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Shouman S, Emara T, Saber HG, Allam MF. Awareness and attitude of primary healthcare patients towards telehealth in Cairo, Egypt. Curr Med Res Opin 2022; 38:993-998. [PMID: 35404179 DOI: 10.1080/03007995.2022.2065141] [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] [Indexed: 11/03/2022]
Abstract
BACKGROUND Telehealth is delivering health care services remotely from healthcare facilities using telecommunications and virtual technology. Egypt is aiming to reach Universal Health Coverage; this increases the demand for telehealth in routine health services. Telehealth helps in increasing access to areas with no available medical services as patients can be monitored remotely. OBJECTIVE To measure the awareness of telehealth among attendees of primary health care units and their acceptance of applying telehealth. METHODOLOGY This was a cross-sectional study among attendees of primary health units. Ethical issues were considered. RESULTS A sample size was calculated to be 162 and 170 valid Arabic interview questionnaires were filled by attendees. The awareness percentage of telehealth among attendees was 64.7% while the willingness to implement telehealth was 78%. Both awareness and willingness were significantly associated with age groups, residence, socioeconomic status, and presence of computer with internet access. Age, residence, and possession of a PC were the only adjusted predictive factors for knowledge about telehealth among patients in the multivariable analysis. CONCLUSION Large percentages of attendees to primary health care centers are aware of telehealth and are willing to implement it. The major cause of refusal to implement telehealth was ignorance of using telecommunication devices and the desire to be in close contact with the physicians.
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Affiliation(s)
- Sara Shouman
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Emara
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Gamal Saber
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Farouk Allam
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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2
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Booth G, Williams D, Patel H, Gilbert AW. What is the content of virtually delivered pain management programmes for people with persistent musculoskeletal pain? A systematic review. Br J Pain 2022; 16:84-95. [PMID: 35111317 PMCID: PMC8801687 DOI: 10.1177/20494637211023074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Virtual consultations (VC) have been embraced by healthcare organisations during the COVID-19 pandemic. VC allows continuation of patient care while adhering to government advised restrictions and social distancing measures. Multidisciplinary pain management programmes (PMPs) are a core element of many pain services and utilising virtual methods to deliver PMPs has allowed them to continue to provide care. This systematic review aimed to explore the content of existing virtually delivered PMPs and discuss if and how these findings can be used to guide clinical delivery. METHODS Eligible studies included adults (aged ⩾18 years) with persistent musculoskeletal pain and any virtually delivered intervention that was described as a PMP or that had components of PMPs. Databases were searched from inception until July 2020. We performed a content analysis comparing existing interventions with established evidence-based clinical guidelines published by the British Pain Society (BPS). Intervention reporting quality was assessed using the Template for Intervention Description and Replication (TIDieR) checklist: an established checklist developed to improve the completeness of the reporting of interventions. RESULTS Eight studies were included. One intervention included six of the seven components recommended by the BPS; none included all seven. 'Skills training and activity management' was present in all eight interventions; 'education' and 'cognitive therapy methods' were present in six interventions; 'graded activation' and 'methods to enhance acceptance, mindfulness and psychological flexibility' were present in four interventions; 'physical exercise' was present in two interventions and 'graded exposure' was present in one intervention. None of the studies described all 12 items of the TIDieR checklist adequately enough for replication. CONCLUSION Published virtual PMPs partially meet established clinical guidelines. Future virtual PMPs should be based on evidence-based clinical guidelines, and more research is needed to explore the effectiveness of virtually delivered PMPs and each recommended component.
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Affiliation(s)
- Gregory Booth
- Therapies Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK,Gregory Booth, Therapies Department, Royal National Orthopaedic Hospital, Brockley Hill, Middlesex, Stanmore HA7 4LP, UK.
