Serum Vitamin D and Immunogenicity of Influenza Vaccination in the Elderly.

Vaccination is the most effective preventive measure that reduces the risk of influenza and post-influenza complications. It prevents influenza-related hospitalizations and deaths in 50-60% and about 80% of patients aged over 65, respectively. There is the clinical plausibility of the association between serum vitamin D (VIT D) content and viral respiratory infections. In this study, we addressed the issue of a vitamin D modulatory effect on the immune response to seasonal influenza vaccination in elderly persons. The study comprised 96 participants aged 60-75 during the 2016/17 epidemic season. After the determination of the baseline content of VIT D and anti-hemagglutinin antibodies (H1, H3, and HB), participants were vaccinated with a trivalent vaccine. The content of the anti-hemagglutinin antibodies was rechecked 4-5 weeks afterward, showing inappreciable alterations. The negative findings of this study make the influence of serum VIT D content on the immunogenicity of influenza vaccination highly unlikely in elderly persons.

Low-Intensity Exercise as a Modifier of Depressive Symptoms and Self-Perceived Stress Level in Women with Metabolic Syndrome.

The study aims to determine the impact of low-intensity exercise and psychoeducation on depressive symptoms and self-perceived stress in women with metabolic syndrome (MetS). Seventy-four women (mean age 69.35 ± 7.20) were included in the study. Participants were divided into two groups: those with MetS (n = 33) and those without MetS (n = 41). Subjects participated in low-intensity general-fitness exercise sessions combined with psychoeducation distributed regularly over a 12-week period. Participants completed the Geriatric Depression Scale-15 (GDS) and the Stress Level Questionnaire (SLQ) before and after the intervention. All investigated parameters significantly decreased for the participants with metabolic syndrome after the intervention. The level of GDS in this group decreased by approximately 37% (p < 0.01), and SLQ by around 23% (p < 0.01). Our results suggest, that low-intensity exercise combined with psychoeducation could lower depressive symptoms and stress level in women with MetS. However, the intervention does not lower anthropometric parameter scores.

Interventions to prevent, delay or reverse frailty in older people: a journey towards clinical guidelines.

BACKGROUND: Age-related frailty is a multidimensional dynamic condition associated with adverse patient outcomes and high costs for health systems. Several interventions have been proposed to tackle frailty. This correspondence article describes the journey through the development of evidence- and consensus-based guidelines on interventions aimed at preventing, delaying or reversing frailty in the context of the FOCUS (Frailty Management Optimisation through EIP-AHA Commitments and Utilisation of Stakeholders Input) project (664367-FOCUS-HP-PJ-2014). The rationale, framework, processes and content of the guidelines are described. MAIN TEXT: The guidelines were framed into four questions - one general and three on specific groups of interventions - all including frailty as the primary outcome of interest. Quantitative and qualitative studies and reviews conducted in the context of the FOCUS project represented the evidence base. We followed the GRADE Evidence-to-Decision frameworks based on assessment of whether the problem is a priority, the magnitude of the desirable and undesirable effects, the certainty of the evidence, stakeholders' values, the balance between desirable and undesirable effects, the resource use, and other factors like acceptability and feasibility. Experts in the FOCUS consortium acted as panellists in the consensus process. Overall, we eventually recommended interventions intended to affect frailty as well as its course and related outcomes. Specifically, we recommended (1) physical activity programmes or nutritional interventions or a combination of both; (2) interventions based on tailored care and/or geriatric evaluation and management; and (3) interventions based on cognitive training (alone or in combination with exercise and nutritional supplementation). The panel did not support interventions based on hormone treatments or problem-solving therapy. However, all our recommendations were weak (provisional) due to the limited available evidence and based on heterogeneous studies of limited quality. Furthermore, they are conditional to the consideration of participant-, organisational- and contextual/cultural-related facilitators or barriers. There is insufficient evidence in favour of or against other types of interventions. CONCLUSIONS: We provided guidelines based on quantitative and qualitative evidence, adopting methodological standards, and integrating relevant stakeholders' inputs and perspectives. We identified the need for further studies of a higher methodological quality to explore interventions with the potential to affect frailty.

Online Health Technologies and Mobile Devices: Attitudes, Needs, and Future.

