scholarly journals One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial

10.2196/30151 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e30151
Author(s):  
Svein Ivar Bekkelund ◽  
Kai Ivar Müller
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Chronic Headache ◽  
Remission Rate ◽  
Face To Face ◽  
The Face ◽  
Video Group ◽  
One Year ◽  
Headache Patients

Background Chronic headache causing severe headache-related disability for those affected by the disease is under- or misdiagnosed in many cases and therefore requires easy access to a specialist for optimal health care management. Objective The goal of the research is to determine whether video consultations are noninferior to face-to-face consultations in treating chronic headache patients referred to a specialist in Northern Norway. Methods Patients included in the study were recruited from general practice referrals to a specialist at a neurological department in Northern Norway (Tromsø) and diagnosed according to the International Headache Society classification system. In a randomized controlled design, the 1-year remission rate of chronic headache (change from ≥15 to <15 headache days per month during the last 3 months), patient satisfaction with a specialist consultation, and need for follow-up consultations by general practitioners were compared between groups consulted by video and face-to-face in a post hoc analysis. Data were collected by interview (baseline) and questionnaire (follow-up). Results From a baseline cohort of 402 headache patients consecutively referred from general practice to a specialist over 2.5 years, 58.0% (233/402) were classified as chronic headache and included in this study. Response rates were 71.7% (86/120) in the video group and 67.3% (76/113) in the face-to-face group. One-year remission from chronic headache was achieved in 43.0% (37/86) in the video group and 39.5% (30/76) in the face-to-face group (P=.38). Patient satisfaction with consultations were 86.5% (32/37; video) and 93.3% (28/30; face-to-face; P=.25). A total of 30% (11/37) in the video group and 53% (16/30) in the face-to-face group consulted general practitioners during the follow-up period (P=.03), and median number of consultations was 1 (IQR 0-13) and 1.5 (IQR 0-15), respectively (P=.19). Conclusions One-year remission rate from chronic headache was about 40% regardless of consultation form. Likewise, patient satisfaction with consultation and need for follow-up visits in general practice post consultation was similar. Treating chronic headache patients by using video consultations is not inferior to face-to-face consultations and may be used in clinical neurological practice. Trial Registration ClinicalTrials.gov NCT02270177; https://clinicaltrials.gov/ct2/show/NCT02270177

scholarly journals One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Svein Ivar Bekkelund ◽  
Kai Ivar Müller
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Chronic Headache ◽  
Remission Rate ◽  
Face To Face ◽  
The Face ◽  
Video Group ◽  
One Year ◽  
Headache Patients

BACKGROUND Chronic headache causing severe headache-related disability for those affected by the disease is under- or misdiagnosed in many cases and therefore requires easy access to a specialist for optimal health care management. OBJECTIVE The goal of the research is to determine whether video consultations are noninferior to face-to-face consultations in treating chronic headache patients referred to a specialist in Northern Norway. METHODS Patients included in the study were recruited from general practice referrals to a specialist at a neurological department in Northern Norway (Tromsø) and diagnosed according to the International Headache Society classification system. In a randomized controlled design, the 1-year remission rate of chronic headache (change from ≥15 to &lt;15 headache days per month during the last 3 months), patient satisfaction with a specialist consultation, and need for follow-up consultations by general practitioners were compared between groups consulted by video and face-to-face in a post hoc analysis. Data were collected by interview (baseline) and questionnaire (follow-up). RESULTS From a baseline cohort of 402 headache patients consecutively referred from general practice to a specialist over 2.5 years, 58.0% (233/402) were classified as chronic headache and included in this study. Response rates were 71.7% (86/120) in the video group and 67.3% (76/113) in the face-to-face group. One-year remission from chronic headache was achieved in 43.0% (37/86) in the video group and 39.5% (30/76) in the face-to-face group (<i>P</i>=.38). Patient satisfaction with consultations were 86.5% (32/37; video) and 93.3% (28/30; face-to-face; <i>P</i>=.25). A total of 30% (11/37) in the video group and 53% (16/30) in the face-to-face group consulted general practitioners during the follow-up period (<i>P</i>=.03), and median number of consultations was 1 (IQR 0-13) and 1.5 (IQR 0-15), respectively (<i>P</i>=.19). CONCLUSIONS One-year remission rate from chronic headache was about 40% regardless of consultation form. Likewise, patient satisfaction with consultation and need for follow-up visits in general practice post consultation was similar. Treating chronic headache patients by using video consultations is not inferior to face-to-face consultations and may be used in clinical neurological practice. CLINICALTRIAL ClinicalTrials.gov NCT02270177; https://clinicaltrials.gov/ct2/show/NCT02270177

