scholarly journals Telemedicine use by pediatric rheumatologists during the COVID-19 pandemic

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rajdeep Pooni ◽  
Tova Ronis ◽  
Tzielan Lee ◽  

Abstract Background To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. Methods An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question. Results The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 86.5% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 65.7% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (35.8%) of those surveyed felt that their level of burnout was increased due to telemedicine. Conclusion In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.

2020 ◽  
Author(s):  
Rajdeep Pooni ◽  
Tova Ronis ◽  
Tzielan Lee

Abstract Background To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. Methods An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question and correlates amongst burnout and satisfaction with telemedicine were examined via ANOVA with appropriate statistical software. Results The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 85.6% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 63.5% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (33.5%) of those surveyed felt that their level of burnout was increased due to telemedicine. Conclusion In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.


Author(s):  
Derar H Abdel-Qader ◽  
Esraa E Al Jomaa ◽  
Jennifer Silverthorne ◽  
Walid Shnaigat ◽  
Salim Hamadi ◽  
...  

Abstract Objectives Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective. Methods An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression. Key findings A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role. Conclusion Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.


2017 ◽  
Vol 44 (3) ◽  
pp. 352-360 ◽  
Author(s):  
Daniel B. Horton ◽  
Karen B. Onel ◽  
Timothy Beukelman ◽  
Sarah Ringold

Objective.To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA).Methods.Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed an anonymous electronic survey on decision making and approaches for withdrawing medications for inactive nonsystemic JIA. Data were analyzed using descriptive statistics.Results.Of 388 clinicians in CARRA, 124 completed surveys (32%), predominantly attending pediatric rheumatologists. The most highly ranked factors in decision making for withdrawing medications were the duration of clinical inactivity, drug toxicity, duration of prior activity, patient/family preferences, joint damage, and JIA category. Diagnoses of rheumatoid factor-positive polyarthritis and persistent oligoarthritis made respondents less likely and more likely, respectively, to withdraw JIA medications. Three-quarters of respondents waited for 6–12 months of inactive disease before stopping methotrexate (MTX) or biologics, but preferences varied. There was also considerable variability in the strategies used to reduce, taper, or stop medications for clinically inactive JIA; most commonly, clinicians reported slow medication tapers lasting at least 2 months. For children receiving combination MTX-biologic therapy, 63% of respondents preferred stopping MTX first. Most clinicians reported using imaging only seldom or sometimes to guide decision making, but most were also reluctant to withdraw medications in the presence of asymptomatic imaging abnormalities suggestive of subclinical inflammation.Conclusion.Considerable variability exists among pediatric rheumatology clinicians regarding when and how to withdraw medications for children with clinically inactive JIA. More research is needed to identify the most effective approaches to withdraw medications and predictors of outcomes.


2008 ◽  
Vol 6 (1) ◽  
pp. 5 ◽  
Author(s):  
Sylvia Ota ◽  
Randy Q Cron ◽  
Laura E Schanberg ◽  
Kathleen O'Neil ◽  
Elizabeth D Mellins ◽  
...  

2020 ◽  
Vol 47 (11) ◽  
pp. 1687-1695 ◽  
Author(s):  
Tamar B. Rubinstein ◽  
Ekemini A. Ogbu ◽  
Martha Rodriguez ◽  
Lindsay Waqar ◽  
Jennifer M.P. Woo ◽  
...  

ObjectiveMental health problems are prevalent in youth with rheumatologic disease. Gaps in knowledge exist regarding their effect, as well as strategies for detection and effective treatment. To address these gaps, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Mental Health Workgroup developed and prioritized an agenda of research topics.MethodsWe systematically reviewed the literature and identified 5 major research domains in further need of study: (A) mental health burden and relationship to pediatric rheumatologic disease, (B) effect of mental health disorders on outcomes, (C) mental health awareness and education, (D) mental health screening, and (E) mental health treatment. Research topics within these areas were developed by workgroup leaders and refined by the workgroup. Members were surveyed to prioritize the topics by importance, feasibility of study, and actionability.ResultsFifty-nine members (57%) completed the survey. Among the proposed research topics, 31/33 were rated as highly important and 4/33 were rated highly for importance, feasibility, and actionability. Topics rated most important related to (A) mental health burden and relationship to rheumatologic disease, and (B) the effect of mental health on outcomes. Topics rated most feasible and actionable were related to (D) mental health screening.ConclusionAddressing gaps in knowledge regarding mental health in youth with rheumatologic disease is essential for improving care. We have identified high priority research topics regarding mental health of pediatric rheumatology patients in need of further investigation that are feasible to study and believed to lead to actionable results in patient care.


