scholarly journals Service use, clinical outcomes and user experience associated with urgent care services that use telephone-based digital triage: a systematic review

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051569
Author(s):  
Vanashree Sexton ◽  
Jeremy Dale ◽  
Carol Bryce ◽  
James Barry ◽  
Elizabeth Sellers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
User Experience ◽  
Service Use ◽  
Urgent Care ◽  
Narrative Synthesis ◽  
Eligibility Criteria ◽  
Patient Level ◽  
High Urgency ◽  
The Impact

ObjectiveTo evaluate service use, clinical outcomes and user experience related to telephone-based digital triage in urgent care.DesignSystematic review and narrative synthesis.Data sourcesMedline, Embase, CINAHL, Web of Science and Scopus were searched for literature published between 1 March 2000 and 1 April 2020.Eligibility criteria for selecting studiesStudies of any design investigating patterns of triage advice, wider service use, clinical outcomes and user experience relating to telephone based digital triage in urgent care.Data extraction and synthesisTwo reviewers extracted data and conducted quality assessments using the mixed methods appraisal tool. Narrative synthesis was used to analyse findings.ResultsThirty-one studies were included, with the majority being UK based; most investigated nurse-led digital triage (n=26). Eight evaluated the impact on wider healthcare service use following digital triage implementation, typically reporting reduction or no change in service use. Six investigated patient level service use, showing mixed findings relating to patients’ adherence with triage advice. Evaluation of clinical outcomes was limited. Four studies reported on hospitalisation rates of digitally triaged patients and highlighted potential triage errors where patients appeared to have not been given sufficiently high urgency advice. Overall, service users reported high levels of satisfaction, in studies of both clinician and non-clinician led digital triage, but with some dissatisfaction over the relevance and number of triage questions.ConclusionsFurther research is needed into patient level service use, including patients’ adherence with triage advice and how this influences subsequent use of services. Further evaluation of clinical outcomes using larger datasets and comparison of different digital triage systems is needed to explore consistency and safety. The safety and effectiveness of non-clinician led digital triage also needs evaluation. Such evidence should contribute to improvement of digital triage tools and service delivery.PROSPERO registration numberCRD42020178500.

scholarly journals An evaluation of service user experience, clinical outcomes and service use associated with urgent care services that utilise telephone-based digital triage: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Vanashree Sexton ◽  
Jeremy Dale ◽  
Helen Atherton
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Clinical Outcomes ◽  
User Experience ◽  
Service User ◽  
Service Use ◽  
Urgent Care ◽  
Narrative Synthesis ◽  
Service User Experience ◽  
Synthesis Approach

Abstract Background Telephone-based digital triage is widely used by services that provide urgent care. This involves a call handler or clinician using a digital triage tool to generate algorithm-based care advice, based on a patient’s symptoms. Advice typically takes the form of signposting within defined levels of urgency to specific services or self-care advice. Despite wide adoption, there is limited evaluation of its impact on service user experience, service use and clinical outcomes; no previous systematic reviews have focussed on services that utilise digital triage, and its impact on these outcome areas within urgent care. This review aims to address this need, particularly now that telephone-based digital triage is well established in healthcare delivery. Methods Studies assessing the impact of telephone-based digital triage on service user experience, health care service use and clinical outcomes will be identified through searches conducted in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus. Search terms using words relating to digital triage and urgent care settings (excluding in-hours general practice) will be used. The review will include all original study types including qualitative, quantitative and mixed methods studies; studies published in the last 20 years and studies published in English. Quality assessment of studies will be conducted using the Mixed Methods Appraisal Tool (MMAT); a narrative synthesis approach will be used to analyse and summarise findings. Discussion This is the first systematic review to evaluate service user experience, service use and clinical outcomes related to the use of telephone-based digital triage in urgent care settings. It will evaluate evidence from studies of wide-ranging designs. The narrative synthesis approach will enable the integration of findings to provide new insights on service delivery. Models of urgent care continue to evolve rapidly, with the emergence of self-triage tools and national help lines. Findings from this review will be presented in a practical format that can feed into the design of digital triage tools, future service design and healthcare policy. Systematic review registration This systematic review is registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO 2020 CRD42020178500).

