Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
1.
Diabet Med ; 39(4): e14755, 2022 04.
Article in English | MEDLINE | ID: covidwho-1550817

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to the rapid implementation of remote care delivery in type 1 diabetes. We studied current modes of care delivery, healthcare professional experiences and impact on insulin pump training in type 1 diabetes care in the United Kingdom (UK). METHODS: The UK Diabetes Technology Network designed a 48-question survey aimed at healthcare professionals providing care in type 1 diabetes. RESULTS: One hundred and forty-three healthcare professionals (48% diabetes physicians, 52% diabetes educators and 88% working in adult services) from approximately 75 UK centres (52% university hospitals, 46% general and community hospitals), responded to the survey. Telephone consultations were the main modality of care delivery. There was a higher reported time taken for video consultations versus telephone (p < 0.001). Common barriers to remote consultations were patient familiarity with technology (72%) and access to patient device data (67%). We assessed the impact on insulin pump training. A reduction in total new pump starts (73%) and renewals (61%) was highlighted. Common barriers included patient digital literacy (61%), limited healthcare professional experience (46%) and time required per patient (44%). When grouped according to size of insulin pump service, pump starts and renewals in larger services were less impacted by the pandemic compared to smaller services. CONCLUSION: This survey highlights UK healthcare professional experiences of remote care delivery. While supportive of virtual care models, a number of factors highlighted, especially patient digital literacy, need to be addressed to improve virtual care delivery and device training.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus, Type 1/therapy , Health Personnel , Self-Management/education , Telemedicine , Adult , Attitude of Health Personnel , Biomedical Technology/education , Blood Glucose Self-Monitoring/instrumentation , Delivery of Health Care/methods , Delivery of Health Care/organization & administration , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/epidemiology , Glycemic Control/instrumentation , Health Personnel/organization & administration , Health Personnel/psychology , Health Personnel/statistics & numerical data , Humans , Insulin Infusion Systems , Pandemics , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Remote Consultation/methods , Remote Consultation/organization & administration , Self-Management/methods , Self-Management/psychology , Surveys and Questionnaires , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/statistics & numerical data , United Kingdom/epidemiology
2.
Am J Public Health ; 111(7): 1328-1337, 2021 07.
Article in English | MEDLINE | ID: covidwho-1264243

ABSTRACT

Objectives. To compare asthma control for children receiving either community health worker (CHW) or certified asthma educator (AE-C) services. Methods. The Asthma Action at Erie Trial is a comparative effectiveness trial that ran from 2016 to 2019 in Cook County, Illinois. Participants (aged 5‒16 years with uncontrolled asthma) were randomized to 10 home visits from clinically integrated asthma CHWs or 2 in-clinic sessions from an AE-C. Results. Participants (n = 223) were mainly Hispanic (85%) and low-income. Both intervention groups showed significant improvement in asthma control scores over time. Asthma control was maintained after interventions ended. The CHW group experienced a greater improvement in asthma control scores. One year after intervention cessation, the CHW group had a 42% reduction in days of activity limitation relative to the AE-C group (b = 0.58; 95% confidence interval = 0.35, 0.96). Conclusions. Both interventions were associated with meaningful improvements in asthma control. Improvements continued for 1 year after intervention cessation and were stronger with the CHW intervention. Public Health Implications. Clinically integrated asthma CHW and AE-C services that do not provide home environmental remediation equipment may improve and sustain asthma control.


Subject(s)
Asthma/therapy , Community Health Workers/organization & administration , House Calls , Patient Education as Topic/organization & administration , Adolescent , Child , Child, Preschool , Comparative Effectiveness Research , Female , Humans , Male , Socioeconomic Factors
4.
J Am Board Fam Med ; 34(Suppl): S21-S25, 2021 02.
Article in English | MEDLINE | ID: covidwho-1099983

ABSTRACT

Pharmacists' roles and training have evolved to prepare pharmacists to provide clinical patient care services as part of interdisciplinary teams in primary care settings. Especially now, amidst a global health crisis such as COVID-19, patients may become more aware of their health status and be exposed to increased medical information in the media. Additionally, some patients may have delayed routine care, which may result in exacerbations of chronic disease states. Pharmacists can help alleviate the burden on primary care providers by serving as a drug information resource for patients and staff while providing patient education on management of chronic disease states.


Subject(s)
Patient Care Team/organization & administration , Patient Education as Topic/organization & administration , Pharmacists/organization & administration , Primary Health Care/organization & administration , Professional Role , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Chronic Disease , Humans , Pandemics , Patient Education as Topic/methods , Primary Health Care/methods , United States/epidemiology
5.
J Surg Res ; 264: 30-36, 2021 08.
Article in English | MEDLINE | ID: covidwho-1065394

ABSTRACT

BACKGROUND: The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. METHODS: We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. RESULTS: One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. CONCLUSIONS: Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.


