including parenteral drug administration. A total of 80% of surveyed Anderson–Fabry disease patients in Poland would prefer home-based treatment, which would be a safe and convenient alternative to clinic-based treatment if patient selection is based on our proposed algorithm. Our recommendations for home-based treatments appear feasible for the long term care of Anderson–Fabry disease patients during the COVID-19 pandemic and beyond. This may also serve as a basis for home-based treatment programs in other rare and ultra-rare genetic diseases.
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Shah AC, O'Dwyer LC, Badawy SM. Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies. JMIR Mhealth Uhealth 2021; 9:e29619. [PMID: 34255706 PMCID: PMC8299344 DOI: 10.2196/29619] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care. OBJECTIVE We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions. METHODS Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes. RESULTS A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions. CONCLUSIONS Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.
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Affiliation(s)
- Aashaka C Shah
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, United States
| | - Linda C O'Dwyer
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sherif M Badawy
- Division of Pediatric Hematology, Oncology, Neuro-Oncology & Stem Cell Transplantation, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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12
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Iqbal MH. Telemedicine: An Innovative Twist to Primary Health Care in Rural Bangladesh. J Prim Care Community Health 2021; 11:2150132720950519. [PMID: 32865108 PMCID: PMC7457686 DOI: 10.1177/2150132720950519] [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: 12/17/2022] Open
Abstract
BACKGROUND Health care service is worsening in the remote villages due to less complete and further away of healthcare facilities and service and makes this service costs compared to those of urban people. Telemedicine service provides a potential solution regarding this particular issue. This study provides empirical evidence of the benefits package consists of hypothetical telemedicine service and evaluates the economic benefit of telemedicine service. METHODS The study measures marginal willingness-to-pay (MWTP) responses to policy change on a sample (n = 203) observations. A randomized conjoint experiment has conducted in 7 remote villages of 3 coastal districts of the southwest coastal region of Bangladesh. Each respondent ranks 3 options-two hypothetical alternatives and the telemedicine status quo scheme. The level of attributes-payment for telemedicine service, sample collection from home, medicine delivery to home, capitation through online technology, service delivery frequency, and blood pressure and glucose measure at home-are randomly and jointly assigned to the 2 alternatives. RESULTS AND CONCLUSIONS Coastal villagers would like to pay more in option 4 and above. The lower payment for telemedicine service does not necessarily imply low demand for telemedicine, as the findings from MWTP illustrate potential demand for telemedicine in coastal villages in Bangladesh.
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13
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Pooni R, Ronis T, Lee T. Telemedicine use by pediatric rheumatologists during the COVID-19 pandemic. Pediatr Rheumatol Online J 2021; 19:93. [PMID: 34134709 PMCID: PMC8206874 DOI: 10.1186/s12969-021-00565-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/18/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. METHODS An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question. RESULTS The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 86.5% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 65.7% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (35.8%) of those surveyed felt that their level of burnout was increased due to telemedicine. CONCLUSION In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.
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Affiliation(s)
- Rajdeep Pooni
- Stanford Cildren's Health, Stanford University School of Medicine, Palo Alto, California, USA.
