Willingness to engage in post-discharge follow-up service conducted via video telemedicine: Cross-sectional study.

BACKGROUND: Leading influencing factors for telemedicine implementation remain unclear, affecting the focus of intervention strategies. Despite recent effectiveness evidence of video telemedicine visits, limited evidence exists regarding patients' willingness to use video follow-up. Moreover, patients' acceptance is crucial for implementing such services. OBJECTIVE: We conducted a large-sample survey to analyze patient willingness and perceptions of post-discharge video follow-up and assessed the factors influencing their willingness during the COVID-19 outbreak. METHOD: In February and March 2022, we conducted a face-to-face questionnaire survey involving inpatients in a tertiary care hospital in Longhua District, Shenzhen, China. We assessed demographics, health-related determinants, access to technology and literacy, preferences, willingness, and opinions toward video telemedicine follow-up. We implemented random forest and logistic regression analyses to obtain reliable results. RESULTS: In total, 1,017 inpatients completed the survey. Overall, as an initial choice, 44.9 % preferred telephone consultation for post-discharge follow-up, which was followed by video telemedicine (17.1 %), WeChat voice calls (11.6 %), SMS text messages (10.7 %), WeChat graphic messages (10.5 %), and in-person visits (4.5 %). Moreover, 54.9 % were willing to experience video visits. The results highlight the perceived benefits outweighing the risks (OR 2.64, 95 % CI 1.76, 3.95), patients' trust in the physician (OR 2.41, 95 % CI 1.45, 3.99), access to a private space (OR 2.18, 95 % CI 1.01, 2.96), medium geographical distance (compared to long distance, OR 0.72, 95 % CI 0.54, 0.98), moderate disease (compared to mild disease, OR 0.75, 95 % CI 0.57, 0.99), followed by the comfort with video technology (OR 1.73, 95 % CI 1.76, 3.95), broadband internet accessibility (OR 1.56, 95 % CI 1.07, 2.27), privacy concerns (OR 0.62, 95 % CI 0.43, 0.89), and prior telemedicine video experience (OR 1.77, 95 % CI 1.15, 2.72), as factors influencing the willingness to use video follow-up. CONCLUSIONS: A low percentage of patients chose video visits as their initial decisions; nevertheless, most had a positive attitude toward video follow-up visits. The willingness to choose video telemedicine post-discharge follow-up was influenced by geographical distance, disease severity, basic telemedicine requirements, physician-patient relationship, and perceptions of video communication.

Preparation, Characterization and Pharmacokinetics of Tolfenamic Acid-Loaded Solid Lipid Nanoparticles.

The clinical use of nonsteroidal anti-inflammatory drugs is limited by their poor water solubility, unstable absorption, and low bioavailability. Solid lipid nanoparticles (SLNs) exhibit high biocompatibility and the ability to improve the bioavailability of drugs with low water solubility. Therefore, in this study, a tolfenamic acid solid lipid nanoparticle (TA-SLN) suspension was prepared by a hot melt-emulsification ultrasonication method to improve the sustained release and bioavailability of TA. The encapsulation efficiency (EE), loading capacity (LC), particle size, polydispersity index (PDI), and zeta potential of the TA-SLN suspension were 82.50 ± 0.63%, 25.13 ± 0.28%, 492 ± 6.51 nm, 0.309 ± 0.02 and -21.7 ± 0.51 mV, respectively. The TA-SLN suspension was characterized by dynamic light scattering (DLS), fluorescence microscopy (FM), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and Fourier transform infrared (FT-IR) spectroscopy. The TA-SLN suspension showed improved sustained drug release in vitro compared with the commercially available TA injection. After intramuscular administration to pigs (4 mg/kg), the TA-SLN suspension displayed increases in the pharmacokinetic parameters Tmax, T1/2, and MRT0-∞ by 4.39-, 3.78-, and 3.78-fold, respectively, compared with TA injection, and showed a relative bioavailability of 185.33%. Thus, this prepared solid lipid nanosuspension is a promising new formulation.