Tele-medicine versus face-to-face consultation in Endocrine Outpatients Clinic during COVID-19 outbreak: a single-center experience during the lockdown period

Abstract Context The COVID-19 outbreak in Italy is the major concern of Public Health in 2020: measures of containment were progressively expanded, limiting Outpatients’ visit. Objective We have developed and applied an emergency plan, tailored for Outpatients with endocrine diseases. Design Cross-sectional study from March to May 2020. Setting Referral University-Hospital center. Patients 1262 patients in 8 weeks. Interventions The emergency plan is based upon the endocrine triage, the stay-safe procedures and the tele-Endo. During endocrine triage every patient was contacted by phone to assess health status and define if the visit will be performed face-to-face (F2F) or by tele-Medicine (tele-Endo). In case of F2F, targeted stay-safe procedures have been adopted. Tele-Endo, performed by phone and email, is dedicated to COVID-19-infected patients, to elderly or frail people, or to those with a stable disease. Main outcome measure To assess efficacy of the emergency plan to continue the follow-up of Outpatients. Results The number of visits cancelled after endocrine triage (9%) is lower than that cancelled independently by the patients (37%, p < 0.001); the latter reduced from 47 to 19% during the weeks of lockdown (p = 0.032). 86% of patients contacted by endocrine-triage received a clinical response (F2F and tele-Endo visits). F2F visit was offered especially to young patients; tele-Endo was applied to 63% of geriatric patients (p < 0.001), visits’ outcome was similar between young and aged patients. Conclusions The emergency plan respects the WHO recommendations to limit viral spread and is useful to continue follow-up for outpatients with endocrine diseases.

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Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017)

AIDS Research and Therapy ◽

10.1186/s12981-019-0241-3 ◽

2019 ◽

Vol 16 (1) ◽

Author(s):

Ahmad Aliyu ◽

Babatunde Adelekan ◽

Nifarta Andrew ◽

Eunice Ekong ◽

Stephen Dapiap ◽

...

Keyword(s):

Patient Adherence ◽

Cross Sectional Study ◽

Emergency Plan ◽

Cross Sectional ◽

Loss To Follow Up ◽

Viral Loads ◽

Review Period ◽

Lost To Follow Up ◽

Differentiated Care

Abstract Background Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria. Methods Records of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up. Results Within the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up. Conclusion Despite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence.

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The Effect of Telemedicine on Patients’ Compliance in Family Medicine Follow-ups in Qatar

Avicenna ◽

10.5339/avi.2022.3 ◽

2021 ◽

Vol 2022 (1) ◽

Author(s):

Yaman M. AlAhmad ◽

Duaa Mahmoud Haggeer ◽

Abrar Yaser Alsayed ◽

Mahmoud Y. Haik ◽

Leen Maen AbuAfifeh ◽

...

Keyword(s):

Health Care ◽

Family Medicine ◽

Health Care Services ◽

Healthcare Services ◽

Cross Sectional Study ◽

Cross Sectional ◽

Telephone Consultation ◽

Face To Face ◽

Primary Health Care Centers

Introduction: Telemedicine is the delivery of health care services to patients distantly. During the Coronavirus Disease 2019 (COVID-19) pandemic, telemedicine has become an essential implement in delivering healthcare services worldwide. Accordingly, in March 2020, the Primary Health Care Centers (PHCCs) in Qatar has started telephone consultation follow-up appointments in Family Medicine (FM) clinics instead of conventional consultation. Given the limited data about telephone consultations in Qatar, our aim of this study is to investigate the possible impact of telemedicine on chronic disease patients’ follow-up compliance. Methods: This study compares the compliance of adult patients with chronic diseases following-up within FM clinics in Qatar's PHCC through telephone consultations with a minimum of three telephone consultations ordered between April to November 2020, in comparison to the compliance of the same group of patients to their prior face-to-face follow-up consultations in FM clinics with a minimum of three face-to-face ordered follow up appointments between April to November 2019. A cross-sectional study will be carried out to investigate the effect of telephone consultation in PHCC on patients’ compliance with reference to conventional face-to-face consultation. Patients’ data will be received from Health Information Management in twenty-seven PHCCs in Qatar. Conclusion: Due to the limited studies on the effectiveness of telemedicine on patient compliance in FM follow-ups within Qatar's PHCC, comparing patients’ follow-up compliance with telephone consultations to their prior face-to-face consultations would be helpful in assessing patients’ quality of care delivering within FM clinics. With telecommunication being easily accessible and time-efficient, it is believed, when used correctly, it might improve compliance and adherence to the management prescribed by the physician and follow-up appointments in Qatar's PHCC. In addition, this study will help in providing recommendations that could guide the organization on forming policies to be applied in PHCCs after the resolution of the COVID-19 pandemic.

