VIRTUAL MANAGEMENT OF HYPERTENSION: ISH POSITION PAPER

The COVID-19 pandemic caused an unprecedented shift from in-person care to delivering health care remotely. To limit the infectious spread, patients and providers rapidly adopted distant evaluation with online or telephone-based diagnosis and management of hypertension. However, many patients and care providers were unprepared for this rapid shift and may not be delivering optimal hypertension assessment and management. Given that it is likely that virtual care of chronic diseases including hypertension will continue into the future, the International Society of Hypertension developed a position paper to provide practical guidance on the virtual management of hypertension to improve its diagnosis and blood pressure control. This position paper is based on the currently available evidence, hypertension guidelines, and international expert opinion. Virtual care is defined as the delivery of healthcare remotely between patients, their carers, and healthcare providers. As different regions and patients have varying degrees of virtual care resources, skills, and preferences, we conceptualize the basic, advanced and complete virtual care models representing advancing degrees of virtual care. This presentation will review the position statements in these three levels of virtual care and discuss the position statements and rationale for selecting blood pressure monitoring devices, cuffless devices, accurate home blood pressure assessments, optimizing patient education, health behavior change, medication adjustment, and long-term monitoring in a virtual care environment.

What do patients with asthma want to know? Google Trends insights into U.S. general population interest between 2004 and 2022 can help structure patient education initiatives

Rationale: The aim of this study is to use the research tool Google Trends to analyze U.S. general population interest in asthma. Methods: The research tool Google Trends (trends.google.com) was used to access data sets for the searched term "asthma” between 2004 and 2022 (English language, U.S. location). Data were normalized and adjusted to make comparisons between search terms substantiated. Each data point was divided by the total searches of the geography and time range it represented. Results: Searches for asthma detected have remained stable in terms of volume between 2004 and 2022 apart from a spike during February-May 2020 which corresponded with one of the peaks of the COVID pandemic. Top 5 states for asthma searches in 2022 were Kentucky, Tennessee, Connecticut, Mississippi, Maryland. The list of the top states is dynamic and has changed since 2004.Top search terms in the U.S. in 2022 were: allergy, allergy asthma, asthma and allergy, asthma symptoms, asthma attack. Searches for allergy have consistently been present in the top 5 terms when patients searched for asthma during the last 18 years, between 2004 and 2022. Conclusions: Asthma-related Google searches reveal topics of high interest that could supplement the understanding about general population interest. Searches for allergy have consistently been present in the top 5 terms when patients searched for asthma during the last 18 years, emphasizing the role of allergists/immunologists in asthma care. Knowledge of variability in search patterns and specific topics could help allergy organizations and practicing allergists focus their educational programs towards patients' interests.

Case Managers Can Better Educate Patients and Families About Opioid Addiction

The article discusses the role of case managers in educating patients and families about opioid addiction. Topics covered include the need to educate healthcare providers about the risk of using substances so they can educate patients on preventing addiction, how case managers and nurses in educating patients that addiction is a medical condition, and community outreach measures that hospitals can initiate to help prevent overdoses.

Sidra Pharmacy's evidence-based approach to meet changing demands on the service: COVID-19

Background: From December 2019, the healthcare system as we know it changed, as the WHO declared a worldwide COVID-19 outbreak. Purpose(s): Evidenced-based review of pharmacy emergency major incident plan, alongside internationally recognised policies, with government updates (Ministry of Public Health;2019;ASHP, 2020;GPhC, 2020;Ministry of Public Health;2020);RPS, 2020). Method(s): Pharmacy leadership identified staff who could work remotely, split shifts;receive cross training. The clinical team worked closely with the infectious disease/antimicrobial stewardship team towards devising a clinical plan to manage those under our care. Result(s): Service changes included: team members resorted to online or telephone discussions;verification of medication orders took place from home;activation of automation systems;changes to the pharmacy homecare service;communication moved to digital virtual platforms;measures such as the addition of floor markings and medication deliveries to clinics were implemented. Patient education leaflets and social media platforms were utilised to inform patients. Introduction of a drive-through pharmacy collection service, home delivery services, online medication request services, along with expansion of the telephone request infrastructure. Tailored 'ABC' analysis were performed to identify 'valuable' medicine. Non-formulary stocks were distributed to all patients, to prevent any panic or assumption about shortage. All 2021 medication supply plan was booked with manufacturers. The Pharmacy Director was able to create new 'just-in time' delivery channels. Conclusion(s): It is important to reach out to approved evidenced-based guidance, and services must change in order to maintain high level patient care within a crisis. The question now arises-iIs there a need for further improvement?'.

