1
|
Pinpattanapong R, Sukharomana M, Charuvanij S. Impact of the COVID-19 pandemic on the quality of care for juvenile idiopathic arthritis patients: insights from Thailand. Orphanet J Rare Dis 2024; 19:320. [PMID: 39223582 PMCID: PMC11367977 DOI: 10.1186/s13023-024-03330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted individuals with chronic conditions. This investigation assessed the quality of care provided to pediatric and adolescent patients with juvenile idiopathic arthritis (JIA) during the pandemic in Thailand. METHODS This cross-sectional analysis enrolled JIA patients aged ≤ 18 years at an academic tertiary care facility from April 2022 to March 2023. Retrospective reviews were performed, complemented by patient and caregiver questionnaires to assess the pandemic's impact on care quality. RESULTS Seventy JIA patients (37 males, 33 females) with a mean age of 13.5 ± 3.1 years were included. A total of 41.4% of the caregivers reported negative impacts on JIA care due to the pandemic and the lockdown, and 31.4% of the patients experienced pandemic-related anxiety. A comparison between the pandemic and prepandemic periods revealed a higher incidence of active disease, although the difference was statistically nonsignificant (37.1% vs 14.2%, p = 0.106). Nonadherence significantly predicted active disease status (adjusted OR 15.04, 95% CI 2.48-91.15, p = 0.03). COVID-19 vaccinations were administered to 85.7% of patients; 52.8% of whom contracted mild COVID-19. Most patients (71.4%) postponed clinic visits; 36% due to lockdowns and 28% due to concerns about COVID-19 exposure in healthcare settings. The majority of patients received telephone JIA management advice from rheumatologists during the lockdown (91.4%). CONCLUSIONS The COVID-19 pandemic and associated lockdown measures affected the care of JIA patients, impacting both physical and mental health. Nonadherence was a critical factor in disease flare-ups. Telemedicine is indispensable for patient care.
Collapse
Affiliation(s)
- Rattakorn Pinpattanapong
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Maynart Sukharomana
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Sirirat Charuvanij
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
| |
Collapse
|
2
|
Steiman A, Inrig T, Lundon K, Murdoch J, Shupak R. Telerheumatology Shared-Care Model: Leveraging the Expertise of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-Trained Extended Role Practitioner in Rural-Remote Ontario. J Rheumatol 2024; 51:913-919. [PMID: 38825360 DOI: 10.3899/jrheum.2023-1143] [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] [Accepted: 05/21/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE A shortage of rheumatologists has led to gaps in inflammatory arthritis (IA) care in Canada. Amplified in rural-remote communities, the number of rheumatologists practicing rurally has not been meaningfully increased, and alternate care strategies must be adopted. In this retrospective chart review, we describe the impact of a shared-care telerheumatology model using a community-embedded Advanced Clinician Practitioner in Arthritis Care (ACPAC)-extended role practitioner (ERP) and an urban-based rheumatologist. METHODS A rheumatologist and an ACPAC-ERP established a monthly half-day hub-and-spoke-telerheumatology clinic to care for patients with suspected IA, triaged by the ACPAC-ERP. Comprehensive initial assessments were conducted in-person by the ACPAC-ERP (spoke); investigations were completed prior to the telerheumatology visit. Subsequent collaborative visits occurred with the rheumatologist (hub) attending virtually. Retrospective analysis of demographics, time-to-key care indices, patient-reported outcomes, clinical data, and estimated travel savings was performed. RESULTS Data from 124 patients seen between January 2013 and January 2022 were collected; 98% (n = 494/504 visits) were virtual. The average age of patients at first visit was 55.6 years, and 75.8% were female. IA/connective tissue disease (CTD) was confirmed in 65% of patients. Mean time from primary care referral to ACPAC-ERP assessment was 52.5 days, and mean time from ACPAC-ERP assessment to the telerheumatology visit was 64.5 days. An estimated 493,470 km of patient-related travel was avoided. CONCLUSION An ACPAC-ERP (spoke) and rheumatologist (hub) telerheumatology model of care assessing and managing patients with suspected IA in rural-remote Ontario was described. This model can be leveraged to increase capacity by delivering comprehensive virtual rheumatologic care in underserved communities.
