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1.
Neurol India ; 70(5): 2003-2008, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36352601

RESUMEN

Background: Telemedicine (TM) consultations have shown to be feasible for the management of neurological conditions including movement disorders. In contrast, satisfaction with such consultations have been less studied. Objective: To assess the satisfaction of persons with a movement disorder with a TM consultation in comparison to previous experiences in face-to-face visits. Subjects and Methods: A cross-sectional multicenter study was carried out. Persons with a diagnosis of a movement disorder underwent a TM consultation. After the consultation concluded, a satisfaction survey was sent for the subject to fill out anonymously. The survey included ease of use-related items, setup-related items, and quality-of-service-related items. Results: A total of 175 survey responses were received (response rate of 71.4%), all of which were included for analysis. A total of 102 subjects considered that the TM consultation involved much less time in comparison to their previous experience with face-to-face visits. Overall, 96% reported to be satisfied with the consultation. In addition, 92% were satisfied or very satisfied with the neurologist ability to communicate recommendations. Furthermore, 93.7% indicated that the consultation was valuable, and 90.9% considered that they would recommend teleconsultation to another patient. Conclusion: Patients with a diagnosis of a movement disorder consider TM as a convenient and potential tool for health services with a high level of satisfaction.


Asunto(s)
COVID-19 , Temblor Esencial , Trastornos Parkinsonianos , Consulta Remota , Telemedicina , Humanos , Pandemias , Satisfacción Personal , Estudios Transversales , Temblor Esencial/diagnóstico , Temblor Esencial/terapia , Estudios de Seguimiento , Satisfacción del Paciente , Trastornos Parkinsonianos/diagnóstico , Trastornos Parkinsonianos/terapia
2.
Can Respir J ; 2022: 2423272, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36353446

RESUMEN

Introduction: This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods: A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results: In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 (p < 0.001). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions: Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.


Asunto(s)
Médicos , Neumología , Consulta Remota , Humanos , Consulta Remota/métodos , Análisis Costo-Beneficio , Pacientes Ambulatorios , Derivación y Consulta , Electrónica
3.
Arq Neuropsiquiatr ; 80(9): 914-921, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36261128

RESUMEN

BACKGROUND: Telemedicine for patients with parkinsonism is feasible, cost-effective and satisfactory. However, the feasibility of this modality of care for this subpopulation is not known in real-life scenarios of developing countries like Brazil. OBJECTIVE: To evaluate the feasibility of telemedicine for patients with parkinsonism in a developing country. METHODS: A cross-sectional study with patients with parkinsonism treated in the Brazilian public healthcare system. We included 130 patients, who were contacted by telephone; those who could be reached underwent a structured interview for data collection. The primary outcomes were the feasibility of teleconsultations and video consultations, but we also performed a logistic regression regarding the feasibility of a video consultation and associated factors. RESULTS: Telemedicine was feasible and accepted by 69 (53.08%) patients regarding teleconsultations and by 50 (38.5%) patients regarding video consultations. Teleconsultations were feasible for 80.2%, and video consultations were feasible for 58.1% of the patients reachable through telephone calls. Having a higher family income was positively correlated with the feasibility for a video consultation while a negative association was observed regarding being married or in a stable union and having a low level of schooling. CONCLUSIONS: A significant proportion of patients with parkinsonism in a developing country are unreachable, unwilling, or unable to participate in telemedicine. Among the reachable patients, feasibility is higher but still lower than what is reported in studies in developed countries. Family income, level of schooling, and marital status were associated with the feasibility of video consultations.


