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Lahat A, Klang E. Can advanced technologies help address the global increase in demand for specialized medical care and improve telehealth services? J Telemed Telecare 2024; 30:1516-1517. [PMID: 36760131 DOI: 10.1177/1357633x231155520] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Adi Lahat
- Department of Gastroenterology, Chaim Sheba Medical Center, affiliated with Tel Aviv University, Tel Aviv, Israel
| | - Eyal Klang
- The Sami Sagol AI Hub, ARC innovation center, Chaim Sheba Medical Center, Affiliated with Tel-Aviv University, Tel Aviv, Israel
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Wehrli S, Baumgartner MR, Dwyer AA, Landolt MA. Latent profiles and predictors of barriers to care in Swiss children and adolescents with rare diseases. J Pediatr Psychol 2024:jsae076. [PMID: 39315918 DOI: 10.1093/jpepsy/jsae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 09/03/2024] [Accepted: 09/03/2024] [Indexed: 09/25/2024] Open
Abstract
OBJECTIVE Children and adolescents with rare diseases face significant barriers when accessing healthcare. We aimed to assess and predict these barriers and investigate associations with health-related quality of life (HRQoL). METHOD We conducted a cross-sectional survey of Swiss parents (N = 189) of children with rare diseases including the Barriers to Care Questionnaire (BCQ), containing six barriers and the Pediatric Quality of Life Inventory (PedsQL). Latent profile analysis (LPA) was used to uncover distinct classes, which were compared using chi-square tests and Mann-Whitney U tests. Relevant medical and sociodemographic class predictors were identified using Elastic Net regression, followed by regression analysis to investigate their role in predicting barriers to care and examine the effects of these classes on HRQoL. RESULTS Two distinct groups were identified, a higher barriers class (59%) and a lower barriers class (41%). In the higher barriers class, participants showed elevated scores across all subscales and specifically on pragmatics and expectations. More barriers to care were linked to a nonstable disease course (OR = 2.27, p = .002) and a diagnosis after the age of 3 months (OR = 2.17, p = .006). Individuals in the higher barriers class exhibited more psychological comorbidities (p = .044), congenital malformations/deformations/chromosomal abnormalities (p=.042), and medical misdiagnoses (p = .006). Children in the higher barriers class had significantly lower PedsQL scores compared to the lower barriers class (p <.05). CONCLUSION This study highlights the need for comprehensive assessment of barriers to pediatric care in rare diseases, offering potential entry points for targeted interventions.
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Affiliation(s)
- Susanne Wehrli
- Department of Psychosomatics and Psychiatry, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Matthias R Baumgartner
- Division of Metabolism, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrew A Dwyer
- Boston College, William F. Connell School of Nursing, Boston, MA, United States
- P50 Massachusetts General Hospital-Harvard Center for Reproductive Medicine Boston, Boston, MA, United States
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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3
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Stephenson KG, Vargo KC, Cacciato NM, Albright CM, Kryszak EM. Developmental Assessment in Children at Higher Likelihood for Developmental Delays - Comparison of Parent Report and Direct Assessment. J Autism Dev Disord 2024:10.1007/s10803-024-06420-4. [PMID: 38874836 DOI: 10.1007/s10803-024-06420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE Accurate assessment of cognitive development of young children is a vital component of developmental evaluations. Direct assessment of developmental skills is not always feasible, but there is limited information on the agreement between direct assessment and caregiver-reported cognitive skills. There is limited information regarding the accuracy of the parent-reported Developmental Profile 4 (DP-4) in comparison to the widely-used developmental measure, the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4). The purpose of the current study was to evaluate whether a standardized parent interview can effectively identify children at risk for cognitive developmental delays. METHODS We compared the agreement between the Bayley-4 Cognitive and the Developmental Profile 4 (DP-4) in young children being evaluated in-person for early developmental delays. 182 children (134 with an autism diagnosis), ages 6-42 months, completed both assessments. RESULTS Results showed that Bayley-4 Cognitive scores had a moderately strong correlation with DP4-Cognitive scores (r = 0.70, p < 0.001). A cutoff of 70 or 69 on the DP-4 Cognitive was determined as ideal for identifying developmental delay based on diagnosis of global developmental delay or the Bayley-4 Cognitive. CONCLUSIONS Our analyses revealed good agreement between DP-4 and Bayley-4 Cognitive scores, even after controlling for confounding variables such as degree of ASD characteristics, age, and sex. These results suggest that caregiver-report measures can be a valid and useful tool in the assessment of young children, particularly when direct developmental assessment is not feasible.