Collapse
Affiliation(s)
- Amanda Steiman
- A. Steiman, MD, MSc, Division of Rheumatology, Sinai Health, and Rebecca Macdonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital and University Health Network
| | - Taucha Inrig
- T. Inrig, BScN, RN, MDiv, Musculoskeletal Health and Outcomes Unit, St. Michael's Hospital
| | - Katie Lundon
- K. Lundon, BScPT, MSc, PhD, Office of Continuing Professional Development, Faculty of Medicine, University of Toronto
| | | | - Rachel Shupak
- R. Shupak, MD, St. Michael's Hospital, Division of Rheumatology, and ACPAC Program Medical Director-Adult Training Program Clinician-Educator, and Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
3
|
Gotthardt CJ, Haynes SC, Murphy RK, Marcin P. Patient and Parent Experience with Pediatric Care Providers During the COVID-19 Pandemic: A Comparison of Press Ganey Survey Scores for Telehealth and In-Person Encounters. Telemed J E Health 2024; 30:1825-1833. [PMID: 38512471 DOI: 10.1089/tmj.2024.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Background: Prior research suggests that pediatric patients and their parents/guardians are generally satisfied with care provided through telehealth. The objective of this study was to compare Press Ganey provider-oriented experience survey scores between telehealth and in-person patient encounters among a variety of pediatric clinical specialties at a large academic medical center. Methods: We analyzed Press Ganey survey data from pediatric patient encounters from UC Davis Health, collected between August 2020 and February 2022. Survey results analyzed respondents' satisfaction with care providers, including satisfaction with explanations given, discussions led, concern showed, and inclusion by providers; and the likelihood the survey respondent would recommend the provider to others. We used logistic regression models, which included case mix variables and clinical specialty to compare the odds of scoring the highest possible survey response ("top box" score). Results: Of the 6,093 survey responses that met inclusion criteria, 1,157 (19%) were associated with telehealth encounters and 4,936 (81%) were associated with in-person encounters. We found no significant difference in the odds of respondents giving a top box score to rate their satisfaction with their care provider between telehealth and in-person encounters. When respondents were asked whether they would recommend the care provider to others, the odds of giving a top box score following a telehealth encounter relative to an in-person encounter was 1.22 (95% confidence interval [0.97-1.52]; p-value = 0.09). Discussion: We found that survey respondents' experiences with their care provider are high and comparable for telehealth and in-person encounters in a pediatric population.
Collapse
Affiliation(s)
- Christine J Gotthardt
- Department of Pediatrics, Davis School of Medicine, University of California, Sacramento, California, USA
| | - Sarah C Haynes
- Department of Pediatrics, Davis School of Medicine, University of California, Sacramento, California, USA
| | - Riley K Murphy
- University of California Davis Health, Sacramento, California, USA
| | - P Marcin
- Department of Pediatrics, Davis School of Medicine, University of California, Sacramento, California, USA
| |
Collapse
|
4
|
Katzow MW, Steinway C, Capossela E, Chen J, Chen V, Fenster T, Galagedera N, Hamill M, Lin E, Mamauag E, Moriarty S, Pathania S, Pliskin L, Ripp A, Ronay A, Santiago MT, Yang M, Jan S. Utilization and Patient-Reported Outcomes of Direct-to-Consumer Telemedicine During the First 6 Weeks of the COVID-19 Pandemic in the Largest Pediatric Ambulatory Network in New York State. Telemed J E Health 2024; 30:e1944-e1953. [PMID: 38597957 PMCID: PMC11296156 DOI: 10.1089/tmj.2023.0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
Objective: We aimed to (1) describe telemedicine utilization and usability during the first 6 weeks of the pandemic and (2) determine if usability varied by individual- or visit-level characteristics. Methods: We conducted a retrospective cohort study of ambulatory pediatric telemedicine visits occurring between March 10, 2020, and April 18, 2020, across a large academic health system. We performed manual chart review to assess individual- and visit-level characteristics and invited caregivers to respond to an adapted Telehealth Usability Questionnaire (TUQ). We used multiple logistic regression to determine predictors of high usability. Results: There were 3,197 ambulatory pediatric telemedicine visits, representing 2,967 unique patients. Patients were racially/ethnically diverse (42.5% non-Hispanic White) and primarily English-speaking (89.2%). Surveys were completed by 441 (17%) of those invited. Every item of the TUQ had agreement or strong agreement from the majority of respondents. Compared with non-Hispanic White, non-Hispanic Asian identity was associated with lower usability in three domains and overall, and non-Hispanic Black identity was associated with higher satisfaction and future use. As compared with caregivers of infants younger than 1 year, caregivers of older patients reported lower usability in the three domains. Conclusions: Telemedicine was successfully implemented across 18 ambulatory pediatric specialties in the largest health system in New York State at the onset of COVID-19, and caregivers found it usable and acceptable. Usability scores did not vary by visit-level characteristics but did vary by race/ethnicity and age. Further research is necessary to identify modifiable drivers of the patient experience, particularly in non-Hispanic Asian communities and older adolescents.