Advances in mobile technology constitute a promising and evolving trend that enables better access to health care especially for the elderly, disabled, and chronically ill. It overcomes geographical, temporal, and organizational barriers at low and affordable costs. The aim of the study was to evaluate the needs and expectations of Polish citizens and their attitudes toward mobile health (mHealth) services using mobile phones and communication devices in medical care and also to evaluate the sociodemographic factors affecting such behavioral processes. A total of 1000 adults were selected from the Polish population by random sampling. The assessment was made with the use of computer-assisted telephone interview (CATI). Approximately 78% of the study participants were proficient mobile phone users with a predominance of young people. Forty-seven percent of them expressed the desire to obtain information about their health via their mobile phone if they had the opportunity to do so. Important factors associated with the aforementioned statement included younger age, being still in education, or unemployed. Among the mHealth supporters, the vast majority of people (84%) would like to receive SMS (short message service) reminders for appointments and prescribed medicines. Other favorable mHealth activities were e-registration (77.9%), viewing test results online (80.6%), or receiving basic medical recommendations (75.7%). Only 30% of the respondents had a positive attitude toward teleconsultation, while 17.8% of them were willing to pay for this option. Further research on emerging new and beneficial mHealth solutions needs to be conducted.

The Internet as a Source of Health Information and Services.

The Internet is increasingly used for health-related purposes and evolves with the ever-changing needs of patients. The aim of this study was to assess the level of reliance on the Internet as a health information source, to examine which online communication activities are the most common for health purposes, and to determine the attitudes and needs of patients in this area and the factors affecting its use. A total of 1000 adults were selected from the Polish population by random sampling. The survey was administered by the Computer-Assisted Telephone Interview (CATI). The study concluded that 76.9% of the participants used the Internet for health purposes, among whom 72.6% of active and 27.4% of passive users were distinguished. The role of the Internet as a source of health information has increased, which corresponds to a growing interest in online health services. The majority of individuals searching for health information in the Internet lived in urban areas, had a high level of education, and was professionally active. We conclude that the increased interest in the use of the Internet related to health determines the direction in which e-health should be developed in the future.

The use of technology in the context of frailty screening and management interventions: a study of stakeholders' perspectives.

BACKGROUND: Health and social care interventions show promise as a way of managing the progression of frailty in older adults. Information technology could improve the availability of interventions and services for older adults. The views of stakeholders on the acceptability of technological solutions for frailty screening and management have not been explored. METHODS: Focus groups were used to gather data from healthy and frail/pre-frail older adults, health and social care providers, and caregivers in three European countries - Italy, Poland and UK. Data were analysed using framework analysis in terms of facilitators or determinants of older adults' adoption of technology. RESULTS: Our findings clustered around the perceived value; usability, affordability and accessibility; and emotional benefits of frailty screening and management technology to stakeholders. We also noted issues relating to social support, previous experience of technology and confidence of stakeholders. CONCLUSIONS: Professionals and caregivers understand the benefits of technology to facilitate frailty care pathways but these views are tempered by concerns around social isolation. Frail older adults raised legitimate concerns about the accessibility and usability of technology, specifically around the potential for their personal information to be compromised. Solutions must be developed within a framework that addresses social contexts and avoids stigma around frailty and ageing.

Patient-centred access to health care: a framework analysis of the care interface for frail older adults.

BACKGROUND: The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system. METHODS: Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability and appropriateness. RESULTS: Generally services were approachable and acceptable, but unavailable. Poor availability related to high staff turnover, staff shortages and a lack of trained personnel. There were problems of long waiting times for specialist care and rehabilitation services, and geographically remote clinics. Critically, there were shortages of long-term inpatient care places, social care workers and caregivers. The cost of treatments created barriers to care and inequities in the system. Participants described a lack of integration between health and social care systems with differing priorities and disconnected budgets. They described an acute medical system that was inappropriate for patients with complex needs, alongside a low functioning social care system, where bureaucratisation caused delays in providing services to the vulnerable. An integrated system with a care coordinator to improve connections between services and patients was suggested. CONCLUSIONS: There is an immediate need to improve access to health and social care systems for pre-frail and frail patients, as well as their caregivers. Health and social care services need to be integrated to reduce bureaucracy and increase the timeliness of treatment and care.

Trends in the use of the Internet for health purposes in Poland.