A randomized trial assessing the impact of educational podcasts on personal control and satisfaction during childbirth.

BACKGROUND: Childbirth education can help pregnant individuals feel in control, relieve anxiety and fear, and decrease pain perception. However, many barriers exist that impede patients from obtaining adequate childbirth education, especially in the era of the COVID-19 pandemic. Advances in technology, such as podcasts, can allow for asynchronous patient education. OBJECTIVE: This study aimed to assess the effect of a labor education podcast on personal perception of control and patient satisfaction during childbirth. STUDY DESIGN: This was a randomized controlled trial that included nulliparous, low-risk women with singleton gestations who reached 36 weeks' gestation at 2 academic hospitals in Philadelphia, Pennsylvania. Participants were randomized at 28 weeks and 0 days of gestation to usual education (control) or podcast education (intervention), which included links to 7 labor-related podcast episodes on patient-suggested topics that were available on widely-used podcatchers. Primary outcomes were assessed with a 3-question birth satisfaction survey and the Labour Agentry Scale to evaluate personal perception of control during childbirth. Secondary outcomes included the Edinburgh Postnatal Depression Scale score. Analyses were performed as intention-to-treat. Parametric and nonparametric data were compared using the Student t-test or Wilcoxon rank-sum test, as appropriate. RESULTS: A total of 201 women were randomized, and 153 were included in the final analysis (78 in podcast and 75 in control group). There were no significant differences in maternal demographics. Patients in the podcast group had higher median birth satisfaction scores compared with the control group (20 [18-21] vs 18 [16-21]; P=.002), without a significant difference in median Labour Agentry Scale scores (57 [50-63] vs 54 [47-62]; P=.12). When restricting analysis to patients who underwent induction, Labour Agentry Scale scores were significantly higher in the podcast group (58 [53-64] vs 54 [47-61]; P=.045), representing an increased perception of control. However, birth satisfaction score was not different between the groups (P=.06). The most downloaded podcasts were on induction and labor anesthesia. More than 95% of participants would recommend the podcasts to family and friends. CONCLUSION: An educational podcast on labor topics was well-received, increased patient satisfaction overall, and increased labor agentry among those who were induced. Podcasts are a promising educational modality to improve patient experience during childbirth, and warrant further exploration.

[Digital adaptation of a therapeutic education program in the context of Covid-19]. / Adaptation numérique d'un programme d'éducation thérapeutique dans le contexte de la Covid-19.

The context of containment due to the Covid-19 epidemic forced professionals to suspend their face-to-face therapeutic education programs. For young patients with asthma, the situation was made even more complex by anxiety-provoking communications (which turned out to be inaccurate) about the possible aggravating role of corticosteroids in the event of Covid-19, which led to untimely discontinuations and sometimes to a decrease in their therapeutic adherence, exposing them to an increased risk of poor control of their disease. Faced with the feeling of abandonment felt by some families in this singular context, a team at Trousseau Hospital in Paris decided to rethink and adapt its distance therapeutic education workshops.

Internet Use for Obtaining Medicine Information: Cross-sectional Survey.