ANTECEDENTES: A telemedicina para pacientes com parkinsonismo é viável, econômica e satisfatória. No entanto, a viabilidade dessa modalidade de atendimento para essa subpopulação não é conhecida no cenário da vida real de países em desenvolvimento como o Brasil. OBJETIVO: Avaliar a viabilidade da telemedicina para pacientes com parkinsonismo em um país em desenvolvimento. MéTODOS: Estudo transversal com pacientes com parkinsonismo atendidos na rede pública de saúde brasileira. Foram incluídos 130 pacientes, que foram contatados por telefone; os que responderam foram submetidos a uma entrevista estruturada para coleta de dados. Os resultados primários foram a viabilidade para teleconsultas e videoconsultas, mas também foi realizada uma regressão logística entre a viabilidade de uma videoconsulta e fatores associados. RESULTADOS: A participação em telemedicina era possível ou consentida por 69 (53,08%) dos pacientes com relação a teleconsultas, e por 50 (38,5%) com relação a videoconsultas. As teleconsultas e videoconsultas eram viáveis para 80,2% e 58,1% dos pacientes acessíveis por telefone, respectivamente. Uma maior renda familiar foi positivamente correlacionada com a viabilidade de uma videoconsulta, enquanto uma associação negativa foi observada com relação a ser casado ou estar em união estável e ter baixo grau de escolaridade. CONCLUSõES: Uma proporção significativa de pacientes com parkinsonismo em um país em desenvolvimento é inacessível, não quer, ou não pode participar da telemedicina. Entre os pacientes contatáveis, a viabilidade é maior, mas ainda menor do que a relatada em estudos em países desenvolvidos. Renda familiar, escolaridade e estado civil foram associados à viabilidade das videoconsultas.


Asunto(s)
Trastornos Parkinsonianos , Consulta Remota , Telemedicina , Humanos , Brasil , Estudios de Factibilidad , Salud Pública , Estudios Transversales , Trastornos Parkinsonianos/terapia
4.
J Med Internet Res ; 24(10): e38267, 2022 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-36287609

RESUMEN

BACKGROUND: Telemedicine is becoming routine in health care. Postpandemic, a universal return to face-to-face consultations may risk a loss of some of the advantages of telemedicine. However, rapid implementation and adoption without robust evaluation of usability, efficacy, and effectiveness could potentially lead to suboptimal health outcomes and downstream challenges to providers. OBJECTIVE: This review assesses telemedicine interventions against international guidance and sufficiency of evidence to support postpandemic utilization in pediatric settings. METHODS: This scoping review was performed following searches on PubMed, Embase, and CINAHL databases on April 15, 2021, and May 31, 2022, and examined studies focused on telemedicine, remote consultation, video call, or remote patient monitoring in children (0-18 years) receiving outpatient care for diabetes, asthma, epilepsy, or renal disease. Exclusion criteria included studies published before 2011 as the technologies used have likely been improved or replaced, studies in adult populations or where it was not possible to disaggregate data for participants younger than 18 years as the focus of the review was on pediatric care, and studies not published in English. Data were extracted by 4 authors, and the data were corroborated by a second reviewer. Studies were examined for feasibility and usability, clinical and process outcomes, and cost-effectiveness. RESULTS: Of the 3158 studies identified, 56 were suitable for final inclusion and analysis. Data on feasibility or usability of interventions (48 studies) were overwhelmingly positive in support of telemedicine interventions, with common themes including convenience, perceived cost savings, and ease of use. However, use in preference to usual care was rarely explored. Clinical and process outcome data (31 studies) were mostly positive. Across all studies, there was limited measurement of standardized clinical outcomes, although these were more commonly reported in asthma (peak flow) and diabetes (glycated hemoglobin [HbA1c]). Implementation science data generally supported cost-effectiveness of telemedicine with a reduction of health care costs. CONCLUSIONS: There is promising evidence supporting telemedicine in pediatric settings. However, there is a lack of evaluation of telemedicine in comparison with usual outpatient care for noninferiority of clinical outcomes, and this review highlights the need for a more standardized approach to evaluation of digital interventions.


Asunto(s)
Asma , Diabetes Mellitus , Consulta Remota , Telemedicina , Adulto , Humanos , Niño , Hemoglobina A Glucada , Asma/terapia
5.
Rural Remote Health ; 22(4): 7196, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36260933