Subject(s)
Appointments and Schedules , COVID-19/transmission , Elective Surgical Procedures/psychology , Fear , Health Services Accessibility/organization & administration , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Cross-Sectional Studies , Elective Surgical Procedures/statistics & numerical data , Female , Health Services Accessibility/statistics & numerical data , Humans , Infection Control/organization & administration , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Middle Aged , Pandemics/prevention & control , Pandemics/statistics & numerical data , Patient Education as Topic/organization & administration , Surgery Department, Hospital/organization & administration , Surveys and Questionnaires/statistics & numerical data , Uncertainty
6.
Ann Acad Med Singap ; 49(9): 652-660, 2020 09.
Article in English | MEDLINE | ID: covidwho-972949

ABSTRACT

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) has significantly affected the way healthcare is delivered in Singapore. Healthcare services such as renal transplantation had to rapidly adjust and meet the needs to (1) protect patients and staff, (2) ramp up, conserve or redeploy resources while (3) ensuring that critical services remained operational. This paper aims to describe the experience of the renal transplant programme at the Singapore General Hospital (SGH) in responding to the risks and constraints posed by the pandemic. METHODS AND MATERIALS: This is a review and summary of the SGH renal transplant programme's policy and protocols that were either modified or developed in response to the COVID-19 Pandemic. RESULTS: A multi-pronged approach was adopted to respond to the challenges of COVID-19. These included ensuring business continuity by splitting the transplant team into different locations, adopting video and tele-consults to minimise potential patient exposure to COVID-19, streamlining work processes using electronic forms, ensuring safe paths for patients who needed to come to hospital, ring-fencing and testing new inpatients at risk for COVID-19, enhancing precautionary measures for transplant surgery, ensuring a stable supply chain of immunosuppression, and sustaining patient and staff education programmes via video conferencing. CONCLUSIONS: Though the COVID-19 pandemic has reduced access to kidney transplantation, opportunities arose to adopt telemedicine into mainstream transplant practice as well as use electronic platforms to streamline work processes. Screening protocols were established to ensure that transplantation could be performed safely, while webinars reached out to empower patients to take precautions against COVID-19.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/organization & administration , Immunosuppressive Agents/supply & distribution , Kidney Transplantation , Telemedicine , Videoconferencing , COVID-19/diagnosis , COVID-19/epidemiology , Delivery of Health Care/methods , Graft Rejection/prevention & control , Humans , Immunosuppressive Agents/therapeutic use , Mass Screening , Organizational Policy , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Personnel Staffing and Scheduling , Physical Distancing , Singapore/epidemiology , Workflow
8.
J Diabetes Sci Technol ; 14(6): 1107-1110, 2020 11.
Article in English | MEDLINE | ID: covidwho-858408

ABSTRACT

With the recent pivot to telehealth as a direct result of the COVID-19 pandemic, there is an imperative to ensure that access to affordable devices and technologies with remote monitoring capabilities for people with diabetes becomes equitable. In addition, expanding the use of remote Diabetes Self-Management Education and Support (DSMES) and Medical Nutrition Therapy (MNT) services will require new strategies for achieving long-term, effective, continuous, data-driven care. The current COVID-19 pandemic has especially impacted underserved US communities that were already disproportionately impacted by diabetes. Historically, these same communities have faced barriers in accessing timely and effective diabetes care including access to DSMES and MNT services, and diabetes technologies. Our call to action encourages all involved to urge US Federal representatives to widen access to the array of technologies necessary for successful telehealth-delivered care beyond COVID-19.


Subject(s)
Cloud Computing/trends , Coronavirus Infections/epidemiology , Diabetes Mellitus/therapy , Health Services Accessibility/trends , Pneumonia, Viral/epidemiology , Telemedicine/trends , Universal Health Care , COVID-19 , Coronavirus Infections/therapy , Democracy , Diabetes Complications/epidemiology , Diabetes Complications/therapy , Diabetes Mellitus/epidemiology , Health Services Accessibility/organization & administration , Healthcare Disparities/organization & administration , Healthcare Disparities/trends , Humans , Inventions/trends , Medically Underserved Area , Pandemics , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Patient Education as Topic/trends , Pneumonia, Viral/therapy , Self-Management/methods , Self-Management/trends , Telemedicine/methods , Telemedicine/organization & administration
9.
Nat Rev Immunol ; 20(10): 594-602, 2020 10.
Article in English | MEDLINE | ID: covidwho-759596
10.
Farm Hosp ; 44(7): 61-65, 2020 06 13.
Article in English | MEDLINE | ID: covidwho-599566

ABSTRACT

Hospital Pharmacy Service (HPS) in Spain have been impacted by the health  crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacy to optimize clinical  outcomes and reduce the risk of contagion. The purpose of this article is to  describe and analyze the experience of HPSs with outpatient Telepharmacy  during the COVID-19 pandemic and expose the lessons learned. Measures have  been adopted in on-site outpatient pharmacy clinics to prevent exposure of  patients and professionals to the virus. These measures are based on national  and international recommendations on social distancing and hygiene. With  regard to remote outpatient pharmacy services, teleconsultation with drug  dispensing has been promoted based on five basic procedures, each with its  advantages and limitations: home drug delivery from HPSs, with the advantage  of universal access and the limitation of entailing a substantial investment in  resources; HPS coordination with primary care pharmacists, which requires no  investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which  requires the patient to go to the pharmacy, without confidentiality being  guaranteed for any patient; geolocation and hospital-based medication  dispensing, which provides universal access and direct traceability, but entails  investment in human resources; and HPS coordination with associations of  patients, which does not entail any additional cost but limits the information  available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of  medication (with a high level of satisfaction among patients); and the need to  foster Telepharmacy as a complementary tool through a mixed model of  outpatient pharmacy consultation service that incorporates the advantages of  each procedure and adapts to the individual needs of each patient in a context of humanized healthcare.


