International Journal of Environmental Research and Public Health

Research

10 pages, 358 KiB

Open AccessArticle

Clinical Experience of Using Telemedicine for the Management of Patients Using Continuous Subcutaneous Insulin Infusion in a Highly Complex Latin American Hospital

by Guillermo Edinson Guzman, María Fernanda Escobar, Oriana Arias-Valderrama, María Angélica Guerra and Veline Martínez

Int. J. Environ. Res. Public Health 2023, 20(9), 5719; https://doi.org/10.3390/ijerph20095719 - 4 May 2023

Viewed by 1981

Abstract

Introduction: Continuous subcutaneous insulin infusion (CSII) has emerged as a potential solution for diabetes management during the pandemic, as it reduces the need for in-person visits and allows for remote monitoring of patients. Telemedicine has also become increasingly important in the management of [...] Read more.

Introduction: Continuous subcutaneous insulin infusion (CSII) has emerged as a potential solution for diabetes management during the pandemic, as it reduces the need for in-person visits and allows for remote monitoring of patients. Telemedicine has also become increasingly important in the management of diabetes during the pandemic, as it allows healthcare providers to provide remote consultations and support. Here, we discuss the implications of this approach for diabetes management beyond the pandemic, including the potential for increased access to care and improved patient outcomes. Methods: We performed a longitudinal observational study between 1 March 2020 and 31 December 2020 to evaluate glycemic parameters in diabetic patients with CSII in a telehealth service. Glycemic parameters were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability control. Results: A total of 36 patients were included in the study, with 29 having type 1 diabetes and 6 having type 2 diabetes. The study found that the proportion of patients achieving target glucose variability and GMI remained unchanged during follow-up. However, in patients with type 2 diabetes, the time in target range increased from 70% to 80%, and the time in hyperglycemia decreased from 2% to 0%. Conclusions: The results of this study suggest that telemedicine is a strategy for maintaining glycemic control in patients using CSII. However, the lack of access to the internet and adequate telemonitoring devices make it difficult to use on a large scale in emerging countries like ours. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

17 pages, 602 KiB

Open AccessArticle

Patient Safety Culture in a Tertiary Hospital: A Cross-Sectional Study

by María Teresa Segura-García, María Ángeles Castro Vida, Manuel García-Martin, Reyes Álvarez-Ossorio-García de Soria, Alda Elena Cortés-Rodríguez and María Mar López-Rodríguez

Int. J. Environ. Res. Public Health 2023, 20(3), 2329; https://doi.org/10.3390/ijerph20032329 - 28 Jan 2023

Cited by 2 | Viewed by 2760

Abstract

Patient safety (PS) culture is the set of values and norms common to the individuals of an organization. Assessing the culture is a priority to improve the quality and PS of hospital services. This study was carried out in a tertiary hospital to [...] Read more.

Patient safety (PS) culture is the set of values and norms common to the individuals of an organization. Assessing the culture is a priority to improve the quality and PS of hospital services. This study was carried out in a tertiary hospital to analyze PS culture among the professionals and to determine the strengths and weaknesses that influence this perception. A cross-sectional descriptive study was carried out. The AHRQ Questionnaire on the Safety of Patients in Hospitals (SOPS) was used. A high perception of PS was found among the participants. In the strengths found, efficient teamwork, mutual help between colleagues and the support of the manager and head of the unit stood out. Among the weaknesses, floating professional templates, a perception of pressure and accelerated pace of work, and loss of relevant information on patient transfer between units and shift changes were observed. Among the areas for improvement detected were favoring feedback to front-line professionals, abandoning punitive measures and developing standardized tools that minimize the loss of information. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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17 pages, 352 KiB

Open AccessArticle

Hospitalisation at Home of Patients with COVID-19: A Qualitative Study of User Experiences

by Jose Cerdan de las Heras, Signe Lindgård Andersen, Sophie Matthies, Tatjana Vektorvna Sandreva, Caroline Klint Johannesen, Thyge Lynghøj Nielsen, Natascha Fuglebjerg, Daniel Catalan-Matamoros, Dorte Gilså Hansen and Thea K. Fischer

Int. J. Environ. Res. Public Health 2023, 20(2), 1287; https://doi.org/10.3390/ijerph20021287 - 10 Jan 2023

Cited by 4 | Viewed by 2070

Abstract

Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection [...] Read more.

Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection and clinicians engage with and experience communication and self-monitoring activities following the HaH model. A qualitative study based on semi-structured interviews of patients and clinicians participating in the early development phase of HaH were conducted. We interviewed eight clinicians and six patients. Five themes emerged from clinicians: (1) staff fear and concerns, (2) workflow, (3) virtual closeness, (4) patient relatives, and (5) future HaH models; four themes emerged from patients: (1) transition to home, (2) joint responsibility, (3) acceptability of technologies, and (4) relatives. Despite technical problems, both patients and clinicians were enthusiastic about the conceptual HaH idea. If appropriately introduced, treatment based on self-monitoring and remote communication was perceived acceptable for the patients; however, obtaining vitals at night was an overwhelming challenge. HaH is generally acceptable, perceived patient-centred, influencing routine clinical workflow, role and job satisfaction. Therefore, it calls for educational programs including more perspective than issues related to technical devices. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

10 pages, 718 KiB

Open AccessArticle

Symptoms of Depression, Anxiety, and Posttraumatic Stress among Patients with Cardiac Pacemakers

by Britta S. Bürker, Randolf I. Hardersen and Knut Tore Lappegård

Int. J. Environ. Res. Public Health 2022, 19(24), 16838; https://doi.org/10.3390/ijerph192416838 - 15 Dec 2022

Viewed by 1735

Abstract

Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of pattern and prevalence of clinically significant psychiatric symptomatology among patients with cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied symptoms of depression, anxiety, and posttraumatic stress among [...] Read more.

Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of pattern and prevalence of clinically significant psychiatric symptomatology among patients with cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied symptoms of depression, anxiety, and posttraumatic stress among PM patients (PM due to syncope or presyncope) compared to participants of (i) a cardiac, (ii) a chronic disease, and (iii) a healthy control group. Symptoms of depression, anxiety and posttraumatic stress were measured by validated self-report scales at least 6 months after implantation of the PM (PM group; n = 38), percutaneous coronary intervention (PCI; PCI control group; n = 23), and first dialysis (Dialysis control group; n = 17). Blood donors constituted the Healthy control group (n = 42). Both PM, PCI, and dialysis patients reported depressive symptoms above clinical cut-off more frequently than the healthy controls (16.2, 26.1, 41.2, and 0%, respectively; p < 0.001). Self-report of symptoms of anxiety and posttraumatic stress did not differ significantly across study groups. However, a non-negligible proportion of PM patients reported on symptoms of posttraumatic stress of anticipated clinical relevance. Identification and treatment of depression deserves attention in clinical routine in all three patient populations. Further study of posttraumatic stress in PM patients seems advisable. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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11 pages, 1510 KiB

Open AccessArticle

Analysis of Healthcare Costs Incurred in Regional Hospitals in Andalusia (Spain) during the COVID-19 Pandemic

by Antonio Lopez-Villegas, Rafael Jesus Bautista-Mesa, Pedro Acosta-Robles, David Hidalgo-Serrano, Francisco Javier Aguirre-Ortega, Miguel Angel Castellano-Ortega, Maria Marta Mollo, Cesar Leal-Costa and Salvador Peiro

Int. J. Environ. Res. Public Health 2022, 19(23), 16132; https://doi.org/10.3390/ijerph192316132 - 2 Dec 2022

Cited by 1 | Viewed by 1430

Abstract

(1) Background: The global health crisis caused by the coronavirus disease (COVID-19) pandemic has led to extreme overloading of different public healthcare systems worldwide. The Spanish Public Healthcare System is one of them. This study aimed to conduct a comparative cost analysis to [...] Read more.