BACKGROUND: In Poland, like in other European countries and in accordance with the global trend, the number of computer users and people who have access to the Internet has increased considerably. The study investigates trends and patterns of Polish health-related Internet use over a period of seven years. The main objective of the study was to estimate the change in the proportion of the population using Internet for health purposes and to show the potential trend in perceptions and preferences of Polish citizens in this respect as well as factors affecting their use. METHODS: The study was based on three national surveys that were conducted in 2005, 2007, and 2012. A total of 3027 adult citizens were selected randomly from the Polish population. A sample collection was carried out by Polish opinion poll agencies by computer-assisted telephone interviews. The subjects were asked to respond to general questions about their Internet use and their Internet use for health-related purposes, as well as to express their opinions about various sources of medical information, frequency, and the need for direct communication with health professionals via the Internet and other interactive forms of online activities. RESULTS: The proportion of the Polish population that used the Internet for health-related purposes increased significantly (41.7% in 2005, 53.3% in 2007, and 66.7% in 2012). The Internet has become an important source of health information for almost half of Polish citizens, overtaking television, radio, press, and courses or lectures in the ranking list. As the medium matures, the use of interactive, health-related online services has also increased remarkably. However, while the main users of the Internet are certainly younger people, the largest growth potential has been observed among the elderly. The profile of the most likely Internet user and the citizen for whom the Internet is an important source of health information has been determined. CONCLUSIONS: The Internet offers enormous opportunities, particularly for providing and improving consumer information services with regard to health care. A sharply increasing trend regarding Internet use, Internet use for health purposes, and the interactive use of the Internet related to health has been observed among Polish citizens.

Immune efficacy of first and repeat trivalent influenza vaccine in healthy subjects and hemodialysis patients.

Influenza vaccination is recommended to patients from groups at risk and to healthy persons alike. It is not completely clear whether persons vaccinated every year benefit more from the vaccination in any given season in comparison with those who are vaccinated for the first time. The aim of the study was to analyze whether influenza vaccination in previous seasons influences the response to ongoing vaccination in the healthy population and in hemodialyzed patients. The outcome measure was the production of anti-hemagglutinin antibodies in 71 hemodialyzed patients (Group A) and 63 patients of primary healthcare clinic, without chronic renal failure (Group B). The patients of these two groups were subdivided into never vaccinated before and previously vaccinated against influenza. After the current vaccination, significantly lower levels of anti-A/H1N1/ antibodies were found in the hemodialyzed compared with non-hemodialyzed previously vaccinated, but not unvaccinated, patients. The hemodialyzed patients, previously unvaccinated, had at baseline significantly lower levels of anti-A/H3N2/ and anti-B antibodies than those who were previously vaccinated; the differences were no longer significant after the current vaccination. We conclude that although antiflu immunization in previous seasons leads to higher baseline antibody titers in hemodialysis compromised patients, which is less evident in non-hemodialyzed patients, it is of little influence on the immunoresponse to current influenza vaccination, in both hemodialyzed and non-hemodialyzed patients.

Usage of medical internet and e-health services by the elderly.

Internet and e-health services have a substantial potential to support efficient and effective care for the elderly. The aim of the study was to investigate the use of Internet for health-related purposes among Polish elderly, the frequency and reasons of use, the importance of e-health services, and factors affecting their use. A total of 242 elderly at the age of ≥60 years were selected from the Polish population by random sampling. Data collection was carried out by phone interviews in October-November 2012. The study shows that the Internet was ever used by 32% of the elderly and 1/5 claimed a regular use. Among the Internet users, 81% of older people used it to obtain information about health or illness. The Internet was one of the less important sources of information (important for 27% of respondents), face to face contact with health professionals and family and friends are still the most required source of medical information (75%). Only 7% of elderly Internet users approached the family physician, specialists, or other health professionals over the Internet. Factors that positively affected the use of Internet among elderly were male gender, younger age, higher education, living with family, mobile phone use, and a subjective assessment of one's own health as good. The doctor's provision of Internet-based services was important in the opinion of approximately 1/4 of older people. We conclude that the development of information and communications technology (ICT) tools increasingly meets the evolving needs of patients in the field of e-health. More and more elderly become beneficiaries of these services.

Support for e-health services among elderly primary care patients.