Collapse
Affiliation(s)
- Michelle W. Katzow
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Caren Steinway
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Errica Capossela
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Department of Pediatrics, University of California San Diego, Rady Children's Hospital, La Jolla, California, USA
| | - Jack Chen
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Victoria Chen
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Talia Fenster
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Nirupa Galagedera
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Megan Hamill
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Elaine Lin
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Department of Pediatric Gastroenterology, NYU Langone Health, New York, New York, USA
| | - Erica Mamauag
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Department of Pediatric Hematology and Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Shannon Moriarty
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Shivany Pathania
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Department of Pediatric Gastroenterology, Brown University/Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Lyndsey Pliskin
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Asher Ripp
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- SUNY Downstate College of Medicine, Brooklyn, New York, USA
| | - Avy Ronay
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Maria T. Santiago
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| | - Margaret Yang
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
- Department of Pediatric Critical Care Medicine, Mount Sinai Kravis Children's Hospital, New York, New York, USA
| | - Sophia Jan
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Cohen Children's Medical Center, Queens, New York, USA
| |
Collapse
|
5
|
Nguyen L, Phan TL, Falini L, Chang D, Cottrell L, Dawley E, Hockett CW, VanWagoner T, Darden PM, Davis AM. Rural Family Satisfaction With Telehealth Delivery of an Intervention for Pediatric Obesity and Associated Family Characteristics. Child Obes 2024; 20:147-154. [PMID: 37036783 PMCID: PMC10979670 DOI: 10.1089/chi.2022.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Objective: To describe satisfaction with the telehealth aspect of a pediatric obesity intervention among families from multiple rural communities and assess differences in satisfaction based on sociodemographic factors. Methods: This is a secondary analysis of data from a pilot randomized controlled trial of a 6-month intensive lifestyle intervention (iAmHealthy) delivered through telehealth to children 6-11 years old with BMI ≥85th%ile and their parents from rural communities. Parents completed a sociodemographic survey and a validated survey to assess satisfaction with the telehealth intervention across four domains (technical functioning, comfort of patient and provider with technology and perceived privacy, timely and geographic access to care, and global satisfaction) on a 5-point Likert scale. Kruskal-Wallis nonparametric rank test were used to compare mean satisfaction scores based on parent sociodemographics. Results: Forty-two out of 52 parents (67% White, 29% Black, 5% multiracial, and 50% with household income <$40,000) completed the survey. Mean satisfaction scores ranged from 4.16 to 4.54 (standard deviation 0.44-0.61). Parents without a college degree reported higher satisfaction across all domains compared with parents with a college degree, including global satisfaction (mean 4.64 vs. 4.31, p = 0.03). Parents reporting a household income <$40,000 (mean 4.70) reported higher scores in the comfort with technology and perceived privacy domain compared with parents with higher incomes (mean 4.30-4.45, p = 0.04). Discussion: Parents from rural communities, especially those from lower socioeconomic backgrounds, were highly satisfied with the iAmHealthy telehealth intervention. These findings can be used to inform future telehealth interventions among larger more diverse populations. ClinicalTrials.gov Identifier: NCT04142034.
Collapse
Affiliation(s)
- Linhda Nguyen
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Thao-Ly Phan
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
- Center for Healthcare Delivery Science, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Lauren Falini
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Di Chang
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lesley Cottrell
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
- West Virginia University Center for Excellence in Disabilities, Morgantown, WV, USA
| | - Erin Dawley
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, School of Medicine, University of South Dakota, Vermillion, SD, USA
| | - Timothy VanWagoner
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Paul M. Darden
- Population Health Research Program, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ann M. Davis
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA
| |
Collapse
|
6
|
Du Y, Gu Y. The development of evaluation scale of the patient satisfaction with telemedicine: a systematic review. BMC Med Inform Decis Mak 2024; 24:31. [PMID: 38303031 PMCID: PMC10832124 DOI: 10.1186/s12911-024-02436-z] [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: 05/17/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, telemedicine become more and more popular, patients attempt to use telemedicine to meet personal medical needs. Patient satisfaction is a key indicator of insight into the patient experience. PURPOSE This systematic review aims to explore the measurement factors of patient satisfaction with telemedicine and develop a more comprehensive and systematic scale of patient satisfaction with telemedicine. METHODS In February 2023, a literature search was conducted on the PubMed, EMBASE, and Web of Science, identifying measurement factors and tools of patient satisfaction with telemedicine. For inclusion, the studies had to have or make a questionnaire about patient satisfaction with telemedicine delivered through video/audio visits in English. The quality of the studies was evaluated according to the Critical Appraisal Tool for Analytical Cross-Sectional Studies of the Joanna Briggs Institute (JBI). The dimensions and items in each tool were also analyzed. RESULTS The initial search showed 14,020 studies. After eliminating duplicates and utilizing inclusion and exclusion criteria, 44 studies were included. This systematic review identified and integrated the measurement factors and develops a scale of patient satisfaction with telemedicine, which was divided into 9 dimensions and consists of 37 items. CONCLUSION Future measurement and evaluation of telemedicine will benefit from scale that was developed in this study, and it will more directly reflecting patient needs when patient satisfaction with telemedicine is evaluated.
