The Patients’ Experiences of Telemedicine for their skin problems: A qualitative study in Singapore (Preprint)

2020 ◽  
Author(s):  
Aloysius Chow ◽  
Sok Huang Teo ◽  
Jing Wen Kong ◽  
Simon Biing Ming Lee ◽  
Yee Kiat Heng ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cost Effective ◽  
Management Plan ◽  
Dermatology Clinic ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment ◽  
Rich Data ◽  
Patients Experience ◽  
Depth Interviews

BACKGROUND Teledermatology is a cost-effective treatment modality for the management of skin disorders. Most evaluations use quantitative data and far less is understood about the patients’ experience. OBJECTIVE This qualitative study explores patients’ perceptions of a teledermatology service linking public primary care clinics to the national specialist dermatology clinic in Singapore. A better understanding of patients’ experiences can help refine and develop the care provided. METHODS Semi-structured in-depth interviews were conducted with patients who had been referred to the teledermatology service. Interviews were digitally recorded and transcribed before undergoing thematic content analysis. RESULTS Twenty-one patients aged between 22 and 72 years were recruited. Three themes were identified from the data of patients’ experiences: positive perceptions of teledermatology, concerns about teledermatology, and ideas for improving the teledermatology service. Patients found the teledermatology service convenient, saving them time, expense and liberating them from the stresses incurred when making an in-person visit to a specialist facility. They valued the confidence and reassurance they gained from having a dermatologist involved in their management plan. Their concerns included data security and the quality of the images shared. Nonetheless, they were keen to see the service expanded beyond the polyclinics. Their experiences and perceptions will inform future service refinement and development. CONCLUSIONS This narrative exploration of users’ experiences of teledermatology produced rich data enabling a better understanding of the patient’s journey, the way they understand and interpret their experiences, and ideas for service refinement. Telemedicine reduces travelling and enables safe distancing, factors that are much needed during pandemics.

scholarly journals What Is Known and Unknown About Twice-Weekly Hemodialysis

2015 ◽  
Vol 40 (4) ◽  
pp. 298-305 ◽  
Author(s):  
Yoshitsugu Obi ◽  
Rieko Eriguchi ◽  
Shuo-Ming Ou ◽  
Connie M. Rhee ◽  
Kamyar Kalantar-Zadeh
Keyword(s):  
Quality Of Life ◽  
De Novo ◽  
Urine Volume ◽  
Cost Effective ◽  
Standard Of Care ◽  
Treatment Regimens ◽  
Interdialytic Weight Gain ◽  
Cost Effective Treatment ◽  
Incremental Hemodialysis

Background: The 2006 Kidney Disease Outcomes Quality Initiative guidelines suggest twice-weekly or incremental hemodialysis for patients with substantial residual kidney function (RKF). However, in most affluent nations de novo and abrupt transition to thrice-weekly hemodialysis is routinely prescribed for all dialysis-naïve patients regardless of their RKF. We review historical developments in hemodialysis therapy initiation and revisit twice-weekly hemodialysis as an individualized, incremental treatment especially upon first transitioning to hemodialysis therapy. Summary: In the 1960's, hemodialysis treatment was first offered as a life-sustaining treatment in the form of long sessions (≥10 hours) administered every 5 to 7 days. Twice- and then thrice-weekly treatment regimens were subsequently developed to prevent uremic symptoms on a long-term basis. The thrice-weekly regimen has since become the ‘standard of care' despite a lack of comparative studies. Some clinical studies have shown benefits of high hemodialysis dose by more frequent or longer treatment times mainly among patients with limited or no RKF. Conversely, in selected patients with higher levels of RKF and particularly higher urine volume, incremental or twice-weekly hemodialysis may preserve RKF and vascular access longer without compromising clinical outcomes. Proposed criteria for twice-weekly hemodialysis include urine output >500 ml/day, limited interdialytic weight gain, smaller body size relative to RKF, and favorable nutritional status, quality of life, and comorbidity profile. Key Messages: Incremental hemodialysis including twice-weekly regimens may be safe and cost-effective treatment regimens that provide better quality of life for incident dialysis patients who have substantial RKF. These proposed criteria may guide incremental hemodialysis frequency and warrant future randomized controlled trials.

Management of dental fluorosis by amodified treatment strategy amidst a global pandemic

2020 ◽  
Vol 12 (2) ◽  
pp. 46-49
Author(s):  
Dr Nileena Mary Cherian ◽  
Dr K. C Ponnappa ◽  
Dr SalinNanjappa ◽  
Dr K. K Nanjamma
Keyword(s):  
Case Report ◽  
Treatment Strategy ◽  
Treatment Modality ◽  
Dental Treatment ◽  
Dental Fluorosis ◽  
Cost Effective ◽  
Treatment Scenario ◽  
Global Pandemic ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment

In recent months, the dental treatment scenario has changed due to the outbreak of the Covid 19 pandemic. Most of the aerosol generating procedures have been avoided. This case report, describes a conservative, less aerosol generating and cost-effective treatment modality, for the immediate aesthetic management of moderate fluorosis using enamel microabrasion technique.

