Trends and Patterns in Electronic Health Record Research (1991-2022): A Bibliometric Analysis of Australian Literature.

Electronic Heath Records (EHRs) play vital roles in facilitating streamlined service provision and governance across the Australian health system. Given the recent challenges due to the COVID-19 pandemic, an ageing population, health workforce silos, and growing inefficiencies in traditional systems, a detailed historical analysis of the use of EHR research in Australia is necessary. The aim of this study is to examine the trends and patterns in EHR research in Australia over the past three decades by employing bibliometric methods. A total of 951 articles published in 443 sources were included in the bibliometric analysis. The annual growth rate of EHR research in Australia was about 17.1%. Since 2022, the main trending topics in EHR research were COVID-19, opioid usage, and natural language processing. A thematic analysis indicated aged care, clinical decision support systems, cardiovascular disease, drug allergy, and adverse drug reaction as the "hot" themes in EHR research in Australia. This study reveals a significant uptrend in EHR research in Australia, highlighting the evolving intellectual and collaborative landscape of this interdisciplinary field. The data also provide guidance for policymakers and funding institutions in terms of the most significant contributions and key fields of research while also holding public interest.

Development of an evidence-informed governance and stewardship framework for elderly healthcare in Iran: A qualitative study.

Background: The ageing population poses significant challenges to healthcare systems, necessitating the establishment of high-functioning, integrated frameworks for elderly healthcare. This study aimed to explore the key challenges associated with the stewardship of elderly care in Iran and to develop a holistic stewardship framework. Methods: For this qualitative study, thirty semi-structured interviews were conducted with key Iranian healthcare stakeholders, utilizing purposive and snowball sampling during 2021-2022. Inductive open coding was utilized to generate new concepts related to key stewardship challenges. The World Health Organization's conceptual framework, outlining the three stewardship tasks, served as the basis for crafting a tailored framework for elderly healthcare stewardship in Iran. Results: Fourteen main challenges and 38 sub-challenges were identified for elderly healthcare stewardship in Iran, categorized according to the WHO framework's three stewardship tasks. Challenges related to WHO stewardship task 1, involving health policy formulation and vision definition, included challenges in vision definition, planning, policymaking, and intergovernmental institutional superiority. Challenges related to WHO stewardship task 2, delineating governance and stewardship through control and regulation, encompassed issues such as support for the elderly, system responsiveness, behavior of healthcare providers, organizational structure, and cross-sectoral leadership challenges. Challenges associated with WHO stewardship task 3, about the use of collective intelligence, explored stakeholder collaboration, information for decision-making, and challenges within the elderly information system, covering data documentation, reporting, analysis, accessibility, distribution, and circulation. Subsequently, a framework was developed, covering areas like defining the vision and direction of health policy, managing information systems, evidence-informed policymaking, and delivering elderly health services with a holistic approach. Conclusion: The present framework shows how a management information system, guided by evidenced-informed policymaking and the formulation of customized health policies, can facilitate the provision of elderly health services based on identified needs. It presents a governance and stewardship pathway that can be adopted by Iranian health policymakers and similar middle-income countries facing analogous challenges in ageing and aged care system stewardship, serving as a model for developing their own frameworks.

Developing public health surveillance dashboards: a scoping review on the design principles.

BACKGROUND: Public Health Dashboards (PHDs) facilitate the monitoring and prediction of disease outbreaks by continuously monitoring the health status of the community. This study aimed to identify design principles and determinants for developing public health surveillance dashboards. METHODOLOGY: This scoping review is based on Arksey and O'Malley's framework as included in JBI guidance. Four databases were used to review and present the proposed principles of designing PHDs: IEEE, PubMed, Web of Science, and Scopus. We considered articles published between January 1, 2010 and November 30, 2022. The final search of articles was done on November 30, 2022. Only articles in the English language were included. Qualitative synthesis and trend analysis were conducted. RESULTS: Findings from sixty-seven articles out of 543 retrieved articles, which were eligible for analysis, indicate that most of the dashboards designed from 2020 onwards were at the national level for managing and monitoring COVID-19. Design principles for the public health dashboard were presented in five groups, i.e., considering aim and target users, appropriate content, interface, data analysis and presentation types, and infrastructure. CONCLUSION: Effective and efficient use of dashboards in public health surveillance requires implementing design principles to improve the functionality of these systems in monitoring and decision-making. Considering user requirements, developing a robust infrastructure for improving data accessibility, developing, and applying Key Performance Indicators (KPIs) for data processing and reporting purposes, and designing interactive and intuitive interfaces are key for successful design and development.

