Medical and Economics Benefits of Tele-expertise in Dermatology: Case study in eight Health Centers in Mali.

Author(s):  
Cheick Oumar Bagayoko ◽  
Mahmoud Cissé ◽  
Joseph Aka ◽  
Adama Dicko ◽  
Abdrahamane Anne ◽  
...  

Abstract Background: Mali, like many Sub-Saharan African countries, is experiencing an acute crisis with respect to the shortage of qualified health professionals. This crisis is even more acute when it comes to specialized medical fields such as dermatology. To address this shortage, a tele-dermatology project has been launched in Mali since 2015 in order to provide access to specialized care to the most remote populations.Objective: The aim of our study is to assess the medico-economic benefits of the pilot phase of this project.Methods: We conducted a retrospective cross-sectional study of all requests for expert advice sent to dermatology experts through the "Bogou" tele-expertise platform.The sample consisted of 52 patients at eight remote sites and ten health professionals, including 4 specialists.The economic study was done using a parameter of cost analysis and the professional evaluation of healthcare providers. It compared consultation and transportation fees (on-site and off-site), and used a questionnaire assessing items on a 5-level Lickert scale and open-ended questions to evaluate the satisfaction of health professionals. Data analysis was performed by SPSS v25.Results: During the period, 374 requests for tele-expertise were made for the benefit of 52 patients. 89.3% of requests were answered by specialists, with an average response time of 46 hours 59 minutes and extremes from 7 minutes to 415 hours 4 minutes. Eczema was the most common medical condition diagnosed. 98% of patients had never completed a dermatological consultation because of a lack of means to travel to the only specialized center in the country. Consequently, they were all very satisfied or satisfied with the tele-expertise service. The 52 participating patients in project have realized a great financial benefit. Together they saved an average of 5,824,500 XOF (9429 euros).All the health professionals surveyed also expressed satisfaction with the application. They confirmed that the project has enabled them to strengthen their skills in the management of dermatological pathologies.Conclusion: Based on the results of our study, we can say that tele-dermatology allows access to specialized care and a reduction in the costs of care for patients in remote areas.

2020 ◽  
pp. postgradmedj-2020-137547
Author(s):  
Ayman El-Menyar ◽  
Wanis H Ibrahim ◽  
Walid El Ansari ◽  
Mohamed Gomaa ◽  
Brijesh Sathian ◽  
...  

BackgroundThe pattern and impact of burnout among the medical staff are not yet well defined. However, the consequences of burnout are not limited to the healthcare providers but also may affect their family, colleagues and patients in a negative manner. We aimed to assess the characteristics and predictors of burnout among health professionals at two large tertiary hospitals.MethodsWe conducted a cross-sectional study during the period from July 2018 to 31 December 2018. Data, via Maslach Burnout Inventory survey, were collected from physicians and other healthcare workers in two hospitals.ResultsA total of 624 responses to questionnaires were analysed. Half of the respondents were physicians, and men constituted the majority. About 10% (95% CI, 7.8 to 12.5) of the respondents satisfied the criteria of burnout. Emotional exhaustion (EE) was observed in 45.7%, depersonalisation (DP) in 26.9% and personal accomplishment (PA) in 41.2% of the respondents. There was a positive correlation between EE and DP (r=0.627, p=0.001), and a weak negative correlation between DP and PA (r=−0.195, p=0.001). Young age, less experience, trauma surgery, lack of habits and getting depressed ≥1 time/week were predictors of burnout.ConclusionsBurnout affects one-tenth of the health professionals in the tertiary hospitals in Qatar. Physicians are more likely to have higher DP and lower PA, whereas nurses prone to have higher EE. In this study, no gender discrepancy is appreciated and the junior medical staff is at a higher risk of burnout.


Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 555 ◽  
Author(s):  
Omotayo Olaoye ◽  
Chloe Tuck ◽  
Wei Ping Khor ◽  
Roisin McMenamin ◽  
Luke Hudson ◽  
...  