RESUMEN

INTRODUCTION: Remote consultations help reduce contact between people and prevent cross-contamination. Little is known about the changes in consultation in European rural primary care during the SARS-CoV-2 (COVID-19) pandemic. The purpose of this mixed-methods cross-sectional study was to find out more about the effects of the pandemic on changes in patient consultations in European rural primary care. METHODS: A key informant survey from 16 member countries of the European Rural and Isolated Practitioners Association (EURIPA) was undertaken using a self-developed questionnaire. The steering committee of this project, called EURIPA Covid-19 study, developed a semi-structured questionnaire with 68 questions, 21 of which included free-text comments. Proportions were calculated for dichotomized or categorized data, and means were calculated for continuous data. Multivariate analysis by logistic regression model was used to assess the association of multiple variables. RESULTS: A total of 406 questionnaires from primary care providers (PCPs) in 16 European countries were collected; 245 respondents (60.5%) were females, 152 PCPs were rural (37.5%), 124 semi-rural (30.5%). Mean age of the respondents was 45.9 years (standard deviation (SD) 11.30) while mean seniority (length of experience) was 18.2 years (SD 11.6). A total of 381 (93.8%) respondents were medical doctors. Significant differences were found between countries in adopting alternative arrangements to face-to-face consultation: remote teleconsultation is well appreciated by both healthcare professionals and patients, but the most common way of remote consultation remains telephone consultation. A factor significantly inversely associated with the adoption of video consultation was the seniority of the PCP (odds ratio 1.19, 95% confidence interval 1.02-1.40, p=0.03). CONCLUSION: Telephone consultation is the most common form of remote consultation. The adoption of video-consultation is inversely related to the seniority of the informants.


Asunto(s)
COVID-19 , Consulta Remota , Telemedicina , Femenino , Humanos , Persona de Mediana Edad , Masculino , Pandemias , SARS-CoV-2 , Estudios Transversales , Teléfono , Telemedicina/métodos
6.
Int J Med Inform ; 168: 104867, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36228416

RESUMEN

BACKGROUND: The COVID-19 pandemic accelerated efforts to deploy and regulate medical teleconsultation in Brazil. Studying the Brazilian Unified Public Health System (SUS) experiences in implementing teleconsultations can help to inform their sustainability. This study identifies the changes required to integrate specialized teleconsultation in local workflows in SUS. METHODS: A case study of teleconsultation performed by a University Hospital and a Municipal Specialty Outpatient Clinic in the south of Brazil collected information from two focus groups with specialised doctors, two key informant interviews and associated documents. The Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework domains of condition, technology, proposal value, users and organization informed a qualitative thematic analysis of this data. RESULTS: Several forms of teleconsultation were used to manage paediatrics and endocrine conditions including instant messaging, WhatsApp, telephone calls and video consultations which were also used for dermatology. In Brazil, telephone interactions are not considered teleconsultation. In contrast, video consultations were longer than face-to-face appointments, facilitate the understanding and evaluation of conditions, and offered continuity of care, comfort, and safety, without the need for patients to travel, reducing the risk of infection. Patients accepted video consultations to varying degrees but some found it difficult to use the technology. The willingness of doctors to provide any form of teleconsultation was important. Management support was key to defining workflows, coordinating care pathways, and providing technical support. CONCLUSIONS: This study highlights particularities of teleconsultation uptake for the included specialities. The NASSS framework provides a useful means of identifying the changes to enable teleconsultation continuity for specialised care in SUS.


Asunto(s)
COVID-19 , Consulta Remota , Humanos , Niño , Pandemias , Brasil , Personal de Salud
7.
Dermatologie (Heidelb) ; 73(11): 859-865, 2022 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-36149473

RESUMEN

BACKGROUND: With increasing shortage of medical personnel also in the medical care in German correctional facilities, telemedicine has been used since 2016, initially in projects and then for regular medical care. Since 2019, there is the possibility of dermatological expertise in regular video consultations. OBJECTIVE: The benefits of an interdisciplinary online consultation with video and store and forward technology for dermatological issues are highlighted in terms of efficiency and feasibility. MATERIAL AND METHODS: A descriptive analysis of 450 dermatological video consultations for German correctional facilities from February 2020 to July 2022 was carried out with respect to procedures, indications and demand. RESULTS: Requests were made via a standardised form with optional photographs, which were sent via a secure cloud to the dermatology department in store and forward mode. The majority of cases could be presented live in a regular weekly video consultation and only single cases required an acute presentation within 24 h. The spectrum of skin diseases was comparable to cases presenting to a dermatology outpatient clinic. The interdisciplinary consultation management together with colleagues from general medicine enabled the transfer of the cases to the medical personnel at the correctional facility on site for follow-up and further medical procedures. Treatment could be started in all cases without delay. CONCLUSION: Teledermatology represents an important contribution to medical care in German correctional facilities and the interdisciplinary cooperation saves time and resources in the presentation and treatment of skin diseases.