(1) Background: The global health crisis caused by the coronavirus disease (COVID-19) pandemic has led to extreme overloading of different public healthcare systems worldwide. The Spanish Public Healthcare System is one of them. This study aimed to conduct a comparative cost analysis to assess the impact of the COVID-19 pandemic on small- and medium-sized regional hospitals in Andalusia (Spain). (2) Methods: This comparative, multicentre, observational, and retrospective study was designed to perform a comparative cost analysis between the Alto Guadalquivir Health Agency (AGHA) and Poniente University Hospital (PUH), both of which belong to the Spanish Public Health System (PHS). The data included in this study corresponds to the total costs by area and year incurred by the 61,335 patients from both healthcare institutions (AGHA = 36,110; PUH = 25,225) in the areas of hospital emergency service (HES), hospitalisation, and intensive care unit (ICU), during the 24 months of the study period (from 1 January 2019 to 31 December 2020). (3) Results: The analysis results showed a significant increase in costs incurred in 2020 for HES relative to those incurred in 2019 for both AGHA (+14%; p < 0.003) and PUH (+36%; p = 0.002). Additionally, costs incurred for ICU increased significantly in 2020 relative to those incurred in 2019 for both AGHA (+30%; p = 0.003) and PUH (+46%; p = 0.002). Hospitalisation costs for AGHA also increased significantly (+9%; p < 0.012) in 2020 versus those obtained in 2019; however, no significant differences were found for PUH (+6%; p = 1) in the same period analysed. However, the number of patients treated in the areas of HES, hospitalisation, and ICU was significantly reduced throughout 2020 compared to 2019. (4) Conclusions: Our findings show that the costs incurred during 2020 in the regional hospitals of Andalusia (Spain) increased significantly in most of the parameters analysed relative to those incurred in the year before the pandemic (i.e., 2019). Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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21 pages, 853 KiB

Open AccessArticle

Is Telemedicine in Primary Care a Good Option for Polish Patients with Visual Impairments Outside of a Pandemic?

by Katarzyna Weronika Binder-Olibrowska, Magdalena Agnieszka Wrzesińska and Maciek Godycki-Ćwirko

Int. J. Environ. Res. Public Health 2022, 19(11), 6357; https://doi.org/10.3390/ijerph19116357 - 24 May 2022

Cited by 4 | Viewed by 2747

Abstract

With the proliferation of telemedicine during the COVID-19 pandemic, attention began to turn to the risk of health disparities associated with its use among people with disabilities. Therefore, the present study investigates the level of interest in using teleconsultations (TCs) in primary healthcare [...] Read more.

With the proliferation of telemedicine during the COVID-19 pandemic, attention began to turn to the risk of health disparities associated with its use among people with disabilities. Therefore, the present study investigates the level of interest in using teleconsultations (TCs) in primary healthcare among people with visual impairments (PVIs) and identifies their motivations and needs. A total of 219 Polish PVIs were surveyed using a combination of closed and open questions. About 50% of the respondents expressed interest in using TCs. The factor most closely related to the willingness to use TCs was age. The predominant reason for using TCs was to obtain a prescription or referral, and the most highlighted need was the possibility to choose between a TC and an in-person visit. The blind and poor-sighted participants differed in some regards. Our study indicates that TCs, under some conditions, may be a beneficial option for PVIs, and provides some directions for its effective implementation. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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24 pages, 2174 KiB

Open AccessArticle

Behavioral Assessment and Treatment via Telehealth for Children with Autism: From Local to Global Clinical Applications

by Kelly M. Schieltz, Matthew J. O’Brien, Loukia Tsami, Nathan A. Call and Dorothea C. Lerman

Int. J. Environ. Res. Public Health 2022, 19(4), 2190; https://doi.org/10.3390/ijerph19042190 - 15 Feb 2022

Cited by 8 | Viewed by 3378

Abstract

Functional analyses (FA) and functional communication training (FCT) are the most commonly used behavioral assessment and treatment approaches via telehealth for children with autism spectrum disorder (ASD) who display challenging behavior. The FA + FCT telehealth model has been shown to maintain treatment [...] Read more.