| | - Tova Ronis
- Children's National Hospital, Washington D.C; George Washington School of Medicine & Health Sciences, Washington DC, USA
| | - Tzielan Lee
- Stanford Cildren's Health, Stanford University School of Medicine, Palo Alto, California, USA
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14
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Talal AH, Sofikitou EM, Jaanimägi U, Zeremski M, Tobin JN, Markatou M. A framework for patient-centered telemedicine: Application and lessons learned from vulnerable populations. J Biomed Inform 2020; 112:103622. [PMID: 33186707 DOI: 10.1016/j.jbi.2020.103622] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 01/03/2023]
Abstract
Virtual technologies can facilitate clinical monitoring, clinician-patient interactions, and enhance patient-centered approaches to healthcare delivery. Telemedicine, two-way communication between a healthcare provider and a patient not in the same physical location, emphasizes patient preference and convenience by substituting the transportation of patients with information transfer. We present a framework for implementation of a comprehensive, dynamic, patient-centered telemedicine network deployed in 12 opioid treatment programs (OTP) located throughout New York State (NYS). The program aims to effectively manage hepatitis C virus (HCV) infection via telemedicine with co-administration of HCV and substance use medications. We have found that the Sociotechnical System model with emphasis on patient-centered factors provides a framework for telemedicine deployment and implementation to a vulnerable population. The issue of interoperability between the telemedicine platform and the electronic health record (EHR) system as well as clinical information retrieval for medical decision-making are challenges with implementation of a comprehensive, dynamic telemedicine system. Targeting telemedicine to a vulnerable population requires additional consideration of trust in the security and confidentiality of the telemedicine system. Our contribution is the valuable lessons learned from implementing a comprehensive, dynamic, patient-centered telemedicine system among an OTP network throughout NYS as applied to a vulnerable population that can be generalized to other difficult-to-reach populations.
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Affiliation(s)
- Andrew H Talal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Elisavet M Sofikitou
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Urmo Jaanimägi
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Marija Zeremski
- Clinical Directors Network, Inc. (CDN), New York, NY, United States
| | - Jonathan N Tobin
- Clinical Directors Network, Inc. (CDN), New York, NY, United States; Center for Clinical and Translational Science, The Rockefeller University, New York, NY, United States
| | - Marianthi Markatou
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States.
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15
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Álvarez-Román MT, De la Corte-Rodríguez H, Rodríguez-Merchán EC, Martín-Salces M, Rivas-Pollmar MI, Butta NV, García-Barcenilla S, Acuña P, Cebanu T, González E, Monzón-Manzano ME, Jiménez-Yuste V. COVID-19 and telemedicine in haemophilia in a patient with severe haemophilia A and orthopaedic surgery. Haemophilia 2020; 27:e137-e139. [PMID: 32516482 PMCID: PMC7300968 DOI: 10.1111/hae.14087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | | | - Nora V Butta
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | - Paula Acuña
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Tamara Cebanu
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Elena González
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | - Víctor Jiménez-Yuste
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain.,Medicine Faculty, Autónoma University of Madrid, Madrid, Spain
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16
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Flannery T, Bladen M, Hopper D, Jones S, McLaughlin P, Penn A, Sayers F, Wells A, Stephensen D. Physiotherapy after COVID-19-"Zoom or room". Haemophilia 2020; 27:e476-e478. [PMID: 33012096 PMCID: PMC7675407 DOI: 10.1111/hae.14166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/05/2020] [Accepted: 09/10/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Thuvia Flannery
- Haemophilia, Haemostasis & Thrombosis Centre, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Melanie Bladen
- Heamophilia Centre, Great Ormond Street Hospital for Children, London, UK
| | - David Hopper
- Haemophilia Centre, Royal Victoria Infirmary, Newcastle, UK
| | | | - Paul McLaughlin
- Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Anne Penn
- Haemophilia, Haemostasis & Thrombosis Centre, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | | | - Anna Wells
- Leeds Haemophilia Centre, St James' University Hospital, Leeds, UK
| | - David Stephensen
- Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, UK
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17
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Naik SS, Manjunatha N, Kumar CN, Math SB, Moirangthem S. Patient's Perspectives of Telepsychiatry: The Past, Present and Future. Indian J Psychol Med 2020; 42:102S-107S. [PMID: 33354053 PMCID: PMC7736740 DOI: 10.1177/0253717620963341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Access to mental health care has significant disparities due to treatment gap, more so particularly for the remotely residing, physically vulnerable, aging populations. Adoption of technology will enable more people to receive specialty care addressing distance, transportation and cost-related barriers to treatment engagement from the comfort of home. Telemedicine has been regarded as "electronic personal protective equipment" by reducing the number of physical contacts and risk contamination for patients during COVID-19 crisis. This review aimed to give a broad view of patients' perception of the use of telepsychiatry in terms of clinical outcome, cost-effectiveness, and solutions to address patients' challenges with the adoption of technology. Over the years, telepsychiatry, both in synchronous and asynchronous modalities, had shown to improve patients' adherence to treatment, follow-up rates, and clinical symptoms, overcome stigma and discrimination, and save cost expenses accessing health care with better satisfaction and usability outcomes. Its utility is widespread such as in delivering care emergency evaluation, crisis intervention, conducting neuropsychological assessments, psychotherapy, promoting lifestyle modification, enhancing self-efficacy, and overcoming patients' linguistic and cultural barriers to care. However, patients' privacy and confidentiality and psychiatrists' legal liability remain as matter of major concern in digital platform. To keep up with the pace of technology and patients' expectations, a more agile approach is essential to develop, improve, and evaluate telepsychiatric interventions.
