scholarly journals Digital Education for the Management of Chronic Wounds in Health Care Professionals: Protocol for a Systematic Review by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Laura Martinengo ◽  
Natalie Jia Ying Yeo ◽  
Zheng Qiang Tang ◽  
Kasturi D/O Markandran ◽  
Bhone Myint Kyaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Chronic Wounds ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Care Providers ◽  
Digital Education ◽  
Wide Range

BACKGROUND Digital education is “the act of teaching and learning by means of digital technologies.” Digital education comprises a wide range of interventions that can be broadly divided into offline digital education, online digital education, digital game-based learning, massive open online courses (MOOCs), psychomotor skills trainers, virtual reality environments, virtual patient simulations, and m-learning. Chronic wounds pose an immense economic and psychosocial burden to patients and the health care system, as caring for them require highly specialized personnel. Current training strategies face significant barriers, such as lack of time due to work commitments, distance from provider centers, and costs. Therefore, there is an increased need to synthesize evidence on the effectiveness of digital education interventions on chronic wounds management in health care professionals. OBJECTIVE Our main objective is to assess the effectiveness of digital education as a stand-alone approach or as part of a blended-learning approach in improving pre- and postregistration health care professionals’ knowledge, attitudes, practical skills, and behavior in the management of chronic wounds, as well as their satisfaction with the intervention. Secondary objectives are to evaluate patient-related outcomes, cost-effectiveness of the interventions, and any unfavorable or undesirable outcomes that may arise. METHODS This systematic review will follow the methodology as described in the Cochrane Handbook for Systematic Reviews of Interventions. As our systematic review is one of a series of reviews on digital education for health professionals’ education, we will use a previously developed search strategy. This search includes the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library), MEDLINE (Ovid), Embase (Ovid), Web of Science, the Educational Resource Information Centre (ERIC) (Ovid), PsycINFO (Ovid), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), the ProQuest Dissertation and Theses database, and trial registries. Databases will be searched for studies published from January 1990 to August 2018. Two independent reviewers will screen the library for included studies. We will describe the screening process using a flowchart as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will extract the data using a previously developed, structured data extraction form. Included studies will be quality-assessed using the Risk of Bias tool from Cochrane. We will narratively summarize the data and, if possible, we will conduct a meta-analysis. We will use Cochrane’s RevMan 5.3 software for data analysis. RESULTS We have completed the screening of titles and abstracts for this systematic review and are currently selecting papers against our inclusion and exclusion criteria through full-text revision. We are expecting to complete our review by the end of April 2019. CONCLUSIONS This systematic review will provide an in-depth analysis of digital education strategies to train health care providers in the management of chronic wounds. We consider this topic particularly relevant given the current challenges facing health care systems worldwide, including shortages of skilled personnel and a steep increase in the population of older adults as a result of a prolonged life expectancy. CLINICALTRIAL PROSPERO CRD42018109971; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=109971 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12488

Comparing retrieval of systematic review searches in health sciences areas using two major databases

2016 ◽  
Vol 30 (8) ◽  
pp. 1-5 ◽  
Author(s):  
Arian Abdulla ◽  
Mangala Krishnamurthy
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Cochrane Library ◽  
Content Type ◽  
English Only ◽  
Literature Searches ◽  
Clinical Topic ◽  
Key Terms

Purpose Effective literature searches are critical to researchers and health care professionals. To conduct literature searches, clinicians, researchers and nurses rely primarily on a few major databases (PubMed, Cochrane, CINAHL, etc.) to retrieve information. However, there is a lack of literature on the comparative efficiencies of major databases for systematic review results on a clinically related topic. This paper aims to fill that gap in the literature. Design/methodology/approach Cochrane Handbook (2011) defines systematic review as a review of a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant research and to collect and analyze data from the studies that are included in the review. In this paper, search results of systematic reviews on a clinical topic between two major databases – PubMed and Cochrane Library – are compared. Findings Searching within PubMed for key terms in the titles and abstracts of articles is important to include in any systematic review, in addition to searching Medical Subject Heading terms. After applying filters, PubMed retrieved 130 systematic reviews that matched the criteria. In Cochrane Library, the searches were performed on the chosen topic using Boolean and phrase searching: text field searches resulted in 251 reviews. The search was further narrowed by subject, which yielded 20 reviews. It is strongly recommended to use multiple health-care specialty databases, check for duplicate reviews in the results and not limit results to English-only publications. Practical implications This paper can be used to introduce new researchers and/or students to methods for conducting systematic reviews using two or more databases on a chosen topic. Originality/value This paper fills a gap in the literature regarding comparative efficiencies of major databases for systematic review results on clinically related topics.