BACKGROUND: The internet is increasingly being used as a source of medicine-related information. People want information to facilitate decision-making and self-management, and they tend to prefer the internet for ease of access. However, it is widely acknowledged that the quality of web-based information varies. Poor interpretation of medicine information can lead to anxiety and poor adherence to drug therapy. It is therefore important to understand how people search, select, and trust medicine information. OBJECTIVE: The objectives of this study were to establish the extent of internet use for seeking medicine information among Norwegian pharmacy customers, analyze factors associated with internet use, and investigate the level of trust in different sources and websites. METHODS: This is a cross-sectional study with a convenience sample of pharmacy customers recruited from all but one community pharmacy in Tromsø, a medium size municipality in Norway (77,000 inhabitants). Persons (aged ≥16 years) able to complete a questionnaire in Norwegian were asked to participate in the study. The recruitment took place in September and October 2020. Due to COVID-19 restrictions, social media was also used to recruit medicine users. RESULTS: A total of 303 respondents reported which sources they used to obtain information about their medicines (both prescription and over the counter) and to what extent they trusted these sources. A total of 125 (41.3%) respondents used the internet for medicine information, and the only factor associated with internet use was age. The odds of using the internet declined by 5% per year of age (odds ratio 0.95, 95% CI 0.94-0.97; P=.048). We found no association between internet use and gender, level of education, or regular medicine use. The main purpose reported for using the internet was to obtain information about side effects. Other main sources of medicine information were physicians (n=191, 63%), pharmacy personnel (n=142, 47%), and medication package leaflets (n=124, 42%), while 36 (12%) respondents did not obtain medicine information from any sources. Note that 272 (91%) respondents trusted health professionals as a source of medicine information, whereas 58 (46%) respondents who used the internet trusted the information they found on the internet. The most reliable websites were the national health portals and other official health information sites. CONCLUSIONS: Norwegian pharmacy customers use the internet as a source of medicine information, but most still obtain medicine information from health professionals and packet leaflets. People are aware of the potential for misinformation on websites, and they mainly trust high-quality sites run by health authorities.

Piloting of virtual group education for diabetes in Cape Town: An exploratory qualitative study.

BACKGROUND: Diabetes is a major public health problem. During the coronavirus disease 2019 (COVID-19) pandemic, patient education and counselling (PEC) for diabetes were curtailed. This project explored the possibility of offering group empowerment and training (GREAT) for diabetes via computer or tablets and Zoom video conferencing. The aim was to explore whether this was feasible in the low-income community context of primary health care in Cape Town, South Africa. METHODS: Three dieticians facilitated four sessions of GREAT for diabetes with a group of five patients with type-2 diabetes. Once the programme was completed, focus group interviews were held with the facilitators and the patients to explore their experience. Interviews were recorded and analysed using a simplified framework method. RESULTS: Usual primary care was not offering PEC and service delivery was brief and mechanistic. The content, resources and group processes were successfully translated into the virtual environment. The guiding style of communication was more difficult. Patients reported changes in their self-management and appreciated being able to save time and money while participating from home. Patients required considerable support and training to use the technology. All participants were concerned about safety and crime with the hardware. CONCLUSION: It was feasible to conduct GREAT for diabetes via tablets and Zoom video conferencing in this low-income community. To implement at scale, a number of concerns need to be addressed. The feasibility of conducting the sessions via smartphone technology should be evaluated.Contribution: Demonstrates how digital technology could be used to develop new ways of empowering people with type 2 diabetes.

A Descriptive Evaluation of Health Literacy and Determinants of COVID-19 Vaccine Acceptance among Patients with IgA Nephropathy with High Vaccine Uptake.

Aims: Shared decision-making regarding COVID-19 vaccination in IgA nephropathy involves the ability to handle health information regarding potential benefits and risk of flare, but few studies have evaluated health literacy in the context of vaccination. We aimed to evaluate the health literacy and COVID-19 vaccination uptake and acceptance in IgA nephropathy. Methods: Single-center cross-sectional study of 126 consecutive patients with IgA nephropathy. Health literacy was assessed using the HLS-EU-47 questionnaire. Determinants of vaccine acceptance such as contextual influences, individual and group influences, and vaccine-specific issues were adapted from the World Health Organization framework. Results: Forty-eight patients (38.1%) with IgAN nephropathy completed the survey between June and August 2021. The participants' median age was 40.5 (31.6, 52.8) years with median disease duration of 2.8 (1.3, 4.3) years. The median general health literacy index was 31.74 (29.88, 35.82) with significantly greater difficulty in the competency of appraising health information and in the domain of disease prevention (p < 0.001). Forty-five patients (93.8%) received at least one dose of COVID-19 vaccine between January and August 2021. Among the 3 unvaccinated patients, 2 intended to receive the vaccination while and 1 did not intend to get vaccinated. There was a high level of trust and belief that their government and healthcare providers had their best interests at heart and that the healthcare providers were honest about the vaccine's risk and benefits, although 31.2% did not understand how the vaccine works and 22.9% believed that there were other ways to prevent infection. Most thought there was adequate safety information, were confident in the system for tracking adverse events and had no issues with access to the vaccine. Conclusion: Participants with IgA nephropathy had high health literacy scores and low vaccine hesitancy. The determinants for vaccine acceptance can potentially guide efforts to optimize vaccination coverage.

