Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Journal Of Diabetes ; 17:17, 2023.
Article in English | MEDLINE | ID: covidwho-2192205

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self-management remains the gold standard of care for diabetes. Improving patients' self-management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID-19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM.

3.
Investigative Ophthalmology and Visual Science ; 63(7):2155-A0183, 2022.
Article in English | EMBASE | ID: covidwho-2058317

ABSTRACT

Purpose : The effect of coronavirus disease 2019 (COVID-19) on ophthalmic surgical case numbers in Australia and globally remains poorly characterised. Increased incidence of COVID-19 in Australia between March and April 2020 led to a national lockdown and elective surgery restrictions. The aim of this population-based study was to quantify the early impact of COVID-19 on ophthalmic surgery in Australia, comparing surgical service rates in 2019 and 2020. Methods : Retrospective analysis of the number of ophthalmic surgical services in 2019 and 2020 in all Australian States and Territories, as recorded by Medicare (Australian Government-funded universal health insurance scheme subsidising healthcare costs for Australian residents). Monthly surgical service rates were calculated and Poisson regression was used to compare the change in service rates between months. Results : Between March and April 2020, surgical service rates decreased for: cataract surgery (by 71%, 95% CI: 70-72%), cataract surgery with minimally invasive glaucoma surgical device insertion (by 71%, 95% CI: 65-75%), pterygium removal (by 67%, 95% CI: 60- 72%), corneal transplantation (by 31%, 95% CI: 9-48%), and collagen crosslinking for corneal ectasias (by 35%, 95% CI: 18-48%). Comparatively, service rates for these surgeries did not differ or decreased less between March and April 2019. Interestingly, glaucoma filtration surgery rates decreased between March and April in 2020 (by 44%, 95% CI: 29- 56%) and also in 2019 (by 45%, 95% CI: 31-55%), whilst retinal detachment surgery rates were unchanged between these months in 2020 (crude decrease 9%, 95% CI: -28 to 16%) and 2019 (crude decrease 11%, 95% CI: -26 to 9%). Conclusions : Despite relatively low rates of COVID-19 community transmission in Australia in 2020, ophthalmic surgical service rates decreased during months in lockdown and with restrictions, largely for non-time-critical conditions. These data may have health planning implications as the pandemic continues, with future lockdowns and restrictions possible, especially as COVID-19 variants emerge.

4.
Swiss Medical Weekly ; 152:34S-35S, 2022.
Article in English | EMBASE | ID: covidwho-2040973

ABSTRACT

Background & aims: COVID19 disproportionately affects the immunosuppressed, but its epidemiology over time is incompletely characterised. We describe Australian experiences of COVID19 in a national observational study of patients with malignancy. Methods: An ongoing multisite prospective cohort study of adult COVID19 patients with active cancer was conducted. Clinical and laboratory data over 28 months (1/3/20-22/7/22) was collated from 15 hospitals. Results: There were 491 patients included. Patients were a median of 63(IQR:50-71) years with majority male (254,52%). Solid organ malignancy was most common (296,60%), followed by haematological malignancy (180,37%), then both (15,4%). Most common solid tumour was breast cancer (74/296,25%);most common haematological cancer was lymphoma (102/180,57%). Majority (275,56%) were undergoing cancer treatment at COVID19 diagnosis. From 2020-2022, patients presented less with lower respiratory tract infections (57%,36%,5%) with increasing outpatient management (26%,50%,67%). Improved mortality was seen (27%,19%,11%). Median inpatient length of stay was 8(4-11) days. Intensive care admission was low (21,4%). For patients who had repeated respiratory PCR testing, median time from first to last positive test was 17(7-25, n = 123) days. Cancer treatment modification occurred in 18(4%) and delay in 74(15%). Conclusion: Despite improvements in outcomes, COVID19 still results in morbidity with impacts on cancer treatment. This preliminary data shows that cancer patients remain a vulnerable group and should be prioritised for public health interventions.

