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telehealth "primary care"

Padraig Dixon, Sandra Hollinghurst, Louisa Edwards, Clare Thomas, Alexis Foster, Ben Davies, Daisy Gaunt, Alan A Montgomery, Chris Salisbury
BACKGROUND: Depression is a prevalent long-term condition that is associated with substantial resource use. Telehealth may offer a cost-effective means of supporting the management of people with depression. AIMS: To investigate the cost-effectiveness of a telehealth intervention ('Healthlines') for patients with depression. METHOD: A prospective patient-level economic evaluation conducted alongside a randomised controlled trial. Patients were recruited through primary care, and the intervention was delivered via a telehealth service...
July 2016: BJPsych Open
Padraig Dixon, Sandra Hollinghurst, Roberta Ara, Louisa Edwards, Alexis Foster, Chris Salisbury
OBJECTIVES: To investigate the long-term cost-effectiveness (measured as the ratio of incremental NHS cost to incremental quality-adjusted life years) of a telehealth intervention for patients with raised cardiovascular disease (CVD) risk. DESIGN: A cohort simulation model developed as part of the economic evaluation conducted alongside the Healthlines randomised controlled trial. SETTING: Patients recruited through primary care, and intervention delivered via telehealth service...
2016: BMJ Open
Padraig Dixon, Sandra Hollinghurst, Louisa Edwards, Clare Thomas, Daisy Gaunt, Alexis Foster, Shirley Large, Alan A Montgomery, Chris Salisbury
OBJECTIVES: To investigate the cost-effectiveness of a telehealth intervention for primary care patients with raised cardiovascular disease (CVD) risk. DESIGN: A prospective within-trial patient-level economic evaluation conducted alongside a randomised controlled trial. SETTING: Patients recruited through primary care, and intervention delivered via telehealth service. PARTICIPANTS: Adults with a 10-year CVD risk ≥20%, as measured by the QRISK2 algorithm, with at least 1 modifiable risk factor...
2016: BMJ Open
Jennifer Zelmer, Elettra Ronchi, Hannele Hyppönen, Francisco Lupiáñez-Villanueva, Cristiano Codagnone, Christian Nøhr, Ursula Huebner, Anne Fazzalari, Julia Adler-Milstein
OBJECTIVE: To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. MATERIALS AND METHODS: A prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015...
August 22, 2016: Journal of the American Medical Informatics Association: JAMIA
Vida Samiei, Sharifa Ezat Wan Puteh, Mohd Rizal Abdul Manaf, Khalib Abdul Latip, Aniza Ismail
BACKGROUND: The idea of launching an internet-based self-management program for patients with diabetes led us to do a cross-sectional study to find out about the willingness, interest, equipment, and level of usage of computer and internet in a medium- to low-social class area and to find the feasibility of using e-telemonitoring systems for these patients. METHODS: A total of 180 patients with type 2 diabetes participated in this study and fulfilled the self-administered questionnaire in Diabetes Clinic of Primary Medical Center of University Kebangsaan Malaysia Medical Centre; the response rate was 84%...
March 2016: Malaysian Journal of Medical Sciences: MJMS
Joseph M Cerimele, John C Fortney, Jürgen Unützer
This Open Forum addresses considerations for improving treatment of bipolar disorder. Most individuals with bipolar disorder report not receiving treatment from a psychiatrist in the past 12 months. In the United States, a large proportion of persons with bipolar disorder seek treatment in primary care. These patients have high symptom severity and functional impairment but are less likely to receive mood-stabilizing medications. In a prior study in a primary care setting, the authors found that one-third of patients with bipolar disorder improved after receiving treatment in primary care in a statewide collaborative care program...
August 15, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
E T Rhodes, L Vernacchio, A A Mitchell, C Fischer, P Giacalone, D S Ludwig, C B Ebbeling
BACKGROUND: Telehealth offers opportunities to extend clinical and research interventions for paediatric obesity. OBJECTIVES: To assess utility of a telephone intervention, implemented through a national primary care paediatric research network, for promoting differentiation in dietary intake, consistent with either a low-glycemic load (Low GL) or Low Fat prescription, among overweight/obese school-age children. METHODS: Five-week telephone dietary counselling intervention for parents of overweight/obese school-age children recruited through the Slone Center Office-based Research Network...
August 5, 2016: Pediatric Obesity
Kristen M Cunanan, Bradley P Carlin, Kevin A Peterson
BACKGROUND: Many clinical trial designs are impractical for community-based clinical intervention trials. Stepped wedge trial designs provide practical advantages, but few descriptions exist of their clinical implementational features, statistical design efficiencies, and limitations. OBJECTIVES: Enhance efficiency of stepped wedge trial designs by evaluating the impact of design characteristics on statistical power for the British Columbia Telehealth Trial. METHODS: The British Columbia Telehealth Trial is a community-based, cluster-randomized, controlled clinical trial in rural and urban British Columbia...