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Affiliation(s)
- Kevin G Stephenson
- Child Development Center, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA.
- Departments of Pediatrics and Psychology, The Ohio State University, Columbus, OH, USA.
| | - Kerrigan C Vargo
- Child Development Center, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Nicole M Cacciato
- Child Development Center, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Charles M Albright
- Child Development Center, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Departments of Pediatrics and Psychology, The Ohio State University, Columbus, OH, USA
| | - Elizabeth M Kryszak
- Child Development Center, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Departments of Pediatrics and Psychology, The Ohio State University, Columbus, OH, USA
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Inchingolo F, Inchingolo AM, Fatone MC, Avantario P, Del Vecchio G, Pezzolla C, Mancini A, Galante F, Palermo A, Inchingolo AD, Dipalma G. Management of Rheumatoid Arthritis in Primary Care: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:662. [PMID: 38928909 PMCID: PMC11203333 DOI: 10.3390/ijerph21060662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024]
Abstract
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms "rheumatoid arthritis" and "primary care" from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs' approach to the disease and patients is mandatory.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | | | - Pasquale Avantario
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Carmela Pezzolla
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | | | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
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Cascini F, Gentili A, Melnyk A, Beccia F, Causio FA, Solimene V, Battilomo S, Paone S, Borghini A, Bartolo M, Chiarolla E, Ricciardi W. A new digital model for the Italian Integrated Home Care: strengths, barriers, and future implications. Front Public Health 2023; 11:1292442. [PMID: 38035284 PMCID: PMC10682786 DOI: 10.3389/fpubh.2023.1292442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Fidelia Cascini
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Andrea Gentili
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andriy Melnyk
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flavia Beccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Andrea Causio
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Solimene
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serena Battilomo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Paone
- Italian National Agency for Regional Healthcare Services (Agenas), Rome, Italy
| | - Alice Borghini
- Italian National Agency for Regional Healthcare Services (Agenas), Rome, Italy
| | | | - Emilio Chiarolla
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Brehon K, Carriere J, Churchill K, Loyola-Sanchez A, Papathanassoglou E, MacIsaac R, Tavakoli M, Ho C, Manhas KP. Evaluating Efficiency of a Provincial Telerehabilitation Service in Improving Access to Care During the COVID-19 Pandemic. Int J Telerehabil 2023; 15:e6523. [PMID: 38046552 PMCID: PMC10687995 DOI: 10.5195/ijt.2023.6523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Scope Early in the COVID-19 pandemic, community rehabilitation stakeholders from a provincial health system designed a novel telerehabilitation service. The service provided wayfinding and self-management advice to individuals with musculoskeletal concerns, neurological conditions, or post-COVID-19 recovery needs. This study evaluated the efficiency of the service in improving access to care. Methodology We used multiple methods including secondary data analyses of call metrics, narrative analyses of clinical notes using artificial intelligence (AI) and machine learning (ML), and qualitative interviews. Conclusions Interviews revealed that the telerehabilitation service had the potential to positively impact access to rehabilitation during the COVID-19 pandemic, for individuals living rurally, and for individuals on wait lists. Call metric analyses revealed that efficiency may be enhanced if call handling time was reduced. AI/ML analyses found that pain was the most frequently-mentioned keyword in clinical notes, suggesting an area for additional telerehabilitation resources to ensure efficiency.