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Affiliation(s)
- Shalini S Naik
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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18
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O'Donovan M, Buckley C, Benson J, Roche S, McGowan M, Parkinson L, Byrne P, Rooney G, Bergin C, Walsh D, Bird R, McGroarty F, Fogarty H, Smyth E, Ahmed S, O'Donnell JS, Ryan K, O'Mahony B, Dougall A, O'Connell NM. Telehealth for delivery of haemophilia comprehensive care during the COVID-19 pandemic. Haemophilia 2020; 26:984-990. [PMID: 32997849 PMCID: PMC7537516 DOI: 10.1111/hae.14156] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The COVID-19 pandemic caused an unprecedented impact to haemophilia healthcare delivery. In particular, rapid implementation of telehealth solutions was required to ensure continued access to comprehensive care. AIMS To explore patient and healthcare provider (HCP) experience of telehealth in a European Haemophilia Comprehensive Care Centre. METHOD A systematic evaluation was performed to survey patient and HCP experience and compare clinical activity levels with telehealth to in-person attendances. RESULTS Public health measures implemented in March 2020 to reduce COVID-19 spread resulted in a 63% decrease in medical/nursing clinic consultation activity compared to the same period in 2019. Implementation of digital care pathways resulted in marked increase in activity (52% greater than 2019). Importantly, enhanced patient engagement was noted, with a 60% reduction in non-attendance rates. Survey of patients who had participated in medical/nursing teleconsultations demonstrated that teleconsultations improved access (79%), reduced inconvenience (82%), was easy to use (94%) and facilitated good communication with the HCP (97%). A survey exploring the telemedicine experience of HCPs, illustrated that HCPs were satisfied with teleconsultation and the majority (79%) would like to continue to offer teleconsultation as part of routine patient care. In addition to medical/nursing reviews, continued access to physiotherapy with virtual exercise classes for people with haemophilia and teleconsultation for acute dental issues was equally successful. CONCLUSION During an unprecedented public health emergency, telehealth has enabled continued access to specialized haemophilia comprehensive care. Our novel findings show that this alternative is acceptable to both patients and HCPs and offers future novel opportunities.
