RESUMO
BACKGROUND: Telehealth has been proposed as an alternative means to providing traditional modes of care while alleviating the need for participant travel and reducing overall healthcare costs. The purpose of this study was to explore contemporary perspectives of patients and stakeholders regarding non-participation in telehealth trials. METHODS: We undertook a two-phase exploratory qualitative study to understand the reasons behind patient non-participation in telehealth. Data were collected through semi-structured interviews with non-participating patient participants (nâ¯=â¯8) and stakeholders (nâ¯=â¯27) including clinicians, study investigators, and study staff. An analysis of interview data were undertaken and guided by a qualitative descriptive approach. FINDINGS: Patients and stakeholders reported many barriers to telehealth participation including technological barriers, limited understanding of disease, and an understated need for services. Both groups had some overlap in their concerns but also provided unique insights. CONCLUSION: The analysis of study findings revealed perspectives of patients and stakeholders including barriers to participation as well as suggestions for future telehealth initiatives. Further research is needed to explore non-participation including patient readiness to assist in the development of future telehealth programs.
RESUMO
Iatrogenic complications present a major challenge to the interventional cardiologist. We describe a case of extensive right coronary artery dissection caused by engagement of a 0.035" guidewire. Attempts to reopen the flush-occluded posterior descending artery using conventional methods were unsuccessful. However, the vessel was successfully restored with the use of intravascular ultrasound guidance and we describe the steps involved in this technique.