Understandability, actionability and suitability of educational videos on dietary management for hypertension

Background: Educational video is a productive means to advocate lifestyle modifications such as changes in the dietary routine. This study assesses the understandability, actionability and suitability of newly developed educational videos aimed at encouraging dietary adjustments among hypertension patients. Method: In all, 183 participants were recruited via convenience sampling and rated the understandability, actionability and suitability of the videos using the Patient Education Materials Assessment Tool for Audio-Visual material (PEMAT-A/V) and the Suitability Assessment of Materials (SAM) scale. Results: Eleven videos were developed from five main topics related to the dietary management of hypertension. Participants agreed that all videos were highly understandable, actionable and suitable for use as educational tools, with scores of more than 85%, 89% and 80%, respectively. Conclusion/Implications: Overall, the newly developed videos gained high scores for understandability, actionability and suitability. This finding reflects positive acceptance of the videos among various healthcare professionals and patients with hypertension.

The Effect of Patient Opioid Education on Opioid Use, Storage, and Disposal Patterns.

We evaluated the impact of patient education over opioid use, storage, and disposal on opioid handling patterns of palliative and chronic nonmalignant pain patients. We compared patient surveys before and after education and conducted further analysis for individual clinics due to group differences found prior to education. A total of 100 patients were included. After education, more patients reported never sharing their prescription opioid (95% vs. 66%; P < 0.01), and all reported awareness that one dose could be harmful to someone else (100% vs. 31%; P < 0.01). In addition, more patients reported locking their opioid for storage (85% vs. 13%; P < 0.01). Lastly, less patients reported leftover opioids (2% vs. 40%; P < 0.01), not always disposing (1% vs. 44%; P < 0.01), or purposefully saving (0% vs. 15%; P < 0.01), and all reported knowing the right way to dispose (100% vs. 14%; P < 0.01). Proper methods of disposal increased, including mixing with unpalatable substances (96% vs. 13%; P < 0.01) and utilizing drug-take-back programs (78% vs. 24%; P < 0.01). This project found that patient education improves knowledge and behavior related to opioid handling patterns. Further initiatives should help to identify higher-risk patients and develop educational tools.

Impact of an Implementation Science-Based Project to Address COVID-19 Vaccine Hesitancy

Background. COVID-19 vaccine uptake remains suboptimal. This project aimed to identify and mitigate reasons for vaccine hesitancy. Baseline patient knowledge and attitudes about COVID-19 vaccination Methods. Between 9/2021 and 1/2022, 16 live in-person and/or virtual patient education programs were held in community centers/clinics in NC and GA. Surveys were administered before/after each session, and longitudinal outcomes 3 weeks later. Results. Surveys were conducted amongst the 1381 participating patients. 64% were already fully vaccinated against COVID-19, 19% had received 1 of 2 doses, and 17% were either unvaccinated (14%) or unsure of their status (3%). Baseline vaccine knowledge was higher among fully vaccinated patients, with patient attitudes varied per vaccination status (Figure). Patients not planning to get vaccinated cited concern for long-term (21%) and short-term (18%) side effects, thinking the vaccines were developed too quickly (16%), not feeling the vaccine would protect them (10%), and not feeling at risk for serious illness (10%). When asked what they thought would increase patient interest in vaccination, providers (n = 28) identified a strong recommendation (39%) or more information (36%) from a patient's own doctor, while patients prioritized transportation (28%) , vaccine availability in their doctor's office (23%), and information from their doctor (23%). Provider confidence in counseling patients improved after the program;more providers felt confident discussing vaccine safety (69%) and efficacy (69%) after the program than at baseline (33% and 41%, respectively). More patients felt confident sharing COVID-19 vaccine information with family and friends after the program (73%) than before (53%). Gains in patient views about COVID-19 vaccination were greatest among those who were unvaccinated/unsure;among this group, more patients agreed that vaccines are safe (72%), effective (76%), and important (78%) after the education, compared to 42%, 46%, and 52% at baseline, respectively. In the longitudinal patient follow-up survey 86% of unvaccinated patients got vaccinated after completing the education session. Conclusion. Patient knowledge and attitudes varied based on vaccine experience, as did patient and provider perceptions about improving vaccine acceptance. Vaccine uptake was high following the program.