5.
Journal of the ASEAN Federation of Endocrine Societies ; 37:55, 2022.
Article in English | EMBASE | ID: covidwho-2006563

ABSTRACT

Introduction Teleconsultation has become an increasingly important service in managing T2DM especially with the ongoing COVID-19 pandemic and is assumed to be less costly to patients compared to physical visits. This study aimed to compare patients' cost for a teleconsultation session vs physical clinic visit. Methodology This was a cross-sectional study from June 2020 to December 2021 in UMMC which included patients who had successfully participated in teleconsultation sessions. Patient interviews were conducted to collect demographics, detailed cost items (direct/ indirect cost) and a self-administered Patient Satisfaction Questionnaire Short Form (PSQ-18). HbA1c and average self-monitoring blood glucose (SMBG) records at baseline and 3-months after teleconsultation were obtained from electronic medical records (EMR). Results A total of 36 patients were recruited. The median cost of attending a physical visit was significantly higher compared to teleconsultation (RM 123.41 [54.29, 219.51] vs RM 41.41 [30.55, 49.66];p<0.001) with a median cost difference of RM 81.24 [20.20,171.69]. Indirect costs (income loss from absence) made up the majority of the cost saving with teleconsultation (teleconsultation RM 10.71 [0.00,18.45], physical visit RM95.24 [0.00,182.74];p<0.001). There was a reduction in HbA1c (9.45% [7.98, 11.38] to 8.25% [7.42, 9.49];p<0.001) and average fasting SMBG (8.11 mmol/L [6.75, 9.70] to 7.20 mmol/L [6.22, 8.71];p=0.03) after 3 months of teleconsultation. Patients reported high satisfaction levels with teleconsultation, with an overall PSQ-18 score of 78%. Conclusion Teleconsultation service in UMMC Diabetes outpatient clinic was cost saving to patients compared to physical visits without compromising blood glucose control. Teleconsultation may be a viable option of healthcare provision for many patients and may be considered as part of routine care.

6.
Diabetes Research and Clinical Practice ; 186, 2022.
Article in English | EMBASE | ID: covidwho-1894928

ABSTRACT

Background: There were reports on lower rates of hospitalization for acute coronary syndrome during COVID-19 pandemic due to fear to attend to hospitals, resulting in delayed diagnosis and treatment. In addition to fragmented care, hospital capacity strain affects access to care continuity for patients with acute coronary syndrome. Aim: To examine the impact of multicomponent integrated care on hard clinical outcomes in patients with acute coronary syndrome. Method: A literature search was conducted on PubMed, EMBASE, Ovid and Cochrane library databases for randomized controlled trials published in English language between January 1980 and November 2020. Trials were eligible if there was intervention with multicomponent integrated care, defined as 2 or more quality improvement strategies targeting different domains (the healthcare system, health-care providers and patients), for 1 month or more among patients with acute coronary syndrome. The outcomes of interest were mortality, hospital re-admission and emergency department visits, stratified by all-cause and cardiovascular-related. We pooled the risk ratio (RR) with 95% confidence interval (CI) for the association between multicomponent integrated care and clinical outcomes using the Mantel-Haenszel test. Results: We identified a total of 74 eligible trials with 92,625 patients with acute coronary syndrome. The most common quality improvement strategies implemented were team change (83.8%), patient education (62.2%) and facilitated patient-provider relay (54.1%). In random-effect models, compared with usual care, multicomponent integrated care was associated with reduced risk for all-cause mortality (RR 0.84, 95% CI 0.78-0.90;p<0.001;I2=0%), cardiovascular mortality (RR 0.81, 95% CI 0.69-0.95;p=0.009;I2=0%), all-cause hospitalization (RR 0.88, 95% CI, 0.78-0.99;p=0.040;I2=58%) and cardiovascular-related hospitalization (RR 0.89, 95% CI 0.77-1.03;p=0.110;I2=79%). The associations of multicomponent integrated care with emergency department visits (RR 0.98, 95% CI 0.81-1.19;p=0.860;I2=66%) and unplanned outpatient visits (RR 1.03, 95% CI 0.90-1.18;p=0.650;I2=40%) were not statistically significant. Discussion: Multicomponent integrated care can improve patients’ outcomes after acute coronary syndrome. Patients with acute coronary syndrome need to understand their condition, adhere to treatment and perform self-management to prevent recurrence with worse prognosis. Our findings highlight that multicomponent integrated care can reduce risk for mortality and hospitalization in these high-risk patients.

7.
Clinical and Experimental Ophthalmology ; 49(8):964-964, 2022.
Article in English | Web of Science | ID: covidwho-1548563
SELECTION OF CITATIONS
SEARCH DETAIL