Agreement for diagnosis of depression and anxiety between self-assessment with e-questionnaire and psychiatric telephone interview among post-COVID-19 patients.

BACKGROUND: Psychological disorders, such as depression and anxiety, are common among individuals who have experienced coronavirus disease 2019 (COVID-19); however, diagnosis may be challenging and subjected to invalidity. This study aimed to examine agreement between online self-assessment and psychiatric telephone interview among COVID-19 survivors. MATERIALS AND METHODS: This cross-sectional descriptive study was carried out from March to June 2021 in Afzalipour Hospital, Kerman, Iran. The inpatients confirmed with COVID-19 were contacted within the first week after discharge and were asked to fill the Hospital Anxiety and Depression scale (HADS) and socio-demography questionnaire. They were later interviewed using Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A). Agreement between the data extracted from self-report and telephone interview was analyzed using Cohen's kappa coefficient, sensitivity, and specificity. RESULTS: Out of 200 post-COVID patients, 60 participants completed all assessments. Prevalence of depression was observed to be 88% via telephone interview and 45% via self-assessment. Moreover, 83% of the participants were diagnosed with anxiety according to the telephone interview, in comparison to 31% diagnosed with anxiety using self-report questionnaire. The agreement between online self-assessment and telephone interview for depression and anxiety was not significant (κ = 0.08 and κ = 0.1, respectively). CONCLUSION: The discordance between online self-report and clinician's assessment via phone contact interview indicates that using self-report evaluations is not sufficient as the single assessment tool for mental health monitoring and reflects the need to employ multiple assessments for diagnosis of psychiatric problems in pandemics.

Health Pandemic and Social Media: A Content Analysis of COVID-Related Posts on a Telegram Channel With More Than One Million Subscribers.

BACKGROUND: Mobile-based social media play an important role in the dissemination of information during public health emergencies. OBJECTIVES: This study aimed to analyze the contents and trends of public messages posted on Telegram during Coronavirus Disease 2019 (COVID-19) pandemic. METHODS: A content analysis of the 1781 messages, posted in a public Telegram channel with more than one million subscribers performed over 9-weeks. The messages were categorized into seven categories. RESULTS: In total, 39% (n=703) of all messages were related to COVID-19. With the official confirmation of the case of COVID-19 in Iran, the number of COVID-related massages started to rise. Overall, the most frequent messages were of joke and humor (n=292, 41.5%), followed by educational messages (n=140, 19.9%). CONCLUSION: Our study showed that the most popular messages during first weeks of COVID pandemic were satirical, indicating that people may not had taken the risks of this pandemic seriously. It is crucial for health organizations to develop strategies for dissemination of reliable health information through social media.

Information Needs of Addicted Individuals: A Qualitative Case Study.

BACKGROUND: The purpose of this study was to investigate the information needs of addicts from the perspective of addicts. By identifying the experiences of the individuals involved in addiction and assessing the information they need, targeted educational interventions can be provided to meet their needs. METHODS: Semi-structured interviews were conducted with 13 addicts in two addiction outpatient clinics. Data were analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. FINDINGS: The information needs of the interviewees included recognizing types of addictive substances and the degree of dependence on them, awareness of the physical and psychological symptoms of addiction to various addictive substances, awareness of various pharmacological and non-pharmacological treatments, physical and psychological symptoms of quitting addiction, awareness of the length of treatment, knowledge about the dose and degree of dependence on drugs, recognizing the causes of failure in quitting addiction, awareness of governmental and non-governmental services, and awareness of the psychological measures and care services necessary after quitting addiction. CONCLUSION: The results of the study showed that the knowledge and awareness of addicted individuals in various fields of addiction is low and it is necessary to provide education based on the information needs of these individuals. This requires the cooperation and efforts of policy makers, the Ministry of Education, welfare managers, and specialists in camps and addiction treatment centers. Specialists in addiction treatment clinics can use the information needs of addicts determined in this study to enrich the education of addicts.

Travel Avoidance Using Telepediatric by Patients and Healthcare Providers: a Review of the Literature.

INTRODUCTION: Telepediatric is one of the subspecialties of telemedicine that can be defined as the use of information and communication technology tools to offer healthcare services to children at a distance. AIM: The use of telepediatric healthcare services for children living in rural or deserved areas may reduce the cost and time of travel to access these services. This study aims to review published papers that assess the percentage of avoided travel or referrals with the use of telepediatric. METHODS: This is a systematic review study. PubMed database was searched in September 2019 to retrieve the published papers. The final 24 retrieved papers were assessed based on the variables such as modality, referral setting, specialty, continent, weight, and percentage of avoided travel. The multivariate linear regression model was used to estimate the percentage of travel avoidance by telepediatric. RESULTS: The linear regression model was determined based on the provided specialty for telepediatric (cardiology, general (multi), and other (rehabilitation, dermatology, psychiatry, respiratory)) with R2 =0.41. The results showed that the mean percentage of avoided travel in cardiology specialty as a baseline was 56%. The use of telepediatric in the general (multi) and other specialties can avoid travel for 26.5% (p=0.02) and 85% (p=0.03) respectively. CONCLUSION: This study showed that telepediatric could reduce travel at least 26.5% and maximal 85%. These results can be used by healthcare providers to decide on the implementation of successful telepediatric systems to reduce referrals.

Impact of Mobile Phone-Based Interventions on Methamphetamine Use and High-risk Sexual Behaviors in Men Who Have Sex with Men (MSM): A Systematic Review.