Smartphone apps have proven to be an effective and acceptable resource for accessing information on antimicrobial prescribing. The purpose of the study is to highlight the development and implementation of a smartphone/mobile app (app) for antimicrobial prescribing guidelines (the Commonwealth Partnerships for Antimicrobial Stewardship—CwPAMS App) in Ghana, Tanzania, Uganda and Zambia and to evaluate patients’ and healthcare providers’ perspectives on the use of the App in one of the participating institutions. Two structured cross-sectional questionnaires containing Likert scale, multiple-choice, and open-ended questions were issued to patients and healthcare workers six months after the introduction of the app at one of the hospital sites. Metrics of the use of the app for a one-year period were also obtained. Download and use of the app peaked between September and November 2019 with pharmacists accounting for the profession that the most frequently accessed the app. More than half of the responding patients had a positive attitude to the use of the app by health professionals. Results also revealed that more than 80% of health care workers who had used the CwPAMS App were comfortable using a smartphone/mobile device on a ward round, considered the app very useful, and found it to improve their awareness of antimicrobial stewardship, including documentation of the indication and duration for antimicrobials on the drug chart. It also encouraged pharmacists and nurses to challenge inappropriate antimicrobial prescribing. Overall, our findings suggest that its use as a guide to antimicrobial prescribing sparked positive responses from patients and health professionals. Further studies will be useful in identifying the long-term consequences of the use of the CwPAMS App and scope to implement in other settings, in order to guide future innovations and wider use.


Antibiotics ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Haya Nassar ◽  
Rana Abu-Farha ◽  
Muna Barakat ◽  
Eman Alefishat

This study aimed to evaluate health professionals’ perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers’ attention to the importance of AMS and support the health care provider’s practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.


2017 ◽  
Vol 44 (4) ◽  
pp. 512-518 ◽  
Author(s):  
Mariana Galante Santiago ◽  
Andréa Marques ◽  
Marianne Kool ◽  
Rinie Geenen ◽  
José António P. da Silva

Objective.The term “invalidation” refers to the patients’ perception that their medical condition is not recognized by the social environment. Invalidation can be a major issue in patients’ lives, adding a significant burden to symptoms and limitations while increasing the risk of physical and psychological disability. In this study in patients with rheumatic diseases, we investigated the relationship between invalidation and sociodemographic, clinical, psychological, and personality characteristics.Methods.This international cross-sectional study included 562 adults with rheumatoid arthritis (n = 124), spondyloarthritis (n = 85), systemic lupus erythematosus (n = 112), or fibromyalgia (FM; n = 241). Assessed were the family and health professionals subscales of the Illness Invalidation Inventory (3*I), happiness (Subjective Happiness Scale), personality (Ten-Item Personality Inventory), pain, and loneliness (numerical rating scales). Univariate and multivariate analyses were used to test different models.Results.Invalidation occurred in all rheumatic diseases, but patients with FM reported the most invalidation. Including all correlated variables in the multivariate model, pain remained as a determinant of invalidation by health professionals, but not by family. Regarding psychological variables, loneliness remained as a determinant of invalidation by family, but not by health professionals. FM and low levels of happiness, agreeableness, and conscientiousness were associated with invalidation while taking account of other variables.Conclusion.Invalidation occurs in all rheumatic diseases and patients with FM experience the most invalidation. Psychological factors (happiness, agreeableness, and conscientiousness), loneliness, and pain intensity are associated with invalidation, irrespective of the rheumatic disease and may deserve dedicated interventions.


Author(s):  
Ahmed Yakubu ◽  
Tukur Dabo Sagir ◽  
Abubakar Panti ◽  
Garba Jamila A. ◽  
Isah Usman Mani ◽  
...  

