Telehealth for patients with interstitial lung diseases (ILD): results of an international survey of clinicians

IntroductionClinicians and policymakers are promoting widespread use of home technology including spirometry to detect disease progression for patients with interstitial lung disease (ILD); the COVID-19 pandemic has accelerated this. Data collating clinicians’ views on the potential utility of telehealth in ILD are limited.AimThis survey investigated clinicians’ opinions about contemporary methods and practices used to monitor disease progression in patients with ILD using telehealth.MethodsClinicians were invited to participate in a cross-sectional survey (SurveyMonkey) of 13 questions designed by an expert panel. Telehealth was defined as home monitoring of symptoms and physiological parameters with regular automatic transmission of data from the patient’s home to the clinician. Data are presented as percentages of respondents.ResultsA total of 207 clinicians from 23 countries participated in the survey. A minority (81, 39%) reported using telehealth. 50% (n=41) of these respondents completed a further question about the effectiveness of telehealth. A majority of respondents (32, 70%) rated it to be quite or more effective than face-to-face visit. There were a greater number of respondents using telehealth from Europe (94, 45%) than Asia (51, 25%) and America (24%). Clinicians reported the most useful telehealth monitoring technologies as smartphone apps (59%) and wearable sensors (30%). Telehealth was most frequently used for monitoring disease progression (70%), quality of life (63%), medication use (63%) and reducing the need for in-person visits (63%). Clinicians most often monitored symptoms (93%), oxygen saturation (74%) and physical activity (72%). The equipment perceived to be most effective were spirometers (43%) and pulse oximeters (33%). The primary barriers to clinicians’ participation in telehealth were organisational structure (80%), technical challenges (63%) and lack of time and/or workload (63%). Clinicians considered patients’ barriers to participation might include lack of awareness (76%), lack of knowledge using smartphones (60%) and lack of confidence in telehealth (56%).ConclusionThe ILD clinicians completing this survey who used telehealth to monitor patients (n=81) supported its’ clinical utility. Our findings emphasise the need for robust research in telehealth as a mode for the delivery of cost-effective healthcare services in ILD and highlight the need to assess patients’ perspectives to improve telehealth utility in patients with ILD.

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The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

International Journal of Health and Life Sciences ◽

10.5812/ijhls.106944 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Saeed Asefzadeh ◽

Bahman Ahadi Nezhad ◽

Saeed Norouzi

Keyword(s):

Health Expenditures ◽

Medical Costs ◽

Healthcare Services ◽

Disease Diagnosis ◽

Cross Sectional Survey ◽

Diagnostic Laboratory ◽

Cross Sectional ◽

Out Of Pocket Payments ◽

Catastrophic Health Expenditures ◽

Catastrophic Expenditures

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

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Strategies for Re-opening Physiotherapy OPDs Post COVID-19 Lockdown – A Cross-sectional Study

10.20944/preprints202106.0111.v1 ◽

2021 ◽

Author(s):

Amarjot Singh Gill ◽

Nistara Singh Chawla ◽

Sandeep Singh Saini

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Healthcare Services ◽

Cross Sectional Study ◽

Practice Pattern ◽

Evidence Based ◽

Sectional Study ◽

Cross Sectional Survey ◽

Exclusion Criteria ◽

Cross Sectional

Background: The practices of various health-care professionals have been improvised to accommodate the on-going covid-19 pandemic situation. Different guidelines have been set in place to ease the process of re-opening of non-elective healthcare services like out-patient physiotherapy clinics. Although the measures taken should be guided by evidence based information, major consensus amongst practicing therapists needs to guide the India physiotherapy clinics. Objective: To identify and present the opinions of different physiotherapists about the various strategies for re-opening the out-patient physiotherapy clinics. Methods: An online cross-sectional survey was conducted. Over 169 participants were selected to participate in the survey according to the pre-decided inclusion and exclusion criteria. The data was collected and saved via google forms. Result and conclusion: A majority of respondents had a consensus over different strategies for re-opening the physiotherapy OPDs. These were regarding different measures to be adapted including modifications in the clinic infrastructure and the practice pattern. This would help in smoothly re-instating the physiotherapy services post the covid-19 lockdown.