scholarly journals Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

2014 ◽  
Vol 2 (34) ◽  
pp. 1-184 ◽  
Author(s):  
Sionnadh McLean ◽  
Melanie Gee ◽  
Andrew Booth ◽  
Sarah Salway ◽  
Susan Nancarrow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Conceptual Framework ◽  
Systematic Reviews ◽  
Social Issues ◽  
Cochrane Library ◽  
Reminder Systems ◽  
Research Activities ◽  
Qualitative Evidence ◽  
Wide Range

BackgroundMissed appointments are an avoidable cost and a resource inefficiency that impact on the health of the patient and treatment outcomes. Health-care services are increasingly utilising reminder systems to counter these negative effects.ObjectivesThis project explores the differential effect of reminder systems for different segments of the population for improving attendance, cancellation and rescheduling of appointments.DesignThree inter-related reviews of quantitative and qualitative evidence relating to theoretical explanations for appointment behaviour (review 1), the effectiveness of different approaches to reminding patients to attend health service appointments (review 2) and factors likely to influence non-attendance (review 3).Data sourcesDatabase searches were conducted on Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, The Cochrane Library, EMBASE (via NHS Evidence from 1 January 2000 to January/February 2012), Health Management Information Consortium database, Institute of Electrical and Electronics EngineersXplore, The King’s Fund Library Catalogue, Maternity and Infant Care, MEDLINE, Physiotherapy Evidence Database, PsycINFO, SPORTDiscus and Web of Science from 1 January 2000 to January/February 2012. Supplementary screening of references of included studies was conducted to identify additional potentially relevant studies. Conceptual papers were identified for review 1, randomised controlled trials (RCTs) and systematic reviews for review 2 and a range of quantitative and qualitative research designs for review 3.MethodsWe conducted three inter-related reviews of quantitative and qualitative evidence, involving a review of conceptual frameworks of reminder systems and adherence behaviours, a review of the reminder effectiveness literature and a review informed by realist principles to explain the contexts and mechanisms that explain reminder effectiveness. A preliminary conceptual framework was developed to show how reminder systems work, for whom they work and in which circumstances. Six themes emerged that potentially influence the effectiveness of the reminder or whether or not patients would attend their appointment, namely the reminder–patient interaction, reminder accessibility, health-care settings, wider social issues, cancellation and rebookings, and distal/proxy attributes. Standardised review methods were used to investigate the effectiveness of reminders to promote attendance, cancellation or rebooking across all outpatient settings. Finally, a review informed by realist principles was undertaken, using the conceptual framework to explain the context and mechanisms that influence how reminders support attendance, cancellation and rebooking.ResultsA total of 466 papers relating to 463 studies were identified for reviews 2 and 3. Findings from 31 RCTs and 11 separate systematic reviews (review 2 only) revealed that reminder systems are consistently effective at reducing non-attendance at appointments, regardless of health-care setting or patient subgroups. Simple reminders that provide details of timing and location of appointments are effective for increasing attendance at appointments. Reminders that provide additional information over and above the date, time and location of the appointment (‘reminder plus’) may be more effective than simple reminders at reducing non-attendance and may be particularly useful for first appointments and screening appointments; simple reminders may be appropriate thereafter for most patients the majority of the time. There was strong evidence that the timing of reminders, between 1 and 7 days prior to the appointment, has no effect on attendance; substantial numbers of patients do not receive their reminder; reminders promote cancellation of appointments; inadequate structural factors prevent patients from cancelling appointments; and few studies investigated factors that influence the effectiveness of reminder systems for population subgroups.LimitationsGenerally speaking, the systematic review method seeks to provide a precise answer to a tightly focused question, for which there is a high degree of homogeneity within the studies. A wide range of population types, intervention, comparison and outcomes is included within the RCTs we identified. However, use of this wider approach offers greater analytical capability in terms of understanding contextual and mechanistic factors that would not have been evident in a more narrowly focused review and increases confidence that the findings will have relevance in a wide range of service settings.ConclusionsSimple reminders or ‘reminder plus’ should be sent to all patients in the absence of any clear contraindication. Other reminder alternatives may be relevant for key groups of patients: those from a deprived background, ethnic minorities, substance abusers and those with comorbidities and/or illnesses. We are developing a practice guideline that may help managers to further tailor their reminder systems for their service and client groups. We recommend future research activities in three main areas. First, more studies should routinely consider the potential for differential effects of reminder systems between patient groups in order to identify any inequalities and remedies. Second, ‘reminder plus’ systems appear promising, but there is a need for further research to understand how they influence attendance behaviour. Third, further research is required to identify strategies to ‘optimise’ reminder systems and compare performance with current approaches.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Digital Education for the Management of Chronic Wounds in Health Care Professionals: Protocol for a Systematic Review by the Digital Health Education Collaboration

