Exploring how virtual primary care visits affect patient burden of treatment

2020 ◽  
Vol 141 ◽  
pp. 104228
Author(s):  
L.T. Kelley ◽  
M. Phung ◽  
V. Stamenova ◽  
J. Fujioka ◽  
P. Agarwal ◽  
...  
PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0241485
Author(s):  
Pilar Espinoza ◽  
Camila A. Varela ◽  
Ivonne E. Vargas ◽  
Galo Ortega ◽  
Paulo A. Silva ◽  
...  

Author(s):  
Rohit . ◽  
Devesh Kumar Joshi ◽  
Raja Paramjeet Singh Banipal

Background: Radiation therapy is associated with certain adverse events which may cause significant discomfort to patient and may affect patient’s life. The objective of the study was to assess radiation related adverse events in the patients who are on radiation therapy and to prevent and manage these adverse events.Methods: A prospective observational study was conducted on 193 patients receiving radiotherapy in Oncology Department at Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. One fraction (2 Gray) dose had been given to patients daily for five days in a week and monitor. The collected data was analyzed by applying IBM SPSS v21.Results: The clinical results observed in 193 consecutive patients with follow-up of 7 weeks and graded according to RTOG Acute Radiation Morbidity Scoring Criteria. Majority of events were reported in age group of 41-60 years followed by 61-80 years, 20-40 years. Epidermal, mucosal, Genitourinary and Lower G.I. reactions are graded. The reactions managed by providing symptomatic treatment.Conclusions: Radiation related adverse events have been found frequently in patients with radiotherapy and chemo-radiotherapy both. As the number of doses increase with time the grade of reactions also increases. Appropriate follow-up and management of these events reduces patient burden of treatment.


2020 ◽  
Vol 10 ◽  
pp. 2235042X2098406
Author(s):  
Eng Sing Lee ◽  
Gayathri Muthulingam ◽  
Evelyn Ai Ling Chew ◽  
Poay Sian Sabrina Lee ◽  
Hui Li Koh ◽  
...  

Background: Patients with multimorbidity must bear not just the burden of their illness, but also the burden of treatment which is, in part, induced by their interactions with the healthcare system. The need to shuttle between different healthcare institutions and multiple healthcare providers can make navigating the healthcare system challenging, and this may be even more so for older patients with limited resources and support. Objectives: Few qualitative studies have explored the experiences of patients with multimorbidity in navigating the healthcare system. This study will explore the experiences of older patients with multimorbidity and their caregivers as they navigate through the healthcare system. We aim to arrive at a better understanding of patient experiences of possible gaps in the continuity of care and how the current system can be modified and adapted to better address the needs of older patients with multimorbidity. Method: Semi-structured, in-depth interviews will be conducted with purposively sampled older patients with multimorbidity, aged 60 and above seen in primary care, together with their caregivers. Interviews will be transcribed verbatim and analysed by the study team using inductive thematic analysis. Conclusions: Our study seeks to explore the navigational experiences within the healthcare system for older patients with multimorbidity in an Asian, multi-ethnic society. The findings will be shared with decision-makers in the healthcare setting in order to improve patient care for this population and ultimately maximise their positive health outcomes, and will add to better understanding how the burden of treatment arising from navigational challenges within the healthcare system may be reduced for older patients with multimorbidity.


2019 ◽  
Vol 36 (5) ◽  
pp. 657-665 ◽  
Author(s):  
Weng Yee Chin ◽  
Carlos King Ho Wong ◽  
Cherry Cheuk Wai Ng ◽  
Edmond Pui Hang Choi ◽  
Cindy Lo Kuen Lam

Abstract Background The Burden of Treatment Questionnaire (TBQ) assesses the impact of a patient’s treatment workload on their quality of life Objectives The aim was to translate and validate the TBQ on Chinese primary care patients with multi-morbidity. Methods The English TBQ was translated and back-translated using professional translators. Cognitive debriefing interviews were performed on 15 patients. The resulting instrument was tested on 200 primary care patients with multi-morbidity (>1 chronic disease) to examine its psychometric performance including exploratory factor analysis, confirmatory factor analysis, internal consistency and reliability. The EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), Short-Form Six-Dimension (SF-6D), WONCA COOP Charts and the Global Health Rating Scale were used to assess convergent and divergent validity. Results Median age of the respondents was 62 years (range 22–95 years) with a median of four conditions. The median TBQ total score was 16 (interquartile range 7.25–30). There was a significant floor effect (>15%) observed for all items. Spearman’s correlations was >0.4 for all items demonstrating adequate internal construct validity. TBQ global score correlated with number of conditions (P = 0.034), EQ-5D-5L (P < 0.001), SF-6D (P < 0.001) and the feelings (P = 0.004), daily activities (P = 0.003) and social activities (P < 0.001) domains of the WONCA COOP. There was no significant correlation between global health rating and TBQ global scores (P = 0.298). Factor analysis demonstrated a three-factor structure. There was good internal consistency (Cronbach’s alpha = 0.842) and good test–retest reliability (intra-class correlation coefficient = 0.830). Conclusion The newly translated Chinese version of the TBQ appears to be valid and reliable for use in Cantonese-speaking, adult primary care patients with multi-morbidity.


2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.


ASHA Leader ◽  
2016 ◽  
Vol 21 (6) ◽  
pp. 18-19
Author(s):  
Barbara E. Weinstein

Addiction ◽  
1997 ◽  
Vol 92 (12) ◽  
pp. 1705-1716 ◽  
Author(s):  
Sandra K. Burge ◽  
Nancy Amodei ◽  
Bernice Elkin ◽  
Selina Catala ◽  
Sylvia Rodriguez Andrew ◽  
...  

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