Functional analyses (FA) and functional communication training (FCT) are the most commonly used behavioral assessment and treatment approaches via telehealth for children with autism spectrum disorder (ASD) who display challenging behavior. The FA + FCT telehealth model has been shown to maintain treatment effectiveness (i.e., child behavioral outcomes and parent acceptability), as well as demonstrate treatment efficiency (i.e., cost savings). However, the majority of these studies have been conducted in the United States. Therefore, the purpose of this study was to evaluate the outcomes obtained with the telehealth FA + FCT model that included global applications. Descriptive statistics were used to analyze the results of the 199 participants who enrolled in the telehealth project across all project sites. The results showed that behavioral outcomes and parent acceptability maintained at similar levels to previous studies across all sites. Additionally, very few differences were found across project sites in relation to drop-out rates, visit cancellations, and technology issues. These results demonstrate the effectiveness of the FA + FCT telehealth model for addressing the challenging behavior needs of children with ASD globally and highlight areas in need of additional evaluation (e.g., drop-outs, cancellations) to determine the conditions under which telehealth could be best used. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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11 pages, 1987 KiB

Open AccessArticle

Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis—A Single-Center Randomized Trial

by Jose Cerdán-de-las-Heras, Fernanda Balbino, Anders Løkke, Daniel Catalán-Matamoros, Ole Hilberg and Elisabeth Bendstrup

Int. J. Environ. Res. Public Health 2021, 18(19), 10016; https://doi.org/10.3390/ijerph181910016 - 23 Sep 2021

Cited by 33 | Viewed by 4270

Abstract

We investigated the usefulness and effectiveness of tele-rehabilitation on exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A randomized study was carried out, including stable patients with IPF for 3 months of tele-rehabilitation: video and chat consultations with a physiotherapist and workout [...] Read more.

We investigated the usefulness and effectiveness of tele-rehabilitation on exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A randomized study was carried out, including stable patients with IPF for 3 months of tele-rehabilitation: video and chat consultations with a physiotherapist and workout sessions with a virtual physiotherapist agent (VAPA). Moreover, 6-min walk test distance (6MWTD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), 7 days pedometry, Saint George Respiratory Questionnaire for interstitial lung disease, The King’s Brief Interstitial Lung Disease Questionnaire, and General Anxiety Disorder 7 Questionnaire were tested before and after 3 months of tele-rehabilitation, as well as after 3 and 6 months follow-up. Patient satisfaction and adherence were also measured for tele-rehabilitation with VAPA. Twenty-nine patients aged 70.9 ± 8.6 years, male 72.4%, FVC% 83.5 ± 17.7, DLCO% 50.6 ± 13.0, 6MWTD 468.4 ± 14.8 were included. Fifteen patients were randomized to tele-rehabilitation with VAPA and 14 to the control group. Differences in 6MWTD between groups were at baseline (+10 m (p = 0.11)) and after 3 (+39.5 m (p = 0.03)), 6 (+34.3 m (p = 0.02)), and 9 months (+40.5 m (p = 0.15)) follow-up. No difference was observed in pedometry and quality of life. Adherence was above 63%. Patient satisfaction was high. Tele-rehabilitation with VAPA appears to be useful in patients with IPF. Exercise capacity was better at follow up at 3 and 6 months compared with the control group. There was no change in quality of life or pedometry. Adherence and patient satisfaction were all high. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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27 pages, 977 KiB

Open AccessArticle

Factors Affecting the Delivery and Acceptability of the ROWTATE Telehealth Vocational Rehabilitation Intervention for Traumatic Injury Survivors: A Mixed-Methods Study

by Jade Kettlewell, Rebecca Lindley, Kate Radford, Priya Patel, Kay Bridger, Blerina Kellezi, Stephen Timmons, Isabel Andrews, Stephen Fallon, Natasha Lannin, Jain Holmes, Denise Kendrick and on behalf of the ROWTATE Team