scholarly journals Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037139
Author(s):  
Nicole Etherington ◽  
Mimi Deng ◽  
Sylvain Boet ◽  
Amy Johnston ◽  
Fadi Mansour ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
High Risk Patient ◽  
Sex And Gender ◽  
Eligibility Criteria ◽  
Clinical Patient ◽  
Processes Of Care ◽  
Operative Care ◽  
The Impact

ObjectivesThis systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.DesignA systematic review.Data sourcesSearches were conducted in PsycINFO, Embase and Medline from inception to 6 September 2018. The reference lists of relevant systematic reviews and included studies were also searched.Eligibility criteria for selecting studiesQuantitative studies of any design were included if they were published in English or French, involved patients of any age undergoing a cardiac surgical procedure and specifically assessed differences in processes of care or clinical patient outcomes by physician’s sex or gender. Studies were screened in duplicate by two pairs of independent reviewers.Outcome measuresProcesses of care, patient morbidity and patient mortality.ResultsThe search yielded 2095 publications after duplicate removal, of which two were ultimately included. These studies involved various types of surgery, including cardiac. One study found that patients treated by female surgeons compared with male surgeons had a lower 30-day mortality. The other study, however, found no differences in patient outcomes by surgeon’s sex. There were no studies that investigated anaesthesiologist’s sex/gender. There were also no studies investing physician’s sex or gender exclusively in the cardiac operating room.ConclusionsThe limited data surrounding the impact of physician’s sex/gender on the outcomes of cardiac surgery inhibits drawing a robust conclusion at this time. Results highlight the need for primary research to determine how these factors may influence cardiac operative practice, in order to optimise provider’s performance and improve outcomes in this high-risk patient group.

The Impact of Environmental Stress on Cognitive Performance: A Systematic Review

2019 ◽  
Vol 61 (8) ◽  
pp. 1205-1246 ◽  
Author(s):  
Kristy Martin ◽  
Emily McLeod ◽  
Julien Périard ◽  
Ben Rattray ◽  
Richard Keegan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Environmental Stress ◽  
Task Performance ◽  
Sea Level ◽  
Cognitive Performance ◽  
Cognitive Task ◽  
Individual Characteristics ◽  
Eligibility Criteria ◽  
Healthy Human ◽  
The Impact

Objective: In this review, we detail the impact of environmental stress on cognitive and military task performance and highlight any individual characteristics or interventions which may mitigate any negative effect. Background: Military personnel are often deployed in regions markedly different from their own, experiencing hot days, cold nights, and trips both above and below sea level. In spite of these stressors, high-level cognitive and operational performance must be maintained. Method: A systematic review of the electronic databases Medline (PubMed), EMBASE (Scopus), PsycINFO, and Web of Science was conducted from inception up to September 2018. Eligibility criteria included a healthy human cohort, an outcome of cognition or military task performance and assessment of an environmental condition. Results: The search returned 113,850 records, of which 124 were included in the systematic review. Thirty-one studies examined the impact of heat stress on cognition; 20 of cold stress; 59 of altitude exposure; and 18 of being below sea level. Conclusion: The severity and duration of exposure to the environmental stressor affects the degree to which cognitive performance can be impaired, as does the complexity of the cognitive task and the skill or familiarity of the individual performing the task. Application: Strategies to improve cognitive performance in extreme environmental conditions should focus on reducing the magnitude of the physiological and perceptual disturbance caused by the stressor. Strategies may include acclimatization and habituation, being well skilled on the task, and reducing sensations of thermal stress with approaches such as head and neck cooling.

Impact of economic and financial crimes on economic growth in emerging and developing countries

2019 ◽  
Vol 26 (3) ◽  
pp. 910-920 ◽  
Author(s):  
Sani Abubakar Saddiq ◽  
Abu Sufian Abu Bakar
Keyword(s):  
Systematic Review ◽  
Developing Countries ◽  
Negative Impact ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Content Type ◽  
Research Reporting ◽  
Financial Crimes ◽  
Emerging And Developing Countries ◽  
The Impact

Purpose The purpose of the study is to investigate the impact of economic and financial crimes on the economies of emerging and developing countries. Design/methodology/approach Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and meta-analysis of economics research reporting guidelines were used to conduct a quantitative synthesis of empirical evidence on the impact of economic and financial crimes in developing and emerging countries. Findings A total of 103 studies were searched, out of which 6 met the selection/eligibility criteria of this systematic review. The six selected studies indicated that economic and financial crimes have a negative impact in emerging and developing countries. Originality/value To the best knowledge of the authors, no published systematic review of the impact of economic and financial crimes in developing countries has been conducted to date.