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Parent Knowledge of Screening and Genetic Testing in Retinoblastoma

Journal of Ophthalmology ◽

10.1155/2020/3839792 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Wei Xiao ◽

Xian Ji ◽

Huijing Ye ◽

Huiqi Zeng ◽

Yang Gao ◽

...

Keyword(s):

Genetic Testing ◽

Southern China ◽

Cross Sectional Study ◽

Cross Sectional ◽

Parent Knowledge ◽

Face To Face ◽

Related Information ◽

Health Related ◽

Oncology Unit

Purpose. To evaluate parent knowledge of screening and genetic testing for retinoblastoma and its potential correlation with demographics, clinical features, and socioeconomical factors. Methods. It was a cross-sectional study conducted at the ocular oncology unit of a tertiary ophthalmic center in Southern China. A face-to-face interview was administered to parents of retinoblastoma children during hospitalization. Parent knowledge was assessed using the sum score of a 7-item questionnaire. Demographics and socioeconomic status were collected from the interview, and clinical data were retrieved from the medical records. Results. A total of 126 parents of retinoblastoma children were included. Parents accurately answered 66.7% to 84.9% of each item in the questionnaire. Only 37 (29.4%) parents correctly answered all 7 questions. Parent knowledge was positively correlated with education, but it was not associated with patients’ laterality, sex, or household income. Physicians and the Internet were the major sources of parental health-related information. During the median follow-up of 492 days, 13 (61.9%) of 21 patients in the full-score group without genetic testing at baseline actually conducted testing during follow-up compared to 29 of 67 (43.3%) in the less-than-full-score group (P=0.136). Conclusion. Overall parent knowledge about retinoblastoma screening and genetic testing was moderate. Higher education was associated with greater parent knowledge. Future studies should validate our findings in other populations, especially in those with different cultural background and healthcare systems.

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Reference values for Lactate Pro 2™ in fetal blood sampling during labor: a cross-sectional study

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0027 ◽

2017 ◽

Vol 45 (3) ◽

Cited By ~ 2

Author(s):

Brynhildur Tinna Birgisdottir ◽

Malin Holzmann ◽

Ingela Hulthén Varli ◽

Sofie Graner ◽

Sissel Saltvedt ◽

...

Keyword(s):

Lactate Concentration ◽

Rank Correlation ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Spearman’S Rank Correlation ◽

Fetal Blood Sampling ◽

Conversion Equation

AbstractObjective:Lactate ProStudy design:A cross-sectional study was conducted at a university hospital in Sweden. A total of 113 laboring women with fetal heart rate abnormalities on cardiotocography (CTG) had FBS carried out. Lactate concentration was measured bedside with both LP1 and LP2 from the same blood sample capillary. A linear regression model was constructed to retrieve a conversion equation to convert LP2 values to LP1 values.Results:LP2 measured higher values than LP1 in all analyses. We found that 4.2 mmol/L with LP1 corresponded to 6.4 mmol/L with LP2. Likewise, 4.8 mmol/L with LP1 corresponded to 7.3 mmol/L with LP2. The correlation between the analyses was excellent (Spearman’s rank correlation, r=0.97).Conclusion:We recommend the following guidelines when interpreting lactate concentration in FBS with LP2: <6.4 mmol/L to be interpreted as normal, 6.4–7.3 mmol/L as preacidemia indicating a follow-up FBS within 20–30 min, and >7.3 mmol/L as acidemia indicating intervention.