Int. J. Environ. Res. Public Health 2021, 18(18), 9744; https://doi.org/10.3390/ijerph18189744 - 16 Sep 2021

Cited by 12 | Viewed by 3935

Abstract

Background: Returning to work after traumatic injury can be problematic. We developed a vocational telerehabilitation (VR) intervention for trauma survivors, delivered by trained occupational therapists (OTs) and clinical psychologists (CPs), and explored factors affecting delivery and acceptability in a feasibility study. Methods: Surveys [...] Read more.

Background: Returning to work after traumatic injury can be problematic. We developed a vocational telerehabilitation (VR) intervention for trauma survivors, delivered by trained occupational therapists (OTs) and clinical psychologists (CPs), and explored factors affecting delivery and acceptability in a feasibility study. Methods: Surveys pre- (5 OTs, 2 CPs) and post-training (3 OTs, 1 CP); interviews pre- (5 OTs, 2 CPs) and post-intervention (4 trauma survivors, 4 OTs, 2 CPs). Mean survey scores for 14 theoretical domains identified telerehabilitation barriers (score ≤ 3.5) and facilitators (score ≥ 5). Interviews were transcribed and thematically analysed. Results: Surveys: pre-training, the only barrier was therapists’ intentions to use telerehabilitation (mean = 3.40 ± 0.23), post-training, 13/14 domains were facilitators. Interviews: barriers/facilitators included environmental context/resources (e.g., technology, patient engagement, privacy/disruptions, travel and access); beliefs about capabilities (e.g., building rapport, complex assessments, knowledge/confidence, third-party feedback and communication style); optimism (e.g., impossible assessments, novel working methods, perceived importance and patient/therapist reluctance) and social/professional role/identity (e.g., therapeutic methods). Training and experience of intervention delivery addressed some barriers and increased facilitators. The intervention was acceptable to trauma survivors and therapists. Conclusion: Despite training and experience in intervention delivery, some barriers remained. Providing some face-to-face delivery where necessary may address certain barriers, but strategies are required to address other barriers. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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15 pages, 520 KiB

Open AccessArticle

TV News and COVID-19: Media Influence on Healthy Behavior in Public Spaces

by Massimiliano Scopelliti, Maria Giuseppina Pacilli and Antonio Aquino

Int. J. Environ. Res. Public Health 2021, 18(4), 1879; https://doi.org/10.3390/ijerph18041879 - 15 Feb 2021

Cited by 54 | Viewed by 8319

Abstract

The COVID-19 outbreak has dramatically changed our life. Despite the rapid growth of scientific publications about medical aspects of the pandemic, less has been explored about the effects of media communication regarding COVID-19 on healthy behaviors. Yet, the scientific literature has widely debated [...] Read more.

The COVID-19 outbreak has dramatically changed our life. Despite the rapid growth of scientific publications about medical aspects of the pandemic, less has been explored about the effects of media communication regarding COVID-19 on healthy behaviors. Yet, the scientific literature has widely debated on how media can influence people’s health-related evaluations, emotions, and behaviors. To fill this gap, the aim of this study was to investigate the relationships between media exposure, people’s attitudes and emotions toward media contents, and healthy behaviors related to the use of public spaces, such as avoiding crowded places, wearing face masks, and maintaining social distance. A questionnaire referring to these variables was administered to an opportunistic sample of 174 participants in Italy during the off-peak period of the COVID-19 outbreak and before restrictions to mobility were extended to the whole country. Results showed that media exposure, the perception of social initiatives of prevention, and moderate levels of fear increase healthier behaviors in the use of public spaces. Perceiving alarming information did not significantly predict healthy behaviors in the use of public spaces. Results are discussed with reference to the previous literature. Suggestions to media communication to increase preventive behaviors during emergencies are also provided. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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12 pages, 318 KiB