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Affiliation(s)
- Mairead O'Donovan
- National Coagulation Centre, St James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Julie Benson
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Sheila Roche
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Mark McGowan
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Laura Parkinson
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Patricia Byrne
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Gloria Rooney
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Catherine Bergin
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Deirdre Walsh
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Rachel Bird
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | | | - Helen Fogarty
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Elizabeth Smyth
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Saad Ahmed
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | | | - Kevin Ryan
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | | | - Alison Dougall
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Niamh M O'Connell
- National Coagulation Centre, St James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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19
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Noun P, Ibrahim A, Hodroj MH, Bou-Fakhredin R, Taher AT. COVID-19 in benign hematology: emerging challenges and special considerations for healthcare professionals. Expert Rev Hematol 2020; 13:1081-1092. [DOI: 10.1080/17474086.2020.1819785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Peter Noun
- Division of Pediatric Hematology-Oncology, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Ahmad Ibrahim
- Division of Hematology and Oncology, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon
- Middle East Institute of Health, Lebanese University, Beirut, Lebanon
| | - Mohammad Hassan Hodroj
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rayan Bou-Fakhredin
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali T. Taher
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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20
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Naderi M, Malek F, Miri Aliabad G, Behnampoor M, Karimi M, De Sanctis V. Congenital Bleeding Disorders amid the COVID-19 pandemic: Open questions and recommendations. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020028. [PMID: 32921723 PMCID: PMC7716957 DOI: 10.23750/abm.v91i3.10203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/11/2020] [Indexed: 11/23/2022]
Abstract
This article reviews the current knowledges of congenital bleeding disorders (CBD) amid the COVID-19 pandemic. It appears that CBD is not associated with higher risk of getting COVID-19 and so the prevalence of COVID-19 among them seems not higher compared to the general population. In absence of specific therapeutic recommendations, it is essential to make a correct assessment of the risk of haemorrhage/thrombosis. Based on expert opinion, strategies for outpatient management include adherence to prescribed regimens, telemedicine, and communication about COVID-19 in patients with CBD. More data should be also collected to better characterize the impact of COVID-19 on patients with CBD. The current findings encourage further studies to determine the prevalence of SARS-CoV2 infection in CBD patients to understand more fully the burden of this novel pathogen and to develop adequate preventive measures against this infection.
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Affiliation(s)
- Majid Naderi
- Genetics of Non-Communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran,.
| | - Fatemeh Malek
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Mahammad Behnampoor
- Department of ediatrics, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences,.
| | - Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy.
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21
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De la Corte-Rodriguez H, Alvarez-Roman MT, Rodriguez-Merchan EC, Jimenez-Yuste V. What COVID-19 can mean for people with hemophilia beyond the infection risk. Expert Rev Hematol 2020; 13:1073-1079. [PMID: 32862729 DOI: 10.1080/17474086.2020.1818066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic represents an unprecedented global health crisis. To combat its effects, many governments have opted for strategies of social isolation that involve a radical change in people's behavior. AREAS COVERED For patients with hemophilia, the negative consequences of these measures can be greater, given they modify aspects of health care and lifestyles needed to counteract the adverse effects of hemophilia. The long-term consequences of the pandemic on patients with hemophilia are not well known. The aim of this special report is to show what COVID-19 could mean for this population, beyond the risk of infection. EXPERT OPINION Considerations of the clinical, care, therapeutic, physical, nutritional, mental health, pain, and disability aspects that might be affected are included. Strategies are also suggested to minimize the effects that these issues can have on patients' lives. Patients, health professionals, and society as a whole must work together to mitigate the effects of the pandemic on people with hemophilia.
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22
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Álvarez Román MT, Butta Coll N, García Barcenilla S, Pérez González L, de la Plaza Collazo I, De la Corte Rodríguez H, Romero Garrido JA, Martín Salces M, Rivas Pollmar MI, Cebanu T, González-Zorrilla E, Acuña P, Monzón Manzano E, Rodríguez Merchán EC, Trelles Martínez R, Blanco Bañares MJ, Gutiérrez Alvariño M, Jiménez Yuste V. Registry of patients with congenital bleeding disorders and COVID-19 in Madrid. Haemophilia 2020; 26:773-778. [PMID: 32524712 PMCID: PMC7307027 DOI: 10.1111/hae.14089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 01/29/2023]
Abstract
Introduction We present the first registry of patients with congenital bleeding disorders and COVID‐19. The study has been carried out in the Community of Madrid, which has the highest number of cases in Spain. The objective is to understand the incidence of COVID‐19, the course of the disease if it occurs and the psychosocial and occupational impact on this population. Methods We included 345 patients (246 of haemophilia, 69 of von Willebrand Disease, two rare bleeding disorders and 28 carriers of haemophilia). A telephone survey was used to collect the data. Results Forty‐two patients presented symptoms suggestive of infection by COVID‐19, and in six cases, the disease was confirmed by RT‐PCR. The cumulative incidence of our series was 1.73%. It is worth noting the complexity of the management of COVID‐19 in two patients on prophylaxis with non‐factor replacement therapy. Adherence to the prescribed treatment was maintained by 95.5% of patients. Although 94% were independent for daily living activities, 42.4% had a recognized disability and 58% required assistance, provided by the Madrid Haemophilia Association (Ashemadrid) in 75% of cases. Only 4.4% of consultations were held in person. Conclusions Patients with congenital bleeding disorders infected with SARS‐CoV‐2 presented a mild course of the disease that did not require admission. Their identification and treatment by a specialist team from a Haemophilia Treatment Center are essential to make a correct assessment of the risk of haemorrhage/thrombosis. COVID‐19 had a major impact on the psychosocial aspects of these patients which must be remedied with recovery plans.