Collapse
Affiliation(s)
- Yifei Du
- Department of Medical Information Technology and Management, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Yu Gu
- Department of Medical Information Technology and Management, Yanjing Medical College, Capital Medical University, Beijing, China.
| |
Collapse
|
7
|
Chow AJ, Saad A, Al‐Baldawi Z, Iverson R, Skidmore B, Jordan I, Pallone N, Smith M, Chakraborty P, Brehaut J, Cohen E, Dyack S, Gillis J, Goobie S, Greenberg CR, Hayeems R, Hutton B, Inbar‐Feigenberg M, Jain‐Ghai S, Khangura S, MacKenzie JJ, Mitchell JJ, Moazin Z, Nicholls SG, Pender A, Prasad C, Schulze A, Siriwardena K, Sparkes RN, Speechley KN, Stockler S, Taljaard M, Teitelbaum M, Trakadis Y, Van Karnebeek C, Walia JS, Wilson K, Potter BK. Family-centred care interventions for children with chronic conditions: A scoping review. Health Expect 2024; 27:e13897. [PMID: 39102737 PMCID: PMC10837485 DOI: 10.1111/hex.13897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/08/2023] [Accepted: 10/10/2023] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Children with chronic conditions have greater health care needs than the general paediatric population but may not receive care that centres their needs and preferences as identified by their families. Clinicians and researchers are interested in developing interventions to improve family-centred care need information about the characteristics of existing interventions, their development and the domains of family-centred care that they address. We conducted a scoping review that aimed to identify and characterize recent family-centred interventions designed to improve experiences with care for children with chronic conditions. METHODS We searched Medline, Embase, PsycInfo and Cochrane databases, and grey literature sources for relevant articles or documents published between 1 January 2019 and 11 August 2020 (databases) or 7-20 October 2020 (grey literature). Primary studies with ≥10 participants, clinical practice guidelines and theoretical articles describing family-centred interventions that aimed to improve experiences with care for children with chronic conditions were eligible. Following citation and full-text screening by two reviewers working independently, we charted data covering study characteristics and interventions from eligible reports and synthesized interventions by domains of family-centred care. RESULTS Our search identified 2882 citations, from which 63 articles describing 61 unique interventions met the eligibility criteria and were included in this review. The most common study designs were quasiexperimental studies (n = 18), randomized controlled trials (n = 11) and qualitative and mixed-methods studies (n = 9 each). The most frequently addressed domains of family-centred care were communication and information provision (n = 45), family involvement in care (n = 37) and access to care (n = 30). CONCLUSION This review, which identified 61 unique interventions aimed at improving family-centred care for children with chronic conditions across a range of settings, is a concrete resource for researchers, health care providers and administrators interested in improving care for this high-needs population. PATIENT OR PUBLIC CONTRIBUTION This study was co-developed with three patient partner co-investigators, all of whom are individuals with lived experiences of rare chronic diseases as parents and/or patients and have prior experience in patient engagement in research (I. J., N. P., M. S.). These patient partner co-investigators contributed to this study at all stages, from conceptualization to dissemination.
