scholarly journals Measures of Effectiveness, Efficiency, and Quality of Telemedicine in the Management of Alcohol Abuse, Addiction, and Rehabilitation: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Clemens Scott Kruse ◽  
Kimberly Lee ◽  
Jeress B Watson ◽  
Lorraine G Lobo ◽  
Ashton G Stoppelmoor ◽  
...  

BACKGROUND More than 18 million Americans are currently suffering from alcohol use disorder (AUD): a compulsive behavior of alcohol use as a result of a chronic, relapsing brain disease. With alcohol-related injuries being one of the leading causes of preventable deaths, there is a dire need to find ways to assist those suffering from alcohol dependence. There still exists a gap in knowledge as to the potential of telemedicine in improving health outcomes for those patients suffering from AUD. OBJECTIVE The purpose of this systematic review was to evaluate the measures of effectiveness, efficiency, and quality that result from the utilization of telemedicine in the management of alcohol abuse, addiction, and rehabilitation. METHODS This review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles used in this analysis were gathered using keywords inclusive of both <i>telemedicine</i> and <i>alcohol abuse</i>, which were then searched in the Cumulative Index to Nursing and Allied Health Literature, Cochrane, and MEDLINE (PubMed) databases. A total of 22 articles were chosen for analysis. RESULTS The results indicated that telemedicine reduced alcohol consumption. Other common outcomes included reduced depression (4/35, 11%), increased patient satisfaction (3/35, 9%), increase in accessibility (3/35, 9%), increased quality of life (2/35, 6%), and decreased cost (1/35, 3%). Interventions included mobile health (11/22, 50%), electronic health (6/22, 27%), telephone (3/33, 14%), and 2-way video (2/22, 9%). Studies were conducted in 3 regions: the United States (13/22, 59%), the European Union (8/22, 36%), and Australia (1/22, 5%). CONCLUSIONS Telemedicine was found to be an effective tool in reducing alcohol consumption and increasing patients’ accessibility to health care services or health providers. The group of articles for analysis suggested that telemedicine may be effective in reducing health care costs and improving the patient’s quality of life. Although telemedicine shows promise as an effective way to manage alcohol-related disorders, it should be further investigated before implementation.

10.2196/13252 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e13252 ◽  
Author(s):  
Clemens Scott Kruse ◽  
Kimberly Lee ◽  
Jeress B Watson ◽  
Lorraine G Lobo ◽  
Ashton G Stoppelmoor ◽  
...  

Background More than 18 million Americans are currently suffering from alcohol use disorder (AUD): a compulsive behavior of alcohol use as a result of a chronic, relapsing brain disease. With alcohol-related injuries being one of the leading causes of preventable deaths, there is a dire need to find ways to assist those suffering from alcohol dependence. There still exists a gap in knowledge as to the potential of telemedicine in improving health outcomes for those patients suffering from AUD. Objective The purpose of this systematic review was to evaluate the measures of effectiveness, efficiency, and quality that result from the utilization of telemedicine in the management of alcohol abuse, addiction, and rehabilitation. Methods This review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles used in this analysis were gathered using keywords inclusive of both telemedicine and alcohol abuse, which were then searched in the Cumulative Index to Nursing and Allied Health Literature, Cochrane, and MEDLINE (PubMed) databases. A total of 22 articles were chosen for analysis. Results The results indicated that telemedicine reduced alcohol consumption. Other common outcomes included reduced depression (4/35, 11%), increased patient satisfaction (3/35, 9%), increase in accessibility (3/35, 9%), increased quality of life (2/35, 6%), and decreased cost (1/35, 3%). Interventions included mobile health (11/22, 50%), electronic health (6/22, 27%), telephone (3/33, 14%), and 2-way video (2/22, 9%). Studies were conducted in 3 regions: the United States (13/22, 59%), the European Union (8/22, 36%), and Australia (1/22, 5%). Conclusions Telemedicine was found to be an effective tool in reducing alcohol consumption and increasing patients’ accessibility to health care services or health providers. The group of articles for analysis suggested that telemedicine may be effective in reducing health care costs and improving the patient’s quality of life. Although telemedicine shows promise as an effective way to manage alcohol-related disorders, it should be further investigated before implementation.


2020 ◽  
Vol 34 (5) ◽  
pp. 520-537
Author(s):  
Fatih Gür ◽  
Ganime Can Gür

Objectives: This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. Data Sources: PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. Study Inclusion and Exclusion Criteria: Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. Data Extraction: This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. Data Synthesis: Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). Results: The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. Conclusions: Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.


2020 ◽  
Vol 7 (6) ◽  
pp. 989-993
Author(s):  
Andrew Thomas ◽  
Annie Thomas

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.


