ABSTRACT
BACKGROUND/OBJECTIVES: We evaluated the acceptance of synchronous (live video) telehealth for pediatric dermatology. METHODS: This was a prospective, single-center study of patient and dermatologist surveys paired at the encounter level for telehealth encounters with Children's Hospital Colorado Pediatric Dermatology Clinic between 21 April 2020 and 22 May 2020. RESULTS: Dermatologists were most receptive to a telehealth encounter for isotretinoin monitoring (96.6%) and non-isotretinoin acne (89.5%). In contrast, 71.8% and 58.8% of patients surveyed were open to telehealth for isotretinoin encounters and non-isotretinoin acne encounters, respectively. There was no significant correlation between patient and dermatologist satisfaction regarding a telehealth encounter (r = 0.09, CI [-0.09, 0.26], p = .34) or between patient and dermatologist preference for telehealth encounter (r = 0.07, CI [-0.11, 0.25] p = .46). Dermatologists reported needing a photo to aid their physical examination in 38/363 (10.7%) of encounters and preferred in-person examinations when an encounter would have benefitted from laboratories, procedures, dermatoscopic examination, examination by palpation, and accurate weights in infants. CONCLUSIONS: Synchronous, live-video telehealth is an effective method of healthcare delivery in certain situations for pediatric dermatology, but it does not replace in-person encounters. Families and dermatologists have different perceptions about its acceptance.
Subject(s)
Acne Vulgaris , Dermatology , Telemedicine , Child , Humans , Infant , Isotretinoin , Patient Satisfaction , Prospective Studies , Telemedicine/methodsABSTRACT
Eligible for 1 MOC SA Credit From the ABD This Photo Challenge in our print edition is eligible for 1 self-assessment credit for Maintenance of Certification from the American Board of Dermatology (ABD). After completing this activity, diplomates can visit the ABD website (http://www.abderm.org) to self-report the credits under the activity title "Cutis Photo Challenge." You may report the credit after each activity is completed or after accumulating multiple credits.
Subject(s)
Clinical Competence , Education, Medical, Continuing , Aged , Certification , Female , Humans , Specialty Boards , United StatesSubject(s)
Graft vs Host Disease , Herpes Zoster/diagnosis , Lymphoma, Follicular , Peripheral Blood Stem Cell Transplantation/adverse effects , Skin Diseases, Genetic/diagnosis , Adult , Biopsy , Female , Graft vs Host Disease/complications , Graft vs Host Disease/diagnosis , Graft vs Host Disease/pathology , Humans , Lymphoma, Follicular/pathology , Lymphoma, Follicular/therapy , Mosaicism , Neoplasm Staging , Patient Care Management/methods , Peripheral Blood Stem Cell Transplantation/methods , Skin/pathology , Treatment OutcomeABSTRACT
There is increasing interest in developing more nuanced methods for managing aggression and violence in long-term psychiatric inpatient settings. However, the dearth of controlled studies has, at times, hampered presentation of viable options. Following the publication of guidelines developed in the California State Hospital forensic system, the authors present a group of 7 cases illustrating different approaches to violence management, including pharmacological, psychotherapeutic, and environmental interventions.
Subject(s)
Guidelines as Topic , Hospitals, Psychiatric/standards , Violence/psychology , Adult , Antipsychotic Agents/therapeutic use , California , Female , Forensic Psychiatry/standards , Humans , Male , Middle Aged , Schizophrenia/drug therapy , Schizophrenia/therapy , Young AdultABSTRACT
Guidelines for treating various conditions can be helpful in setting practice standards, but the presence of several sets of guidelines from different countries, experts, and settings, written at different times, can also create confusion. Here we provide a "guideline of guidelines" for the treatment of schizophrenia, or "meta-guidelines, which not only reconcile the various existing standards but also update them to include the use of several newer agents, most of which were marketed following the publication of existing standards.