The effectiveness of telepsychiatry measured using the Health of the Nation Outcome Scale and the Mental Health Inventory

2003 ◽  
Vol 9 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcome ◽  
General Practice ◽  
Initial Assessment ◽  
Face To Face ◽  
Significant Difference ◽  
Outcome Scores ◽  
The Face ◽  
One Year

In a telepsychiatry project in rural Queensland, data were collected from 124 patients attending hospital and general practice facilities for mental health-care and then again at follow-up one year later. Thirty-two of the patients were dealt with using telepsychiatry. Two health status scales were used to measure effectiveness: the Health of the Nation Outcome Scale (HoNOS), administered by the practitioners; and the Mental Health Inventory (MHI), which was self-administered by the patients. There was a significant difference between the initial assessment and follow-up groups on most subscales of the HoNOS, but no significant difference between the face-to-face and telepsychiatry groups. Similarly, the MHI results showed a significant difference on all subscales between the initial assessment and follow-up groups, but no significant difference between the face-to-face and telepsychiatry groups. Individuals who used and did not use telepsychiatry all had improved health outcome scores on the HoNOS and MHI during the study period. Telepsychiatry was as effective as face-to-face care.

Realtime teleconsultations versus face-to-face consultations in dermatology: immediate and six-month outcome

2003 ◽  
Vol 9 (4) ◽  
pp. 204-209 ◽  
Author(s):  
Håkan Granlund ◽  
Carl-Johan Thoden ◽  
Christer Carlson ◽  
Kari Harno
Keyword(s):  
Patient Satisfaction ◽  
General Practitioner ◽  
Analogue Scale ◽  
Controlled Study ◽  
Face To Face ◽  
Consultation Group ◽  
The Face ◽  
Patient Groups

We evaluated the outcome of both realtime teleconsultations and face-to-face consultations in dermatology. Forty-six patients were enrolled in an open controlled study. Twenty-nine patients (60%) answered the questionnaire sent to them after six months. Over the six-month follow-up, similar proportions of the two patient groups had visited a general practitioner or a specialist in the consulting hospital. At follow-up, overall patient satisfaction with the consultation, measured on a linear analogue scale (0–10), had fallen only slightly and to the same extent after both types of consultation, that is by 1.2 (SD 3.7) after realtime teleconsultations and by 1.4 (SD 4.5) after face-to-face consultations. The proportions of patients who would prefer the same mode of consultation for their next appointment had decreased from 83% to 50% in the realtime teleconsultation group and from 83% to 62% in the face-to-face consultation group. However, in neither group was the change significant. The study suggests that patient satisfaction with teleconsultation is well preserved after six months.

scholarly journals COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
University Hospitals ◽  
Health Crisis ◽  
Patient Satisfaction Questionnaire ◽  
Telephone Consultation ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p&lt; 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p &gt; 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

scholarly journals P071 Survey of rheumatology patient satisfaction with telephone consultations during the COVID-19 pandemic

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Management Plan ◽  
Service Development ◽  
Telephone Consultation ◽  
Face To Face ◽  
Communication Difficulties ◽  
Strongly Agree ◽  
The Uk

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.

The Prognosis of Depression in Old Age

1983 ◽  
Vol 142 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Elaine Murphy
Keyword(s):  
Life Events ◽  
Life Stress ◽  
Intimate Relationship ◽  
Class Differences ◽  
Poor Outcome ◽  
Physical Health Problems ◽  
The Face ◽  
One Year ◽  
Severe Life Events

SummaryThe paper describes a one year prospective study of 124 elderly depressed patients. Only one third of the group had a good outcome. Poor outcome was associated with severity of initial illness, those with depressive delusions having a particularly poor outcome. Outcome was also influenced by physical health problems and severe life events in the follow-up year. Social class differences in outcome were thought to be due to class differences in the experience of severe life events. There was no evidence that an intimate relationship protected against relapse in the face of continuing life stress.

scholarly journals Face-to-face to online: PhD academic writing @Maastricht University

2020 ◽  
pp. 13-19
Author(s):  
Neill Wylie
Keyword(s):  
Academic Writing ◽  
Online Courses ◽  
Global Perspective ◽  
Innovative Teaching ◽  
Face To Face ◽  
Strong Focus ◽  
Writing Course ◽  
The Face ◽  
Language Needs