Open AccessArticle

Assessing Communication during Remote Follow-Up of Users with Pacemakers in Norway: The NORDLAND Study, a Randomized Trial

by Daniel Catalan-Matamoros, Antonio Lopez-Villegas, Knut Tore Lappegård and Remedios Lopez-Liria

Int. J. Environ. Res. Public Health 2020, 17(20), 7678; https://doi.org/10.3390/ijerph17207678 - 21 Oct 2020

Cited by 5 | Viewed by 2692

Abstract

As effective communication is a key ingredient for the provision of quality healthcare services, this study aimed to explore the communication experiences in the remote monitoring of older adults with a pacemaker. The study was based on a non-masked randomized observational design. The [...] Read more.

As effective communication is a key ingredient for the provision of quality healthcare services, this study aimed to explore the communication experiences in the remote monitoring of older adults with a pacemaker. The study was based on a non-masked randomized observational design. The Healthcare Communication Questionnaire and in-depth interviews were conducted for data collection. A total of 49 patients participated in the study. The study findings reveal overall positive communication experiences by pacemaker users in remote monitoring with no significant differences from users in hospital monitoring. The remote option is perceived as safe and convenient, and communicating with the clinicians from home is considered comfortable and confidential. The study provides insights into the content of communication experiences in telehealth and practical implications in healthcare contexts. In a world that increasingly relies on remote communication, it is crucial to match technologies to patient needs and assess communication with patients. This will ensure the success of new models of care and establish appropriate criteria for the use of telehealth services. These criteria are all relevant in the implementation of health technology in the future as a part of effective patient-centered care. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

17 pages, 2383 KiB

Open AccessArticle

The Effect of the COVID-19 Pandemic on Physicians’ Use and Perception of Telehealth: The Case of Lebanon

by Samar Helou, Elie El Helou, Victoria Abou-Khalil, Jad Wakim, Jeanine El Helou, Alain Daher and Charline El Hachem

Int. J. Environ. Res. Public Health 2020, 17(13), 4866; https://doi.org/10.3390/ijerph17134866 - 6 Jul 2020

Cited by 45 | Viewed by 7317

Abstract

The COVID-19 pandemic forced physicians to quickly adapt and find ways to provide their usual offline services by using online tools. We aimed to understand how physicians adapted to the sudden need for telehealth and if their perception of telehealth changed due to [...] Read more.

The COVID-19 pandemic forced physicians to quickly adapt and find ways to provide their usual offline services by using online tools. We aimed to understand how physicians adapted to the sudden need for telehealth and if their perception of telehealth changed due to their experience during the COVID-19 pandemic. We conducted an exploratory sequential mixed-methods study. We interviewed five Lebanese physicians and thematically analyzed the interviews. We developed a questionnaire based on the analysis results and administered it online to physicians in Lebanon. In total, 140 responses were collected. We found that, during the COVID-19 pandemic, physicians engaged in more telehealth activities in the realms of telemedicine, public awareness, continuing medical education, research, administration, and teaching. They also expanded their repertoire of information-technology tools. Our results also show that there was a significant shift in the physicians’ perceptions, indicating greater openness and willingness to adopt telehealth services. However, a significant amount of skepticism and uncertainty regarding telemedicine remains, especially concerning its efficiency, safety, and the adequacy of existing regulations. Based on our findings, we offer recommendations for health IT policy makers, developers, and researchers, to sustain the continuity of telehealth activities beyond the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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Review

Jump to: Research, Other

15 pages, 597 KiB

Open AccessReview

Telerehabilitation as a Therapeutic Exercise Tool versus Face-to-Face Physiotherapy: A Systematic Review

by Mª Teresa Muñoz-Tomás, Mario Burillo-Lafuente, Araceli Vicente-Parra, Mª Concepción Sanz-Rubio, Carmen Suarez-Serrano, Yolanda Marcén-Román and Mª Ángeles Franco-Sierra

Int. J. Environ. Res. Public Health 2023, 20(5), 4358; https://doi.org/10.3390/ijerph20054358 - 28 Feb 2023

Cited by 30 | Viewed by 5124

Abstract

Digital physiotherapy, often referred to as “Telerehabilitation”, consists of applying rehabilitation using telecommunication technologies. The objective is to evaluate the effectiveness of therapeutic exercise when it is telematically prescribed. Methods: We searched PubMed, Embase, Scopus, SportDiscus and PEDro (30 December 2022). The results [...] Read more.