Los servicios de farmacia hospitalaria (SFH) en España se han visto afectados  por la crisis sanitaria provocada por SARS-CoV-2 y han tenido que adoptar sus  procedimientos de atención farmacéutica (AF) al paciente externo (PE) mediante estrategias de Telefarmacia, con los objetivos de maximizar los resultados en  salud y reducir el riesgo de contagio. El objetivo de ese artículo es describir y  analizar los procedimientos AFPE durante la pandemia SARS-CoV-2 y comunicar  las lecciones aprendidas en los SFH. En relación con las consultas externas de AF presenciales, se han adoptado medidas para minimizar el contagio viral de  pacientes y profesionales, siguiendo las recomendaciones nacionales e  internacionales de referencia de distanciamiento temporal, espacial y  recomendaciones higiénicas. En cuanto a las consultas externas de AF no  presenciales, se han potenciado las teleconsultas con dispensación del  tratamiento en base a cinco procedimientos básicos, cada uno de ellos con sus  ventajas y limitaciones: dispensación domiciliaria desde SFH que presenta las  ventajas de la universalidad de acceso, pero requiere una elevada inversión en  recursos; coordinación del SHF con farmacéuticos de atención primaria, que  conlleva una nula inversión en recursos, pero limita el acceso a determinadas zonas geográficas; coordinación del SFH con farmacéuticos comunitarios, que  utiliza una amplia red de oficinas de farmacia, pero exige el desplazamiento del  paciente sin garantías de confidencialidad para todos los casos; geolocalización y dispensación hospitalaria, que permite un acceso universal y trazabilidad directa, pero requiere un incremento en recursos humanos; y coordinación del SFH con  asociaciones de pacientes, que no requiere inversión económica, pero limita el  acceso a las patologías de los asociados. Destacamos finalmente tres lecciones  aprendidas: la capacidad de AFPE de SFH españoles ante una crisis sanitaria; la  utilidad de la Telefarmacia para el seguimiento clínico, la coordinación  asistencial, información al PE, dispensación y entrega informada (con elevada  satisfacción de los pacientes); y la necesidad de potenciar la Telefarmacia como herramienta complementaria, en un modelo mixto de AFPE que incorpore las  ventajas de cada uno de los procedimientos adaptándose a las necesidades individuales de los pacientes en un entorno de humanización de la asistencia  sanitaria.


Subject(s)
Ambulatory Care/organization & administration , Betacoronavirus , Coronavirus Infections , Delivery of Health Care/organization & administration , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral , Telemedicine/organization & administration , COVID-19 , Delivery of Health Care/statistics & numerical data , Directive Counseling/organization & administration , Distance Counseling/organization & administration , Forecasting , Geography, Medical , Health Services Needs and Demand , Home Care Services/organization & administration , Hospitals, University/organization & administration , Humans , Medication Systems, Hospital/organization & administration , Outpatients , Patient Education as Topic/organization & administration , Pharmacy Service, Hospital/statistics & numerical data , SARS-CoV-2 , Spain
12.
Diabetes Technol Ther ; 22(6): 440-443, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-291219

ABSTRACT

Today, in the United States, we have a health care system that is designed to treat symptoms, not people-and to do so as cheaply as possible with the dual goals of minimizing costs and preventing hospital visits. We are failing on all fronts. We spend more money on health care per capita than our Organization for Economic Co-operation and Development (OECD) peers, and our outcomes are mediocre at best. Medicine is not personal, health care professionals often have their hands tied by payers, and geography has too much influence on the quality of care available. This has to end, especially since we have the technology to create a truly patient-focused, whole-person approach-one that treats physical and mental health equally and meets people where they are in every sense. Telemedicine can level the playing field and enable higher quality, decentralized care that-when needed-brings specialty care to the masses. Other technologies have an important role, too. For patients with insulin-dependent diabetes (type 1 diabetes), widespread uptake of continuous glucose monitors may be the game-changer we need right now that can facilitate telemedicine to remote places and remove health care disparities. Both health professionals and patients will win-and ultimately payers will, too.


Subject(s)
Coronavirus Infections/prevention & control , Diabetes Mellitus, Type 1/therapy , Healthcare Disparities , Organizations, Nonprofit , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/organization & administration , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Diabetes Mellitus, Type 1/virology , Humans , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Pneumonia, Viral/complications , SARS-CoV-2 , Telemedicine/methods , United States
SELECTION OF CITATIONS
SEARCH DETAIL