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Affiliation(s)
| | - Nora Butta Coll
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | | | | | | | | | | | | | - Tamara Cebanu
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | - Paula Acuña
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | | | | | | | | | - Victor Jiménez Yuste
- Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain.,Medicine Faculty, Autónoma University of Madrid, Madrid, Spain
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23
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Valentino LA, Skinner MW, Pipe SW. The role of telemedicine in the delivery of health care in the COVID-19 pandemic. Haemophilia 2020; 26:e230-e231. [PMID: 32397000 PMCID: PMC7272827 DOI: 10.1111/hae.14044] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Leonard A Valentino
- National Hemophilia Foundation, New York, NY, USA.,Rush University, Chicago, IL, USA
| | - Mark W Skinner
- Institute for Policy Advancement Ltd, Washington, DC, USA.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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24
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Timmer MA, Kloek CJJ, de Kleijn P, Kuijlaars IAR, Schutgens REG, Veenhof C, Pisters MF. A Blended Physiotherapy Intervention for Persons With Hemophilic Arthropathy: Development Study. J Med Internet Res 2020; 22:e16631. [PMID: 32558654 PMCID: PMC7334756 DOI: 10.2196/16631] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/16/2019] [Accepted: 01/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background Joint bleeds are the hallmark of hemophilia, leading to a painful arthritic condition called as hemophilic arthropathy (HA). Exercise programs are frequently used to improve the physical functioning in persons with HA. As hemophilia is a rare disease, there are not many physiotherapists who are experienced in the field of hemophilia, and regular physiotherapy sessions with an experienced physiotherapist in the field of hemophilia are not feasible for persons with HA. Blended care is an innovative intervention that can support persons with HA at home to perform the advised physical activities and exercises and provide self-management information. Objective The aim of this study was to develop a blended physiotherapy intervention for persons with HA. Methods The blended physiotherapy intervention, namely, e-Exercise HA was developed by cocreation with physiotherapists, persons with HA, software developers, and researchers. The content of e-Exercise HA was compiled using the first 3 steps of the Center for eHealth Research roadmap model (ie, contextual inquiry, value specification, and design), including people with experience in the development of previous blended physiotherapy interventions, a literature search, and focus groups. Results A 12-week blended intervention was developed, integrating face-to-face physiotherapy sessions with a web-based app. The intervention consists of information modules for persons with HA and information modules for physiotherapists, a graded activity program using a self-chosen activity, and personalized video-supported exercises. The information modules consist of text blocks, videos, and reflective questions. The patients can receive pop-ups as reminders and give feedback on the performance of the prescribed activities. Conclusions In this study, we developed a blended physiotherapy intervention for persons with HA, which consists of information modules, a graded activity program, and personalized video-supported exercises.