| | - Deborah Williams
- Therapies Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Hasina Patel
- Therapies Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Anthony W Gilbert
- Therapies Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK,School of Health Sciences, University of Southampton, Southampton, UK
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3
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Chomistek K, Barnabe C, Naqvi SF, Birnie KA, Johnson N, Luca N, Miettunen P, Santana MJ, Stinson J, Schmeling H. Acceptability of an Adolescent Self-Management Program for Juvenile Idiopathic Arthritis. ACR Open Rheumatol 2021; 4:142-151. [PMID: 34791829 PMCID: PMC8843737 DOI: 10.1002/acr2.11373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
Objective The study objective was to test the acceptability of a self‐management program (SMP) for adolescents with juvenile idiopathic arthritis (JIA) focused on disease information, self‐management, and social support needs. Methods This study was conducted using inductive qualitative methods to explore the acceptability of an in‐person/videoconference SMP. Two groups of four adolescents with JIA (mean age = 13.5, SD = 0.8) and two groups of pediatric rheumatology health care professionals (n = 4, n = 5) participated in four feedback sessions each. The SMP was presented to study participants, and feedback was provided on the content, format, and structure of the program. Thematic analysis was used to analyze the data. Results Adolescents felt that the content was appropriate and would be effective in supporting self‐management of their arthritis. Participants advised that the trustworthiness of the information would be increased if a rheumatology health care provider facilitated the session. Potential barriers to participation included distance and availability (weekdays and times), but the option for videoconference‐based participation was an appropriate solution to both of these issues. Minor changes were made to content and format, and required changes were made to address participant recommendations for improvement. Conclusion This study confirmed the acceptability of an in‐person/videoconference SMP for patients with JIA. Modifications were made to the SMP based on the focus group feedback, and future directions include a pilot randomized controlled trial to assess feasibility and preliminary effectiveness of the program.
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Affiliation(s)
- Kelsey Chomistek
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Syeda Farwa Naqvi
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn A Birnie
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Johnson
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Nadia Luca
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Paivi Miettunen
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Maria J Santana
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Jennifer Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Heinrike Schmeling
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
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Williams D, Booth G, Cohen H, Gilbert A, Lucas A, Mitchell C, Mittal G, Patel H, Peters T, Phillips M, Rudge W, Zarnegar R. Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative. Br J Pain 2021; 16:191-202. [PMID: 35425594 PMCID: PMC8998524 DOI: 10.1177/20494637211039252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The COVID-19 pandemic interrupted the delivery of face-to-face pain services including pain management programmes in the United Kingdom with considerable negative impact on patients with chronic musculoskeletal pain. We aimed to develop and implement a remotely delivered pain management programme (PMP) using video-conferencing technology that contains all the core components of a full programme: the ‘virtual PMP’ (vPMP). By reporting on the process of this development, we endeavour to help address the paucity of literature on the development of remote pain management programmes. Methods: The vPMP was developed by an inter-disciplinary group of professionals as a quality improvement (QI) project. The Model for Improvement Framework was employed with patient involvement at the design phase and at subsequent improvements. Improvement was measured qualitatively with frequent and repeated qualitative data collection leading to programme change. Quantitative patient demographic comparisons were made with a patient cohort who had been on a face-to-face PMP pathway. Results: Sixty-one patients on the PMP waiting list were contacted and 43 met the criteria for the programme. Fourteen patients participated in three vPMP cycles. Patient involvement and comprehensive stakeholder consultation were essential to a robust design for the first vPMP. Continued involvement of patient partners during the QI process led to rapid resolution of implementation problems. The most prominent issues that needed action were technical challenges including training needs, participant access to physical and technological resources, participant fatigue and concerns about adequate communication and peer support. Conclusion: This report demonstrates how a remotely delivered PMP, fully in line with national guidance, was rapidly developed and implemented in a hospital setting for patients with chronic musculoskeletal pain. We also discuss the relevance of our findings to the issues of cost, patient experience, patient preferences and inequities of access in delivering telerehabilitation for chronic pain.
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Affiliation(s)
- Deborah Williams
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Gregory Booth
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Helen Cohen
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Anthony Gilbert
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Andrew Lucas
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Chloe Mitchell
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Gayatri Mittal
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Hasina Patel
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Tamsin Peters
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Mia Phillips
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Will Rudge
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Roxaneh Zarnegar
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
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5
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Beks H, King O, Clapham R, Alston L, Glenister K, McKinstry C, Quilliam C, Wellwood I, Williams C, Wong Shee A. Community health programs delivered through information and communications technology in high-income countries: a scoping review (Preprint). J Med Internet Res 2020; 24:e26515. [PMID: 35262498 PMCID: PMC8943572 DOI: 10.2196/26515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/15/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges. Objective The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals. Methods The Joanna Briggs Institute’s scoping review methodology guided the review of the literature. Results The search retrieved 7110 unique citations. Each title and abstract was screened by at least two reviewers, resulting in 399 citations for full-text review. Of these 399 citations, 72 (18%) were included. An additional 27 citations were identified through reviewing the reference lists of the included studies, resulting in 99 citations. Citations examined 83 ICT-delivered programs from 19 high-income countries. Variations in program design, ICT platforms, research design, and outcomes were evident. Conclusions Included programs and research were heterogeneous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared with participants receiving in-person programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers.
