THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF CHRONIC DISEASES - HEALTH CHALLENGES AND JUSTIFICATION OF THE PROJECT IMPLEMENTATION.

OBJECTIVE: Aim: To present the essentials of the pilot project for testing a telemedicine model in the field of chronic diseases, along with a snapshot of the health challenges. PATIENTS AND METHODS: Materials and Methods: This review paper use the synthetic method summarizing the main objectives of the telemedicine project in the field of chronic diseases with a focus on COPD. The described project will have a pilot character and is aimed at clinical verification through the implementation of a new method and accompanying organizational and technological solutions (platform, devices) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. The main (primary) outcome will be the leveling of social inequalities in health by reducing the residence and income factor in access to screening and medical services through the use of telemedicine. CONCLUSION: Conclusions: Implementation of telemedicine solutions creates an opportunity for patients diagnosed with COPD and their families by improving access to specialized medical care. With early detection of COPD exacerbation symptoms (deterioration of remotely monitored spirometric parameters), it will be possible to introduce appropriate preventive measures for these patients offsetting the adverse consequences.

Quality of Life and Depression in Rheumatoid Arthritis Patients Treated with Biologics - A Single Centre Experience.

Introduction: Patients with rheumatoid arthritis (RA) often experience depression, which has a very negative impact on the assessment of the quality of life (QoL). However, there are not many studies that assess the relationship between depression and QoL in RA patients. The aim of the study was to assess the level of QoL and determine the mutual relationship between anxiety and depression levels and QoL in patients treated for RA. Material and Methods: The study included 101 patients (aged:52.4±16.97), who met the established criteria for a diagnosis of RA and treatment with a biological agent. Only standardized tools were used to examine the patients: WHO-QoL, HADS and the VAS scale. Results: The mean RA duration in the group studied was 13.54±9.51 years and the disease activity score was 4.8±0.8. The mean QoL perception score was 3.48± 0.8. Nearly 40% of the respondents could not clearly determine their QoL, perceiving it as neither poor nor good, and 10% believed their QoL is poor or very poor. The correlation analysis revealed that anxiety is significantly and negatively associated with QoL in the psychological domain (r = -0.472, p < 0.001) and social domain (r = -0.298, p = 0.023) and depression is significantly and negatively associated with QoL in the psychological domain (r = -0.322, p = 0.01) and physical health domain (r = -0.209, p = 0.04). In the multiple linear regression model, depression was an independent negative predictor affecting the following domains: perception of QoL and perception of health, and physical health. Conclusion: RA patients treated with biologics present a low level of health perception and an average level of QoL perception. Depression and anxiety negatively correlate with QoL domains: the higher the anxiety and depression levels, the poorer the QoL in the psychological and social relationships domains. Depression is an independent determinant of decreased QoL.