ABSTRACT
During the COVID-19 pandemic, many patients with rheumatic diseases were left without specialized care and information support, however, the current level of digitalization makes it possible to transfer the training and education of patients and their relatives to an online format. Objective: to analyze the experience of holding a rheumatological school in an online format as a method of improving the medical literacy of the population. Patients and methods. A cross-sectional study was performed by voluntary anonymous questioning of 157 patients who, from September 2020 to November 2021, took part in the online school on rheumatology held at the Clinical Rheumatology Center "New Hospital" (Yekaterinburg). All patients filled out an online questionnaire that included 15 questions related to age, place of residence, motivation of students, sources of information about the school, assessment of the form and content of lectures, quality and novelty of the information provided, and degree of doctor’s credibility. Results and discussion. Analysis of the results of the survey demonstrated the interest of patients in obtaining high-quality medical information on rheumatology problems, a positive assessment of the format and content of the online school, its positive role in clarifying the essence of the disease and related problems. Conclusion. Online schools for patients seem to be a relevant and promising area of medical prevention. © 2022, Ima-Press Publishing House. All rights reserved.
ABSTRACT
Background: The COVID-19 pandemic has brought signifcant changes to the work of healthcare professionals around the world. Technologies of tele-medicine counseling and education of patients have become widespread. The largest platforms for informing patients are social networks such as Facebook, Instagram, Twitter. Objectives: to study the possibilities and impact of the social network as a digital medical tool on the education and management of rheumatological patients Methods: The study was conducted in the form of a survey in the social network Instagram in the blog @revmatologg-sarapulova, dedicated to the rheumatological diseases, and was dedicated to the level of information. At the time of the survey, the number of subscribers to the blog was 4895 people, 223 people answered the questions submitted. The survey was conducted in a Google form and was anonymous. Results: 86% of respondents lived in Russian Federation, 17.5%-in the survey region, 14% of patients were from other countries. 72% indicated the presence of rheumatic disease as the reason for reading the blog, 7%-disease in relatives, 14% are guided by the desire to know more about rheumatological diseases. 68.5% of the respondents rated the information presented in the blog as very interesting (10 points on a scale from 0 to 10), 13.3%-9 points and 9.1%-8 points. It should be noted that none of the participants in the study gave less than 5 points. The most interesting in the blog, the majority calls information posts (88.8%) and answers the questions (77.6%). 2 out of 3 patients (64.5%) after getting acquainted with the information provided began to know more about their disease, 14% began to lead a healthier lifestyle, 9.8% realized the need to visit a doctor. 83.3% of participants rated the information on the blog as more detailed than what they get at their doctor's appointment, and 81% would seek advice from a blogger. When answering the question 'Do you share the information you get from the blog with your healthcare provider?' 47.2% noted that they prefer not to report, 28%-report, while 44.9% of respondents indicated that the doctor is neutral about the information received, 22.9%-positively, 7.6%-negatively. In general, 86% agreed that social networks are an important source of medical information, and as other sources they noted self-search for information in the Internet and visiting a doctor. 65.7% of the respondents asked the question to the author of the blog and received a response that was helpful in 90.6% of cases. 36.8% previously applied for telemedicine counseling through any messengers/systems, and 20.1% plan to do so. In 57.8% of cases, the opinion of the attending physician coincided with the result of a telemedicine counseling, in 12.8% it did not, and 17.8% of patients consulted only online. Conclusion: social networks are an important source of information for patients and a means of choosing a medical specialist. However, it is alarming that in about half of the cases, patients do not share the information received with the attending physician, which can be explained both by lack of time and the lack of an adequate level of trust.
ABSTRACT
Purpose: Due to the coronavirus pandemic, adjustments were made to the standards for the provision of medical care to patients with rheumatological diseases, including an implementation of video consultations. The format of telemedicine services has its own characteristics in each country, largely dependent on how actively the Internet is used by the population. According to official data for 2018, Internet users in Russia accounted for 75.4% of the total population, while in the 55+ age group - only 36%. The aim of the study was to assess the development of telemedicine consultations (TMC) in the field of rheumatology in one of the medical offices in a large industrial center. Methods: The study included patients who applied for TMC. After it was held, all of them were asked to answer several questions in the Google form. The total number of participants was 36 patients. Results: A feature of the development of TMC was the extremely slow popularization of this method. Since the permission for this type of activity had been obtained, only 36 TMC were carried out in 5 months, while 488 traditional consultations have taken place. 77.8% of these were women, the overwhelming majority aged 31-50 years. 29 people lived in the immediate vicinity of the office, 3 - in the same region, but 4 people - in Russia up to 4000 km away from the office. About a quarter of the patients used online video consultations more than once. According to patients, 83.3% were able to completely, and 16.7% partially solve their problems. It was easy to establish contact for 86.1% of patients. The main reasons for applying for TMC were: it’s much faster than waiting in line for an in-person consultation, they just needed to clarify some issues (drug dose, control of analyzes). About half of the patients assessed the convenience of TMC (from home), the avoidance of infectious contacts in transport, and the quickness of urgent issues resolving. The main problems raised in the course of TMC were the routine control of laboratory tests and the correction of the therapy received. From this point of view, patients with gout and rheumatoid arthritis look the most promising for management. And, indeed, they constituted a significant part of those who applied for TMS. It’s remarkable that all patients noted their readiness to continue using TMC, since it turned out to be more convenient (100% of respondents' answers) due to the ability of receiving advice at a convenient time while staying at home, and the consultation is comparable to the face-to-face format (83.3%) in terms of quality;about half said that it saves time, and there is no problem of making an appointment with a doctor. For about a third of patients noted that this form of medical care is significantly cheaper than in-person visit. According to the doctor who conducted the consultations, 83.3% of patients were completely satisfied with the quality of this medical service and solved their problems. Conclusions: TMC represents a promising format of medical care for patients with rheumatic diseases.