Better Care Through Hypofractionation

Aim: In the context of the COVID-19 pandemic, the radiation oncology department at our institution aimed to adapt its approach by analyzing and expanding the use of hypofractionation in order to be able to continue treating patients according to prescribed timelines, to reduce the risks of patient and staff exposure to COVID-19 and minimize the risks of service interruptions due to departmental outbreaks. Process: Site specific treatment groups were asked to review existing literature on hypofractionation. Practice guides were then developed for each tumour site and a hypofractionation policy was created. To ensure close follow-up of this policy, weekly meetings were established in each treatment group in which all cases were reviewed. The use of non-hypofractionated schedules had to be justified by the treating physician. Data were collected to analyze the impact of these measures on the service. Patients were surveyed to gauge the level of safety felt during their treatments. Benefits/Challenges: When the same number of patients treated per year is maintained, hypofractionation increases availability at treatment machines, allowing reallocation of human resources. For example, technologists could be allocated to other tasks such as quality improvement initiatives, patient education and research. Hypofractionation also reduces overall costs to cancer programs, where potential savings from the reduced costs could be reinvested in new technologies and radiotherapy equipment. Fewer fractions also increase patient comfort, reduce the number of visits and improve waiting room management. This approach also increases the capacity to prepare for the next wave of patients that is anticipated post-pandemic due to decreased access to diagnosis and care during the past two years. Impact/Outcomes: The use of hypofractionation quickly became common practice in our centre. In only a few months, the number of fractions given per new treatment start fell from 10.81 in 2019-2020 to 8.29 in 2020-2021. The sustainability of this practice change is maintained, as hypofractionation is now standard practice for most tumour sites at our institution. Satisfaction amongst patients regarding this change during the first wave of the pandemic was very high (70% very satisfied and 30% satisfied). Radiotherapy centres facing human resource shortages as well as the health care network as a whole would benefit from expanding the use of hypofractionation in their centres. Copyright © 2022

Study the Impact of Social Media on the Outbreak of COVID-19 Pandemic

There are lots of social media tools that are accessible for medical or healthcare professionals, which include different social networking blogs, microblogs, media-sharing sites, wikis, virtual reality. All these different media tools can be utilized to develop or improve specialized networking and organiza tional promotion, education, patient education, patient care, and different public health agendas. But they also can perpetuate the risks to patients and healthcare professionals regarding the circulation of low-quality information, violate the patient privacy, and also have legal issues. To prevent all these risks, professional organizations and healthcare institutions have introduced a few guidelines. These guidelines were established to deliver emergency medicine residency programs control with leadership and best perform in the suitable practice and guidelines of social media but are valid to all residency programs that desire to create a social media presence. In this chapter, the authors describe how socialmedia made their impact on this pandemic COVID-19 situation. Copyright © 2023 Ubiquity Press. All rights reserved.

Feasibility and First Experiences from an Online Kidney School for Patients with Chronic Kidney Disease.

Objectives: To examine patients' and relatives' experiences with participation in an online kidney school (OKS) and its influence on their choice of treatment modality; furthermore, to report on healthcare professionals' (HCPs) first experiences with OKS. Methods: A mixed-methods design with parallel data collection involving two questionnaires for participants, including patients and relatives and a focus group discussion (FGD) with HCPs. Results: The OKS was feasible, and overall, patients and relatives were satisfied. Participation in the OKS increased the percentage of those who felt ready to make a decision regarding treatment. One over-arching theme (evolvement of the online kidney school over time) and three sub-themes (concerns and perceived barriers, facilitators, and benefits and future possibilities) emerged from the FGD. Conclusions: The OKS proved feasible, was well-accepted, and increased participants' abilities to choose a preferred treatment modality. HCPs displayed initial concerns regarding the quality of the OKS and worried about the practicality of conducting the OKS. They experienced a feeling of something being lost. However, over time, HCPs developed strategies to tackle initial concerns and discovered that patients were more capable of participating than they had anticipated.