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Affiliation(s)
- Hannah Beks
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Renee Clapham
- St Vincents Health Australia, Melbourne, Australia
- Ballarat Health Services, Ballarat, Australia
| | - Laura Alston
- School of Medicine, Deakin University, Geelong, Australia
- Colac Area Health, Colac, Australia
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Kristen Glenister
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Carol McKinstry
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Claire Quilliam
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
| | - Ian Wellwood
- Faculty of Health Sciences, Australian Catholic University, Ballarat, Australia
| | | | - Anna Wong Shee
- School of Medicine, Deakin University, Geelong, Australia
- Ballarat Health Services, Ballarat, Australia
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6
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Kumar S, Kumar A, Kumar M, Kumar A, Arora R, Sehrawat R. Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study. J Clin Orthop Trauma 2020; 11:S704-S710. [PMID: 32837105 PMCID: PMC7395587 DOI: 10.1016/j.jcot.2020.07.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The current COVID-19 pandemic has implications on the morbidities of orthopedic patients due to lack of routine follow-ups, and inpatient and outpatient-based interventions. Telemedicine has recently emerged as an alternative for healthcare delivery to the patients and providing them with important information about orthopedic self-care and medications that can be followed without a hospital visit. However, due to lack of physical assessment, telemedicine is bound to have some limitations as well. The aim of this study is to analyze the effectiveness of proactive telemedicine in maintaining follow-up of orthopedic patients, and their satisfaction with telemedicine as an alternative mode of treatment delivery. METHODS This one-month cross-sectional study enrolled the follow-up patients that visited the orthopedic outpatient-department in February 2020. The patients were sequentially called according to the order of their registration, on a daily basis. Consenting patients were provided with telemedicine-based consultations, and those requiring physical evaluation were called for outpatient visits after documenting the valid reasons. The response-rates and the volume of patients requiring physical visits were measured for different diagnosis-based groups. Patients were asked to complete a questionnaire that included overall patient satisfaction with telemedicine, its effectiveness, and ease in following the telemedicine-based treatment. RESULTS The response rate to telemedicine was 88.67%. Among the patients availing telemedicine, 71.43% were managed without needing physical visits to the outpatient-department. The need for physical examination and failed patient-doctor communication were the most common reasons for advising physical outpatient visits. The overall satisfaction-rate to telemedicine was 92%, and only 7.2% of patients had difficulty in understanding or following telemedicine-based advice. CONCLUSIONS Telemedicine can effectively reduce the need for physical visits to outpatient-departments for follow up of orthopedic patients. The response-rate and overall patient-satisfaction rates to telemedicine are high. Further efforts in expanding the use of telemedicine and addressing its limitations, especially those related to the failed communications, are needed to develop it as an alternative to physical orthopedic consultations in the current situation.
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Affiliation(s)
| | - Arvind Kumar
- Department of Orthopaedics, HIMSR, New Delhi, India,Corresponding author. Department of Orthopaedics, HIMSR, New Delhi, India.
| | - Mukesh Kumar
- Department of Orthopaedics, HIMSR, New Delhi, India
| | - Ashok Kumar
- Gastroenterology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rajesh Arora
- Department of Orthopaedics, HIMSR, New Delhi, India
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7
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Adapa K, Jain S, Kanwar R, Zaman T, Taneja T, Walker J, Mazur L. Augmented reality in patient education and health literacy: a scoping review protocol. BMJ Open 2020; 10:e038416. [PMID: 32938599 PMCID: PMC7497551 DOI: 10.1136/bmjopen-2020-038416] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Health literacy enables the patients in understanding the basic healthcare information and taking informed health decisions; thus, it is a desirable goal of any healthcare system. It increases patients' adherence to treatment, improves the quality of care and eases the overall burden on the healthcare system. In recent years, technological solutions are being increasingly used in educating patients and achieving better health literacy. Augmented reality (AR) provides powerful, contextual and situated learning experiences and supplements the real world with virtual objects. AR could potentially be an effective learning methodology for the patients, thus, warranting a comprehensive overview of the current state of AR in patient education and health literacy. METHODS The proposed scoping review will be based on the framework developed by Arksey and O'Malley, including the refinements suggested by Levac et al. A systematic search for references in the published literature will be conducted in nine research databases-Institute of Electrical and Electronics Engineers (IEEE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycInfo, Embase, Web of Science, Scopus, Association for Computing Machinery (ACM) and Association for Information Systems eLibrary (AISeL). The unpublished studies from ProQuest Dissertations and Theses, Conference Proceedings Citation Index and grey literature references obtained from a web search will also be included. Databases will be searched from inception to 14 January 2020. Two independent reviewers will screen the studies from the search results in two successive stages of title/abstract screening followed by full-text screening. Data variables will be extracted from the selected studies to characterise study design, type of AR technology employed and the relational factors affecting patient education. Lastly, key stakeholders will be consulted to gather their insights about the study findings. ETHICS AND DISSEMINATION The results will be disseminated through stakeholder meetings and conference presentations. The data used are from publicly available secondary sources, so this study does not require ethical review.