Maastricht University (UM) has a distinct global perspective and a strong focus on innovation. UM offers an array of PhD courses to distance and campus based students who have access to elective, credit bearing modules and the language needs of these students are catered for by the Language Centre. Many PhD candidates choose to take an academic writing course in their first or second year of their degree. In recent years, demand for a more student focused, flexible academic writing course has grown. In line with UM’s policy of supporting innovative teaching practices, the Language Centre’s face-to-face PhD academic writing course, PhD Writing 1, has been transformed into a fully online course containing eight interactive webinar sessions named Online PhD Writing, which runs in addition to the face-to-face rendition. On the back of the success of this course, coupled with increased demand for a follow up course, this author was tasked with creating an advanced online PhD academic writing course to cater for global students with diverse time zones and schedules. This paper evaluates the challenges posed and the advances made in constructing both online courses and explores the technologies used in implementing them.

scholarly journals Use of Tablet Video for Delivery of Neonatal Discharge Instructions to First-Time Parents

2021 ◽  
Vol 53 (2) ◽  
pp. 145-147
Author(s):  
Kristine L. Cece ◽  
Jane E. Chargot ◽  
Micheleen Hashikawa ◽  
Melissa A. Plegue ◽  
Katherine J. Gold
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Satisfaction ◽  
Controlled Trial ◽  
Patient Perceptions ◽  
Discharge Instructions ◽  
Face To Face ◽  
Randomized Controlled ◽  
Use Of Technology ◽  
Video Group ◽  
First Time

Background and Objectives: While video discharge instructions have been shown to improve retention of information and patient satisfaction, data are limited regarding patient perceptions of video tools. Methods: We conducted a randomized controlled trial to assess self-rated comprehension and overall satisfaction with video versus face-to-face neonatal discharge instructions in first-time mothers. Results: Video instructions were no different from face-to-face instructions, though there was a nonsignificant increase in confidence in caring for their newborn in the video group. Conclusions: Broader use of technology may allow for a more standardized approach to patient education and improve efficiency for clinicians, without compromising patient satisfaction and confidence in caring for themselves and their dependents.

scholarly journals The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers: a Randomized Controlled Trial

2020 ◽  
Vol 27 (5) ◽  
pp. 539-555 ◽  
Author(s):  
Elina Järvelä-Reijonen ◽  
Sampsa Puttonen ◽  
Leila Karhunen ◽  
Essi Sairanen ◽  
Jaana Laitinen ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Acceptance And Commitment Therapy ◽  
Systemic Inflammation ◽  
Post Intervention ◽  
Face To Face ◽  
Stress Biomarkers ◽  
Acceptance And Commitment ◽  
Acceptance And Action Questionnaire ◽  
The Face

Abstract Background Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. Method Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties). Results A group × time interaction (p = .012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p = .035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF. Conclusion The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress. Trial Registration ClinicalTrials.gov Identifier: NCT01738256, Registered 17 August, 2012

scholarly journals Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

2019 ◽  
Vol 69 (686) ◽  
pp. e595-e604 ◽  
Author(s):  
Victoria Hammersley ◽  
Eddie Donaghy ◽  
Richard Parker ◽  
Hannah McNeilly ◽  
Helen Atherton ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Technical Problems ◽  
Face To Face ◽  
Information Giving ◽  
Care Services ◽  
Primary Care Services ◽  
Quasi Experimental ◽  
Primary Care Clinicians

BackgroundGrowing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice.AimTo explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice.Design and settingComparison of audio-recordings of follow-up consultations in UK primary care.MethodPrimary care clinicians were provided with video-consulting equipment. Participating patients required a smartphone, tablet, or computer with camera. Clinicians invited patients requiring a follow-up consultation to choose a VC, TC, or FTFC. Consultations were audio-recorded and analysed for content and quality. Participant experience was explored in post-consultation questionnaires. Case notes were reviewed for NHS resource use.ResultsOf the recordings, 149/163 were suitable for analysis. VC recruits were younger, and more experienced in communicating online. FTFCs were longer than VCs (mean difference +3.7 minutes, 95% confidence interval [CI] = 2.1 to 5.2) or TCs (+4.1 minutes, 95% CI = 2.6 to 5.5). On average, patients raised fewer problems in VCs (mean 1.5, standard deviation [SD] 0.8) compared with FTFCs (mean 2.1, SD 1.1) and demonstrated fewer instances of information giving by clinicians and patients. FTFCs scored higher than VCs and TCs on consultation-quality items.ConclusionVC may be suitable for simple problems not requiring physical examination. VC, in terms of consultation length, content, and quality, appeared similar to TC. Both approaches appeared less ‘information rich’ than FTFC. Technical problems were common and, though patients really liked VC, infrastructure issues would need to be addressed before the technology and approach can be mainstreamed in primary care.

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