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N06 Patient perspectives on the role of the IBD nurse and telemedicine during COVID-19 pandemic: results from a Belgian tertiary IBD unit

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab074.820 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S610-S611

Author(s):

G Dewitte ◽

J Geldof ◽

M Truyens ◽

T Lobaton

Keyword(s):

Continuity Of Care ◽

Care Delivery ◽

Cross Sectional Study ◽

University Hospital ◽

Additional Stress ◽

Remote Communication ◽

Biologic Treatment ◽

Cross Sectional ◽

Admission Screening

Abstract Background Many inflammatory bowel disease (IBD) patients experienced additional stress due to the COVID-19 pandemic. Concerns for COVID-19 disease increased the risk of immunomodulatory or biologic treatment discontinuation. Furthermore, lockdown threatened the continuity of chronic care delivery. To guarantee the continuity of care our IBD unit rapidly adapted and developed new ways of remote communication. This included telephonic clinics and telephonic pre-admission screening before every appointment at the dayclinic. In this process the IBD nurse played a pivotal role. The aim was to assess patients’ concerns during the first COVID-19 wave and their acceptance of telemedicine. Methods A cross-sectional study was performed using an anonymous electronic questionnaire (REDCap®) to assess IBD patients’ satisfaction regarding care delivery at the IBD unit of the Ghent University Hospital during the first COVID-19 wave. Results A total of 274 patients participated. Mean age was 47.5 years (SD ± 15.4). According to patients’ answers, 57.2% had Crohn’s disease, 34.5% ulcerative colitis and 8.3% reported ‘other’. During the first wave, 43.6% of patients contacted their IBD nurse; usually questions regarding medication (20.6%), appointments (18.4%) or SARS-CoV2 infection risk (6%). For the majority of patients (96.5%) these contacts were sufficient. In person follow-up consultation was scheduled for 178 patients. From those, 31 considered cancelling their consultation due to the pandemic and 18 effectively cancelled (Fig 1). Half of the population (51.6%) received intravenous therapy at the day clinic. Telephonic pre-admission screening the day before was done for all patients and well received in most of them (98.5%). During the first wave, endoscopy was planned in 31.5% of the responding patients. A minority (11.1%) postponed or cancelled endoscopic appointments. From those, 55.6% reported that the main reason was fear of the coronavirus. Ninety-four (39.2%) of responders had a telephonic consultation during the first wave. Different aspects regarding satisfaction and acceptance of telemedicine were also assessed (Fig 2–3). For further follow-up, 60.2% preferred balanced combination of telephonic and face-to-face consultations. Conclusion Remote ways of care delivery were generally well received during the first wave of the pandemic. Only a minority of patients cancelled appointments without discussion with the medical team. The most frequent patient concerns were about medications and appointments. The challenges in continuity of care during the pandemic created a window for new ways of care delivery in the future.

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Prevalence and Risk Factors for Vitamin D Insufficiency among Adults with Epilepsy at University Hospital in Jeddah, Saudi Arabia: A Cross Sectional Study

Asian Journal of Education and Social Studies ◽

10.9734/ajess/2021/v14i130348 ◽

2021 ◽

pp. 49-58

Author(s):

Doaa K. Mohorjy ◽

Iman Kamal Ramadan ◽

Bahaa A. Abalkhail ◽

Khalid M. Jaamal

Keyword(s):

Vitamin D ◽

Antiepileptic Drugs ◽

Multiple Linear Regression Model ◽

Cross Sectional Study ◽

Vitamin D Insufficiency ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Epileptic Patients

Background: Vitamin D is essential for bone physical condition, and vitamin D insufficiency may add to further autoimmune diseases, infections or even cancer. Enzyme-inducing antiepileptic drugs have been predominantly linked with osteoporosis hazard proved their impacts on vitamin D. The study aim was to determine the prevalence of vitamin D insufficiency and deficiency and the covariates associated with it among the adult epileptic patients attending King Fahd neurology outpatient clinics. Subjects and Methods: 297 adult epilepsy patients joined this cross-sectional study at King Fahd Hospital in 2017. Vitamin D level was considered as deficiency (<10ng/ml), insufficiency (<30ng/ml), or normal (≥30ng/ml). Antiepileptic drugs were sorted out according to their enzyme inducing criteria. Results: 87.88% adult epileptic patients were between 18 – 50 years of age, more than half were females, married, and with higher degree of education, less than half received monthly income of less than 5,000 SR, nearly two third were either smokers or ex-smokers. Multiple linear regression model for predictors of vitamin D insufficiency and deficiency declared that; enzyme induced antiepileptic drugs, polytherapy, and smoking were significantly correlated with vitamin deficiency and insufficiency (p < 0.05). Conclusion: Vitamin D insufficiency and deficiency is widespread among adult epileptic patients. Screening of vitamin D level should be taken into consideration as part of the regular follow up of epileptic patients.