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Affiliation(s)
- Karthik Adapa
- Department of Radiation Oncology and Carolina Health Informatics Program, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Saumya Jain
- Department of Radiation Oncology, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Richa Kanwar
- Department of Radiation Oncology, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Tanzila Zaman
- Department of Radiation Oncology and Carolina Health Informatics Program, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Trusha Taneja
- Department of Radiation Oncology and Carolina Health Informatics Program, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Jennifer Walker
- Health Sciences Library, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Lukasz Mazur
- Department of Radiation Oncology and Carolina Health Informatics Program, University of North Carolina System, Chapel Hill, North Carolina, USA
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8
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Esbensen BA, Kennedy N, Brodin N. Prevention and adherence in Rheumatic and Musculoskeletal disease. Best Pract Res Clin Rheumatol 2020; 34:101525. [PMID: 32417107 DOI: 10.1016/j.berh.2020.101525] [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: 10/24/2022]
Abstract
Rheumatic and Musculoskeletal Diseases (RMDs) are chronic conditions that affect a substantial number of people. RMDs are significantly related to co-morbidity. Therefore, focusing on prevention in RMDs is of importance to promote and maintain health. Prevention includes primary-, secondary-, tertiary-, and clinical prevention. Primary prevention aims to prevent the onset of disease before the disease process begins, secondary prevention includes detecting and reducing disease and risk factors at the earliest possible point, and tertiary prevention aims to limit the influence of a recognized or verified disease and to address or reduce further development or worsening of the disease, including physical and psychosocial disability. Clinical prevention attempts to integrate prevention into the disease management to limit disease progression and prevent complications and relapse. This chapter will focus on the evidence for prevention and highlight how innovations and trends can contribute by using digital technologies as an example.
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Affiliation(s)
- Bente Appel Esbensen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Valdemar Hansens Vej 13-17, Entrance 5, DK-2600, Glostrup, Denmark.
| | - Norelee Kennedy
- Discipline of Physiotherapy, School of Allied Health, Faculty of Education & Health Sciences and Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Nina Brodin
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, S-141 83, Huddinge, Sweden.
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9
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Leon L, Redondo M, Fernández-Nebro A, Gómez S, Loza E, Montoro M, Garcia-Vicuña R, Galindo M. Expert recommendations on the psychological needs of patients with rheumatoid arthritis. Rheumatol Int 2018; 38:2167-2182. [PMID: 29808295 DOI: 10.1007/s00296-018-4057-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/17/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To establish feasible and practical recommendations for the management of the psychological needs of patients with rheumatoid arthritis (RA) from the moment of diagnosis through the course of the disease. METHODS A nominal group meeting was held with an RA expert team including rheumatologists and psychologists, at which a guided discussion addressed the most important psychological and emotional needs in RA. Based on the comments collected, and a literature review, a matrix document of recommendations for telematics discussion was prepared, as well as a Delphi survey to test agreement with these recommendations. Agreement was defined if at least 80% of participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grading of recommendations was established following the Oxford criteria, and the degree of agreement through the Delphi. RESULTS Thirteen recommendations were established, addressing several key processes: (1) identification of psychological problems and needs in patients with RA, and a guideline for their management in daily practice; (2) communication with patients; (3) referral criteria to mental health professionals. CONCLUSIONS These recommendations are intended to help health care professionals openly address the psychological aspects of patients in daily practice to follow and treat them properly.
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Affiliation(s)
- Leticia Leon
- Rheumatology Unit, IDISSC, San Carlos Clinical Hospital, Madrid, Spain.,Faculty of Heath Sciences, Camilo José Cela University, Madrid, Spain
| | - Marta Redondo
- Faculty of Heath Sciences, Camilo José Cela University, Madrid, Spain
| | - Antonio Fernández-Nebro
- Rheumatology Clinical Management Unit, Biomedical Research Institute in Malaga (IBIMA), Regional University Hospital in Malaga, University of Malaga, Malaga, Spain
| | - Susana Gómez
- Pfizer Medical Department, Alcobendas, Madrid, Spain
| | | | - María Montoro
- Pfizer Medical Department, Alcobendas, Madrid, Spain
| | | | - María Galindo
- Rheumatology Service, 12 de Octubre University Hospital, Av. Cordoba, s/n, 28041, Madrid, Spain.
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