Asunto(s)
Dermatología , Consulta Remota , Enfermedades de la Piel , Telemedicina , Humanos , Dermatología/métodos , Prisiones , Consulta Remota/métodos , Enfermedades de la Piel/diagnóstico , Telemedicina/métodos
8.
Int J Med Inform ; 167: 104861, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36067628

RESUMEN

OBJECTIVES: Long-term care combined with complex follow-up processes is among the essential needs of lung transplantation. Therefore, Telemedicine-based strategies can provide an effective approach for both patients and clinicians by applying remote patient monitoring. Hence, the main objective of this study was to investigate Telemedicine and telehealth usage in lung transplantation. METHOD: A systematic review was conducted in four databases using keywords. Eligible studies were all English papers that developed Telemedicine-based programs to enhance patient care in lung organ transplantation. The interventions were analyzed analysis to determine the main descriptive areas. The quality of the included articles was evaluated using Mixed Methods Appraisal Tool (MMAT) tool by two authors. RESULTS: Of the 261 retrieved articles, 27 met our inclusion criteria. Of these, 22 studies were devoted to the post-transplantation phase. All articles were published from 2002 to 2021 and the trend of publications has increased in recent years. Most of the studies were conducted in the United States and Canada. All eligible studies can be categorized into five types of Telemedicine interventions, 15 (55.56%) articles devoted to Telemonitoring, four (14.81%) for Teleconsultation, four (14.81%) articles for Telerehabilitation, three (11.11%) articles for Telespirometery, and one (3.70%) article were done regarding Tele-education. CONCLUSION: This integrated review provides researchers with a new understanding of Telemedicine-based care solutions. Findings show that remote patient care in lung transplantation includes various aspects, especially self-care improvement.


Asunto(s)
Trasplante de Pulmón , Consulta Remota , Telemedicina , Humanos , Monitoreo Fisiológico , Atención Dirigida al Paciente , Telemedicina/métodos , Estados Unidos
9.
Stud Health Technol Inform ; 298: 142-146, 2022 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-36073473

RESUMEN

Teleconsultation has become a new means of using care which has taken off significantly since the COVID crisis, The pooling of the technological environment within the TC makes it possible to set up practice reviews by reusing the data collected. Our aim was to evaluate the relevance of antibiotic therapy during teleconsultations carried out on the national teleconsultation platform "Qare" in 4 common infections. 143,428 TCs with structured prescriptions were analyzed, with an appropriate prescription in more than 82% of cases, higher than in the literature. The use of data makes it possible to quickly assess practices and inform doctors to improve their practices.


Asunto(s)
COVID-19 , Médicos , Consulta Remota , Antibacterianos/uso terapéutico , COVID-19/tratamiento farmacológico , Humanos , Prescripciones
10.
Health Policy ; 126(10): 933-944, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36050194

RESUMEN

The COVID-19 pandemic has boosted the adoption of digital health technologies such as teleconsultation. This research aimed to assess and compare barriers and facilitators for teleconsultation uptake for primary care practitioners in Hong Kong and the Netherlands and evaluate the role of their different healthcare funding models in this adoption process within the context of the COVID-19 pandemic. A qualitative research following a social constructivist paradigm was performed. The study employed a conceptual framework from Lau and colleagues that identifies four levels of factors influencing change in primary care: (1) external contextual factors; (2) organization-related factors; (3) professional factors; and (4) characteristics of the intervention. The four levels were studied through semi-structured, open-ended interviews with primary care physicians. External factors were additionally assessed by means of a literature review. Hong Kong and the Netherlands showed different penetration rates of teleconsultation. Most stakeholders in both settings shared similar barriers and facilitators in the organizational, professional, and intervention levels. However, external contextual factors (i.e., current teleconsultation legislation, available incentives, and level of public awareness) played an important and differing role in teleconsultation uptake and had a direct effect on the organization, the professionals involved, and the type of technology used. Political and organizational actions are required to develop a comprehensive legal framework for the sustainable development of teleconsultation in both settings.