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Does education degree affect the patient’s attitude towards the treatment after myocardial infarction?

Seminars in Cardiovascular Medicine ◽

10.2478/semcard-2020-0001 ◽

2020 ◽

Vol 26 (1) ◽

pp. 1-6

Author(s):

Jolita Badarienė ◽

Vilma Dženkevičiūtė ◽

Egidija Rinkūnienė ◽

Živilė Girkantaitė ◽

Dovilė Šilinskienė ◽

...

Keyword(s):

Myocardial Infarction ◽

Treatment Plan ◽

Cross Sectional Study ◽

University Hospital ◽

Cross Sectional ◽

Post Secondary ◽

Education Degree ◽

Vilnius University ◽

Design And Methods

SummaryObjectives. To assess the association between education degree and attitude towards the treatment after myocardial infarction (MI).Design and Methods. The participants of this cross-sectional study were 191 (140 men and 51 women) outpatients in a period of 3 months – 5 years after acute MI (mean age 59 ± 9.2 years) from Vilnius University Hospital Santaros Klinikos. All patients were asked to complete two questionnaires: “Quality of Life and Treatment after Myocardial Infarction” and “Cholesterol-lowering Drugs Consumption Peculiarities”. The data was analyzed using the SPSS software.Results. The education degree (a higher (post-secondary education provided by a college or university) vs. a lower (secondary or vocational education) education degree) had similar influence on the patients’ occasional concern (43.2%; n = 35 vs. 52.9%; n = 55, respectively; p = 0.226) and on the frequent concern (25.9%; n =21 vs. 26.9%; n = 28, respectively; p = 0.226) about MI. Patients with a higher education degree were more likely to identify themselves as the main subjects in MI treatment in comparison with patients that had a lower education degree (30.5%; n = 25 vs. 15.2%; n = 16, respectively, p = 0.033). More educated patients found it easier to follow up the doctor’s treatment plan than less educated patients (23.2%; n = 19 vs. 9.5%; n = 10, respectively; p = 0.035).Conclusions. More educated patients are more likely to follow up the doctor’s treatment plan and see it easier than less educated patients. Thus, more attention should be paid to less educated patients in order to increase their own impact on their post-MI treatment.

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Perspective of pediatricians and adolescent patients on the transition process in a university hospital

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2022/40/2020490 ◽

2022 ◽

Vol 40 ◽

Author(s):

Luiza Mariana Cordeiro Silva ◽

Letícia Mansano Souza ◽

Elizete Prescinotti Andrade ◽

Lilia D’Souza-Li

Keyword(s):

Transition Process ◽

Tertiary Hospital ◽

Great Difficulty ◽

Cross Sectional Study ◽

University Hospital ◽

Readiness Assessment ◽

Cross Sectional ◽

Face To Face ◽

Adolescent Patients ◽

Transition Plan

ABSTRACT Objective: To map the transition process from the perspective of pediatricians and their adolescent patients, and to suggest a transition protocol. Methods: This is a descriptive, cross-sectional study conducted in a pediatric outpatient clinic of a public tertiary hospital. Pediatricians answered a questionnaire about the transition process, and that was evaluated in a descriptive manner. The Transition Readiness Assessment Questionnaire (TRAQ) on health autonomy was answered by the adolescents and the analysis was performed using the χ2 and Mann-Whitney tests. p<0.05 were considered significant. Results: 31 pediatricians (16 residents, 15 supervisors) were enrolled, with a mean age of 40.1 (±16.9), 87% women, with years working in Pediatrics ranging from 2 to 45 years (median of 5 years). Most doctors agreed that there was no transition plan, but they stimulated the patient’s autonomy and talked to the patient and family members about any existing chronic diseases. A total of 102 adolescent patients participated, with a median age of 15; 56% were female. The TRAQ median was 58, with similar scores between females and males, and higher scores in those older than 16 years of age (Mann-Whitney U test, p=0.01). The patients reported ease in face-to-face communication with their doctors, but great difficulty in talking about health issues over the phone. Conclusions: Even without a transition protocol, adolescents developed several self-care skills as they aged. The lack of a transitional protocol led to conflicting opinions, which reinforces the need for improvement. We suggest a flowchart and transition protocol.