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Electronic Health Use in the European Union and the Effect of Multimorbidity: Cross-Sectional Survey (Preprint)

10.2196/preprints.7299 ◽

2017 ◽

Author(s):

Francisco Lupiáñez-Villanueva ◽

Dimitra Anastasiadou ◽

Cristiano Codagnone ◽

Roberto Nuño-Solinís ◽

Maria Begona Garcia-Zapirain Soto

Keyword(s):

Health Care Professionals ◽

Online Survey ◽

New Technologies ◽

Cost Effective ◽

Health Problems ◽

Exploratory Research ◽

The European Union ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Electronic Health

BACKGROUND Multimorbidity is becoming increasingly common and is a leading challenge currently faced by societies with aging populations. The presence of multimorbidity requires patients to coordinate, understand, and use the information obtained from different health care professionals, while simultaneously striving to distinguish the symptoms of different diseases and self-manage their sometimes conflicting health problems. Electronic health (eHealth) tools provide a means to disseminate health information and education for both patients and health professionals and hold promise for more efficient and cost-effective care processes. OBJECTIVE The aim of this study was to analyze the use of eHealth tools, taking into account the citizens’ sociodemographic and clinical characteristics, and above all, the presence of multimorbidity. METHODS Cross-sectional and exploratory research was conducted using online survey data from July 2011 to August 2011. Participants included a total of 14,000 citizens from 14 European countries aged 16 to 74 years, who had used an eHealth tool in the past 3 months. The variables studied were sociodemographic variables of the participants, the questionnaire items assessing the frequency of using eHealth tools, the degree of morbidity, and the eHealth adoption gradient. Chi-square tests were conducted to examine the relationship between the sociodemographic and clinical variables of participants and the group the participants were assigned to according to their frequency of eHealth use (eHealth user group). A one-way analysis of variance (ANOVA) allowed for assessing the differences in the eHealth adoption gradient average between different groups of individuals according to their morbidity level. A two-way between-groups ANOVA was performed to explore the effects of multimorbidity and age group on the eHealth adoption gradient. RESULTS According to the eHealth adoption gradient, most participants (68.15%, 9541/14,000) were labeled as rare users, with the majority of them (55.1%, 508/921) being in the age range of 25 to 54 years, with upper secondary education (50.3%, 464/921), currently employed (49.3%, 454/921), and living in medium-sized cities (40.7%, 375/921). Results of the one-way ANOVA showed that the number of health problems significantly affected the use of eHealth tools (F2,13996=11.584; P<.001). The two-way ANOVA demonstrated that there was a statistically significant interaction between the effects of age and number of health problems on the eHealth adoption gradient (F4,11991=7.936; P<.001). CONCLUSIONS The eHealth adoption gradient has proven to be a reliable way to measure different aspects of eHealth use. Multimorbidity is associated with a more intense use of eHealth, with younger Internet users using new technologies for health purposes more frequently than older groups with the same level of morbidity. These findings suggest the need to consider different strategies aimed at making eHealth tools more sensitive to the characteristics of older populations to reduce digital disadvantages.

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Wearable Technology to Increase Self-Awareness of Low Back Pain: A Survey of Technology Needs among Health Care Workers

Sensors ◽

10.3390/s21248412 ◽

2021 ◽

Vol 21 (24) ◽

pp. 8412

Author(s):

Andrea Ferrone ◽

Christopher Napier ◽

Carlo Menon

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Economic Cost ◽

Machine Learning Techniques ◽

Self Awareness ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Learning Techniques ◽

Monitoring Technologies

Low back pain (LBP) is a leading contributor to musculoskeletal injury worldwide and carries a high economic cost. The healthcare industry is the most burdened, with nurses, in particular, being highly prone to LBP. Wearable technologies have the potential to address the challenges of monitoring postures that contribute to LBP and increase self-awareness of workplace postures and movements. We aimed to gain insight into workers’ perceptions of LBP and whether they would consider using wearable monitoring technologies to reduce injury risks. We conducted a cross-sectional survey to gather information from a selected population of nurses. Sixty-four participants completed the survey, and data were analyzed with the support of Machine Learning techniques. Findings from this study indicate that the surveyed population (64 nurses) is interested in these new approaches to monitor movement and posture in the workplace. This technology can potentially change the way ergonomic guidelines are implemented in this population.