Asunto(s)
COVID-19 , Consulta Remota , Hong Kong , Humanos , Países Bajos , Pandemias , Atención Primaria de Salud , Investigación Cualitativa
11.
Artículo en Inglés | MEDLINE | ID: mdl-36150178

RESUMEN

Objective: To assess user perception regarding different aspects of the telepsychiatry process.Methods: This cross-sectional survey study was conducted between July and September 2020 with follow-up patients attending teleconsultation at a tertiary care center (N = 108). The online survey included questions about the user's experience such as the appointment process and different aspects of teleconsultation, as well as perceived benefits, difficulties experienced, and suggestions for improvement. The sociodemographic and clinical data were retrieved from the electronic record.Results: The majority of patients expressed satisfaction with teleconsultation. The patients who were living far from the center (> 100 km) and those with psychotic illness favored telepsychiatry. Patients with nonpsychotic illnesses reported significantly less satisfaction with counseling in teleconsultation.Conclusions: The findings substantiate the acceptance of telepsychiatry services and emphasize the need for a tailor-made hybrid form of consultation as per the patient's profile.


Asunto(s)
Psiquiatría , Consulta Remota , Telemedicina , Estudios Transversales , Humanos , Satisfacción del Paciente , Percepción , Teléfono
12.
Can J Surg ; 65(5): E643-E649, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36170983

RESUMEN

BACKGROUND: Increasing strain on public health resources in Canada, in particular with respect to accessing specialist care, necessitates the exploration of alternative models of care. The aim of this study was to assess the efficacy of electronic consultation (eConsult) in providing orthopedic surgery specialist service to patients in the Champlain Local Health Integration Network (LHIN) of Ontario. METHODS: This was a cross-sectional review of all 564 Champlain LHIN orthopedic surgery referral requests received via the Champlain Building Access to Specialist service through the eConsult (BASE) system in 2017. Primary outcome measures were impact on primary care provider (PCP) referral pattern and time to receive orthopedic consultation. RESULTS: eConsult prevented unnecessary in-person consultation 64% of the time, while PCP referral decisions were modified 51% of the time. Of all eConsults, 94% were rated as valuable to PCPs in their practice and 97% of eConsults resulted in actionable advice. eConsults took an average of 14.5 minutes of specialist time to complete, and the mean time from referral to response was 3.7 days. CONCLUSION: The eConsult system spares unnecessary consultation to orthopedic surgery; catches important referrals that would have otherwise been missed; saves time for patients, PCPs and orthopedic surgeons; and improves efficiency in a socialized health care system.


Asunto(s)
Atención Primaria de Salud , Consulta Remota , Estudios Transversales , Accesibilidad a los Servicios de Salud , Humanos , Ontario , Derivación y Consulta , Consulta Remota/métodos
13.
Artículo en Inglés | MEDLINE | ID: mdl-36141806

RESUMEN

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.


Asunto(s)
COVID-19 , Consulta Remota , Actitud , COVID-19/epidemiología , Humanos , Pandemias , Percepción
14.
Trials ; 23(1): 814, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-36167557

RESUMEN

BACKGROUND: Increasing life expectancy is associated with a growing number of people living in nursing homes, while the availability of outpatient medical care, especially from family doctors, is stagnating in this sector. Consequently, numerous and often avoidable, low-threshold hospitalizations of nursing home residents are observed. This results in unnecessary use of resources such as emergency services and emergency rooms as well as in potential health risks to the nursing home residents related to hospitalization. This study aims to improve this healthcare gap by implementing an intersectoral telemedicine approach. METHODS: Twenty-five nursing homes are participating and provided with telemedical equipment to perform teleconsultations. Additionally, an early warning system and a digital patient record system are implemented. Telephysicians based at RWTH Aachen University Hospital are ready to support the nursing homes around the clock if the family doctor or an emergency service practice is not available in time. Mobile non-physician practice assistants from the telemedicine centre can be dispatched to perform delegable medical activities. General practitioners and the medical emergency practices also have access to the telemedical infrastructure and the non-physician practice assistants. DISCUSSION: Optimal@NRW adds a telemedicine component to standard care - combining elements of outpatient and inpatient health care as well as emergency service practices - to enable timely medical consultation for nursing home residents in case of the development of an acute medical condition. In addition to optimized medical care, the goal is to reduce unnecessary hospital admissions. The intersectoral approach allows for the appropriate use of resources to match the individually needed medical treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04879537 . Registered on May 10, 2021.