Technology-Enabled Collaborative Care for Concurrent Diabetes and Distress Management During the COVID-19 Pandemic: Protocol for a Mixed Methods Feasibility Study.

BACKGROUND: The COVID-19 pandemic disrupted the delivery of diabetes care and worsened mental health among many patients with type 2 diabetes (T2D). This disruption puts patients with T2D at risk for poor diabetes outcomes, especially those who experience social disadvantage due to socioeconomic class, rurality, or ethnicity. The appropriate use of communication technology could reduce these gaps in diabetes care created by the pandemic and also provide support for psychological distress. OBJECTIVE: The purpose of this study is to test the feasibility of an innovative co-designed Technology-Enabled Collaborative Care (TECC) model for diabetes management and mental health support among adults with T2D. METHODS: We will recruit 30 adults with T2D residing in Ontario, Canada, to participate in our sequential explanatory mixed methods study. They will participate in 8 weekly web-based health coaching sessions with a registered nurse, who is a certified diabetes educator, who will be supported by a digital care team (ie, a peer mentor, an addictions specialist, a dietitian, a psychiatrist, and a psychotherapist). Assessments will be completed at baseline, 4 weeks, and 8 weeks, with a 12-week follow-up. Our primary outcome is the feasibility and acceptability of the intervention, as evident by the participant recruitment and retention rates. Key secondary outcomes include assessment completion and delivery of the intervention. Exploratory outcomes consist of changes in mental health, substance use, and physical health behaviors. Stakeholder experience and satisfaction will be explored through a qualitative descriptive study using one-on-one interviews. RESULTS: This paper describes the protocol of the study. The recruitment commenced in June 2021. This study was registered on October 29, 2020, on ClinicalTrials.gov (Registry ID: NCT04607915). As of June 2022, all participants have been recruited. It is anticipated that data analysis will be complete by the end of 2022, with study findings available by the end of 2023. CONCLUSIONS: The development of an innovative, technology-enabled model will provide necessary support for individuals living with T2D and mental health challenges. This TECC program will determine the feasibility of TECC for patients with T2D and mental health issues. TRIAL REGISTRATION: ClinicalTrials.gov NCT04607915; https://clinicaltrials.gov/ct2/show/NCT04607915. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39724.

Development of New Stroke Interprofessional Education (Stripe) E-Learning Platform

Background and Aims: The COVID-19 pandemic had affected traditional face-to-face learnings due to manpower shortage in frontline and safe management measures. Stroke patients with respiratory symptoms were also admitted to isolation wards instead of stroke unit. Isolation ward staff may not be familiar with post stroke care. Hence a stroke e-learning platform was developed to facilitate staff learning in the midst of chaos. Method(s): An e-learning platform was designed and developed, using a multi-disciplinary approach, to ensure optimal stroke care and learning opportunity were maintained. The content was developed based on healthcare professionals' and stroke survivors' learning needs across the stroke care continuum. This e-educational learning guide was published and shared with various stakeholders in multiple meeting platforms. The link can be easily accessible through mobile devices. Result(s): The e-learning platform consists of three domains. First domain was infographics development, which was a 1-page recent evidence on stroke care for busy healthcare professionals. Second domain was short voice-annotated presentations ranging from 10 to 15 minutes on stroke care across the continuum. Third domain consists of patient education materials, which includes rehabilitation short video and fact sheets for stroke survivors and caregivers. Many positive feedbacks were received Conclusion(s): This e-learning platform is useful for all healthcare professionals even in the new post-COVID normal era. There are plans to include more educational materials in the future.