The Efficacy of Traditional Cognitive Behavioural Therapy for Depressed Adults with Anhedonia: A Systematic Review

2021 ◽  
Vol 7 (5) ◽  
pp. 520-544
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Primary Outcome ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Eligibility Criteria ◽  
Cognitive Behavioural ◽  
System Therapy ◽  
Randomised Controlled ◽  
The Impact

To date, the impact of traditional cognitive behavioural therapy (CBT) on anhedonia in major depressive disorder (MDD) has yet been systematically evaluated. This systematic review aims to examine the efficacy of traditional CBT for depressed adults with anhedonia. A literature search for randomised controlled trials of traditional CBT in adults with MDD from inception to July 2020 was conducted in 8 databases. The primary outcome was the levels of anhedonia. Ten studies with adults with MDD met the eligibility criteria. Our results indicate that traditional CBT is as effective as euthymic therapy, positive psychology therapy, self-system therapy,and medications for anhedonia in depression. Besides, our data provide further support for the development of augmented CBT to optimise treatment outcome for depressed adults with anhedonia. Received 11th June 2021; Revised 2nd September 2021; Accepted 20th September 2021

scholarly journals Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031598 ◽  
Author(s):  
Clare Meernik ◽  
Hannah M Baker ◽  
Sarah D Kowitt ◽  
Leah M Ranney ◽  
Adam O Goldstein
Keyword(s):  
Systematic Review ◽  
Risk Perceptions ◽  
Longitudinal Research ◽  
Age Groups ◽  
Experimental Studies ◽  
Final Analysis ◽  
Eligibility Criteria ◽  
Product Appeal ◽  
The Impact

ObjectivesGiven the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults.DesignPubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018.Eligibility criteriaQuantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation.Data extraction and synthesisThree authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure.ResultsThe review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies).ConclusionThis review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.

scholarly journals The impact of asynchronous e-visits on clinical outcomes and healthcare delivery: A systematic review (Preprint)

2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Antibiotic Prescribing ◽  
Infection Management ◽  
The Impact

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable

scholarly journals Using Patient Portals to Improve Patient Outcomes: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Hae-Ra Han ◽  
Kelly T Gleason ◽  
Chun-An Sun ◽  
Hailey N Miller ◽  
Soo Jin Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Service Use ◽  
The United States ◽  
Preventive Service ◽  
Patient Portal ◽  
Patient Portals ◽  
Wide Range

BACKGROUND With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes. OBJECTIVE This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions. METHODS In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria. RESULTS All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient’s condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed. CONCLUSIONS Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.

scholarly journals Systematic review of the current state of research on Online Social Networks: Taxonomy on experience of use

Comunicar ◽  
2019 ◽  
Vol 27 (60) ◽  
pp. 81-91 ◽  
Author(s):  
Miguel-Ángel Pertegal-Vega ◽  
Alfredo Oliva-Delgado ◽  
Ana Rodríguez-Meirinhos
Keyword(s):  
Systematic Review ◽  
Social Networks ◽  
User Experience ◽  
Psychosocial Development ◽  
Online Social Networks ◽  
Social Processes ◽  
Redes Sociales ◽  
Eligibility Criteria ◽  
Identity Processes ◽  
Revisión Sistemática