BACKGROUND: E-health has a substantial potential to improve access to as well as support efficient and effective care for the elderly. Questions remain and must be addressed, however, regarding the challenges faced by the elderly in the use of this technology. The aim of the study was to assess the attitude (needs) and preferences of the elderly in a selected region of Poland regarding selected e-health services and the factors associated with them. MATERIALS AND METHODS: The study was conducted among 286 patients over 60 years of age being served by general practitioners in southwest Poland's Lower Silesia Province. The assessment pertaining to e-health was based on a specially designed questionnaire. RESULTS: Nearly one-third of the study respondents had a computer at home, and 61% of these (19% of all surveyed elderly) used it. Twenty-two percent of respondents used the Internet, at least occasionally, whereas 62% used mobile phones. Approximately 41% (n=116) of the elderly had a favorable attitude toward e-health services (labeled here as supporters) and were willing to use it if/when offered an opportunity to do so. A substantial majority (84%) of supporters expressed a desire to receive simple medical recommendations via mobile phone or a computer, although significant majorities (61% and 60%, respectively) would like to receive the results of tests by e-mail or short message service reminders for scheduled visits or prescribed medications. Slightly less than half (47%) of e-health supporters would request appointments online. Among the more important factors associated with support of e-health services were urban residence, higher education, and normal cognitive function, as well as having a computer, Internet access, or a mobile phone. CONCLUSIONS: The majority of elderly patients in this Polish community are not overly enthusiastic about using information and communications technology tools in their healthcare. Nevertheless, a substantial percentage (41%) among this group support selected e-health services.

Implementing an Early Detection Program for Autism Spectrum Disorders in the Polish Primary Healthcare Setting-Possible Obstacles and Experiences from Online ASD Screening.

A screening questionnaire for autism symptoms is not yet available in Poland, and there are no recommendations regarding screening for developmental disorders in Polish primary healthcare. The aim of this study was to assess the opinions of parents and physicians on the legitimacy and necessity of screening for autism spectrum disorders, potential barriers to the implementation of the screening program, and the evaluation and presentation of the process of online ASD screening, which was part of the validation program for the Polish version of one of the screening tools. This study involved 418 parents whose children were screened online and 95 primary care physicians who expressed their opinions in prepared surveys. The results indicate that both parents and doctors perceive the need to screen children for ASD in the general population without a clear preference as to the screening method (online or in person). Moreover, online screening is considered by respondents as a satisfactory diagnostic method. Therefore, online screening may prove to be at least a partial method of solving numerous obstacles indicated by participants' systemic difficulties including time constraints, the lack of experienced specialists in the field of developmental disorders and organizational difficulties of healthcare systems.

Does it make sense to use written instruments to assess communication skills? Systematic review on the concurrent and predictive value of written assessment for performance.

OBJECTIVES: To evaluate possible associations between learners' results in written and performance-based assessments of communication skills (CS), either in concurrent or predictive study designs. METHODS: Search included four databases for peer-reviewed studies containing both written and performance-based CS assessment. Eleven studies met the inclusion criteria. RESULTS: Included studies predominantly assessed undergraduate medical students. Studies reported mainly low to medium correlations between written and performance-based assessment results (Objective Structured Clinical Examinations or encounters with simulated patients), and gave correlation coefficients ranging from 0.13 to 0.53 (p < 0.05). Higher correlations were reported when specific CS, like motivational interviewing were assessed. Only a few studies gave sufficient reliability indicators of both assessment formats. CONCLUSIONS: Written assessment scores seem to predict performance-based assessments to a limited extent but cannot replace them entirely. Reporting of assessment instruments' psychometric properties is essential to improve the interpretation of future findings and could possibly affect their predictive validity for performance. PRACTICE IMPLICATIONS: Within longitudinal CS assessment programs, triangulation of assessment including written assessment is recommended, taking into consideration possible limitations. Written assessments with feedback can help students and trainers to elaborate on procedural knowledge as a strong support for the acquisition and transfer of CS to different contexts.