BACKGROUND: Today, increased use of methamphetamine in homosexual men is associated with high-risk sexual behaviors and (HIV) epidemic. Mobile phone-based interventions are an accessible and rapid method to provide healthcare services to this population. This study aimed to systematically review the effects of mobile phone-based interventions on methamphetamine use and high-risk sexual behaviors in homosexual men. METHODS: This systematic review was conducted by two researchers via searching in PubMed, Google Scholar, Web of Science, Scopus, and PsycINFO databases to retrieve the published articles regarding the effects of mobile phone-based interventions on the control of methamphetamine use and high-risk sexual behaviors. FINDINGS: Among 250 unique articles that were retrieved, only five cases met all the inclusion criteria of the study. Accordingly, some of the applied interventions included text messaging (n = 4) and mobile apps (n = 1). In this regard, the use of text messaging significantly decreased the rates of methamphetamine use, condomless anal intercourse (CAI), and HIV transmission among homosexual men. CONCLUSION: According to the results, short-term interventions based on text messaging could decrease the rates of methamphetamine use and the high-risk sexual behaviors associated with HIV infection in homosexual men. Despite the positive impact of these interventions, long-term follow-ups are required for individuals using methamphetamine in different communities.

Role of Telehealth in the Management of COVID-19: Lessons Learned from Previous SARS, MERS, and Ebola Outbreaks.

Concerns about the prevention and management of COVID-19 are on the rise, as it is crucial in contagious epidemics that travel and transfer of the patients be minimal for diagnosis, treatment, and follow-ups. Telemedicine or telehealth can play an important role, especially with previous successful experiences in the management of acute infectious respiratory epidemics such as SARS and MERS. In order to better control the rapid spread of coronavirus and manage the COVID-19 crisis, both developed and developing countries can improve the efficiency of their health system by replacing a proportion of face-to-face clinical encounters with telehealth. Recent technological advancement facilitates this reform, but there is a need for national or state-wide rules and regulations to be adapted accordingly.

Design, Development, and Evaluation of a Teleophthalmology System Using a Low-Cost Fundus Camera.

INTRODUCTION: The increasing prevalence of diabetic retinopathy in developing countries has become a worldwide concern. This problem is preventable by timely diagnosis and treatment; however, in the majority of cases, patients attend the eye clinics very late because of a lack of specialists and travel difficulties. Running a teleophthalmology system would significantly help to manage this disease. AIM: This study seeks to assess the accuracy of the teleophthalmology system and its effect on reducing unnecessary referrals in Iran. METHODS: This study was conducted on 125 diabetic patients. First, the patients were examined by a retina specialist using a slit lamp and, then, single-field digital photos were captured by a portable, low-cost fundus camera. The images were uploaded onto a website and, after two months, were assessed by two retina specialists and two general practitioners (GPs). Finally, the diagnoses based on the digital photos were contrasted with the diagnoses established through face-to-face visits as a gold standard. RESULTS: Out of 125 diabetic patients, eight (6.4%) were removed because of low-quality images and a total of 117 were evaluated. The sensitivity and specificity of each retina specialist presented with the photographs produced success rates of 90% and 97% respectively when judged against the gold standard of face-to-face visits. The rates of sensitivity for retinopathy referrals from the retina specialists were 92% and 85%. The sensitivity and specificity of their diagnoses of clinically significant macular edema (CSME) were calculated at 93% and 100%. The rates of sensitivity for each GP were 95% and 93% and the level of specificity was estimated to be approximately 98% for both GPs. The diagnosis rate for GPs when viewing the photographs as opposed to hosting face-to-face visits was more than 90%. Generally, with the implementation of this system, between 40% and 55% of referrals were calculated to have been avoidable. CONCLUSION: Our results from the first-ever research conducted on this topic in Iran showed that the teleophthalmology system is extremely accurate, that it can prevent unnecessary referrals and that it is useful for locating treatable patients. The results of this study could be of assistance in the running and expansion of such systems throughout Iran and Kerman Province to reduce eye damage arising from diabetes, decrease avoidable referrals to clinics, increase the availability of specialist visits for people in remote and rural areas and optimize the use of clinical infrastructures for patients in emergencies.

Investigating Pharmacists' Views on Telepharmacy: Prioritizing Key Relationships, Barriers, and Benefits.

Background: Telepharmacy can help deliver pharmaceutical advice from an expert pharmacist to another party, such as a physician, inexperienced pharmacist, or pharmacy technician. In this study, we consider term "2-person discussions" as teleconsultation between expert pharmacists to each of the aforementioned persons. Objectives: This study has 2 aims: first to prioritize 2-person discussions between the parties involved in telepharmacy services when we have limited budget and time and would like to implement the best efficient telepharmacy system. Second to examine the barriers and benefits of implementing a telepharmacy. Methods: The research population included 40 pharmacists working in Kerman pharmacies (Iran). Their viewpoints were evaluated using a valid and reliable researcher-made questionnaire. The first part of the questionnaire focused on professional-demographic information, while the second part addressed the most important 2-person discussions and also asked about barriers to and benefits of implementing telepharmacy. Results: The findings indicate that the following 2-person discussions are priority for implementation: physician-pharmacist, pharmacist-hospital ward, and pharmacist-pharmacist. Payment and reimbursement issues and lack of access to information technology infrastructure were among the most important barriers. Efficient training about medicine usage, drug-drug interactions, and adverse effects was the most important benefit of telepharmacy. Conclusion: In this study, pharmacists' first priority regarding who to involve in a 2-person telepharmacy consultation was to establish a long-distance connection between physicians and pharmacists. This finding indicates that the pharmacists were more interested in providing teleconsultation services to physicians and other pharmacists rather than communicating with pharmaceutical technicians.