Factors disrupting the continuity of care for patients with chronic disease during the pandemics: A systematic review.

Background and Aims: Continuous routine care is necessary to prevent long-term complications of chronic diseases and improve patients' health conditions. This review study was conducted to determine the factors disrupting continuity of care for patients with chronic diseases during the pandemic. Methods: All original articles published on factors disrupting continuity of care for patients with chronic disease during a pandemic between December 2019 and June 28, 2023, in PubMed, Web of Science, Scopus, and ProQuest databases were searched. Selection of articles, data extraction, and qualitative evaluation of articles (through STROBE and COREQ checklist) were done by two researchers separately. Data graphing form was used to extract the data of each study and then the data were classified by thematic analysis method. Results: Out of 1708 articles reviewed from the databases, 22 were included. The factors disrupting the continuity of care for patients with chronic diseases during the epidemics were classified into two main categories: patient-side factors and health system-side factors. Patient-side factors including psychological, individual and social, disease-related, and health system-side factors including provider access, health system institutional, and infrastructural and financial problems were among the subcategories disrupting the continuity of care for patients with chronic diseases during the pandemic. Based on the studies, psychological factors and access to the provider were among the most frequent factors affecting the continuity of care for patients with chronic diseases in the pandemic. Conclusion: Considering the factors disrupting the continuity of care and applying appropriate interventions based on them, can guarantee the continuity of providing services to chronic patients in health crises.

Factors affecting oral and dental services` utilization among Elderly: a scoping review.

BACKGROUND: Regular use of oral and dental services by the elderly is one of the important factors in reducing oral and dental diseases. This study aimed to identify the factors affecting oral and dental services` utilization among elderly. METHODS: The published articles on the factors affecting oral and dental services` utilization among elderly were found through a scoping search and using related keywords in PubMed, Scopus, Embase, and Web of Science databases within January 2000 - December 2022 according to the PRISMA guidelines. The data were analyzed using the thematic analysis method. RESULTS: Among the 2381 articles retrieved from the databases, forty-two were extracted. The factors affecting oral and dental services` utilization among elderly were classified into five main components as follows: access, demographic factors, social factors, health level, and mental factors. The results showed that income, education level, living area, number of teeth, and importance of care were the most frequent in the main components of access, demographic factors, social factors, health level, and mental factors, respectively. CONCLUSION: Equitable utilization of oral and dental services is the right of all members of the society, especially the elderly. Therefore, it is necessary to provide the elderly with suitable conditions to utilize such services, which are mostly luxury items. Furthermore, increasing the elderly's awareness and encouraging them to use oral and dental services regularly can help reduce the burden of oral and dental diseases.

Medication supply chain resilience during disasters: exploration of causes, strategies, and consequences applying Strauss and Corbin's approach to the grounded theory.

BACKGROUND: Due to the importance of procurement of medicines and medical supplies during disasters and the significance of an existing resilient supply chain, the present study aimed to explore the causes, strategies, and consequences of the medication supply chain resilience during the Kermanshah, Iran, earthquake experience in 2018. METHODS: This was a qualitative study based on the grounded theory method. The suggested approach by Strauss and Corbin was used. Thirty-two in-depth and semi-structured interviews were conducted via theoretical sampling, and data were saturated. Open-ended and probing questions were used, and all the interviews were recorded with the prior permission of the participants. Field notes and memoing were also used along with the interviews. Transcribed data were analyzed in three levels of open coding, selective, and axial coding by two researchers with sufficient reflexivity without any conflict of interest. RESULTS: The results led to the identification of eight main categories, including "Disaster Management Structure", "Information Management", "Supply Chain Monitoring", "Socio-Cultural Factors", "Planning", "Resource Management", "Medical Service Coverage", and "Waste of time and resources". According to Strauss and Corbin's model, socio-cultural factors and inappropriate structures and planning related to the health system during disasters may waste time and resources. CONCLUSIONS: "Waste of time and resources" during disasters can be considered the main determinant that can damage the resilience of the medication supply chain. Policymakers need to seek applied strategies for decreasing waste. Socio-cultural interventions, preparedness of information infrastructures and coordination among the stewards and the community during disasters can help the supply chain preserve its resilience and act more effectively.

Policy requirements in promoting older people health care in Iran: A qualitative study.

