ABSTRACT
OBJECTIVES: This study aimed to assess the disease activity indices (DAI) of rheumatoid arthritis (RA) by telephone-based tele-visits compared to face-to-face clinic encounters. METHODS: Patients with RA attending outpatient clinics between December 2021 and May 2022 were prospectively recruited. Disease activity assessments were initially performed in the clinic using the disease activity score 28-C-reactive protein (DAS28-CRP) and disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR). Within two weeks of the clinic visit, a telephone-based assessment gathered information on demographics, Routine Assessment of Patient Index Data 3 (RAPID3) score, and satisfaction. Disease activity scores were dichotomized into remission or low disease activity and moderate to high disease activity. RESULTS: A total of 78 patients completed the two-point interview. Of those, 62 (79.49%) were women, with a mean age of 54.73±13.71 years. Seropositivity for rheumatoid factor and/or anti-citrullinated peptide was observed in 51 (83.61%) participants. Twenty-seven percent of the patients were classified as in remission or low disease activity by RAPID3. This was 71% for DAS28-CRP and 33% for DAS28-ESR. Based on the dichotomized disease activity classification, the agreement percentage between RAPID3 and DAS28-ESR was 78.08%, while it was 47.22% between RAPID3 and DAS28-CRP, which resulted in kappa statistic values of 0.48 (moderate agreement) and 0.14 (low agreement), respectively. Satisfaction rates were low. CONCLUSION: Telephone-based RAPID3 showed a low-moderate agreeability compared to DAS28 and had low satisfaction rates. This suggests that tele-rheumatology care by this means was not feasible for following up with patients with RA and warrants further development.
ABSTRACT
Background Patients need to be educated and all possible treatment alternatives should be explored. Patients should be given options that they can choose from based on their demographic information, clinical information, and possible options for treating a given issue. This is especially true in elective surgery. The concept of safety plays a major part in every field, particularly in medicine. The patient's safety is a key factor for a better experience and a better outcome. Objective This study aims to determine patient perceptions of surgical safety with an emphasis on surgical team interaction throughout the phases of care. Methods A descriptive cross-sectional prospective study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Patients undergoing elective surgery and hospitalized for more than 24 hours were asked to give their opinions regarding interactions between them and the surgical teams, including the nurses, anesthesiologists, and surgeons who operated on them. Only patients aged 18 or above were included in the sample. The analysis was carried out using the IBM Statistical Package for Social Sciences (SPSS), version 25 (IBM SPSS Statistics, Armonk, NY). Results More than 70% of the study respondents had had more than one surgery. One hundred and ten of the study respondents said that the specific surgeons who attended to them encouraged them to ask questions. The majority of the respondents (76.7%) said that the surgical team gave them definite physical comfort, while the rest (23.3%) stated that they got somewhat less physical comfort from the surgical team. The average rating of the satisfaction pre-surgery was mean (M) = 8.51, standard deviation (SD) = 1.9, (95% confidence interval (CI): 8.19 - 8.83) while the average satisfaction rating for postoperative care was M = 9.05, SD = 1.35, (95% CI: 8.82 - 9.27). Conclusions Most patients valued surgeon-patient interaction as it was seen to reduce pre-surgery anxiety, helped in giving options, and improved the patient's overall understanding of the surgical procedure. Surgical teams are generally highly rated in terms of overall service pre- and post-surgery.