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Affiliation(s)
- Merel A Timmer
- van Creveldkliniek, University Medical Center Utrecht, Utrecht, Netherlands
| | - Corelien J J Kloek
- Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Piet de Kleijn
- van Creveldkliniek, University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, Netherlands.,Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Martijn F Pisters
- Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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25
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Hermans C, Weill A, Pierce GF. The COVID‐19 pandemic: New global challenges for the haemophilia community. Haemophilia 2020; 26:371-372. [DOI: 10.1111/hae.14001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Cedric Hermans
- Hemostasis and Thrombosis Unit Division of Hematology Saint‐Luc University Hospital Université Catholique de Louvain (UCLouvain) Brussels Belgium
| | - Alain Weill
- World Federation of Hemophilia Montreal QC Canada
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26
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Thornburg CD, Montgomery RR, Pipe SW. How we approach: Training pediatric coagulationists. Pediatr Blood Cancer 2019; 66:e27982. [PMID: 31486588 DOI: 10.1002/pbc.27982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 11/09/2022]
Abstract
Unique expertise is required for the care of children, adolescents, and young adults with bleeding and clotting disorders. A number of Hemophilia Treatment Centers have developed pediatric hemostasis and thrombosis fellowship programs to facilitate subspecialty training and recruitment and retention in this field. This manuscript reviews an approach to training pediatric coagulationists including a description of current programs, sample curriculum, funding sources, and expected outcomes.
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Affiliation(s)
- Courtney D Thornburg
- Hemophilia and Thrombosis Treatment Center, Rady Children's Hospital San Diego, San Diego, California.,Department of Pediatrics, UC San Diego, La Jolla, California
| | - Robert R Montgomery
- Blood Research Institute, Versiti, Milwaukee, Wisconsin.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Steven W Pipe
- Departments of Pediatrics and Pathology, University of Michigan, Ann Arbor, Michigan
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27
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Valerio L, Trinchero A, Barco S. Telemedicine and decentralized models of care: from anticoagulant monitoring to an expanded concept of vascular medicine. Intern Emerg Med 2019; 14:1213-1215. [PMID: 31428920 DOI: 10.1007/s11739-019-02174-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Luca Valerio
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Langebeckstraße 1, 551131, Mainz, Germany
| | - Alice Trinchero
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Langebeckstraße 1, 551131, Mainz, Germany
| | - Stefano Barco
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Langebeckstraße 1, 551131, Mainz, Germany.
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28
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Winikoff R, Scully MF, Robinson KS. Women and inherited bleeding disorders - A review with a focus on key challenges for 2019. Transfus Apher Sci 2019; 58:613-622. [PMID: 31582329 DOI: 10.1016/j.transci.2019.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The area of women and inherited bleeding disorders has undergone quick expansion in recent years. More patients are being identified and expertise to diagnose and manage these patients is now essential for practising physicians. Programs to help educate and empower patients and caregivers are now in place. Common inherited bleeding disorders affecting women include von Willebrand disease (VWD), inherited platelet disorders, and rare inherited bleeding disorders such as factor VII (FVII) deficiency and factor XI (FXI) deficiency. Specific clinical tools have been developed to help clinicians and patients screen for the presence of these bleeding disorders in both adult and pediatric populations. Affected women can experience heavy menstrual bleeding and resulting iron deficiency anemia, postpartum hemorrhage, and hemorrhagic ovarian cysts which need to be properly managed. Excessive bleeding can adversely affect quality of life in these women. Front line therapy for bleeding in mild cases focuses on the use of non-specific hemostatic agents such as DDAVP ®, tranexamic acid and hormonal agents but specific factor replacement and/or blood products may be required in more severe cases, in severe bleeding or as second line treatment when bleeding is not responsive to first line agents. Iron status should be optimised in these women especially in pregnancy and use of an electronic app can now help clinicians achieve this. These patients should ideally be managed by a multidisciplinary team whenever possible even remotely. Although clinical research has closed some knowledge gaps regarding the diagnosis and management of these women, there remains significant variation in practise and lack of evidence-based guidelines still exists in many spheres of clinical care in which caregivers must rely on expert opinion. Ongoing efforts in education and research will continue to improve care for these women and restore quality of life for them.