Collapse
Affiliation(s)
- Andrea J. Chow
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Ammar Saad
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Zobaida Al‐Baldawi
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Ryan Iverson
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | | | | | | | - Maureen Smith
- Canadian Organization for Rare DisordersOttawaOntarioCanada
| | - Pranesh Chakraborty
- Newborn Screening Ontario, Children's Hospital of Eastern OntarioOttawaOntarioCanada
- Department of PediatricsUniversity of OttawaOttawaOntarioCanada
| | - Jamie Brehaut
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Eyal Cohen
- Department of PediatricsUniversity of Toronto/Hospital for Sick ChildrenTorontoOntarioCanada
| | - Sarah Dyack
- Department of PediatricsDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Sharan Goobie
- Department of PediatricsDalhousie UniversityHalifaxNova ScotiaCanada
| | - Cheryl R. Greenberg
- Department of Pediatrics and Child HealthUniversity of ManitobaWinnipegManitobaCanada
| | - Robin Hayeems
- Child Health Evaluative SciencesUniversity of Toronto/Hospital for Sick ChildrenTorontoOntarioCanada
| | - Brian Hutton
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Michal Inbar‐Feigenberg
- Division of Clinical & Metabolic GeneticsHospital for Sick ChildrenTorontoOntarioCanada
- Department of PediatricsUniversity of TorontoTorontoOntarioCanada
| | - Shailly Jain‐Ghai
- Department of Medical GeneticsUniversity of AlbertaEdmontonAlbertaCanada
| | - Sara Khangura
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Jennifer J. MacKenzie
- Department of PediatricsMcMaster UniversityHamiltonOntarioCanada
- Department of MedicineQueen's UniversityKingstonOntarioCanada
| | | | - Zeinab Moazin
- Newborn Screening Ontario, Children's Hospital of Eastern OntarioOttawaOntarioCanada
| | - Stuart G. Nicholls
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Amy Pender
- McMaster Children's HospitalHamiltonOntarioCanada
| | - Chitra Prasad
- Department of PediatricsWestern UniversityLondonOntarioCanada
| | - Andreas Schulze
- Department of Biochemistry and Department of PediatricsUniversity of TorontoTorontoOntarioCanada
- Clinical and Metabolic GeneticsHospital for Sick ChildrenTorontoOntarioCanada
| | - Komudi Siriwardena
- Department of Medical GeneticsUniversity of AlbertaEdmontonAlbertaCanada
| | | | - Kathy N. Speechley
- Departments of Pediatrics and Epidemiology and BiostatisticsWestern UniversityLondonOntarioCanada
| | | | - Monica Taljaard
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | | | | | - Clara Van Karnebeek
- Departments of Pediatrics and Human GeneticsEmma Center for Personalized Medicine, Amsterdam UMCAmsterdamThe Netherlands
| | | | - Kumanan Wilson
- Department of PediatricsUniversity of OttawaOttawaOntarioCanada
- Department of MedicineUniversity of OttawaOttawaOntarioCanada
- Bruyère Research InstituteOttawaOntarioCanada
| | - Beth K. Potter
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| |
Collapse
|
8
|
Horton DB, Yang Y, Neikirk A, Huang C, Crystal S, Davidow A, Haynes K, Gerhard T, Rose CD, Strom BL, Parlett L. Impact of the COVID-19 Pandemic on the Management of Juvenile Idiopathic Arthritis: Analysis of United States Commercial Insurance Data. J Clin Rheumatol 2023; 29:388-395. [PMID: 37798830 PMCID: PMC10843854 DOI: 10.1097/rhu.0000000000002035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND/OBJECTIVE Given limited information on health care and treatment utilization for juvenile idiopathic arthritis (JIA) during the pandemic, we studied JIA-related health care and treatment utilization in a commercially insured retrospective US cohort. METHODS We studied rates of outpatient visits, new disease-modifying antirheumatic drug (DMARD) initiations, intra-articular glucocorticoid injections (iaGC), dispensed oral glucocorticoids and opioids, DMARD adherence, and DMARD discontinuation by quarter in March 2018-February 2021 (Q1 started in March). Incident rate ratios (IRR, pandemic vs prepandemic) with 95% confidence intervals (CIs) were estimated using multivariable Poisson or Quasi-Poisson models stratified by diagnosis recency (incident JIA, <12 months ago; prevalent JIA, ≥12 months ago). RESULTS Among 1294 children diagnosed with JIA, total and in-person outpatient visits for JIA declined during the pandemic (IRR, 0.88-0.90), most markedly in Q1 2020. Telemedicine visits, while higher during the pandemic, declined from 21% (Q1) to 13% (Q4) in 2020 to 2021. During the pandemic, children with prevalent JIA, but not incident JIA, had lower usage of iaGC (IRR, 0.60; 95% CI, 0.34-1.07), oral glucocorticoids (IRR, 0.47; 95% CI, 0.33-0.67), and opioids (IRR, 0.44; 95% CI, 0.26-0.75). Adherence to and discontinuation of DMARDs was similar before and during the pandemic. CONCLUSIONS In the first year of the pandemic, visits for JIA dropped by 10% to 12% in commercially insured children in the United States, declines partly mitigated by use of telemedicine. Pandemic-related declines in intra-articular glucocorticoids, oral glucocorticoids, and opioids were observed for children with prevalent, but not incident, JIA. These changes may have important implications for disease control and quality of life.