10.2196/12488 ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. e12488 ◽  
Author(s):  
Laura Martinengo ◽  
Natalie Jia Ying Yeo ◽  
Zheng Qiang Tang ◽  
Kasturi D/O Markandran ◽  
Bhone Myint Kyaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Education ◽  
Health Care Professionals ◽  
Chronic Wounds ◽  
Digital Health ◽  
Digital Education

scholarly journals Use of Apps to Promote Childhood Vaccination: Protocol for a Systematic Review

10.2196/16929 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e16929
Author(s):  
Michelle Helena Van Velthoven ◽  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Mary Mooney ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
English Language ◽  
Search Strategy ◽  
Grey Literature ◽  
Information Storage ◽  
Childhood Vaccination ◽  
Cochrane Central Register ◽  
Technical Standards

Background The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer support, and feedback. Objective The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage, and record sharing. Methods We will identify relevant papers by searching the following electronic databases: PubMed, Embase by Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Education Resources Information Center (ERIC). We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to papers written in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies, and extract the relevant data. All studies will involve the use of apps relating to child vaccinations. The primary outcome is the uptake of vaccinations. Secondary outcomes are as follows: (1) use of app for sharing of information and providing vaccination reminders and (2) use of app for storage of vaccination information; knowledge and decision making by parents regarding vaccination (ie, risks and benefits of vaccination); costs and cost-effectiveness of vaccination apps; use of the app and measures of usability (eg, usefulness, acceptability, and experiences of different users: parents and health care professionals); use of technical standards for development of the app; and adverse events (eg, data leaks and misinformation). We will exclude studies that do not study an app. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data. Results This project was funded by the Sir David Cooksey Fellowship in Healthcare Translation at the University of Oxford, Oxford, United Kingdom. We will submit the full systematic review for publication in the Journal of Medical Internet Research. Conclusions This review will follow, where possible, the Cochrane Collaboration and the Centre for Review and Dissemination methodologies for conducting systematic reviews. We will report our findings based on guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review results will be used to inform the development of a vaccination app. International Registered Report Identifier (IRRID) PRR1-10.2196/16929

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

scholarly journals Protocol for a Systematic Review of the Effectiveness of Provider-targeted Interventions to Improve Opioid Prescribing in Primary Care

2021 ◽  
Author(s):  
Pallavi Prathivadi ◽  
Natalie Connell ◽  
Louisa Picco ◽  
Karleen F Giannitrapani ◽  
Hong-nei Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Primary Care Providers ◽  
Cochrane Library ◽  
Narrative Synthesis ◽  
Care Providers ◽  
Strict Adherence ◽  
Targeted Interventions ◽  
Opioid Prescribing ◽  
Wide Range

Abstract Background: Improving primary care opioid prescribing is a public health priority in many western nations. Governments, policymakers and key stakeholders are intervening on multiple levels to address patient, prescriber and systems factors contributing to opioid over-prescription in primary care. Many opioid prescribing interventions specifically target primary care providers (PCPs); however, the overall effectiveness of these interventions is not known. Identifying effective components of PCP-targeted behaviour change interventions may help inform scalability and translation of prescribing interventions across countries and varying primary healthcare settings. The aim of this systematic review is to assess the effectiveness of provider-targeted interventions to improve opioid prescribing in primary care. This protocol reports the methods of the proposed narrative synthesis review that will be guided by the Theoretical Domains Framework (TDF). Methods: The study will follow Cochrane methods for conducting a narrative synthesis. Reporting is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The review will conduct searches in PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Library databases for studies published in the English language from 2010 onwards. Reference lists of accepted articles will be also screened for additional studies meeting inclusion. Any opioid prescribing behaviour will be measured as an outcome. Intervention components will be mapped to domains of the TDF. No geographic limits will be applied. All stages of screening and data extraction will involve a dual review with gold standard adjudication. The Cochrane Risk of Bias tool will be used to evaluate quality and risk. Discussion: This review is being conducted in strict adherence to Cochrane principles. The protocol was submitted for registration to Prospero prior to publication for transparency and to avoid duplication of research. Formal ethics approval is not required for this research. The findings of this review will inform the delivery and implementation of PCP targeted opioid prescribing interventions. Findings will be disseminated to a wide range of stakeholders involved in quality improvement, prescribing interventions, education and training; professional groups, policymakers, researchers and PCPs.Systematic review registration: Submitted to Prospero 22 December 2020; pending registration

