scholarly journals A153 QUALITY OF CARE AND OUTCOMES IN A TERTIARY HOSPITAL INFLAMMATORY BOWEL (IBD) CENTER: MONITORING AND TREATMENT ALGORITHMS DURING FOLLOW-UP

2018 ◽  
Vol 1 (suppl_2) ◽  
pp. 229-229
Author(s):  
S Restellini ◽  
L Gonczi ◽  
Z Kurti ◽  
T Bessissow ◽  
W Afif ◽  
...  
2015 ◽  
Vol 51 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Lars-Petter Jelsness-Jørgensen ◽  
Tomm Bernklev ◽  
Øistein Hovde ◽  
Ingrid Prytz Berset ◽  
Gert Huppertz-Hauss ◽  
...  

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ronald Kiguba ◽  
Charles Karamagi ◽  
Sheila M. Bird

Abstract Background Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria in-patients is not well documented in sub-Saharan Africa, particularly in Uganda. The study sought to describe the patterns of malaria diagnosis and treatment among adult in-patients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014. Methods A prospective cohort of 762 consented in-patients aged ≥ 18 years was assembled. Proportions of in-patients who received preadmission and in-hospital anti-malarials, missed Day 1 dosing of hospital-initiated anti-malarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of anti-malarials. Results One in five (19%, 146/762) in-patients had an admission or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22–42 years). Microscopy was requested in 77% (108/141) of in-patients with an admission malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for Plasmodium falciparum malaria parasitaemia. Only 13% (11/83) of in-patients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated anti-malarial treatment followed by injectable Q only (23%, 23/100) amongst in-patients who received in-hospital anti-malarials. A quarter (25%, 25/100; 95% CI: 17–35%) of in-patients missed Day 1 dosing of hospital-initiated anti-malarials. Each additional admission diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital anti-malarials (aOR = 2.6, 95% CI: 1.52–4.56; P-value = 0.001). Conclusions Half the malaria microscopy results were not available; yet, the rate of testing was high. The majority of in-patients initiated on injectable AS or Q did not receive the recommended follow-up oral AL. One in four in-patients delayed to initiate hospital anti-malarials by at least one calendar day. The hospital should encourage prompt availability of malaria test-results to promote the timely initiation and completion of anti-malarial treatment, thereby improving the quality of care for hospitalized malaria patients in Uganda.


2017 ◽  
Vol 49 (9) ◽  
pp. 997-1002 ◽  
Author(s):  
Marco Daperno ◽  
Aurora Bortoli ◽  
Anna Kohn ◽  
Patrizia Politi ◽  
Stefano Marconi ◽  
...  

2020 ◽  
Author(s):  
Ronald Kiguba ◽  
Charles Karamagi ◽  
Sheila M. Bird

Abstract Background: Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria inpatients is not well documented in sub-Saharan Africa, particularly in Uganda. We sought to describe the patterns of malaria diagnosis and treatment among adult inpatients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014.Methods: A prospective cohort of 762 consented inpatients aged >18 years was assembled. Proportions of inpatients who received preadmission and in-hospital antimalarials, missed Day 1 dosing of hospital-initiated antimalarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of antimalarials.Results: One in five (19%, 146/762) inpatients had an admitting or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22 to 42 years). Microscopy was requested in 77% (108/141) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for malaria parasitaemia. Only 13% (11/83) of inpatients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); only 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated antimalarial followed by injectable Q only (23%, 23/100). A quarter (25%, 25/100; 95% CI: 17% to 35%) of inpatients missed Day 1 dosing of hospital-initiated antimalarials. Each additional admitting diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital antimalarials (aOR = 2.6, 95% CI: 1.52-4.56; P-value = 0.001).Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. The majority of inpatients initiated on injectable AS or Q did not receive the recommended follow-up treatment of oral AL. One in four inpatients delayed to initiate hospital antimalarials by at least one calendar day. The hospital should encourage prompt availability of malaria test-results to promote the timely initiation and completion of antimalarial treatment, thereby improving the quality of care for hospitalized malaria patients in Uganda.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 56-57
Author(s):  
M Painchaud ◽  
S Singh ◽  
R M Penner

Abstract Background Due to the COVID-19 pandemic, clinics were forced to implement telehealth into clinical practice. Inflammatory bowel disease (IBD) patients are a unique population that require long-term care to achieve and maintain deep remission of disease. Thus, they require stable and continuous contact with healthcare providers, often with multiple appointments. We examined an IBD predominant practice, also providing care for general gastrointestinal (GI) conditions in Kelowna, British Columbia. As telehealth has the potential to become a standard of care for clinics, patient satisfaction must be considered. We hypothesize that with the efficacy and ease of remote appointments, there will be an increase in patient satisfaction, quality of care, and quality of communication. Aims We aim to compare the level of patient satisfaction between in-person appointments pre-pandemic, and current remote appointment telehealth practices. Methods An online survey was sent to the 608 patients who had participated in one or more remote appointment between March 15-June 15, 2020. The survey compared the level of patient satisfaction, quality of care, and quality of communication between patient and doctor before and during the pandemic. It was also determined if patients would elect to continue with remote appointments in the future due to ease of use, and time/financial resources saved. Results Of the 273 participants, 80% were IBD patients while 20% were treated for other GI conditions. A total of 78% reported that they would elect to continue with remote appointments as their primary point of care with their doctor. The remaining 22% reported that they prefer in-person visits due to the necessity of a physical exam, yet specified that communication by these remote means was still of good quality. Levels of patient satisfaction before and during the pandemic remained consistent, where 59% of patients assigned a satisfaction rating of 10 (highest) to their pre-pandemic in-person appointments, and 54% of patients assigned a rating of 10 to their remote appointments during the pandemic. Similar consistent results were found for quality of care and quality of communication. A total of 70% of patients reported that if this service had not been available, they would have sought out other forms of care; 18% of the total responses considering emergency care. Conclusions IBD patients at Kelowna Gastroenterology perceived similar levels of satisfaction, quality of care, and quality of communication with both in-person and telehealth appointments. This suggests that telehealth practices may be a cost-effective, sustainable appointment style that provides comparable quality to in-person appointments. Funding Agencies None


Seizure ◽  
1999 ◽  
Vol 8 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Nicola Mills ◽  
Max O. Bachmann ◽  
Rona Campbell ◽  
Iain Hine ◽  
Mervyn McGowan

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