Quality and reliability of YouTube as an educational tool for patients undergoing radiological musculoskeletal intervention

Purpose: With increasing demands and time constraints on physicians, compounded by the telemedicine era of COVID, patients are ill-equipped to make informed decisions regarding their treatments1. Patients are seeking further information on the internet, particularly the audio-visual platform YouTube2. Appropriate patient education is paramount for patients undergoing treatment, particularly intervention, as it provides appropriate expectations and reduces anxiety1. This aim of this study was to objectively evaluate videos on YouTube that related to commonly performed musculoskeletal procedures against validated scoring systems. Methods and Materials: YouTube was utilised to search for common musculoskeletal procedures including "facet joint injection", "knee injection" and "shoulder injection". The first thirty videos returned for each search were assessed for suitability as it was deemed this was likely to encompass a patient search results as average user's will only assess the first 5 search results 3. 90 total videos were identified, and after exclusion 51 were included for analysis by three independent reviewers. Data extracted from the videos included video authorship, year published, number of views and number of 'likes' and 'dislikes'. Videos were scored for quality and reliability using three separate and validated tools for online medical video assessment;Journal of American Medical Association (JAMA) benchmark criteria, the global quality scoring (GQS) and the DISCERN criteria. Result(s): Of the 51 videos analysed, 88% were authored by a medical doctor, and the average number of views were 67,552. The overall video quality and reliability was poor. The mean DISCERN score was 32.78 (<39 = poor). The mean JAMA score was 1.79 (<3 = low quality) and the GQS was 2.39 (<3 = poor). As per DISCERN standards 24.18% of videos were very poor, 46.70% were poor, 26.79% were fair, 2.61% were good, and 0% were excellent. There was no significant difference in quality or reliability across the three video categories. Conclusion(s): YouTube is a popular medium for individuals seeking health related information, however, it provides substandard information for patient education on three commonly performed radiological guided musculoskeletal procedures;failing to meet benchmark criteria. Radiologists and referring physicians should avoid the recommendation of YouTube as an education aid at this time, as it may misinform patients and provide misconceptions with altered expectations.

Sustainable Remote Work for Radiation Therapists: Implementation in a Large Urban Radiation Therapy Centre

Purpose: The COVID 19 pandemic created an urgent need to reduce onsite staff at the hospital. Remote work was implemented for Radiation Therapists (RTs) to reduce COVID 19 transmission, conserve personal protective equipment and facilitate physical distancing for staff required onsite. We report our experiences with a rapid pivot to remote work for RTs during the pandemic and the plan for a sustainable remote work strategy. Material(s) and Method(s): On March 16, 2020, our multi-site healthcare network provided emergency guidelines for remote work. The guidelines included the ability to perform full job duties remotely, appropriate space and equipment, no impact on patient care, and operational feasibility. RTs were asked to self-identify to their Supervisor if they met these requirements and wanted to work remotely. Commencing March 23, 2020, rotations were developed for on and offsite schedules balancing operational needs, skill mix, equity between team members, and cohorting to minimize COVID risk. Those performing direct patient facing activities were not able to work from home. Activities that could be performed remotely included radiation therapy planning, process and protocol development, quality assurance checks, project or research activities, and telephone patient education. Organizational implementation of technology solutions supported this rapid pivot to remote work. For example, remote access was required to clinical applications, email, and document management. Microsoft Teams was used for virtual communication and meetings. Result(s): From March 2020 to Dec 2021, 133 (64%) RTs worked remotely for >=1 day. 32% of RTs worked >100 shifts remotely, and 12% worked more than 200 shifts remotely. This resulted in 15,413 remote work shifts (25% of total shifts worked) for an average of 685 remote work shifts per month, peaking to a maximum of 1096 shifts during March 2021. Generally, remote work was well received by RTs. Many RTs reported benefits, including eliminating lengthy commutes, improved flexibility, reduced distractions and a break from PPE. Initially, there were some IT challenges, such as slow connectivity and incompatible home equipment, that made remote work difficult. Some RTs reported a sense of social isolation. There was a perceived lack of fairness between those who could and could not work remotely. There were also some challenges communicating between onsite and offsite teams, shift coverage, and onsite support. Conclusion(s): Overall, we demonstrated that RTs can successfully work remotely over a multi-year timeframe. Generally, this was a positive experience for RTs, who reported improved work-life balance and more flexibility with job duties. However, there were concerns about a lack of fairness for those in patient-facing roles. Despite these concerns, most RTs support continuing with remote work. Our department will continue with a long-term remote work strategy based on best practices for remote work and input from RTs Copyright © 2022 Elsevier Ireland Ltd. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).