BACKGROUND: The demographic structure of Iran as a developing country has undergone various changes in recent years. Therefore, the present study sought to analyze policy and upstream documents related to the older people health in Iran in order to identify and analyze the requirements considered by health policymakers to promote the older people health in Iran. MATERIALS AND METHODS: This is a qualitative study conducted in 2021 through national qualitative document analysis. All upstream documents published and related to older people health were reviewed between February 1979 and October 2021. The Scott's four-step method was used to extract the related documents. RESULTS: Policy requirements for promoting older people healthcare in Iran were categorized into 4 main themes in the form of a conceptual framework and 15 sub-themes. Thus, in order to ensure the health of the older people in Iran, it is necessary to take into account the four categories of managerial requirements, financing, infrastructures, and providing older people services. In other words, the sustainable financing requirements and the infrastructural requirements should firstly exist together as basic requirements. Then, geriatric health management requirements are needed to provide the older people health services along with the previous requirements and finally ensure the health of the older people in Iran. CONCLUSION: The results of this study can be helpful in the review of upstream older people health policy documents by policy makers in order to better promote the health of the older people and pave the way for new policies to enter the agenda of policy makers.

Qualitative document analysis on Iranian contents and trends of population policies: Lessons learned and avenues for future.

Population-related policies are among macro-strategic policies considered by all governments in the world. To achieve the desired population structure, it is first necessary to identify the general policy approach over time. This article aims to identify the main requirements of population policies during the last 70 years in Iran. This is a qualitative content analysis study conducted via the analysis of all relevant national policy documents from 1951 to 2022. To retrieve the relevant documents, we searched the official website of eight policymaking bodies in Iran. After identifying the documents, their eligibility was evaluated using Scott's method, and as a result, 40 documents were selected for analysis. Finally, we used a qualitative content analysis to synthesize the data using MAXQDA version 10. The findings showed that the political requirements for population reduction can be classified into four main themes of "Religious, scientific, and legal infrastructure", "Changes in the rules", "Institution building, programming and division of tasks", and "Information and service provision", with 11 sub-themes. Furthermore, the political requirements for an increasing population can be divided into six main themes of "Education & acculturation", "Legal dos, and don'ts", "Financial and non-financial support for families", "Structural and information infrastructure", "Health services", and "Stewardship", with 30 sub-themes. In this study, by an all-round look, and the analysis of policies of the last 70 years of Iran, it was determined how the population policies originate from the political-cultural background of society, and provide the ground for the changes in the cultural-social, political, and economic structures and as a result demographic change. In other words, the main requirements to formulate the population increase and decrease policies in Iran as a country with golden experiences to implement the population policies were shown; which can be helpful as a guide to formulate the population policies in Iran and provide a model for successful policy making in the countries with a similar background to Iran.

Tele-dentistry, its trends, scope, and future framework in oral medicine; a scoping review during January 1999 to December 2021.

BACKGROUND: Tele-dentistry has been increasingly used for different purposes of visit, consultation, triage, screening, and training in oral medicine. This study aims to determine the main facilitators, barriers, and participants` viewpoints of applying tele-dentistry in oral medicine and develop a framework indicating the input, process, output, and feedback. METHOD: This was a scoping review conducted in 2022 applying Arksey and O'Malley (2005) approach. Four databases including ISI web of science, PubMed, Scopus, and ProQuest were searched from January 1999 to December 2021. Inclusion criteria consisted of all original and non-original articles (reviews, editorials, letters, comments, and book chapters), and dissertations in English with a full text electronic file. Excel2016 was used for descriptive quantitative analysis and MAXQDA version 10 was applied for qualitative thematic analysis. A thematic framework was developed customizing the results of the review in a virtual mini expert panel. RESULTS: Descriptive results show that among 59 included articles, 27 (46%) have addressed the various applications of tele-dentistry during COVID-19 pandemic in the field of oral medicine. From geographical distribution perspective, most of the papers were published in Brazil (n = 13)/ 22.03%, India (n = 7)/11.86% and USA (n = 6)/10.17%. Thematic analysis shows that seven main themes of "information", "skill", "human resource", 'technical", "administrative', 'financial', and 'training and education' are explored as facilitators. 'Individual', 'environmental', 'organizational', 'regulation', 'clinical', and 'technical barriers' are also identified as main barriers of tele-dentistry in oral medicine. CONCLUSION: According to the results for using tele-dentistry services in oral medicine, a diverse category of facilitators should be considered and at the same time, different barriers should be managed. Users` satisfaction and perceived usefulness of tele-dentistry as final outcomes can be increased considering the system`s feedback and applying facilitator incentives as well as decreasing the barriers.