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Affiliation(s)
- R Winikoff
- Division of Hematology-Oncology, Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - M F Scully
- Department of Medicine, Memorial University of Newfoundland Medical School, NL, Canada.
| | - K S Robinson
- Division of Hematology, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Department of Medicine, Halifax, NS, Canada.
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29
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Qian W, Lam TTN, Lam HHW, Li CK, Cheung YT. Telehealth Interventions for Improving Self-Management in Patients With Hemophilia: Scoping Review of Clinical Studies. J Med Internet Res 2019; 21:e12340. [PMID: 31293241 PMCID: PMC6652120 DOI: 10.2196/12340] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/14/2019] [Accepted: 06/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background The introduction of home therapy for hemophilia has empowered patients and their families to manage the disease more independently. However, self-management of hemophilia is demanding and complex. The uses of innovative interventions delivered by telehealth routes such as social media and Web-based and mobile apps, may help monitor bleeding events and promote the appropriate use of clotting factors among patients with hemophilia. Objective This scoping review aims to summarize the literature evaluating the effectiveness of telehealth interventions for improving health outcomes in patients with hemophilia and provides direction for future research. Methods A search was conducted in Ovid MEDLINE, EMBASE, and PubMed databases for studies that (1) focused on patients with hemophilia A or B; (2) tested the use of remote telehealth interventions via the internet, wireless, satellite, telephone, and mobile phone media on patients and caregivers; and (3) reported on at least one of the following patient-/caregiver-focused outcomes related to empowering patients/caregivers to be active decision makers in the emotional, social, and medical management of the illness: quality of life, monitoring of bleeding episodes, joint damage or other measures of functional status, medication adherence, and patients’ knowledge. Implementation outcomes (user metrics, cost saving, and accuracy of electronic records) were also evaluated. Reviews, commentaries, and case reports comprising ≤10 cases were excluded. Results Sixteen articles fulfilled the inclusion criteria. The majority of the interventions (10/16, 62%) evaluated both implementation outcomes and patient-/caregiver-focused outcomes. User performance and accuracy and comprehensiveness of electronic records were also measured in most studies (4/16, 87%). The components of the interventions were rather homogenous and typically involved electronic logging and reminders for prophylactic infusions, reporting of spontaneous and traumatic bleeding events, monitoring of infusion product usage and home inventory, and real-time communication with health care professionals and hemophilia clinics. Telemedicine-supported education and information interventions seemed to be particularly effective among adolescent and young adult patients. Although the patients reported improvements in their health-related quality of life and perception of illness, telemonitoring devices did not appear to have a significant effect on quantifiable health outcomes such as joint health. Longitudinal studies seemed to suggest that the response and adherence rates to recording decreased over time. Conclusions Preliminary evidence from this review suggests that telehealth-delivered interventions could feasibly improve patients’ adherence to medication use and promote independence in disease management. Given the complexity and resources involved in developing a mature and established system, support from a dedicated network of hemophilia specialists and data managers will be required to maintain the technology, improve adherence to prophylactic treatment and recording, and validate the electronic data locally.