The widespread use of online social networks (OSN) among young people has been accompanied by an increase of publications about them and their effects on the psychosocial development of users. Previous panoramic reviews on OSN research are now outdated and do not provide a comprehensive view of the complexity of the user experience. The aims of this systematic review were three: to identify quantitative studies on OSN; to build a taxonomy about the user experience; and to classify studied variables in the topics and subtopics. The literature search and review according to PICoS strategy led to 546 identified publications that met the eligibility criteria. The taxonomy included nine major topics: overall use; activities and types of use; perceptions and attitudes OSN; the social network of online contacts; needs and motives for use; profile and privacy management; social processes; identity processes; and cognitive-emotional processes related to use of OSN. The three most studied topics were: overall use; activities and types of use; and social processes related to use of OSN. Classification and quantification of the different variables studied about the users’ experience is detailed. Several theoretical perspectives are discussed, as well as the gaps and challenges in OSN research. The proposed taxonomy could be useful for researchers to better delineate the aims of future studies. La generalización del uso de redes sociales en jóvenes ha supuesto un incremento notable de las publicaciones sobre ellas y sobre sus efectos en el desarrollo psicosocial de los usuarios. Las tentativas previas de revisión panorámica sobre redes quedaron desfasadas y no aportan una visión comprehensiva de la complejidad de la experiencia de uso. Los objetivos de esta revisión sistemática actualizada fueron: identificar estudios cuantitativos sobre redes; construir una taxonomía sobre la experiencia de uso; y clasificar las variables estudiadas en temas y subtemas. La búsqueda y revisión de literatura siguiendo la estrategia PICoS identificó 546 estudios que cumplían los criterios de inclusión. La taxonomía incluyó nueve grandes temáticas investigadas: descripción y cuantificación del uso; actividades y tipos de uso; percepción y actitudes influyentes en el uso; red social de contactos; necesidades y motivos de uso; gestión del perfil y privacidad; procesos sociales; procesos identitarios; y procesos cognitivos-emocionales. Los tres temas más estudiados fueron: la descripción y cuantificación del uso; las actividades y tipos de uso; y los procesos sociales relacionados con el uso. Se detalla la clasificación, cuantificación e integración de las diversas variables estudiadas sobre la experiencia de uso. Las diferentes tradiciones de estudio, así como las lagunas, problemas y retos de la investigación sobre redes son discutidas. Dicha taxonomía será de utilidad para que investigadores puedan encuadrar mejor los objetivos de futuros estudios.

scholarly journals What Is the Impact of Ambulatory Vital Sign Monitoring on Deterioration Detection and Related Clinical Outcomes in Hospitalised Patients: a Systematic Review and Meta-analysis.

2021 ◽  
Author(s):  
Carlos Morgado Areia ◽  
Christopher Biggs ◽  
Mauro Santos ◽  
Neal Thurley ◽  
Stephen Gerry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Standard Care ◽  
Meta Analysis ◽  
Ambulatory Monitoring ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Monitoring Systems ◽  
Hospitalised Patients ◽  
The Impact

Abstract Background: Timely recognition of the deteriorating inpatient remains challenging. Ambulatory monitoring systems (AMS) may augment current monitoring practices. However, there are many challenges to implementation in the hospital environment, and evidence describing the clinical impact of AMS on deterioration detection and patient outcome remains unclear. Objective: To assess the impact of vital signs monitoring on detection of deterioration and related clinical outcomes in hospitalised patients using ambulatory monitoring systems, in comparison with standard care.Methods: A systematic search was conducted in August 2020 using MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, CENTRAL and Health Technology Assessment databases, as well as grey literature. Studies comparing the use of AMS against standard care for deterioration detection and related clinical outcomes in hospitalised patients were included. Deterioration related outcomes (primary) included unplanned intensive care admissions, rapid response team or cardiac arrest activation, total and major complications rate. Other clinical outcomes (secondary) included in-hospital mortality and hospital length of stay. Exploratory outcomes included alerting system parameters and clinical trial registry information. Results: Of 8706 citations, 10 studies with different designs met the inclusion criteria, of which 7 were included in the meta-analyses. Overall study quality was moderate. The meta-analysis indicated that the AMS, when compared with standard care, was associated with a reduction in intensive care transfers (risk ratio, RR, 0.87; 95% confidence interval, CI, 0.66 to 1.15), rapid response or cardiac arrest team activation (RR, 0.84; 95% CI 0.69 to 1.01), total (RR, 0.77; 95% CI 0.44 to 1.32) and major (RR, 0.55; 95% CI 0.24 to 1.30) complications prevalence. There was also association with reduced mortality (RR, 0.48; 95% CI 0.18 to 1.29) and hospital length of stay (mean difference, MD, -0.09; 95% CI -0.43 to 0.44). However, none were statistically significant.Conclusion: This systematic review indicates that implementation of AMS may have a positive impact on early deterioration detection and associated clinical outcomes, but differing design/quality of available studies and diversity of outcomes measures limits a definite conclusion. Our narrative findings suggested that alarms should be adjusted to minimise false alerts and promote rapid clinical action in response to deterioration.PROSPERO Registration number: CRD42020188633

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