The mutual relationship of the policymakers, providers, and the community on the children's oral health; New windows for more discussions.

BACKGROUND: The multidisciplinary and comprehensive nature of children`s oral health with mutual interactions among various determinants makes the area a window of more discussion among oral health policymakers, stakeholders, providers, and other interested parties. This commentary presents a triangle framework of the children`s oral health, including all the above groups, for new discussions in oral health policymaking. MAIN BODY: Three leading influencers could be recognised in children`s oral health as a triangle despite the contextual differences among the countries. The first angle, Families and community, determine the individual background, demographic, biological, genetic, and psychological factors, as well as community-based and social background, including cultural and socioeconomic factors. The second angle, Oral health providers, includes a variety of determinants from the provider`s perception toward oral health provision of services to availability of dental services, teledentistry and digital technology, surveillance, and monitoring systems for children`s oral health. And finally, as the third angle, Oral health policymakers affect the mechanism for funding dental care and supporting schemes, affordability of oral health services, regulations and standards and public education. Macro environmental policies related to the children`s ecosystem, community water fluoridation, and social marketing for promoting probiotics products` consumption are categorized in this category. CONCLUSION: The triangle framework of children`s oral health presents a big picture of the oral health concept at the multilevel. Although these determinant factors interact with each other, each can have a cumulative effect on children`s oral health; policymakers could try to consider them as a big picture with a systematic approach for better achievement of oral health among children considering the local and national contextual factors of the community.

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system.

Background: COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era. Method: This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software. Result: Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects." Conclusion: To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

Bibliometric analysis of COVID-19 publications shows the importance of telemedicine and equitable access to the internet during the pandemic and beyond.

BACKGROUND: Pandemics highlight the increasing role of information and communications technology for improving access to health care. This study aimed to present a bibliometric analysis of the concept of digital divide reported in the published articles concerning the coronavirus disease 2019 (COVID-19) pandemic. METHODS: To conduct this bibliometric analysis of research topics and trends, we used VOSviewer software. We developed a search strategy to retrieve peer-reviewed publications related to 'digital divide in the COVID-19 era' from the Scopus database. RESULTS: In total, 241 publications on the topic of digital divide and COVID-19 were retrieved from Scopus database between 2020 and 2021. The analysis of keywords co-occurrence of research topics revealed four main clusters including: 'telemedicine', 'Internet access and Internet use', 'e-learning' and 'epidemiology'. Seven characteristic categories were examined in these research topics, including: sociodemographic, economic, social, cultural, personal, material and motivational. CONCLUSION: 'Telemedicine' and 'Internet access and Internet use' as the largest clusters are connected to topics addressing inequalities in online health care access. Thus, policymakers should develop or modify policies in more egalitarian Internet access for all community members not only during a pandemic like the COVID-19 but also at regular times.

Older people's health promotion policies challenges: Making an avenue for policy responses in a developing country.

BACKGROUND: Older people's health policies suffer from many challenges in Iran. The issue is more highlighted considering the increasing rate of the older population in the country. This study aimed to explore the challenges of older people's health policies in Iran as well as make an avenue for policy responses. MATERIALS AND METHODS: This study was a qualitative study that was conducted using conventional content analysis in 2020-2021 in Iran. The purposive and snowball sampling methods were used for semi-structured interviews with 30 selected participants. Data were analyzed through the content analysis approach using Granheim and Landman's five-step thematic method. RESULTS: The results of analyzing the data were categorized into four main themes, 16 sub-themes, and 70 final codes. The main themes were executive, policymaking, intra- and inter-sectoral, and environmental challenges. CONCLUSIONS: Older people are facing challenges in receiving appropriate and timely care. In order to achieve a wide national policy dialogue for covering all older people's health needs in policy agendas and better formulation and implementation of the policies, it is necessary for Iranian health policymakers to address executive challenges and apply effective strategies.

How does the dental benefits act encourage Australian families to seek and utilise oral health services?