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A Cross-Sectional Study of Olfactory and Taste Disorders in COVID-19 Patients in China

10.21203/rs.3.rs-46082/v1 ◽

2020 ◽

Author(s):

Jianhui Li ◽

Yi Sun ◽

Meirong Li ◽

Hu Yuan ◽

Changliang Yang ◽

...

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Early Screening ◽

Cross Sectional ◽

Face To Face ◽

Taste Disorders ◽

Spss Software ◽

Research Period

Abstract Objective To determine the prevalance and features of olfactory and taste disorders in coronavirus disease of 2019（CoVID-19）patients in China. Methods A cross-sectional study was performed from 3 April to 15 April 2020 in Wuhan. A total of 187 patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection completed face-to-face interviews or telephone follow-up. Patients information including epidemiological, clinical, imaging, and serological records and treatment and outcomes data. Patients were further evaluated using questionnaires and visual analogue scale. Statistical analysis was performed with SPSS software (version 22.0). Results The enrolled 187 patients, 23 (12.3%) reported olfactory disorders, 42 (22.46%) reported taste disorders. Females are more prone to olfactory and taste disorders. Among patients that can clearly describe the fluctuation of olfactory and taste disfunctions, 4 (20.0%) and 7(18.92%) cases occurred before other symptoms appeared, the average number of days in advance was 3.5 and 3.57, respectively. The majority of patients can return to normal or basic normal, but in 4(17.39%) and 9(21.43%) cases olfactory and taste can not fully recoveried during the research period. Conclusions Prevalence of olfactory and taste disorders substantially lower in China cohorts compared to abroad COVID-19 cohorts. The prevalence of olfactory and taste disorders in COVID-19 patients was higher in females than in males. In some patients, olfactory and taste disorders precede other symptoms and can be used as a symbol for early screening and warning. The restoration of olfactory and taste function was independent of age; females recover more easily than males; olfactory or taste disorders was not easily recovered for patients with clinically classified as severe; when olfactory or taste disorders itself was serious, it was not easy to recover; olfactory or taste disorders occured early in the disease were more likely to be recovered, otherwise they were hard to be recovered.

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ASTHMETIC CHILDRENS;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2628 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1209-1212

Author(s):

Sikandar Ali Bhand ◽

Chetan Das ◽

Farzana Sheikh ◽

Muhammad Akber Nizamani ◽

Muhammad Saeed

Keyword(s):

Corn Oil ◽

Early Morning ◽

Cross Sectional Study ◽

Health Science ◽

University Hospital ◽

Age Group ◽

Cross Sectional ◽

History Of ◽

Asthma Triggers

Objective: Objective of this study to determine the clinical presentation and frequency of asthma triggers in the children suffering from asthma at Liaquat university of medical and health science. Subjects & Methods: This cross sectional study was carried out at Liaquat University Hospital Hyderabad. All the patients were selected from OPD and pediatric ward of LUMHS. Complete history of allergy was taken from the cases and their parents and all the triggers of asthma were documented on the proforma. Results: Total 100 patients were included in the study. Majority of the cases in the age group of 1- 3years and 2nd most common age group was 4- 7 years with the percentage of 39% and 33% respectively. Majority of the cases 51%, while moderate was present in 35% cases and 14% children were seen with severe asthma condition. Asthma triggers in the children was found as; Smoking, Exercise, Dust, Pets, Ice, Plants, Carpets, Eggs, Corn oil, Allergic rhinitis and Without triggers, with the percentage of 22.%, 55.%, 51.%, 10.%, 34.%, 05.% ,11.%, 12.% , 27.%, 46.% and17.% respectively. Conclusions: In the conclusion of this study we concluded that allergic triggers perform the important role in the severity of asthma disease, these triggers attacks at night and early morning, so to avoid from the smoke, dust, allergens and proper management of asthma with good compliance and regular follow up of the patients.

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