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Affiliation(s)
- Katelyn Brehon
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Jay Carriere
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Katie Churchill
- Allied Health Professional Practice and Education, Alberta Health Services, Alberta, Canada
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | | | - Elizabeth Papathanassoglou
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rob MacIsaac
- Spinal Cord Injury Alberta, Edmonton, Alberta, Canada
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Chester Ho
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Strunga M, Urban R, Surovková J, Thurzo A. Artificial Intelligence Systems Assisting in the Assessment of the Course and Retention of Orthodontic Treatment. Healthcare (Basel) 2023; 11:healthcare11050683. [PMID: 36900687 PMCID: PMC10000479 DOI: 10.3390/healthcare11050683] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
This scoping review examines the contemporary applications of advanced artificial intelligence (AI) software in orthodontics, focusing on its potential to improve daily working protocols, but also highlighting its limitations. The aim of the review was to evaluate the accuracy and efficiency of current AI-based systems compared to conventional methods in diagnosing, assessing the progress of patients' treatment and follow-up stability. The researchers used various online databases and identified diagnostic software and dental monitoring software as the most studied software in contemporary orthodontics. The former can accurately identify anatomical landmarks used for cephalometric analysis, while the latter enables orthodontists to thoroughly monitor each patient, determine specific desired outcomes, track progress, and warn of potential changes in pre-existing pathology. However, there is limited evidence to assess the stability of treatment outcomes and relapse detection. The study concludes that AI is an effective tool for managing orthodontic treatment from diagnosis to retention, benefiting both patients and clinicians. Patients find the software easy to use and feel better cared for, while clinicians can make diagnoses more easily and assess compliance and damage to braces or aligners more quickly and frequently.
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Pachito DV, de Azeredo-da-Silva ALF, de Oliveira PRBP, Bagattini ÂM, Basso J, Gehres LG, Mallmann ÉDB, Rodrigues ÁS, Riera R, Gadenz SD. Telehealth Strategies to Support Referral Management to Secondary Care in Brazil: A Cost-Effectiveness Analysis. Value Health Reg Issues 2022; 31:74-80. [PMID: 35568011 DOI: 10.1016/j.vhri.2022.03.003] [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: 12/03/2021] [Revised: 02/16/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study aimed to assess the cost-effectiveness of a remotely operated referral management system (RORMS) compared with a conventional referral management system (CRMS) in Brazil. METHODS This is a model-based cost-effectiveness analysis under the perspective of the Unified Healthcare System (Sistema Único de Saúde [SUS]) in Brazil. A Markov microsimulation model was developed to compare costs and referral outcomes of the RORMS and the CRMS. Model consisted of 4 states representative of sequential stepwise assessments of referral suitability, 3 states representative of referral outcomes, and 1 exit model state. Target population represented cases being referred from primary healthcare units to specialized care in SUS. Model inputs related to costs and effectiveness in the RORMS arm were obtained from the data set of a RORMS between July and December 2019. Model inputs for the CRMS model arm were obtained from administrative data sets of 2 Brazilian localities for the year 2019. Relative effect size of RORMS in comparison with CRMS in SUS was obtained from published studies. Effectiveness outcome was unnecessary referrals averted. The incremental cost-effectiveness ratio was calculated for the base case. Probabilistic sensitivity analysis was conducted. RESULTS In the base-case analyses, RORMS dominated CRMS, with expected cost-savings from $50.42 to $80.62 per unnecessary referral averted. RORMS was the dominant strategy in 83.7% of 100 000 simulations in the probabilistic sensitivity analysis. In 16.2% of simulations, incremental cost-effectiveness ratio was between $0 and $222 per unnecessary referral averted. CONCLUSIONS Model-based simulations indicate that the RORMS is likely to be cost saving in comparison with the CRMS.
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Affiliation(s)
| | | | | | | | - Josué Basso
- Regula Mais Brasil, Hospital Sírio-Libanês, São Paulo, Brazil
| | | | | | - Átila S Rodrigues
- Ministry of Health, Brazil; Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Rachel Riera
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, São Paulo, Brazil
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Gadenz SD, Basso J, de Oliviera PRBP, Sperling S, Zuanazzi MVD, Oliveira GG, da Silva IM, Motta RM, Gehres LG, de Brito Mallmann É, Rodrigues ÁS, Pachito DV, de Faria Leao B. Telehealth to support referral management in a universal health system: a before-and-after study. BMC Health Serv Res 2021; 21:1012. [PMID: 34563176 PMCID: PMC8467186 DOI: 10.1186/s12913-021-07028-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. METHODS Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. RESULTS At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. CONCLUSIONS Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.