BACKGROUND: This study aimed to analyse the content of the Dental Benefits Act 2008 as a foundation for the Child Dental Benefits Schedule (CDBS) to determine how the Act encourages Australian families to seek and utilise oral health services. METHODS: This was a qualitative narrative document analysis conducted in 2022. Data was collected by searching formal websites for retrieving documents that reported the Australian Dental Benefits Act. The eligibility of the retrieved documents was assessed based on authenticity, credibility, representativeness, and meaningfulness of the data. A seven-steps procedure was applied for framework analysis. RESULTS: The content of the Dental Benefits Act 2008 provides directions on the three categories of operational, collective, and constitutional rules. Operational rules at the level of oral health providers and the population, as the service end users, can be demonstrated as rules in use in a mutual interaction with the collective and constitutional rules. The consequence of governing the rules at the community level can easily define how the oral health services are provided and utilised. The response is sent to the government level for better regulation of oral health service delivery and utilisation. Then, with interaction and advocacy with the diverse range of stakeholders and interdisciplinary partnerships, with community groups, non-government sectors and councils, the rules can be transformed, adopted, monitored, and enforced. Another mechanism of response has occurred at the providers' and users' level and to the operational rules to community groups and stakeholders via advertising and promoting the utilisation and provision of oral health services. CONCLUSION: This study integrates the perspective of politicians with those of policy makers to reconsider the role and significance of the rules based on the triple collaborations among oral health users and oral service providers, the community, and the stakeholders as well as the government. A comprehensive attention is still needed in future revisions of the Dental Benefits Act 2008 according to the contextual factors, socioeconomic and geographical attributes of the population for better implementation of de facto rules and more effective outcomes of the interventions. It is recommended that further research be undertaken utilising a mix-method approach for a holistic view prior to further revisions of the Act or proposal of probable upcoming schemes.

Usability of Iranian Primary Vitiligo Patient Registry (IPVPR): A Pilot Study.

BACKGROUND: Usability is essential for the acceptance and success of vitiligo patient registry system. Poor usability could decrease system efficiency and effectiveness, and have a negative impact on using the system and providing services. This study aims to evaluate the usability of vitiligo patient registry system. METHODS: This pilot study was conducted in 2021. In total, 17 users who were working in the vitiligo ward participated in the study. System usability scale (SUS) was used to evaluate the usability of vitiligo patient registry system. RESULTS: In the usability evaluation stage, the mean score of the system usability scale was obtained as 77.79. CONCLUSION: Developing vitiligo patient registry system with high usability and making decisions based on the registered data could provide better understanding of this disease and facilitate research in this field. Application of this system and its acceptance by users could decrease costs and increase effectiveness and quality of services.

Comparison of Health Status Indicators in Iran with the Eastern Mediterranean Countries Using Multiple Attribute Decision-Making Methods.

Background: Improving public health is the main goal of healthcare systems across the world. Healthcare policymakers often use comparisons between different healthcare systems to better position their country and use the outcome to develop novel strategies to improve their own public health. The present study aimed to compare the health status indicators in Iran with those of the Eastern Mediterranean (EM) countries using the multiple attribute decision-making (MADM) methods. Methods: A descriptive-analytical study was conducted in 2021 at Shiraz University of Medical Sciences, Shiraz, Iran. Data on the ranking of health status indicators in EM countries were obtained from the annual publications of the World Health Organization, World Health Statistics (2016-2020). As part of the MADM mathematical models, the "criteria importance through intercriteria correlation" (CRITIC) model was used to assign weights to health status indicators. In addition, the "multi-criteria optimization and compromise solution" (VIKOR) model was used to rank the EM countries. Results: The results showed that Bahrain and Somalia ranked first and last on health status indicators, respectively. Iran was ranked fifth among the EM countries. However, while Iran has a better status on all indicators than the mean value of all EM countries, there is a significant gap between the health status in Iran compared to the top-ranked countries. Conclusion: Health care strategies adopted by top-ranked countries, such as Bahrain and Qatar, can be used by Iran and other EM countries as a model to improve their healthcare system.

Identification and Prioritization of Critical Factors Affecting the Performance of Iranian Public Hospitals Using the Best-Worst Method: A Prospective Study.

Background: In the ever-changing healthcare environment, policymakers and managers need a comprehensive evaluation system to accurately identify and prioritize factors affecting hospital performance. The present study aimed to identify and rank critical factors affecting hospital performance using the best-worst method (BWM). Methods: A cross-sectional study was conducted during 2016-2019 to identify and prioritize factors affecting the performance of Iranian public hospitals using the BWM. Initially, the content validity ratio (CVR) was used to screen the identified factors. Then, using a linear programming formula, a pairwise comparison between the best/worst criterion with all other identified criteria was performed. Results: The most important internal factor was efficiency, and its associated indicators were mainly related to financial factors. Among all external factors, the most prominent were economic, legal, and political factors, which were negatively affected by budgeting policies and the payment system. A megatrend was also identified in the form of a national health insurance system as well as a shift from employer-based to government-subsidized insurance coverage. Conclusion: External factors (economic and political) had a greater impact on the performance of public hospitals than internal factors (efficiency and effectiveness). A preprint of this study was published at https://www.researchsquare.com/article/rs-453223/v1 with doi: 10.21203/rs.3.rs-453223/v1.