Tools for early screening of autism spectrum disorders in primary health care - a scoping review.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests itself in early childhood. Early diagnosis of these disorders allows for the initiation of early therapy, which is crucial for the child's further functioning in society. OBJECTIVES: This review aims to gather and present the existing ASD screening tools that can be used in primary care and adapted to different countries conditions linguistically and culturally. ELIGIBILITY CRITERIA: We searched for English-language publications on ASD screening tools for children aged 0-3 years suitable for use in primary care (i.e. free, requiring no additional training or qualifications). SOURCES OF EVIDENCE: Four databases were explored to find English studies on ASD screening tools intended for the rapid assessment of children aged 0-3. CHARTING METHODS: The information sought (specific features of the questionnaires relevant to primary health care workers, psychometric and diagnostic values of a given cultural adaptation of screening tools, and the linguistic and cultural changes made) were extracted and collected to create profiles of these tools. RESULTS: We found 81 studies which met inclusion criteria and underwent full data extraction. Three additional data sources were included. These allowed to create 75 profiles of adaptations for 26 different screening tools and collect data on their psychometric values and characteristic features. CONCLUSIONS: The results of our study indicate the availability of several diagnostic tools for early ASD screening in primary care setting concordant culturally and linguistically with a given population. They could be an effective method of accelerating the diagnostic process and starting personalized therapy faster. However, most tools have significant limitations - some are only available for research purposes, while others do not have scientific evidence to prove their effectiveness.

Perception and Attitude toward Teleconsultations among Different Healthcare Professionals in the Era of the COVID-19 Pandemic.

Teleconsultation has become one of the most important and sometimes the only possible forms of communication between healthcare professionals (HCPs) and their patients during the COVID-19 pandemic. The perceptions and attitudes of HCPs to teleconsultations may affect the quality of the therapeutic process provided using them. Therefore, this study aimed to understand the attitudes to and perceptions of medical teleconsultation among various HCPs during the COVID-19 pandemic. We analyzed data from a dedicated questionnaire on preferences, attitudes, and opinions about teleconsultation, which was filled by 780 Polish HCPs. Most of the HCPs were doctors and nurses (69% and 19%, respectively); most of the doctors were family physicians (50.1%). During the pandemic, teleconsultation and face-to-face contact were reported as the preferred methods of providing medical services with similar frequency. Doctors and nurses displayed the most positive attitude toward teleconsultation while the paramedics and physiotherapists took the least positive view of it. The most frequently indicated ratio of the optimal number of teleconsultations to in-person visits in primary health facilities care was 20%:80%. Most HCPs appreciate the value of teleconsultation, and more than half of them are willing to continue this form of communication with the patient when necessary or desirable.

What do we know about written assessment of health professionals' communication skills? A scoping review.

OBJECTIVE: The aim of this scoping review was to investigate the published literature on written assessment of communication skills in health professionals' education. METHODS: Pubmed, Embase, Cinahl and Psychnfo were screened for the period 1/1995-7/2020. Selection was conducted by four pairs of reviewers. Four reviewers extracted and analyzed the data regarding study, instrument, item, and psychometric characteristics. RESULTS: From 20,456 assessed abstracts, 74 articles were included which described 70 different instruments. Two thirds of the studies used written assessment to measure training effects, the others focused on the development/validation of the instrument. Instruments were usually developed by the authors, often with little mention of the test development criteria. The type of knowledge assessed was rarely specified. Most instruments included clinical vignettes. Instrument properties and psychometric characteristics were seldom reported. CONCLUSION: There are a number of written assessments available in the literature. However, the reporting of the development and psychometric properties of these instruments is often incomplete. Practice implications written assessment of communication skills is widely used in health professions education. Improvement in the reporting of instrument development, items and psychometrics may help communication skills teachers better identify when, how and for whom written assessment of communication should be used.

Informed citizen and empowered citizen in health: results from an European survey.

BACKGROUND: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals' control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. METHODS: Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens' attitudes and behavior towards health professionals and health systems. RESULTS: Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. CONCLUSIONS: The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways.

The impact of telehome care on health status and quality of life among patients with diabetes in a primary care setting in Poland.

BACKGROUND: Telehome care has been proposed as a solution to the challenges of providing effective and affordable care for patients with diabetes. METHODS: A total of 100 adult patients with type 2 diabetes-divided between insulin and noninsulin requiring-was enrolled in a randomized, controlled trial aimed at investigating the effects of telehome monitoring. The experimental group (n = 50) received an in-home wireless glucose monitor and transmitter, whereas the control group (n = 50) was instructed to follow the conventional arrangement. RESULTS: There was an overall reduction in HbA1c values in both experimental and control groups after 6 months. A significant difference in HbA1c values between the groups was observed only among the noninsulin-requiring patients (decline from 6.95% ± 0.82% to 6.66% ± 0.86% in IB vs. 7.21% ± 2.02% to 7.2% ± 1.86% in IIB; p = 0.02). The experimental group reported considerably less hyperglycemic and hypoglycemic events. The profile of the patient who benefited the most from telemonitoring consisted of older, more educated patient who had acquired the disease relatively recently, and who spends most of the time at home. The experimental group had higher overall scores on quality of life measures and sense of control over diabetes. There was a positive association between educational attainment and ability to use the telemonitoring system without help (p = 0.045). CONCLUSIONS: Although not conclusive because of the small sample and short observation period, the study suggests that telehome monitoring is an effective tool in controlling type 2 diabetes in a primary care setting.