The Role of Novel Bone Forming Agents in the Treatment of Osteoporosis

2020 ◽  
pp. 089719002096122
Author(s):  
Hansita B. Patel ◽  
Lynsie J. Lyerly ◽  
Cheryl K. Horlen
Keyword(s):  
Elderly Population ◽  
Cost Effective ◽  
The Elderly ◽  
Bisphosphonate Therapy ◽  
Evidence Based ◽  
First Line ◽  
Treatment Of Osteoporosis ◽  
Cost Effective Treatment

Osteoporosis is a growing epidemic that leads to significant morbidity and mortality among the elderly population due to associated fractures that lead to disabilities and reduced quality of life. Bisphosphonates are well-established as a first-line and cost-effective treatment for osteoporosis. Unfortunately, clinicians are often uncertain as to how to select treatments when bisphosphonates are ineffective as initial treatment or contraindicated. Romosozumab and abaloparatide are 2 alternative agents that have been recently FDA approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture or patients who have failed or are intolerant to other osteoporosis therapies. Currently, the National Osteoporosis Foundation (NOF) has no formal recommendations in regard to these 2 novel agents. The purpose of this review is to help guide pharmacists on how to ensure appropriate utilization of these 2 novel bone-forming agents as potential alternatives to bisphosphonate therapy by providing evidence-based recommendations according to the current literature and key counseling points.

scholarly journals Omalizumab Reduces Unplanned Healthcare Interactions in Irish Patients With Chronic Spontaneous Urticaria

2021 ◽  
Vol 2 ◽  
Author(s):  
Katie Ridge ◽  
Vyanka Redenbaugh ◽  
Niall Conlon
Keyword(s):  
Cost Effective ◽  
Healthcare Resource Utilization ◽  
Decision Makers ◽  
Chronic Spontaneous Urticaria ◽  
First Line ◽  
Cost Effective Treatment ◽  
Before And After ◽  
Irish Data ◽  
Impaired Quality

Chronic spontaneous urticaria (CSU) is a common, debilitating skin disorder associated with impaired quality of life and psychological comorbidity. Symptoms can be difficult to control and many individuals will not respond to first line treatment. Due to the chronic and unpredictable nature of the disorder, patients frequently have repeated healthcare attendances. Despite this, little is known about healthcare resource utilization internationally. Furthermore, there is no Irish data to inform fundholding decision makers. Omalizumab is an anti IgE monoclonal antibody used in refractory urticaria. It is a comparatively high cost medicine and access to this treatment can be challenging. Recent assessments of omalizumab compared with usual care suggest that omalizumab is a cost-effective treatment for refractory urticaria. We carried out a retrospective review of 47 patients commenced on omalizumab. We evaluated unplanned primary and secondary care attendances and urticaria symptomatology before and after treatment. As expected, patients with refractory disease that were commenced on omalizumab had objective improvements in urticaria symptoms. Importantly, we show that this is reflected in a dramatic reduction in unplanned healthcare interactions at primary care and emergency departments. These data suggest that omalizumab may benefit these patients by reducing disease activity and thereby reducing the need for unplanned healthcare interactions.

scholarly journals Women Residents’ Quality of Life in the Shophouse in Medan, Indonesia

2020 ◽  
Vol 5 (15) ◽  
pp. 395-401
Author(s):  
Wahyuni Zahrah
Keyword(s):  
Quality Of Life ◽  
Open Access ◽  
Qualitative Study ◽  
Publishing House ◽  
Phenomenological Approach ◽  
Mixed Use ◽  
International Publishing ◽  
Depth Interviews ◽  
Open Access Article

In Medan, Indonesia, shop houses are famous buildings, though they have spatial and thermal comfort limitations. This investigation aims to find out the essence of shop house women residents' quality of life. This research is a qualitative study with a phenomenological approach. The collection of data used in-depth interviews with seven women dwellers. The research indicates that the quality of life in women's view is not determined by mere material abundance, but rather by feeling sufficient and gratitude. This research can contribute to enriching the quality of life and built environment studies of urban mixed-use living.   Keywords: shop house; quality of life; women; mixed-use living eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2495.