1993 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
David M. Dush

The hospice movement grew in part as a reaction to the perception that modern medical care had become too technological at the expense of being impersonal and insensitive to human psychological and spiritual concerns. In the United States, the institutionalization of hospice care under Medicare and other reimbursement systems has further established hospice as an alternative to high-technology, high-cost care. The present paper examines the question: What if hospice care becomes itself high-technology, aggressive, costly health care in order to remain true to its goal of maximizing quality of life? Implications for the goals and philosophical underpinnings of palliative care are discussed.


2013 ◽  
Vol 2 (2) ◽  
pp. 5-15
Author(s):  
Riawati Jahja

Trials have demonstrated improvement in patients’ quality of life through palliative care services (PCS). However, many of these trials are limited by their research methodologies. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched to conduct a systematic review of review articles related to PCS from January 2001 to December 2011. The paper examined evidence from studies on PCS that aimed to improve elderly patients’ end-of-life outcomes by i) systematically reviewing literature on models of palliative care (PC) delivery patients received; ii) exploring methodological issues surrounding recruitment of the patients, implementation of the studies and comparison of health care services; and iii) addressing the costs of care with/without a palliative program. Seventeen trials and three observational studies were selected from nine systematic review articles. Overall, early introduction of PC to patients following identification of their life-limiting conditions and needs re-quires an organized and coordinated care approach to ensure accessibility of these services. The ideal system that offers the potential of improving patients’ quality of life is one that is integrated, interdisciplinary and holistic. Dying is commonly institutionalized; however, providing outreach programs that allow patients to die at their place of wish, such as domiciliary care, offers the potential of addressing the issue of ever-increasing health-care expenditure for the aged. However, further investigation is needed to evaluate the cost effectiveness of these programs. Methodological problems and ethical issues surrounding the study of terminally-ill patients necessitate that researchers use a combination of observational studies and surveillance system over time. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15937 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 5-15


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 199-199
Author(s):  
Graham McFarlane ◽  
Karmugi Balaratnam ◽  
Peter Selby ◽  
Shabbir Alibbhai ◽  
M. Catherine Brown ◽  
...  

199 Background: Little is known about the perceptions of palliative patients on the impact of continued alcohol consumption after a cancer diagnosis and whether they are similar to the perceptions of patients who are considered potentially curative. Methods: Patients with diverse cancer subtypes were surveyed at a comprehensive cancer centre, cross-sectionally. Specifically, palliative and non-palliative cancer patients were asked about their perceptions on the benefits/harms of continued drinking on cancer-related quality of life, fatigue, and overall survival, and whether they had received information on their alcohol consumption from their health care providers. Palliative status was established by chart review. Results: Of 1049 patients, 48% were male, with median age of 58 (18-98) years; cancer sites included gastrointestinal, genitourinary, breast, thoracic, hematologic, and others; 16% were classified as being palliative at the time of survey; and 14% reported receiving counselling information on alcohol use sometime after their cancer diagnosis. Compared to curative patients, palliative patients were more likely to perceive continued alcohol consumption as harmful to their fatigue (OR=1.39, P=0.05) and survival (OR=1.45, P=0.03), but less so on quality of life (OR=1.16, P=0.35). When compared to those who had not been counselled, informed patients were twice as likely (OR=2.01, P<0.01) to perceive continued drinking as harmful to their levels of fatigue, although there was less of a difference in their perception of quality of life (OR =1.39, P=0.20) and survival (OR=1.40, P=0.19). Conclusions: Palliative patients are more likely to perceive continued alcohol consumption as harmful to their fatigue and overall survival, when compared to non-palliative patients, especially after receiving counselling. Given the lack of data on the benefits or harm of mild-moderate alcohol use and a strong emphasis on quality of life, future research should focus on effects of alcohol in palliative patients, and there should be improved education to both providers and patients on regarding the current lack of information.


1999 ◽  
Vol 8 (1) ◽  
pp. 19-34 ◽  
Author(s):  
Richard Warner

SummaryObjective – Starting from research on environmental factors that influence schizophrenia, the author speculates on innovations that could reduce the occurrence of the illness, improve its course and enhance the quality of life of sufferers and their relatives. Results – Ranging from education about obstetric risks to a stigma-reducing campaign, the suggestions could be of interest, not only to clinicians, but also to advocates, policy-makers and communications specialists. Conclusions – Several of the suggestions, which would be innovative in the United States, are already established features of Italian mental health care. These features include social enterprises, family support payments and a disability pension system without severe disincentives to work.


2015 ◽  
Vol 21 (4) ◽  
pp. 414-422 ◽  
Author(s):  
Wichuda Jiraporncharoen ◽  
Surinporn Likhitsathian ◽  
Chawin Lerssrimongkol ◽  
Surin Jiraniramai ◽  
Ladawan Siriluck ◽  
...  

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