Determining Factors Influencing Specialty Preferences of Iranian Medical Doctors: A Qualitative Study.

Background: The medical specialty choice of physicians directly affects the healthcare system, community wellbeing, and their own professional life. It is therefore important to identify its underlying factors to predict such medical career choices and to draw up a comprehensive evidence-based public health policy and health human resources planning. The present qualitative study aimed to identify these determinants of career choices through semi-structured interviews with medical doctors in the context of country-specific social and cultural characteristics. Methods: The present qualitative study was carried out in 2019-2020 at Shiraz University of Medical Sciences (Shiraz, Iran). The target population was medical students, junior doctors, and medical residents. The purposive sampling method was used to recruit the participants and sampling continued until data saturation, i.e., no new information could be extracted. Data were collected through individual, face-to-face, semi-structured interviews and analyzed using the conventional content analysis method. Inductive thematic analysis was used to interpret the data based on which a thematic map was developed illustrating the factors influencing medical specialty preferences in Iran. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln. Results: Analysis of the interview data resulted in three main themes and fourteen sub-themes. The main themes were "Personal determinants", "Career-related factors", and "Interpersonal influences". The most important sub-themes were personal interests, income, and prestige. Conclusion: The determinants influencing the specialty preferences of Iranian medical doctors are identified. Our findings will facilitate the development of a comprehensive evidence-based public health policy, health human resources planning, and appropriate medical education policy.

Responsiveness level and its effect on services quality from the viewpoints of the older adults hospitalized during COVID-19 pandemic.

BACKGROUND: Aging is a sensitive period of life. Attention to the needs of this stage is considered a social necessity. This study is conducted to investigate the responsiveness level and its effect on service quality from the hospitalized older adults' viewpoints during the COVID-19 pandemic in the south of Iran. METHODS: It was a cross-sectional descriptive-analytic study that was conducted on 386 old patients. The study instrument was a standard questionnaire that includes three sections of demographic information, World Health Organization Responsiveness, and SERVQUAL. Data were analyzed applying descriptive and inferential statistics the same as Independent T-test, ANOVA, Pearson correlation, and multiple linear regression. RESULTS: The mean levels of responsiveness and service quality were 90.72 ± 9.38 (from 160) and 68.01 ± 8.51 (from 110) respectively. This indicates the average level of these variables from the old patients' viewpoints. There was a significant positive correlation between responsiveness and service quality (r = 0.585). According to the results of multiple linear regression, the dimensions of communication, dignity, prompt attention, primary facilities, social support, information confidentiality, right to choose, and autonomy were identified as the predictors of service quality. CONCLUSION: The average level of responsiveness and service quality perceived from the old patients' viewpoints during the COVID-19 pandemic can be considered a necessity for supportive planning among the older adults. Meanwhile, according to the impacts of responsiveness on service quality, educational programs are recommended to promote the level of healthcare providers' responsiveness.

Factors affecting medication adherence among older adults using tele-pharmacy services: a scoping review.

BACKGROUND: Medication adherence among older adults (aged 60 and above), particularly those with chronic conditions who take several medications, is critical, and tele-pharmacy services are a way to improve medication adherence. This study sought to determine the factors influencing medication adherence (MA) in older adults using tele-pharmacy services. METHOD: The Joana Briggs Institute scoping review methodology was implemented. Searches were conducted in databases PubMed, Scopus, ProQuest, Web of Science, and Embase from 2000 to the present day, to identify both qualitative and quantitative studies focusing on the use of tele-pharmacy by older people. Factors impacting MA were extracted and analyzed into themes using a qualitative approach. A concept map was also designed summarising these factors. RESULTS: Of 7495 articles obtained in the initial search, 52 articles met the inclusion criteria. The analysis resulted in 5 themes and 21 sub-themes representing factors that impacted MA with tele-pharmacy. These themes are divided broadly into technology and user related factors. Technology factors included design of the tele-pharmacy intervention, commercial aspects, and adherence measurement method. User factors included user-health constraints, behaviors and perceptions. CONCLUSION: Industry, policymakers, and stakeholders should consider using tele-pharmacy services for improving medication adherence among older adults; however, ensuring interventions facilitate communication between patients and health care teams, and are accompanied by user training and support, is essential for technology uptake and effectiveness.