Online communication between doctors and patients in Europe: status and perspectives.

BACKGROUND: Use of the Internet for health purposes is steadily increasing in Europe, while the eHealth market is still a niche. Online communication between doctor and patient is one aspect of eHealth with potentially great impact on the use of health systems, patient-doctor roles and relations and individuals' health. Monitoring and understanding practices, trends, and expectations in this area is important, as it may bring invaluable knowledge to all stakeholders, in the Health 2.0 era. OBJECTIVE: Our two main goals were: (1) to investigate use of the Internet and changes in expectations about future use for particular aspects of communication with a known doctor (obtaining a prescription, scheduling an appointment, or asking a particular health question), and (2) to investigate how important the provision of email and Web services to communicate with the physician is when choosing a new doctor for a first time face-to-face appointment. The data come from the second survey of the eHealth Trends study, which addressed trends and perspectives of health-related Internet use in Europe. This study builds on previous work that established levels of generic use of the Internet for self-help activities, ordering medicine or other health products, interacting with a Web doctor/unknown health professional, and communicating with a family doctor or other known health professional. METHODS: A representative sample of citizens from seven European countries was surveyed (n = 7022) in April and May of 2007 through computer-assisted telephone interviews (CATI). Respondents were questioned about their use of the Internet to obtain a prescription, schedule an appointment, or ask a health professional about a particular health question. They were also asked what their expectations were regarding future use of the Internet for health-related matters. In a more pragmatic approach to the subject, they were asked about the perceived importance when choosing a new doctor of the possibility of using email and the Web to communicate with that physician. Logistic regression analysis was used to draw the profiles of users of related eHealth services in Europe among the population in general and in the subgroup of those who use the Internet for health-related matters. Changes from 2005 to 2007 were computed using data from the first eHealth Trends survey (October and November 2005, n = 7934). RESULTS: In 2007, an estimated 1.8% (95% confidence interval [CI], 1.5 - 2.1) of the population in these countries had used the Internet to request or renew a prescription; 3.2% (95% CI 2.8 - 3.6) had used the Internet to schedule an appointment; and 2.5% (95% CI 2.2 - 2.9) had used the Internet to ask a particular health question. This represents estimated increases of 0.9% (95% CI 0.5 - 1.3), 1.7% (95% CI 1.2 - 2.2), and 1.4% (95% CI 0.9 - 1.8). An estimated 18.0% (95% CI 17.1 - 18.9) of the populations of these countries expected that in the near future they would have consultations with health professionals online, and 25.4% (95% CI 24.4 - 26.3) expected that in the near future they would be able to schedule an appointment online. Among those using the Internet for health-related purposes, on average more than 4 in 10 people considered the provision of these eHealth services to be important when choosing a new doctor. CONCLUSIONS: Use of the Internet to communicate with a known health professional is still rare in Europe. Legal context, health policy issues, and technical conditions prevailing in different countries might be playing a major role in the situation. Interest in associated eHealth services is high among citizens and likely to increase.

Access to an Electronic Health Record: A Polish National Survey.

In Poland, as in many countries around the world, e-health services are becoming more and more popular. Obligatory e-sick leave was implemented, followed by e-prescriptions and e-referrals. Therefore, it is worth considering the introduction of a complete electronic health record (EHR) that can be accessed by doctors and patients. The main aim of the study is to find out whether patients want to have access to their EHRs and if they would agree to pay for such a service. The research was based on three surveys conducted among 1000 Polish adults in 2007, 2012, and 2018. The sample collection was carried out by the national opinion poll agency, with the use of computer-assisted telephone interviews. Over 60% of respondents were interested in the possibility of accessing EHRs in general, and almost 50% of them were ready to pay for it. Nevertheless, when analyzing all the year-on-year trends, they were subject to a gradual decrease. The youngest age group was the one most interested in EHRs, while the group comprising respondents in middle age was the one mostwilling to pay for it. There is still great potential in implementing EHRs on a bigger scale.