Digital physiotherapy, often referred to as “Telerehabilitation”, consists of applying rehabilitation using telecommunication technologies. The objective is to evaluate the effectiveness of therapeutic exercise when it is telematically prescribed. Methods: We searched PubMed, Embase, Scopus, SportDiscus and PEDro (30 December 2022). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to telerehabilitation and exercise therapy. RCTs on patients over 18 years and two groups were included, one working with therapeutic exercise through telerehabilitation and one working with conventional physiotherapy group. Results: a total of 779 works were found. However, after applying the inclusion criteria, only 11 were selected. Telerehabilitation is most frequently used to treat musculoskeletal, cardiac and neurological pathologies. The preferred telerehabilitation tools are videoconferencing systems, telemonitoring and online platforms. Exercise programs ranged from 10 to 30 min and were similar in both intervention and control groups. In all the studies, results proved to be similar for telerehabilitation and face-to-face rehabilitation in both groups when measuring functionality, quality of life and satisfaction. Conclusion: this review generally concludes that intervention through telerehabilitation programs is as feasible and efficient as conventional physiotherapy in terms of functionality level and quality of life. In addition, telerehabilitation shows high levels of patients’ satisfaction and adherence, being values equivalent to traditional rehabilitation. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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12 pages, 2508 KiB

Open AccessReview

Remote Monitoring of CIEDs—For Both Safety, Economy and Convenience?

by Knut Tore Lappegård and Frode Moe

Int. J. Environ. Res. Public Health 2022, 19(1), 312; https://doi.org/10.3390/ijerph19010312 - 28 Dec 2021

Cited by 13 | Viewed by 3009

Abstract

Cardiac implantable electronic devices such as pacemakers and defibrillators are increasingly monitored by systems transmitting information directly from the patient to the hospital. This may increase safety and patient satisfaction and also under certain circumstances represent an economic advantage. The review summarizes some [...] Read more.

Cardiac implantable electronic devices such as pacemakers and defibrillators are increasingly monitored by systems transmitting information directly from the patient to the hospital. This may increase safety and patient satisfaction and also under certain circumstances represent an economic advantage. The review summarizes some of the recent research in the field of remote monitoring of cardiac devices. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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25 pages, 798 KiB

Open AccessReview

A Narrative Review of Factors Historically Influencing Telehealth Use across Six Medical Specialties in the United States

by Pavani Rangachari, Swapandeep S. Mushiana and Krista Herbert

Int. J. Environ. Res. Public Health 2021, 18(9), 4995; https://doi.org/10.3390/ijerph18094995 - 8 May 2021

Cited by 23 | Viewed by 5943

Abstract

Prior to the COVID-19 pandemic, studies in the US have identified wide variations in telehealth use across medical specialties. This is an intriguing problem, because the US has historically lacked a standardized set of telehealth coverage and reimbursement policies, which has posed a [...] Read more.