Asunto(s)
Servicios Médicos de Urgencia , Consulta Remota , Telemedicina , Servicios Médicos de Urgencia/métodos , Hospitalización , Humanos , Casas de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto
15.
Multimedia | Recursos Multimedia | ID: multimedia-9884

RESUMEN

A AMHB agrade a participação dos doutores: Dr. Carlos Michaelis: Advogado Especialista em Direito Médico, consultor em telemedicina e Assessor do CREMESP. Dr.Sílvio Eduardo Valente: Médico, advogado e perito Médico. Doutor em Biodireito pela USP. Presidente da comissão de Direito Médico da OAB-SP (2014-2018).


Asunto(s)
Consulta Remota/legislación & jurisprudencia , Telemedicina/legislación & jurisprudencia , Promoción de la Salud , COVID-19/prevención & control
16.
Artículo en Inglés | MEDLINE | ID: mdl-36011421

RESUMEN

Telemedicine is becoming a standard method of consultation, and the COVID-19 pandemic has increased its need. Telemedicine is suitable for non-communicable diseases (NCDs) in the pediatric population, as these are chronic conditions that affect many children worldwide. The aim of this study was to analyze the bibliometric parameters of publications on the use of telemedicine for the most common NCDs in children before and after the COVID-19 pandemic. Following the electronic search, 585 records were selected. "Metabolic diseases" was the most frequent topic before and after the pandemic, accounting for 34.76% in 2017-2019 and 33.97% in 2020-2022. The average IF of the journals from which records were retrieved was 5.46 ± 4.62 before and 4.58 ± 2.82 after the pandemic, with no significant variation. The number of citations per reference averaged 14.71 ± 17.16 in 2017-2019 (95% CI: 12.07; 17.36) and 5.54 ± 13.71 in 2020-2022 (95% CI: 4.23; 6.86). Asthma, metabolic diseases, and neurodevelopmental disorders were the most explored topics. A relevant finding concerns the increasing number of observational studies after the pandemic, with a reduction of the interventional studies. The latter type of study should be recommended as it can increase the evaluation of new strategies for the management of NCDs.


Asunto(s)
COVID-19 , Consulta Remota , Telemedicina , Bibliometría , COVID-19/epidemiología , Niño , Humanos , Pandemias , Telemedicina/métodos
17.
Bull Cancer ; 109(10): 1051-1058, 2022 Oct.
Artículo en Francés | MEDLINE | ID: mdl-35995614

RESUMEN

RATIONAL: Teleconsultation (TLC) practice, which suddenly arrived in the cancer patients care, has experienced an undeniable quantitative boom given the health context. A quantitative and qualitative assessment of this practice now seems necessary. This study aims to describe the use of TLC by oncologists in the Auvergne-Rhône-Alpes region during the pandemic in order to assess its advantages and limits, and to estimate the barriers encountered and the possible levers for its promotion in oncology. METHOD: The use of TLC in daily medical practice was evaluated using a descriptive observational survey from October to December 2021. Health's professionals were invited to answer an online survey composed of around thirty questions. RESULTS: Of the 200 oncologists contacted, 72 took part in the survey. Among them, 64 have already made at least one TLC. TLCs represented 25 % of consultations during the confinement period. New cancer patients, the fact of not seeing the patient physically and the absence of the possibility of carrying out a physical examination are the 3 main obstacles to TLC. The mastery of computer tools is one of the main levers. All cancer patients appear eligible for TLC ; the professionals surveyed prefer this solution for certain socio-demographic and medical characteristics of the patients (the fact of living far from the cancer centre, of having a stable clinical situation, of being under surveillance or being treated with oral anti-cancer drugs…). Despite a median level of satisfaction of 63 % estimated by doctors, less than 10 % of medical consultations are currently kept in TLC. CONCLUSION: TLC is now an integrated practice in oncology but seems more relevant for a specific patient profile and clinical situation. In addition, technical and training constraints still limit its use in clinical practice today.