ABSTRACT
Background: Telemedicine counseling (TMC) has gained rapid development during the COVID-19 pandemic. The prospect of using this technology in rheumatology was based on the possibility of getting maximum information about the patient during the survey, examination and interpretation of laboratory and instrumental data, that is excepting direct contact with the patient. Several rheumatological clinics have reported on the success of using TMC. However, there is very little data of the difficulties that can be encountered when organizing this process. Objectives: To characterize the identified problems during TMC in rheumatology, to suggest potential directions for their elimination. Methods: Since June 2021, on the basis of the Medical Association “New Hospital”, Yekaterinburg, Russian Federation, 76 TMCs have been performed on the profile of rheumatology in patients aged 29 to 71 years. Of these, 13 applied to the primary TMC, the other patients were preliminarily examined in person. The consultation included the preliminary acquaintance with the examination results, a 20-minute video communication and writing of a conclusion. After each TMC, a survey was conducted between the doctor and the patient, including the identified deficiencies in counseling. The frequency of identified problems is presented as an absolute indicator and as a percentage of the total number of TMCs performed. Results: We noted a high degree of patient satisfaction: 74 (97.4%) responded that they received answers to all. However, according to the doctor, the following groups of problems were identified. [1] Technical problems in 29 (38.2%): most often there were various problems with the Internet, but there were also registered: the end of the charge on the patient's tablet, the patient was not registered in the electronic queue. Elimination of these violations depends on the work of IT-specialists, but each consulting physician should be prepared for an immediate transition to an alternative form of communication (for example -telephone). [2] Lack of objective examination, leading to the impossibility of correct remote diagnosis -8 (10.5%). This problem was identified due to the inability to establish the presence or absence of arthritis during the initial diagnosis (6 cases) and to clarify the nature of the rash (2 cases). All patients are invited for a face-to-face consultation. [3] The need to write prescriptions for psychotropic drugs -12 (15.8%), which under the conditions of national legislation cannot be done in the TMC regime. [4] The time spent directly on remote communication with the patient was 17.2 minutes (from 8 to 31), however, taking into account the study data and writing the conclusion, the total time was 40.7 minutes (from 21 to 73). Thus, it turned out that the average time for remote and face-to-face consultations is the same, while TMC's payment is only about 50% of the face-to-face consultation. This situation reduces the doctor's interest in carrying out TMC. The solution to the problem is associated with reducing the time for the documentation process through technical improvements. In addition, of the 9 patients in whom the TMC process lasted 60 minutes or more, 5 were diagnosed with fibromyalgia. It is possible that with a previously established diagnosis of fibromyalgia, only face-to-face counseling should be recommended to patients. Conclusion: The TMC system is promising, however, there are a number of problems that need to be improved, since they can reduce the doctor's interest in using this technology.
ABSTRACT
Background: A feature of healthcare in 2020 was the work in conditions of massive incidence of COVID-19, limited and redistribution of human resources. One of the right decisions in these conditions is to organize schools for patients, which allow simultaneous education and convey the necessary information to a large number of people. The key aspects of the organization of telemedicine schools for patients are presented. Objectives: To assess the feasibility of telemedicine schools for patients as a technology of modern health care in rheumatology. Methods: The work was carried out by the method of a one-stage cross-sectional study of the questionnaire survey of participants of education in rheumatology, conducted in an on-line mode. The number of participants in rheumatology schools was 197 people, the results of the questionnaire were received from 36 respondents. The questionnaire based on the Google platform. Results: 10 key principles of organizing online patient education at the present stage were identified: the use of distance technologies, the interest of a medical institution administration, the team approach, the technical possibilities of implementing schools, adaptation of lecture material for patients, the role of a specialized specialist in the educational process, patient participation, measurement efficiency and timely correction, development and improvement of educational technology for patients, desire for cooperation and exchange of experience. Conclusion: The emergence of new opportunities related to online health education of the population, including educational activities for patients, opens up new prospects for improving clinical care aimed at promoting health and preventing disease.