THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF GERIATRICS - 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 geriatrics, 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 geriatrics. The described project involving telemedical care of patients with geriatric complexes in the area of frailty syndrome, sarcopenia and malnutrition, according to the proposed model addresses the aforementioned problems. The project provides a holistic model of home and outpatient care, which will allow concerting on 3 groups of the above-mentioned geriatric syndromes. The project will have a pilot character and is aimed at clinical verification through the introduction (implementation) of the new method and accompanying organizational and technological solutions (platform, equipment) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. CONCLUSION: Conclusions: The implementation of telemedicine solutions creates an opportunity for geriatric patients and their families by improving access to specialized medical care. This project will support patients, but also caregivers, who (through training and telemedicine) will be better able to provide care services with the ability to reconcile them with their own work.

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.

[Welfare as the goal of the analgesic pharmacotherapy accompanying biological treatment in patients with rheumatoid arthritis and ankylosing spondylitis]. / Dobrostan jako cel dzialania farmakoterapii przeciwbólowej towarzyszacej leczeniu biologicznemu u chorych na reumatoidalne zapalenie stawów oraz zesztywniajace zapalenie stawów kregoslupa.

Therapy of chronic rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) needs a comprehensive approach to the patient, based on the control of pain and improvement in overall condition, which affects the quality-of-life. This requires optimizing the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics and control of adverse drug reactions. The aim of the study was to evaluate the efficacy and safety of pain pharmacotherapy in patients with rheumatoid arthritis and ankylosing spondylitis treated as the basic pharmacotherapy-biological drugs, the analysis of awareness of pharmacovigilance and evaluation of analgesic treatment costs. Material and methods. Examined group consisted of 102 people with RA or AS received biological therapy. Test method was questionnaire with closed and open questions. Results. 86.2% of respondents used a pain medication (41%--an ad hoc basis, but 23%--at least once a day), while 79.4%--NSAIDs (33%--an ad hoc basis and 17%--at least once a day). In 85.3% of those not observed adverse effects of pain pharmacotherapy. 5 persons declared abdominal pain. Most of the patients complied with the recommendations of the doctor in the pain treatment. For the third respondents the cost of pharmacotherapy of pain was monthly 1-10 zl, but 6% of patients paying for drugs from 50-60 and above 60 zl monthly. Conclusions. Biological treatment in RA and AS is effective but requires additional analgesic therapy. Adverse effects seen during pharmacological treatment of chronic pain in rheumatic diseases are, in practice sporadic. Therapeutic patient education with chronic diseases is proper. Costs borne by the patient's pain relief in this group are not too high.