Asunto(s)
Antineoplásicos , Neoplasias , Consulta Remota , Humanos , Oncología Médica , Neoplasias/terapia , Pandemias , Encuestas y Cuestionarios
18.
Curr Oncol ; 29(8): 5566-5578, 2022 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-36005177

RESUMEN

BACKGROUND: Since cancer pain requires complex modalities of care, the proper strategy for addressing its telemedicine-based management should be better defined. This study aimed to trace a pathway for a progressive implementation of the telemedicine process for the treatment of pain in the setting of cancer patients. METHODS: The features of the model were investigated to dissect the dropout from the telemedicine pathway. A cross-sectional patient satisfaction study was conducted. The degree of satisfaction was evaluated through a developed 22-item questionnaire (Likert scale 0-7). RESULTS: A total of 375 video consultations for 164 patients (mean age 62.9 years) were performed through remote consultations for cancer pain management between March 2021 and February 2022. After the exclusion of 72 patients, 92 (56.1%) were included in the analysis. The dropout ratio was 8.7%. The number of visits and pharmacological therapies for neuropathic pain correlated with the risk for readmission (p < 0.05). Overall, the satisfaction was very high (mean > 5.5 for all items). CONCLUSION: Feedback from patients reflected high satisfaction rates with the care provided. A methodological approach based on the degree of satisfaction combined with the analysis of the pathways can help to implement the quality of a service provided through telemedicine. While not without limitations, our hybrid protocol can be useful for addressing cancer pain through a patient-centered approach.


Asunto(s)
Dolor en Cáncer , Neoplasias , Consulta Remota , Telemedicina , Dolor en Cáncer/terapia , Estudios Transversales , Humanos , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/terapia , Satisfacción del Paciente , Satisfacción Personal , Consulta Remota/métodos , Telemedicina/métodos
19.
Int J Med Inform ; 166: 104844, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36007433

RESUMEN

BACKGROUND: The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare. OBJECTIVE: This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors. METHODS: A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study. RESULTS: Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services. CONCLUSIONS: We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.


Asunto(s)
COVID-19 , Aplicaciones Móviles , Consulta Remota , Glucemia , COVID-19/epidemiología , Colesterol , Humanos , Lipoproteínas HDL , Área sin Atención Médica , Pandemias , Triglicéridos
20.
BMJ Open ; 12(8): e055049, 2022 08 03.
Artículo en Inglés | MEDLINE | ID: mdl-35922103

RESUMEN

OBJECTIVE: To provide an overview of the use of and evidence for eConsult in correctional facilities worldwide. DESIGN: Scoping review. DATA SOURCES: Three academic databases (MEDLINE, Embase and CINAHL) were searched to identify papers published between 1990 and 2020 that presented data on eConsult use in correctional facilities. The grey literature was also searched for any resources that discussed eConsult use in correctional facilities. Articles and resources were excluded if they discussed synchronous, patient-to-provider or unsecure communication. The reference lists of included articles were also hand searched. RESULTS: Of the 226 records retrieved from the academic literature search and 595 from the grey literature search, 22 were included in the review. Most study populations included adult male offenders in a variety of correctional environments. These resources identified 13 unique eConsult services in six countries. Six of these services involved multiple medical specialties, while the remaining services were single specialty. The available evidence was organised into five identified themes: feasibility, cost-effectiveness, access to care, provider satisfaction and clinical impact. CONCLUSIONS: This study identified evidence that the use of eConsult in correctional facilities is beneficial and avoids unnecessary transportation of offenders outside of the facilities. It is feasible, cost-effective, increases access to care, has an impact on clinical care and has high provider satisfaction. Some gaps in the literature remain, and we suggest further research on patient satisfaction, enablers and barriers to implementation, and women, youth and transgender populations in this setting to inform service providers and stakeholders. Despite some gaps, eConsult is evidently an important tool to provide timely, high-quality care to offenders.


Asunto(s)
Medicina , Consulta Remota , Adolescente , Adulto , Instalaciones Correccionales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Calidad de la Atención de Salud
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