scholarly journals Electronic tools to bridge the language gap in health care for migrants: Systematic review of the literature (Preprint)

2020 ◽  
Author(s):  
Frédérique Thonon ◽  
Swati Perrot ◽  
Abhijna Vithal Yergolkar ◽  
Olivia Rousset-Torrente ◽  
James W Griffith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Literacy ◽  
Language Proficiency ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
General Information ◽  
Care Providers ◽  
Scientific Publications ◽  
Positive Results

BACKGROUND Migrants may face significant delays and barriers in accessing health care, especially those who do not speak fluently the language of the host country. Some applications (apps) or electronic tools have been specifically developed to be used in medical consultations to facilitate the dialogue between health care professionals and migrants with low language proficiency, as well as apps to promote health amongst migrants. OBJECTIVE We conducted a systematic review to examine the evidence related to the development, adaptation, acceptability and effectiveness of electronic tools designed to help health care providers communicate with, or promote health amongst, migrants having a low proficiency in the language of the country of origin and/or low health literacy. METHODS We conducted a search of three scientific publications databases: Pubmed, Scopus and Embase. The study selection was performed by two researchers independently. We collected data about: general information about the app, information about health literacy and cultural adaptation, information about the development of the app, evidence about the app’s acceptability/efficacy and information about the apps’ use. Data was collected by two researchers independently and results were compared for triangulation and synthesis. Results were reported according to the PRISMA checklist. RESULTS We included 61 articles presenting a total of 48 applications. About one third of them (N=16) were designed solely to facilitate the interaction between migrants and a health care provider during a consultation, while the remaining two thirds (N=32) were designed to promote health amongst migrants with a language barrier. Thirty-two applications (67%) had their acceptability evaluated. Amongst them, 78% reported an overall good or very good acceptability, 3% reported an adequate acceptability. Half of the applications had their efficacy evaluated. Amongst them, for 5 of them the study was ongoing (21%); half had significant positive results, with 12% having had partially positive results meaning that the application showed significant efficacy in some measured outcomes but not all; and 8% applications had non-significant results. CONCLUSIONS Overall the applications included had good levels of acceptability, while only half had their efficacy evaluated. In those evaluations, the endpoints used are mostly related to reported behavior change and knowledge improvement, which is common for evaluations of health promotion programs. In the future, it is inevitable that more health applications will be created. Thus, it is essential that applications that claim to have a public health objective undergo a rigorous evaluation of their acceptability, efficacy and actual use. Indicators of outcomes, such as changes in health status, or access to care should be reported in future studies, beyond only reported changes in behavior and knowledge. This systematic review has helped us note the characteristics associated with improved acceptability and efficacy, which can be helpful for the development of future applications.

scholarly journals Effectiveness of Educational Interventions to Increase Knowledge of Evidence-Based Practice Among Nurses and Physiotherapists in Primary Health Care: Protocol for a Systematic Review

10.2196/17621 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e17621
Author(s):  
Henk Verloo ◽  
Pauline Melly ◽  
Roger Hilfiker ◽  
Filipa Pereira
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Care ◽  
Systematic Reviews ◽  
Evidence Based Practice ◽  
Daily Practice ◽  
Educational Interventions ◽  
Care Practice ◽  
Evidence Based ◽  
Cochrane Central Register