Collapse
Affiliation(s)
- Daniel B. Horton
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | | | | | - Cecilia Huang
- Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
| | - Stephen Crystal
- Rutgers Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
- Rutgers School of Social Work, New Brunswick, NJ, USA
| | - Amy Davidow
- New York University School of Global Public Health, New York, NY, USA
| | - Kevin Haynes
- Janssen Research & Development, Titusville, NJ, USA
| | - Tobias Gerhard
- Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
- Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, New Brunswick, NJ, USA
| | | | - Brian L. Strom
- Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
- Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | | |
Collapse
|
9
|
Bajgain B, Rabi S, Ahmed S, Kiryanova V, Fairie P, Santana MJ. Patient-reported experiences and outcomes of virtual care during COVID-19: a systematic review. J Patient Rep Outcomes 2023; 7:126. [PMID: 38038800 PMCID: PMC10692047 DOI: 10.1186/s41687-023-00659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 11/15/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION The onset of COVID-19 has caused an international upheaval of traditional in-person approaches to care delivery. Rapid system-level transitions to virtual care provision restrict the ability of healthcare professionals to evaluate care quality from the patient's perspective. This poses challenges to ensuring that patient-centered care is upheld within virtual environments. To address this, the study's objective was to review how virtual care has impacted patient experiences and outcomes during COVID-19, through the use of patient-reported experience and outcome measures (PREMs and PROMs), respectively. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to evaluate patient responsiveness to virtual care during COVID-19. Using an exhaustive search strategy, relevant peer-reviewed articles published between January 2020 and 2022 were pulled from MEDLINE, CINAHL, EMBASE, and PsychInfo databases. Study quality was independently assessed by two reviewers using the Mixed Methods Appraisal Tool. A patient partner was consulted throughout the study to provide feedback and co-conduct the review. RESULTS After removing duplicates, 6048 articles underwent title and abstract review, from which 644 studies were included in the full-text review stage. Following this, 102 articles were included in the study. Studies were published in 20 different countries, were predominantly cross-sectional, and reported on the delivery of virtual care in specialized adult outpatient settings. This review identified 29 validated PREMs and 43 PROMs. Several advantages to virtual care were identified, with patients citing greater convenience, (such as saving travel time and cost, less waiting experienced to see care providers) and increased protection from viral spread. Some studies also reported challenges patients and caregivers faced with virtual care, including feeling rushed during the virtual care appointment, lack of physical contact or examination presenting barriers, difficulty with communicating symptoms, and technology issues. CONCLUSION This review provides supportive evidence of virtual care experiences during the COVID-19 pandemic from patient and caregiver perspectives. This research provides a comprehensive overview of what patient-reported measures can be used to record virtual care quality amid and following the pandemic. Further research into healthcare professionals' perspectives would offer a supportive lens toward a strong person-centered healthcare system.
Collapse
Affiliation(s)
- Bishnu Bajgain
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Sarah Rabi
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Sadia Ahmed
- Alberta SPOR SUPPORT Unit, Patient Engagement Team, Calgary, AB, Canada.
| | - Veronika Kiryanova
- Patient and Community Engagement Research, University of Calgary, Calgary, AB, Canada
| | - Paul Fairie
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta SPOR SUPPORT Unit, Patient Engagement Team, Calgary, AB, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta SPOR SUPPORT Unit, Patient Engagement Team, Calgary, AB, Canada
| |
Collapse
|
10
|
Kayaalp GK, Akgün Ö, Demirkan FG, Tanatar A, Çakmak F, Ayaz NA. Parent Views on Telemedicine in Pediatric Rheumatology: A Survey Study. Telemed J E Health 2023; 29:1548-1556. [PMID: 36800172 DOI: 10.1089/tmj.2022.0433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Objectives: The rapid expansion in the use of telemedicine after the COVID-19 pandemic has led many patients with chronic diseases to seek alternative ways for follow-ups. This study aimed to investigate the demands and opinions of parents of children with rheumatic diseases toward telemedicine and to examine the factors affecting telemedicine preference. Methods: A single-center, cross-sectional, Web-based survey study was conducted. Sociodemographic data, characteristics of the disease, access to the clinic, internet use, and views on telemedicine were assessed. Factors effecting telemedicine preference were evaluated by multivariate analysis. Results: A total of 245 parents have completed the survey. The diagnoses of patients were recurrent fever syndromes (55.1%), juvenile idiopathic arthritis (31.0%), systemic connective tissue diseases (8.2%), and vasculitis (5.7%). The majority of patients came to the clinic by public transport (n = 190, 77.6%). Sixty-eight (27.8%) patients missed at least one outpatient appointment in the last year. Majority (n = 172, 70.2%) of parents stated that they would prefer telemedicine visits if it becomes available. Multivariate analysis revealed that the most related factors to telemedicine preference were higher education level (odds ratio [OR]: 6.69, confidence interval [95% CI]: 2.21-20.25, p = 0.001), missing an appointment (OR: 3.04, 95% CI: 1.41-6.56, p = 0.004), and travel time longer than 1 h (OR: 2.13, 95% CI: 1.13-3.86, p = 0.012). Conclusion: Telemedicine visits are in demand in pediatric rheumatology and should be considered an alternative method to ensure continuity of patient follow-up. A personal approach should be followed when selecting patients for telemedicine.
