Incorporating patient perspectives in the science of uterus transplantation

BACKGROUND Background: Online forward triage tools (OFTT) or symptom checkers are being widely used during this COVID-19 pandemic. The effects and utility of such tools however, have not been widely assessed. OBJECTIVE Objective: To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, exploring patient perspectives as well as eliciting recommendations for tool improvement. METHODS Methods: We employed a mixed-method sequential explanatory study design. Quantitative data of all users of the OFTT between March 2nd, 2020 and May 12th, 2020 were collected. A follow-up survey of people who consented to participation was conducted. Secondly, qualitative data was collected through key informant interviews (n=19) to explain the quantitative findings, as well as explore tool utility, user experience and elicit recommendations. RESULTS Results: An estimate of the effects, (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, and recommendations for tool improvement. In the study period, 6,272 users consulted our OFTT; 560 participants consented to a follow-up survey and provided a valid e-mail address. 176 (31.4%) participants returned a complete follow-up questionnaire. 85.2% followed the recommendations given. 41.5% reported that their fear was allayed after using tool and 41.1% would have contacted the GP or visited a hospital had the tool not existed. Qualitatively, seven overarching themes emerged namely i) accessibility of tool, ii) user-friendliness of tool, iii) utility of tool as an information source, iv) utility of tool in allaying fear and anxiety, v) utility of tool in decision making (test or not to test), vi) utility of tool in reducing the potential for onward transmissions (preventing cross infection) and vii) utility of tool in reducing health system burden. CONCLUSIONS Conclusion: Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden, but can also serve as an information source, reduce anxiety and fear, reduce cross infections and facilitate decision making (to test or not to test). Further studies are needed to assess the transferability of these COVID-19 OFTT findings to other contexts as the second wave sweeps across Europe.

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Rethinking Telerehabilitation: Attitudes of Physical Therapists and Patients

Journal of Patient Experience ◽

10.1177/23743735211034335 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110343

Author(s):

Fereshteh Saaei ◽

Susan G Klappa

Keyword(s):

Patient Population ◽

Physical Therapists ◽

Physical Therapist ◽

Patient Survey ◽

Patient Perspectives ◽

Remote Care ◽

Virtual Therapy ◽

Therapy Sessions

COVID-19 has accelerated the adoption of telehealth among various specialties, including rehabilitation. The fast-paced implementation of telerehabilitation has laid bare its challenges, providing an opportunity for innovation in order to enhance the experience of remote care. The purpose of this study sought to understand the attitudes toward telerehabilitation from physical therapist (PT) and patient perspectives. Two surveys administered to PTs, and the general patient population explored beliefs regarding telerehabilitation. There were a total of 289 participant responses in this study. There were 228 PT respondents and 61 patients who responded to the patient survey. Qualitative results describe current attitudes toward telerehabilitation. Results indicated both groups were receptive to virtual therapy sessions; however, some challenges were also reported. Current challenges and trends in utilizing telerehabilitation are further discussed.

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SPD PATIENT PERSPECTIVES

Pediatric Dermatology ◽

10.1111/pde.14675 ◽

2021 ◽

Vol 38 (3) ◽

Keyword(s):

Patient Perspectives

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Food Allergy Treatment Value: Child Caregiver and Patient Perspectives

Pediatric Allergy and Immunology ◽

10.1111/pai.13464 ◽

2021 ◽

Author(s):

Moaz Abdelwadoud ◽

Sanaz Eftekhari ◽

Hannah Jaffee ◽

Melanie Carver ◽

T. Joseph Mattingly

Keyword(s):

Food Allergy ◽

Patient Perspectives ◽

Allergy Treatment ◽

Child Caregiver

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Preimplantation genetic testing for aneuploidy in uterus transplant patients

Therapeutic Advances in Reproductive Health ◽

10.1177/26334941211009848 ◽

2021 ◽

Vol 15 ◽

pp. 263349412110098

Author(s):

Rhea Chattopadhyay ◽

Elliott Richards ◽

Valerie Libby ◽

Rebecca Flyckt

Keyword(s):

Genetic Testing ◽

In Vitro Fertilization ◽

Immunosuppressive Agents ◽

Live Birth Rate ◽

Preimplantation Genetic Testing ◽

Vitro Fertilization ◽

Uterus Transplantation ◽

Advantages And Disadvantages ◽

Dilation And Curettage

Uterus transplantation is an emerging treatment for uterine factor infertility. In vitro fertilization with cryopreservation of embryos prior is required before a patient can be listed for transplant. Whether or not to perform universal preimplantation genetic testing for aneuploidy should be addressed by centers considering a uterus transplant program. The advantages and disadvantages of preimplantation genetic testing for aneuploidy in this unique population are presented. The available literature is reviewed to determine the utility of preimplantation genetic testing for aneuploidy in uterus transplantation protocols. Theoretical benefits of preimplantation genetic testing for aneuploidy include decreased time to pregnancy in a population that benefits from minimization of exposure to immunosuppressive agents and decreased chance of spontaneous abortion requiring a dilation and curettage. Drawbacks include increased cost per in vitro fertilization cycle, increased number of required in vitro fertilization cycles to achieve a suitable number of embryos prior to listing for transplant, and a questionable benefit to live birth rate in younger patients. Thoughtful consideration of whether or not to use preimplantation genetic testing for aneuploidy is necessary in uterus transplant trials. Age is likely a primary factor that can be useful in determining which uterus transplant recipients benefit from preimplantation genetic testing for aneuploidy.

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