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The State of Vaccine Confidence in Poland: A 2019 Nationwide Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124565 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4565 ◽

Cited By ~ 1

Author(s):

Filip M. Furman ◽

Wojciech Stefan Zgliczyński ◽

Mateusz Jankowski ◽

Tomasz Baran ◽

Łukasz Szumowski ◽

...

Keyword(s):

Cost Effective ◽

Vaccine Safety ◽

Cross Sectional Study ◽

Childhood Vaccination ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Positive Correlation ◽

Immunization Programme ◽

National Immunization Programme ◽

Vaccine Confidence

Vaccination is considered as one of the most successful and cost-effective public health interventions. This study aimed to assess (1) the attitudes and behaviors towards mandatory childhood vaccination, with particular emphasis on socio-economic factors determining the vaccine confidence among adults in Poland as well as to (2) identify the potential impact of anti-vaccination movement on vaccination coverage among children and adolescents aged ≤19 years. This cross-sectional study was carried in 2019 on a nationwide, representative sample of 1079 individuals aged 18 and over in Poland (53.7% females). Most of the respondents (74.6%) agreed or strongly agreed that mandatory vaccinations are safe, and only 8% of participants neglected the safety of vaccines. The results of multivariate analysis showed that the lowest level of vaccine confidence was observed among participants aged 25–34 years (aOR: 0.48, 95%CI: 0.29–0.80; p = 0.01). There was a positive correlation (r = 0.35; p < 0.001) between trust in doctors and vaccine confidence. Moreover, there was a positive correlation between trust in scientific knowledge and vaccine confidence (r = 0.19; p < 0.001). Also, a negative correlation (r = −0.13; p < 0.001) between trust in horoscopes and vaccine confidence was observed. Most of the parents declared (97.7%), that their children were vaccinated following the national immunization programme. However, 8.5% of parents who currently vaccinated their children declared that they would stop vaccinating children when vaccination obligation will be abolished. This study demonstrates relatively high confidence in mandatory vaccination among adults in Poland. While most of society trusts in vaccine safety, young adults are the least trustful of vaccinations.

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Antipsychotic use in a resource-limited setting: Findings in an Eastern Cape psychiatric hospital

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v23i0.1093 ◽

2017 ◽

Vol 23 ◽

Author(s):

Ingrid Eloff ◽

Willem Esterhuysen ◽

Kavendren Odayar

Keyword(s):

Psychiatric Hospital ◽

Health Sector ◽

Retrospective Chart Review ◽

Cost Effective ◽

Eastern Cape ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Resource Limited ◽

Significant Difference ◽

Switch Group

Background: Second-generation antipsychotics (SGAs) are commonly prescribed despite the fact that large, naturalistic studies have failed to show superior efficacy and tolerability when compared with first-generation antipsychotics (FGAs). In addition to this, the availability of SGAs in the South African public health sector is limited because of higher acquisition costs. Therefore, judicious use of FGAs, which are affordable and more widely available, should be considered.Aims: This study aimed to (1) determine how frequently patients are switched from an FGA to an SGA in an acute psychiatric hospital in the Eastern Cape, (2) determine reasons for switching and (3) compare the profiles of the switch group to the non-switch group.Method: The study is a cross-sectional survey conducted as a retrospective chart review at a psychiatric hospital in the Eastern Cape over a study period of 2 months. The demographics, diagnostic data, antipsychotic drug used and whether a switch from an FGA to an SGA took place were recorded using a data collection document. The sample included 169 patients.Results: Of the 169 patients, 125 (74%) were initiated on an FGA and 44 (26%) on an SGA on admission. Of the 125 patients who were initiated on an FGA, 43 (34%) were switched to an SGA during the course of the admission. Therefore, 87 (51%) participants were discharged on an SGA. The main reasons for switching were the emergence of extrapyramidal side-effects (EPSE) (63%) followed by lack of efficacy (19%). The only statistically significant difference between the switch and non-switch groups was that the switch group was on average younger than the non-switch group.Conclusion: SGAs, with the exception of clozapine, have not been proven to be superior to FGAs. Although FGAs are more prone to cause EPSE, SGAs carry significant risks of their own. FGAs are also more freely available and cost effective in South-Africa. Despite these facts the prescribing of and switching to SGAs remain prevalent in our setting with a switch rate of 34% and more than half of our patients being discharged on SGAs.