Collapse
Affiliation(s)
- Gülşah Kavrul Kayaalp
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Özlem Akgün
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Fatma Gül Demirkan
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Ayşe Tanatar
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Figen Çakmak
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
11
|
Niyyati S, Fung A, Zhang Q, Ng C, Amed S, Bone JN, Ziabakhsh S, Hursh BE. Patient Perceptions of Telehealth for Pediatric Type 1 Diabetes During the COVID-19 Pandemic: A Follow-up Study. Can J Diabetes 2023; 47:579-586.e6. [PMID: 37187438 PMCID: PMC10182595 DOI: 10.1016/j.jcjd.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES There was rapid uptake of pediatric diabetes telehealth at the onset of the COVID-19 pandemic and initial studies demonstrated good usability and satisfaction. As exposure to telehealth continued to increase during the pandemic, we aimed to determine changes in telehealth usability and changes in future preferences for telehealth care. METHODS A telehealth questionnaire was administered early in the pandemic and again more than 1 year later. Survey data were linked with a clinical data registry. A multivariable proportional odds logistic mixed-effects model was used to assess the association between exposure to telehealth and outcome of future preference for telehealth. Multivariable linear mixed-effects models were used to examine associations between exposure to early and later pandemic periods and the outcome of usability scores. RESULTS Survey response rate was 40%, with 87 early and 168 later period participants. Virtual visits increased from 46% to 92% of all telehealth visits. Virtual visits improved in "ease of use" (p=0.0013) and "satisfaction" (p=0.045); there were no improvements in telephone visits. The odds of indicating higher preference for more future telehealth visits was 5.1-fold higher in the later pandemic group (p=0.0298). Eighty percent of participants would like their future care to include telehealth visits. CONCLUSIONS At our tertiary diabetes centre, families' desire for future telehealth care has increased during this 1-year period of additional telehealth exposure, and virtual care has now become the preferred option. This study provides important family perspectives that can help guide development of future diabetes clinical care.
Collapse
Affiliation(s)
- Sajad Niyyati
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex Fung
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Qian Zhang
- Biostatistics Core, Research Informatics, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Crystal Ng
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazhan Amed
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- Biostatistics Core, Research Informatics, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shabnam Ziabakhsh
- British Columbia Women's Hospital and Health Centre, Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Brenden E Hursh
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
| |
Collapse
|
12
|
Esposito S, Rosafio C, Antodaro F, Argentiero A, Bassi M, Becherucci P, Bonsanto F, Cagliero A, Cannata G, Capello F, Cardinale F, Chiriaco T, Consolaro A, Dessì A, Di Mauro G, Fainardi V, Fanos V, Guarino A, Li Calzi G, Lodi E, Maghnie M, Manfredini L, Malorgio E, Minuto N, Modena MG, Montori R, Moscatelli A, Patrone E, Pescio E, Poeta M, Ravelli A, Spelta M, Suppiej A, Vai S, Villa L, Zanini R, Botti R, Gaddi AV. Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF). J Pers Med 2023; 13:jpm13020235. [PMID: 36836469 PMCID: PMC9965862 DOI: 10.3390/jpm13020235] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens.