Background: Contraception can be defined as all temporary or permanent measures designed to prevent pregnancy. Bilateral tubal ligation is a surgical and permanent form of contraception offered to women who completed their family size or for limitation of family size due to medical condition. The practices of bilateral tubal ligation is limited in Sub-Saharan African countries, Nigeria inclusive because of great desire for a large family size, cultural and religious factors, misunderstanding and fear of the procedure. The aim of the study was to determine the perception and acceptability of bilateral tubal ligation as a form of contraception among women attending Antenatal clinic at Usmanu Danfodiyo University Teaching Hospital Sokoto.Methods: This was a cross sectional study conducted among women attending antenatal clinic between 1st of May to 31st of July, 2018. The information was obtained using a structured questionnaire to obtain the respondent’s socio-demographic characteristics, questions on perception and acceptability of bilateral tubal ligation. Data analysis was done with statistical package for social sciences version 22 (SPSS Inc, Chicago, IL, USA).Results: The study revealed that 73% of the respondents were aware of bilateral tubal ligation, but only 44% of them have good perception towards it. Majority of the respondents (63.8%) reject BTL for contraception. Most of their reasons were cultural believe (33.3%), regret (31.6%), religious believe (26.6%) and fear of surgery (8.5%).Conclusions: There was poor perception and low acceptability toward bilateral tubal ligation among the study population, mostly due to cultural and religious believes, as well as fear of regret, despite awareness of BTL among majority of the respondents.


Author(s):  
Jing Xu ◽  
Hanadi Hamadi ◽  
Kristen Hicks-Roof ◽  
Robert Zeglin ◽  
Chloe Bailey ◽  
...  

Objective: During the Coronavirus Disease 2019 (COVID-19) pandemic, many other health providers needed to rapidly adopt telehealth services to ensure continuity of patient care, without the opportunity to extensively evaluate the usability of the adopted technology. Therefore, this study aims to examine health professionals’ telehealth usability during COVID-19 in Florida. Design: This cross-sectional study employed the Telehealth Usability Questionnaire (TUQ) to licensed healthcare providers in Florida in June 2020. Setting and Participants: A total of 399,660 selected health professionals with Florida licensure were recruited from open-access Florida healthcare to participate in a Qualtrics web-based survey. A total of 1868 health professionals completed the survey. Multiple linear and mixed regression models were applied to analyze the overall and subdomain scores from TUQ. Main outcome measures: Telehealth Usability. Results: The analysis of overall TUQ score showed younger, female healthcare professionals, and participants who reported an increase of telehealth usage during pandemic had a significantly higher overall TUQ score. Compared with the score from physicians and nurses, the scores from the mental health group and social work group were significantly higher, while the score rehabilitation group was significantly lower. Analysis of the subdomain scores were consistent with the overall scores. Conclusion:  The findings from this study indicate that the health professionals’ telehealth usability is related to age, gender, and the change of telehealth usage during the COVID-19 pandemic. While pandemics represent only one possible impetus for the healthcare system to swiftly switch to telehealth platforms, each profession should consider providing adequate resources to accommodate the need for change.


2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Vareda ◽  
T Garcia ◽  
J Rachadell

Abstract Background From disease prevention to health promotion, communication is key for Public Health (PH) practice and, according to the 9th Essential Public Health Operation its goal is to improve populations health literacy and capacity to access, understand and use information. Though social media is frequently presented as a potentially useful tool for PH communication, there is a lack of evidence about its effectiveness and impact on PH outcomes. This study researches Instagram® as a PH tool and aims to know who is using it, what content is shared on the platform and how much engagement there is. Methods This cross-sectional study regards information on 1000 Instagram® posts with the hashtags publichealth, publichealthpromotion, healthpromotion, publichealthmatters and publichealtheducation. Authors categorized post content and creators, and reviewed the number of likes and comments per post to determine engagement. Data analysis was performed on IBM SPSS® Statistics. Results The most common content categories were communicable diseases (n = 383), non-communicable diseases (n = 258) and healthy lifestyles (n = 143). Health professionals post more about communicable diseases (43,6%) and non-professionals about healthy lifestyles (36,1%). Non-professionals (n = 191) post about PH issues almost as much as health professionals (n = 220) and PH associations (n = 201). Most don't reference their sources (n = 821). Posts on communicable diseases have the most likes and comments per post (mean of 172 likes and 3,1 comments). Conclusions Half the Instagram® posts analysed in this study were made by health professionals or organizations. Communicable diseases, non-communicable diseases and healthy lifestyles were the most frequent content categories and had the most engagement. The majority of posts didn't reference their sources. Though Instagram® seems to be a potential PH communication tool, further research is needed to confirm its benefits for PH. Key messages Social media platforms like Instagram® are potentially powerful tools for PH communication. There is a need to understand the efficacy of social media as health promotion tools.


Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.


2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.


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