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Affiliation(s)
- Wenji Qian
- School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Shanghai, China
| | - Teddy Tai-Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | | | - Chi-Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Paediatric Haematology & Oncology, Hong Kong Children's Hospital, Hong Kong, China (Hong Kong)
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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30
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Telemedicine and telerehabilitation: current and forthcoming applications in haemophilia. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:385-390. [PMID: 30747703 DOI: 10.2450/2019.0218-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 12/22/2018] [Indexed: 12/14/2022]
Abstract
In persons with haemophilia (PWH), the importance of comprehensive disease management to prevent bleeding, joint damage and secondary diseases has been well established. However, because haemophilia is a chronic disease, intervention programmes carried out for prolonged periods of time may create problems of patient adherence. Driven by continuous technological innovation, telemedicine is being increasingly proposed as a way to provide PWH with a range of services designed to improve their health, saving the time and cost involved in going to the treatment centre, and increasing therapeutic adherence. The aim of this article is to identify and discuss the tools available for the management of PWH by means of telemedicine and information technology. Video conferences are helpful to obtain a rapid evaluation at a distance of the occurrence and severity of bleeding episodes by the personnel of the treatment centre. Cell phones and associated applications (apps) help to improve the regular implementation of replacement therapy and monitor any ensuing adverse effect. Portable sensors help to improve lifestyle and to monitor the degree of physical activity through the fulfilment of a given number of daily walking steps and other physical activities. In the context of telerehabilitation, exergames have the potential to improve the musculoskeletal function of PWH by exploiting the recreational features of videogames. Thus, telemedicine and its multiple applications may be useful in the management of haemophilia, especially for patients living far from specialised centres. However, since this is a recent and rapidly evolving field, published studies are few and have, so far, involved only a limited number of cases. Therefore, additional evidence needs to be obtained by means of accrual of cumulative data from multiple centres specialised in haemophilia.
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31
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Megías-Vericat JE, Monte-Boquet E, Martín-Cerezuela M, Cuéllar-Monreal MJ, Tarazona-Casany MV, Pérez-Huertas P, Bonanad S, Poveda-Andrés JL. Pilot evaluation of home delivery programme in haemophilia. J Clin Pharm Ther 2018; 43:822-828. [PMID: 29906305 DOI: 10.1111/jcpt.12718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES Most of the clotting factor (CF) dispensations to haemophiliac patients are centralized in a few haemophilia treatment centres, necessitating frequent visits and long travel distances. The aim was to evaluate the home delivery programme developed by the Outpatient Pharmaceutical Care Unit (OPCU) through the association of patients (ASHECOVA). METHODS A specific software programme was designed to communicate the individual CF requirements. Dispensations were prepared in advance, and an ASHECOVA member collected and delivered to patients' homes in optimal conditions. Data regarding the programme were analysed from December 2011 to December 2017. An electronic satisfaction survey with 34 questions was conducted, asking about organizational aspects, education and communication, use of apps and satisfaction level. RESULTS AND DISCUSSION Forty-nine patients were included and 2464 home deliveries were made, without any reported incident related to dispensation errors, drug preservation, communication or confidentiality problems. This system avoids 11.4 annual dispensation visits per patient to OCPU, and a mean travel distance, time and cost of 1189.1 km, 945.3 minutes and 373.5 euros, respectively. Overall satisfaction with home delivery was 9.7, without any change suggested in the current system. Ninety-five per cent of individuals believed that the programme improves adherence and all patients would recommend it to other patients. The most common benefits reported were less frequent visits to hospital, reducing time and cost spent on transportation. WHAT IS NEW AND CONCLUSION The home delivery programme guarantees a proper follow-up of treatments with full patient satisfaction. This programme allows OPCU to achieve better pharmaceutical care, traceability of the process and optimization of working times and CF stock management.
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Affiliation(s)
- J E Megías-Vericat
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - E Monte-Boquet
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - M Martín-Cerezuela
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - M J Cuéllar-Monreal
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - M V Tarazona-Casany
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - P Pérez-Huertas
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - S Bonanad
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - J L Poveda-Andrés
- Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe, Valencia, Spain
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32
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Hermans C, Kulkarni R. Women with bleeding disorders. Haemophilia 2018; 24 Suppl 6:29-36. [DOI: 10.1111/hae.13502] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 12/26/2022]
Affiliation(s)
- C. Hermans
- Haemostasis and Thrombosis Unit; Division of Haematology; Cliniques universitaires Saint-Luc; Brussels Belgium
| | - R. Kulkarni
- Department of Pediatrics and Human Development; Michigan State University; East Lansing MI USA
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