Background The implementation of evidence-based practice (EBP) in daily health care practice is strongly encouraged; it is widely recognized as a means to improve the quality and safety of health care for patients and reduce avoidable costs. Primary care nurses and physiotherapists face numerous challenges in trying to ensure that they deliver effective daily care. Broadly promoted educational interventions aim to increase the integration and implementation of EBP in their daily practice. Objective This systematic review will retrieve and evaluate publications examining the effectiveness of educational interventions to increase the integration and implementation of EBP among nurses, nurse practitioners, and physiotherapists active in primary care. Methods We will conduct a systematic review of published articles in relevant professional, scientific journals (from their start dates) and in the following electronic databases, from inception until October 31, 2020: Medline Ovid SP (from 1946), PubMed (NOT Medline[sb]; from 1996), Embase.com (from 1947), CINAHL Ebesco (from 1937), the Cochrane Central Register of Controlled Trials Wiley (from 1992), PsycINFO Ovid SP (from 1806), Web of Science Core collection (from 1900), PEDro (from 1999), the JBI Database of Systematic Reviews and Implementation Reports (from 1998), and the Trip Database (from 1997). We will use the predefined search terms of “evidence-based practice,” “nurses,” or “physiotherapists” and combinations with other terms, such as “educational interventions.” We will also conduct a hand search of the bibliographies of all the relevant articles and a search for unpublished studies using Google Scholar, the ProQuest Dissertations and Theses dissemination, Mednar, WorldCat, OpenGrey, and Grey Literature Report. We will consider publications in English, French, German, and Portuguese. Results The electronic database searches were completed in October 2020. Retrieved articles are currently being screened, and the entire study is expected to be completed by March 2021. Conclusions This systematic review will provide specific knowledge about the effectiveness of educational interventions to increase the implementation and integration of EBP in the daily practice of nurses and physiotherapists providing primary care services. Its findings will inform us about the types and frequencies of the most successful educational interventions. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42017077309; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77309 International Registered Report Identifier (IRRID) DERR1-10.2196/17621

scholarly journals Electronic Consultation in Primary Care Between Providers and Patients: Systematic Review

10.2196/13042 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e13042 ◽  
Author(s):  
Freda Mold ◽  
Jane Hendy ◽  
Yi-Ling Lai ◽  
Simon de Lusignan
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Care ◽  
The United States ◽  
Care Staff ◽  
Cochrane Library ◽  
Small Scale ◽  
Care Providers ◽  
Long Term Conditions ◽  
Electronic Consultation

Background Governments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain. Objective This study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care. Methods A systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis. Results This review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes. Conclusions E-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.

scholarly journals The Development of a Community-wide Primary Health Comprehensive Planning and Response Coordination Group to Plan for and Manage Seasonal Influenza and Possible Pandemic Response

2019 ◽  
Vol 34 (s1) ◽  
pp. s56-s57
Author(s):  
Philip Schroeder ◽  
Kelly Robertson ◽  
Deborah Callahan ◽  
Gareth Frew ◽  
Graeme McColl
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Seasonal Influenza ◽  
Influenza Pandemic ◽  
Primary Response ◽  
Health Providers ◽  
Care Providers ◽  
Primary Health ◽  
Wide Range

Introduction:The Canterbury Primary Response Group (CPRG) was formed following the threats of severe acute respiratory syndrome (SARS) and avian influenza worldwide. The possible impact of these viruses alerted health care professionals that a community-wide approach was needed to manage and coordinate a response to any outbreak or potential outbreak. In Canterbury, New Zealand, the CPRG group took the responsibility to coordinate and manage the regional, out of hospital, planning and response coordination to annual influenza threats and the possible escalation to pandemic outbreaks.Aim:To outline the formation of a primary health and community-wide planning group, bringing together not only a wide range of health providers, but also key community agencies to plan strategies and responses to seasonal influenza and possible pandemic outbreaks.Methods:CPRG has developed a Pandemic Plan that focuses on the processes, structures, and roles to support and coordinate general practice, community pharmacies, community nursing, and other primary health care providers in the reduction of, readiness for, response to, and recovery from an influenza pandemic. The plan could reasonably apply to other respiratory-type pandemics such as SARS.Results:A comprehensive group of health professionals and supporting agencies meet monthly (more often if required) under the chair of CPRG to share information of the influenza-like illness (ILI) situation, virus types, and spread, as well as support strategies and response activities. Regular communication information updates are produced and circulated amongst members and primary health providers in the region.Discussion:Given that most ILI health consultations and treatments are self or primary health administered and take place outside of hospital services, it is essential for providers to be informed and consistent with their responses and knowledge of the extent and symptoms of ILI and any likelihood of a pandemic.

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