Prior to the COVID-19 pandemic, studies in the US have identified wide variations in telehealth use across medical specialties. This is an intriguing problem, because the US has historically lacked a standardized set of telehealth coverage and reimbursement policies, which has posed a barrier to telehealth use across all specialties. Although all medical specialties in the US have been affected by these macro (policy-level) barriers, some specialties have been able to integrate telehealth use into mainstream practice, while others are just gaining momentum with telehealth during COVID-19. Although the temporary removal of policy (coverage) restrictions during the pandemic has accelerated telehealth use, uncertainties remain regarding future telehealth sustainability. Since macro (policy-level) factors by themselves do not serve to explain the variation in telehealth use across specialties, it would be important to examine meso (organizational-level) and micro (individual-level) factors historically influencing telehealth use across specialties, to understand underlying reasons for variation and identify implications for widespread sustainability. This paper draws upon the existing literature to develop a conceptual framework on macro-meso-micro factors influencing telehealth use within a medical specialty. The framework is then used to guide a narrative review of the telehealth literature across six medical specialties, including three specialties with lower telehealth use (allergy-immunology, family medicine, gastroenterology) and three with higher telehealth use (psychiatry, cardiology, radiology) in the US, in order to synthesize themes and gain insights into barriers and facilitators to telehealth use. In doing so, this review addresses a gap in the literature and provides a foundation for future research. Importantly, it helps to identify implications for ensuring widespread sustainability of telehealth use in the post-pandemic future. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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Other

Jump to: Research, Review

22 pages, 1769 KiB

Open AccessSystematic Review

Knowledge Update on the Economic Evaluation of Pacemaker Telemonitoring Systems

by Antonio Lopez-Villegas, César Leal-Costa, Mercedes Perez-Heredia, Irene Villegas-Tripiana and Daniel Catalán-Matamoros

Int. J. Environ. Res. Public Health 2021, 18(22), 12120; https://doi.org/10.3390/ijerph182212120 - 18 Nov 2021

Cited by 2 | Viewed by 2818

Abstract

(1) Introduction: In the last two decades, telemedicine has been increasingly applied to telemonitoring (TM) of patients with pacemakers; however, presently, its growth has significantly accelerated because of the COVID-19 pandemic, which has pushed patients and healthcare workers alike to seek new ways [...] Read more.

(1) Introduction: In the last two decades, telemedicine has been increasingly applied to telemonitoring (TM) of patients with pacemakers; however, presently, its growth has significantly accelerated because of the COVID-19 pandemic, which has pushed patients and healthcare workers alike to seek new ways to stay healthy with minimal physical contact. Therefore, the main objective of this study was to update the current knowledge on the differences in the medium-and long-term effectiveness of TM and conventional monitoring (CM) in relation to costs and health outcomes. (2) Methods: Three databases and one scientific registry were searched (PubMed, EMBASE, Scopus, and Google Scholar), with no restrictions on language or year of publication. Studies published until July 2021 were included. The inclusion criteria were: (a) experimental or observational design, (b) complete economic evaluation, (c) patients with implanted pacemakers, and (d) comparison of TM with CM. Measurements of study characteristics (author, study duration, sample size, age, sex, major indication for implantation, and pacemaker used), analysis, significant results of the variables (analysis performed, primary endpoints, secondary endpoints, health outcomes, and cost outcomes), and further miscellaneous measurements (methodological quality, variables coded, instrument development, coder training, and intercoder reliability, etc.) were included. (3) Results: 11 studies met the inclusion criteria, consisting of 3372 enrolled patients; 1773 (52.58%) of them were part of randomized clinical trials. The mean age was 72 years, and the atrioventricular block was established as the main indication for device implantation. TM was significantly effective in detecting the presence or absence of pacemaker problems, leading to a reduction in the number of unscheduled hospital visits (8.34–55.55%). The cost of TM was up to 87% lower than that of CM. There were no significant differences in health-related quality of life (HRQoL) and the number of cardiovascular events. (4) Conclusions: Most of the studies included in this systematic review confirm that in the TM group of patients with pacemakers, cardiovascular events are detected and treated earlier, and the number of unscheduled visits to the hospital is significantly reduced, without affecting the HRQoL of patients. In addition, with TM modality, both formal and informal costs are significantly reduced in the medium and long term. Full article

(This article belongs to the Special Issue Global Research in Telehealth: Challenges, Emerging Opportunities and Needs in Society)

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