Ultrasound-guided foam sclero -therapy of the small saphenous vein

Phlebologie ◽  
2017 ◽  
Vol 46 (02) ◽  
pp. 60-62 ◽  
Author(s):  
R. D. Murena-Schmidt
Keyword(s):  
Saphenous Vein ◽  
Clinical Investigation ◽  
Varicose Veins ◽  
Age Groups ◽  
Cost Effective ◽  
Ultrasound Guided ◽  
Patient’S Satisfaction ◽  
Cost Effective Treatment

SummaryUltrasound guided sclerotherapy (UGFS) of varicose veins is a worldwide spread method, in many countries recognized by guidelines. Important for the outcome is the patients history, clinical investigation and a detailed colour coded ultrasound mapping previous to UGFS.In previous studies varicose small saphenous vein (SSV) treatment with UGFS were reported to have worse results compared to GSV. Other studies report good outcome after UGFS of SSV varicose veins up to 12 months follow up.In my experience UGFS of insufficient SSV is safe and effective with high patient‘s satisfaction, good longterm results and improvement in quality of life. UGFS can be used in all age groups. UGFS has the additional benefit that repeated treatments are easy to perform if needed and that this method is very cost effective. Treatment sessions last 20 to 30 minutes so that patients do not need significant time off work.

Patients with Sacroiliac Joint Pain and Arthritis

2016 ◽  
Author(s):  
Jianguo Cheng
Keyword(s):  
Sacroiliac Joint ◽  
Multimodal Therapy ◽  
Cost Effective ◽  
Surgical Approaches ◽  
Low Back ◽  
Multiple Modalities ◽  
Effective Treatment Modality ◽  
Cost Effective Treatment ◽  
Radiofrequency Denervation ◽  
Effectiveness Studies

Chronic pain originating from the sacroiliac joint (SIJ) is common. Pathophysiology is often related to biomechanical derangement affecting the SIJ or traumatic, degenerative, arthritic, and idiopathic changes of the SIJ. Diagnosis of SIJ pain is suggested by typical patterns of distribution, pain characteristics, and a combination of provocative tests, confirmed by diagnostic block of the SIJ, and differentiated from several other causes of low back pain. Multimodal therapy includes educational, physical, pharmacologic, interventional, and surgical approaches and should be individualized. The efficacy and safety of radiofrequency denervation of the sacroiliac joint have been demonstrated in randomized controlled trials. Multiple modalities of radiofrequency treatment exist, and comparative effectiveness studies are required to determine the most efficacious and cost-effective treatment modality. 

How involved are involved fathers in Hungary? Exploring caring masculinities in a post-socialist context

2020 ◽  
Vol 9 (3) ◽  
pp. 487-502 ◽  
Author(s):  
Judit Takács
Keyword(s):  
Quality Of Life ◽  
Qualitative Study ◽  
Cost Benefit ◽  
Work Life ◽  
Active Engagement ◽  
Related Factors ◽  
Life Balance ◽  
Empirical Base ◽  
Depth Interviews

This study examines what can enable or constrain Hungarian fathers to be actively involved in care through analysing interviews by applying Hanlon’s approach to caring masculinities as valued identities for men and Dermott’s concept of intimate fathering. The empirical base of this qualitative study ‐ the first of its kind in Hungary ‐ is a collection of 55 semi-structured in-depth interviews. Several interrelated factors were shown as potentially enabling or constraining men’s active engagement in their paternal role, including work- and work‐life balance-related factors, practical cost-benefit calculations, quality of life concerns, childhood socialisation patterns and attitudes towards the gendered parenting models of one’s own parents.

scholarly journals Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Heidi Bergenholtz ◽  
Malene Missel ◽  
Helle Timm
Keyword(s):  
Qualitative Study ◽  
End Of Life ◽  
Death And Dying ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Surgical Ward ◽  
Life Threatening ◽  
Depth Interviews ◽  
Acute Hospital Setting

Abstract Background End-of-life (EOL) conversations are highly important for patients living with life-threatening diseases and for their relatives. Talking about the EOL is associated with reduced costs and better quality of care in the final weeks of life. However, there is therefore a need for further clarification of the actual wishes of patients and their relatives concerning EOL conversations in an acute hospital setting. Aim The purpose of this study was to explore the wishes of patients and their relatives with regard to talking about the EOL in an acute hospital setting when living with a life-threatening disease. Methods This study is a qualitative study using semi-structured in-depth interviews. A total of 17 respondents (11 patients and six spouses) participated. The patients were identified by the medical staff in a medical and surgical ward using SPICT™. The interview questions were focused on the respondents’ thoughts on and wishes about their future lives, as well as on their wishes regarding talking about the EOL in a hospital setting. Results This study revealed that the wish to talk about the EOL differed widely between respondents. Impairment to the patients’ everyday lives received the main focus, whereas talking about EOL was secondary. Conversations on EOL were an individual matter and ranged from not wanting to think about the EOL, to being ready to plan the funeral and expecting the healthcare professionals to be very open about the EOL. The conversations thus varied between superficial communication and crossing boundaries. Conclusion The wish to talk about the EOL in an acute hospital setting is an individual matter and great diversity exists. This individualistic stance requires the development of conversational tools that can assist both the patients and the relatives who wish to have an EOL conversation and those who do not. At the same time, staff should be trained in initiating and facilitating EOL discussions.

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