2018 ◽  
Vol 2 (4) ◽  
pp. 228-233 ◽  
Author(s):  
Donald E. Nease ◽  
Dee Burton ◽  
Sarah L. Cutrona ◽  
Lauren Edmundson ◽  
Alex H. Krist ◽  
...  

IntroductionEffective patient engagement is central to patient-centered outcomes research. A well-designed infrastructure supports and facilitates patient engagement, enabling study development and implementation. We sought to understand infrastructure needs from recipients of Patient-Centered Outcomes Research Institute (PCORI) pilot grant awards.MethodsWe surveyed recipients of PCORI pilot project awards on self-perceived strengths in engagement infrastructure through PCORI’s Ways of Engaging-Engagement Activity Tool survey, and interviewed leaders of 8 projects who volunteered as exemplars. Descriptive statistics summarized the survey findings. We conducted a thematic analysis of the interview transcripts.ResultsOf the 50 surveyed pilots, 22 answered the engagement infrastructure questions (44% response rate). Survey and interview findings emphasized the importance of committed institutional leadership, ongoing relationships with stakeholder organizations, and infrastructure funding through Clinical and Translational Science Awards, PCORI, and institutional discretionary funds.ConclusionsThese findings highlight the importance of and how to improve upon existing institutional infrastructure.


Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 592
Author(s):  
Shamoukh Alshahrani ◽  
Abrar Alshuaibi ◽  
Malak Alkhaldi ◽  
Pradeep Koppolu

Aim: The present study aims to evaluate the perception and awareness of interdental aids in different regions of Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted, in order to evaluate the perception and knowledge of patients towards oral hygiene products among the population of the Kingdom of Saudi Arabia. In total, 812 out of 1124 participants responded and completed the survey (response rate 72.2%). The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. p < 0.05 was used to indicate statistical significance. Results: A total of 812 participants responded, of which 486 participants (60%) declared using a toothpaste and toothbrush for cleaning their teeth. The cohort consisted of 274 (34%) females who brushed twice daily, while 96 (33%) males brushed their teeth once a day and 18% of the participants did not even brush once a day. The results indicated that 332 (64%) female participants and 174 (60%) male participants had perception and knowledge of the use of dental floss or any other device to clean between their teeth, while 174 (48.50%) male participants and 174 (49.10%) female participants cleaned their tongue with the same brush, rather than using a tongue scrubber or any other aids. Conclusion: The total awareness of interdental aids in Saudi Arabia is unsatisfactory, as demonstrated by the participants not being conscious or informed about the maintenance of their oral health. A majority of participants did not report adopting basic techniques, such as tongue brushing. This study reveals that no interdental aids were used by 16% of the participants. Thus, it is crucial to develop an effective educational program which emphasizes oral healthcare in this population.


2021 ◽  
pp. 089719002110123
Author(s):  
Nicole Bradley ◽  
Yuman Lee ◽  
Muaz Sadeia

Introduction: The latest vancomycin therapeutic drug monitoring guidelines for serious MRSA infections have made a pivotal change in dosing, switching from targeting trough levels to AUC dosing. Because of these new recommendations, antimicrobial stewardship programs across the country are tasked with implementing AUC based dosing. Objectives: To assess plans for institutional adoption of vancomycin AUC dosing programs and perceptions of currently used programs in hospitals across the US. Methods: An electronic survey was distributed to members of the American College of Clinical Pharmacy IDprn Listserv and American Society of Health-System Pharmacists between May and June 2020 to assess current institutional vancomycin dosing. Institutional program use and multiple software user parameters were analyzed using descriptive statistics. Results: Two hundred two pharmacists responded to the survey with the majority practicing in institutions with 251-500 beds. Most respondents have yet to implement AUC dosing (142/202, 70.3%) with many of them planning to do so in the next year (81/142, 57.0%). Of those that already implemented AUC dosing programs, purchased Bayesian software (23/60, 38.3%) and homemade software (21/60, 35.0%) were the 2 methods most frequently utilized. Purchased Bayesian software users were more likely to recommend their software to other institutions and ranked user friendliness higher compared to non-purchased software. Conclusion: Most respondents have not made the switch to vancomycin AUC dosing, but there is a growing interest with many institutions looking to adopt a program within the next year.


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