Collapse
Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | | | | | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Marta Bassi
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | | | | | | | - Giulia Cannata
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Fabio Capello
- UO Territorial Pediatrics, Primary Care Department, AUSL Bologna, 40126 Bologna, Italy
| | - Fabio Cardinale
- UOC of Pediatrics and ED with an Allergy-Pneumological and Immuno-Rheumatological Focus, Giovanni XXIII Pediatric Hospital, University of Bari, 70124 Bari, Italy
| | - Tiziana Chiriaco
- Health Department, ASL Roma 3, 00125 Rome, Italy
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Alessandro Consolaro
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa, 16126 Genoa, Italy
| | - Angelica Dessì
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | | | - Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | - Alfredo Guarino
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Giada Li Calzi
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Lodi
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Luca Manfredini
- Pediatric Pain and Palliative Care Service, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | | | - Nicola Minuto
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Maria Grazia Modena
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Rossano Montori
- Community Medicine and Primary Care, AUSL Modena, 41124 Modena, Italy
| | - Andrea Moscatelli
- UOC Anesthesia and Intensive Care, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Patrone
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Elena Pescio
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marco Poeta
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Angelo Ravelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa, 16126 Genoa, Italy
- Scientific Directorate, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Maddalena Spelta
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Agnese Suppiej
- Pediatric Clinic, University of Ferrara, 44124 Ferrara, Italy
| | | | - Luca Villa
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | | | - Renato Botti
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonio Vittorino Gaddi
- Center for Metabolic Diseases and Atherosclerosis, University of Bologna, 40126 Bologna, Italy
| |
Collapse
|
13
|
Olateju A, Cervantes M, Dowshen N, Kuhns LM, Dhar CP. Acceptability of Telemedicine Among Parents of Adolescent Patients in an Adolescent Clinic: Cross-sectional Survey Study. JMIR Pediatr Parent 2022; 5:e39704. [PMID: 36542447 PMCID: PMC9813812 DOI: 10.2196/39704] [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: 05/18/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, new literature has described the perceptions of adolescent patients on the use of telemedicine for their health care, but less attention has been devoted to parents' and caregivers' perspectives on telemedicine usage for their adolescents. Parents' perspectives are important, as they undoubtedly influence how children learn to make decisions about their health care. OBJECTIVE This study describes the level of acceptability (measured based on accessibility and satisfaction) expressed by caregivers of adolescent patients with regard to telemedicine visits in an urban adolescent medicine practice. METHODS A cross-sectional survey was sent electronically to parents and guardians of patients aged <18 years who completed outpatient telemedicine visits to an adolescent medicine practice in Chicago, Illinois, from March 2020 to February 2021. The questions focused on accessibility and satisfaction. The data were analyzed to describe response frequencies. RESULTS Among a sample of 71 survey respondents, the vast majority reported that telemedicine was very easy to use (58/71, 82%) and was at least as convenient as in-person visits (70/71, 99%). Over 90% of respondents reported that their adolescents' needs were addressed (69/69, 100%) and that they were at least as comfortable with the level of privacy and the confidential conversations between their adolescents and medical providers in telemedicine visits (65/71, 92%) as they were with those in in-person visits. CONCLUSIONS Our findings suggest that parents and guardians find telemedicine to be an acceptable way for their children and adolescents to receive appropriate health care.
Collapse
Affiliation(s)
- Adetola Olateju
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Marbella Cervantes
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Nadia Dowshen
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Lisa M Kuhns
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Cherie Priya Dhar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| |
Collapse
|
14
|
Jackson LE, Edgil TA, Hill B, Owensby JK, Smith CH, Singh JA, Danila MI. Telemedicine in Rheumatology Care: A Systematic Review. Semin Arthritis Rheum 2022; 56:152045. [DOI: 10.1016/j.semarthrit.2022.152045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/14/2022]
|
15
|
Bassi M, Strati MF, Parodi S, Lightwood S, Rebora C, Rizza F, d'Annunzio G, Minuto N, Maghnie M. Patient Satisfaction of Telemedicine in Pediatric and Young Adult Type 1 Diabetes Patients During Covid-19 Pandemic. Front Public Health 2022; 10:857561. [PMID: 35392480 PMCID: PMC8980324 DOI: 10.3389/fpubh.2022.857561] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/14/2022] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the satisfaction of the use of telemedicine and telenursing in children and young adults with Type 1 Diabetes and their families followed in the Regional Pediatric Diabetes Center of Giannina Gaslini Institute (Liguria, Italy). An anonymous survey form was administered to 290 patients (138 filled out by caregivers and 152 by patients). The questionnaire consisted of two parts: the first one included a series of questions related to the patient's personal and medical data; the second one was directed toward the satisfaction in the use of telemedicine and telenursing during Covid-19 pandemic. The data collected showed that 92.4% of the population was overall very satisfied with the quality of the service provided. Satisfaction was much higher especially in those who live outside of the province of Genoa (p = 0.017) and in those on insulin pump treatment (p = 0.037). Telemedicine and telenursing have an essential role in diabetology and are highly appreciated in our Center, where most patients prefer to continue regular follow-up via video-call as well as in person. Telenursing was also proved to be an effective and appreciated tool for educating and supporting patients using insulin pumps and glucose sensors.
Collapse
Affiliation(s)
- Marta Bassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Marina Francesca Strati
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Parodi
- Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Simone Lightwood
- IT Service (Servizio Informatico Aziendale-SIA), Istituto Giannina Gaslini, Genoa, Italy
| | - Clara Rebora
- Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Francesca Rizza
- Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Nicola Minuto
- Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Mohamad Maghnie
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| |
Collapse
|