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Affiliation(s)
- Sabrina Dalbosco Gadenz
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
| | - Josué Basso
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
| | | | - Stephan Sperling
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
| | | | | | - Ivonice Martins da Silva
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
| | - Raphael Mendes Motta
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
| | - Luana Gonçalves Gehres
- Ministry of Health, Esplanada dos Ministérios, Bloco G, 3º Andar, 70058-900, Brasília, Distrito Federal, Brazil
| | - Érica de Brito Mallmann
- Ministry of Health, Esplanada dos Ministérios, Bloco G, 3º Andar, 70058-900, Brasília, Distrito Federal, Brazil
| | - Átila Szczecinski Rodrigues
- Ministry of Health, Esplanada dos Ministérios, Bloco G, 3º Andar, 70058-900, Brasília, Distrito Federal, Brazil
| | - Daniela V Pachito
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil.
| | - Beatriz de Faria Leao
- Regula Mais Brasil Hospital Sírio-Libanês, Rua Barata Ribeiro,142, 01308-000, São Paulo, SP, Brazil
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Belvís R, Santos-Lasaosa S, Irimia P, López Blanco R, Torres-Ferrús M, Morollón N, López-Bravo A, García-Azorín D, Mínguez-Olaondo A, Guerrero Á, Porta J, Giné-Ciprés E, Sierra Á, Latorre G, González-Oria C, Pascual J, Ezpeleta D. Telemedicine in the management of patients with headache: current situation and recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2021; 38:S0213-4853(21)00054-2. [PMID: 33867184 DOI: 10.1016/j.nrl.2021.01.018] [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: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has caused an unexpected boost to telemedicine. We analyse the impact of the pandemic on telemedicine applied in Spanish headache consultations, review the literature, and issue recommendations for the implementation of telemedicine in consultations. METHOD The study comprised 3 phases: 1) review of the MEDLINE database since 1958 (first reported experience with telemedicine); 2) Google Forms survey sent to all members of the Spanish Society of Neurology's Headache Study Group (GECSEN); and 3) online consensus of GECSEN experts to issue recommendations for the implementation of telemedicine in Spain. RESULTS COVID-19 has increased waiting times for face-to-face consultations, increasing the use of all telemedicine modalities: landline telephone (from 75% before April 2020 to 97% after), mobile telephone (from 9% to 27%), e-mail (from 30% to 36%), and video consultation (from 3% to 21%). Neurologists are aware of the need to expand the availability of video consultations, which are clearly growing, and other e-health and m-health tools. CONCLUSIONS The GECSEN recommends and encourages all neurologists who assist patients with headaches to implement telemedicine resources, with the optimal objective of offering video consultation to patients under 60-65 years of age and telephone calls to older patients, although each case must be considered on an individual basis. Prior approval and advice must be sought from legal and IT services and the centre's management. Most patients with stable headache and/or neuralgia are eligible for telemedicine follow-up, after a first consultation that must always be held in person.
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Affiliation(s)
- R Belvís
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - S Santos-Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria Aragón, Zaragoza, España
| | - P Irimia
- Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, España
| | - R López Blanco
- Servicio Integrado de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, España; Hospital General de Villalba, Hospital Universitario Infanta Elena, Valdemoro, España
| | - M Torres-Ferrús
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - N Morollón
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - A López-Bravo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, España; Departamento de Neurología, Hospital Reina Sofía, Tudela, Navarra, España
| | - D García-Azorín
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | | | - Á Guerrero
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - J Porta
- Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - E Giné-Ciprés
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Á Sierra
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - G Latorre
- Departamento de Neurología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - C González-Oria
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J Pascual
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España
| | - D Ezpeleta
- Servicio de Neurología, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid, España
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