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Association between socioeconomic status and comorbidities among patients with rheumatoid arthritis: results of a nationwide cross-sectional survey

Rheumatology ◽

10.1093/rheumatology/kez081 ◽

2019 ◽

Vol 58 (9) ◽

pp. 1617-1622 ◽

Cited By ~ 3

Author(s):

Anna Shin ◽

Seunghwan Shin ◽

Ji Hyoun Kim ◽

You-Jung Ha ◽

Yun Jong Lee ◽

...

Keyword(s):

Socioeconomic Status ◽

Low Income ◽

Suicide Ideation ◽

Healthcare Services ◽

Depressive Mood ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Comprehensive Health ◽

Musculoskeletal Systems

Abstract Objectives We examined the association between socioeconomic status (SES) and comorbidity distribution among patients with RA. Methods Information on comprehensive health status of 1088 RA patients (weighted n = 612 303) was obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey database. SES components were household equivalence income, education and area of residence. To minimize confounding by age, patients were stratified by median age (63 years). Age-adjusted odds ratio (OR) with 95% confidence interval (95% CI) was estimated, comparing weighted prevalence of individual comorbidities between low and high SES groups in each age stratum. Results Among RA patients aged <63 years (mean 49 years, 70% female), we observed age-adjusted associations of depression (OR 2.13, 95% CI 1.01, 4.53), depressive mood (OR 2.68, 95% CI 1.54, 4.65), suicide ideation (OR 3.01, 95% CI 1.79, 5.07), diabetes (OR 3.09, 95%CI 1.31, 7.29), obesity (OR 2.04, 95% CI 1.30, 3.20), hypertriglyceridemia (OR 2.36, 95% CI 1.28, 4.34) and osteoarthritis (OR 2.12, 95% CI 1.13, 3.99) with low income, of suicide ideation with low education (OR 2.25, 95% CI 1.14, 4.44), but no association of any comorbidities with area of residence. Unhealthy behavior patterns were comparable between low- and high-income groups but patients with low income reported a numerically higher rate of failed access to necessary healthcare services. We did not find any association between SES and comorbidities among those aged ⩾63 years (mean 72 years, 83% female). Conclusion Among Korean RA patients aged <63 years, socioeconomic inequalities of multiple comorbidities in mental, cardiometabolic and musculoskeletal systems were found.

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v3 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities.Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v2 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district. Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities. Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Aggression at the service delivery interface: Do you see what I see?

Journal of Management & Organization ◽

10.5172/jmo.837.14.2.180 ◽

2008 ◽

Vol 14 (2) ◽

pp. 180-192 ◽

Cited By ~ 4

Author(s):

Loraleigh Keashly ◽

Joel H Neuman

Keyword(s):

Service Delivery ◽

Service Provider ◽

Service Providers ◽

Temporal Dynamics ◽

Healthcare Services ◽

Department Of Veterans Affairs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Research Attention ◽

Us Military

AbstractAggression at the service delivery interface (the point of contact between service provider and service recipient) has become a focus of much recent research attention. However, much of what we know is based on cross-sectional survey data – which tells us little about the underlying dynamics within specific aggressive incidents. Further, these data are often collected from the perspective of the service provider alone. For this study, we focused on specific hostile interactions during the delivery of healthcare services and gathered data from the perspectives of service providers and service recipients. Drawing on interviews with US Department of Veterans Affairs (VA) staff and US military veterans, we categorised and compared each party's attributions for the initiation of hostile (unpleasant) encounters. We found that staff and veterans had different perspectives on the nature of precipitating factors and that the initial attribution for the event was linked to differences in subsequent responding. These findings are discussed in terms of their insight into the temporal dynamics of aggressive events and their implications for the prevention and management of hostility at the service delivery interface.

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