July 17, 2016: Clinical Trials: Journal of the Society for Clinical Trials
Megan Coffman, Miranda Moore, Anuradha Jetty, Kathleen Klink, Andrew Bazemore
Despite rapid advancements in telehealth services, only 15% of family physicians in a 2014 survey reported using telehealth; use varied widely according to the physician's practice setting or designation. Users were significantly more likely than nonusers to work in federally designated "safety net" clinics and health maintenance organizations (HMOs) but not more likely than nonusers to report working in a patient-centered medical home (PCMH) or accountable care organization.
July 2016: Journal of the American Board of Family Medicine: JABFM
Alicia O'Cathain, Sarah J Drabble, Alexis Foster, Kimberley Horspool, Louisa Edwards, Clare Thomas, Chris Salisbury
BACKGROUND: Evidence of benefit for telehealth for chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service for 2 chronic conditions: depression and high risk of cardiovascular disease (CVD). This new telehealth service consisted of regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use Web-based resources and helped to optimize medication, improve treatment adherence, and encourage healthier lifestyles...
2016: Journal of Medical Internet Research
Karen Day, Timothy W Kenealy, Nicolette F Sheridan
BACKGROUND: Action research (AR) and randomized controlled trials (RCTs) are usually considered to be theoretically and practically incompatible. However, we argue that their respective strengths and weaknesses can be complementary. We illustrate our argument from a recent study assessing the effect of telemonitoring on health-related quality of life, self-care, hospital use, costs and the experiences of patients, informal carers and health care professionals in two urban hospital services and one remote rural primary care service in New Zealand...
2016: BMC Medical Research Methodology
Rita Hamilton, Simon Driver, Shayan Noorani, Librada Callender, Monica Bennett, Kimberley Monden
OBJECTIVE: Describe the utilization, accessibility, and satisfaction of primary and preventative health-care services of community-dwelling individuals with spinal cord injury (SCI). DESIGN: Cross sectional, in-person or telephonic survey, utilizing a convenience sample. SETTING: Community. PARTICIPANTS: Individuals with SCI greater than 12-months post injury. INTERVENTIONS: N/A. OUTCOME MEASURES: Demographic, injury related, and 34-item questionnaire of healthcare utilization, accessibility, and satisfaction with services...
May 25, 2016: Journal of Spinal Cord Medicine
Lori Uscher-Pines, Shira Fischer, Ramya Chari
Telehealth has great promise to improve and even revolutionize emergency response and recovery. Yet telehealth in general, and direct-to-consumer (DTC) telehealth in particular, are underutilized in disasters. Direct-to-consumer telehealth services allow patients to request virtual visits with health care providers, in real-time, via phone or video conferencing (online video or mobile phone applications). Although DTC services for routine primary care are growing rapidly, there is no published literature on the potential application of DTC telehealth to disaster response and recovery because these services are so new...
August 2016: Prehospital and Disaster Medicine
Victoria A Wade, Alan D Taylor, Michael R Kidd, Colin Carati
BACKGROUND: This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal. METHODS: Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability...
2016: BMC Health Services Research
Milena Soriano Marcolino, Renato Minelli Figueira, Julia Pereira Afonso Dos Santos, Clareci Silva Cardoso, Antonio Luiz Ribeiro, Maria Beatriz Alkmim
BACKGROUND: In Brazil, the majority of healthcare resources are concentrated in the largest cities, whereas most communities lack proper healthcare assistance in primary care and have difficulties accessing specialists and diagnostic examinations. Considering this, the Telehealth Network of Minas Gerais (TNMG) was created. It is a public telehealth initiative that provides support to primary healthcare (PHC), performing teleconsultation and telediagnosis (electrocardiogram [ECG], Holter, ambulatory blood pressure monitoring, spirometry, and retinography analysis) mainly for small and remote cities in the state of Minas Gerais, Brazil...
May 11, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Ann Vander Stoep, Carolyn A McCarty, Chuan Zhou, Carol M Rockhill, Erin N Schoenfelder, Kathleen Myers
The Children's Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5...
April 27, 2016: Journal of Abnormal Child Psychology
Rosemary McKenzie, Michelle Williamson
BACKGROUND: Telephone triage and advice services (TTAS) have become commonplace in western health care systems particularly as an aid to patient access and demand management in the after hours period. In 2011 an after hours general practitioner (GP) helpline was established as a supplementary service to existing 24-h nurse-TTAS in Australia. Callers to the service in the after hours period who are triaged by a nurse as needing to see a GP immediately or within 24 h may speak with a GP on the line to obtain further assessment and advice...
2016: BMC Health Services Research
Erno Harzheim, Marcelo Rodrigues Gonçalves, Roberto Nunes Umpierre, Ana Célia da Silva Siqueira, Natan Katz, Milena R Agostinho, Elise B Oliveira, Josué Basso, Rudi Roman, Rafael G Dal Moro, Carlos Pilz, Ricardo S Heinzelmann, Carlos André Aita Schmitz, Lisiane Hauser, Sotero Serrate Mengue
INTRODUCTION: In 1988, Brazil adopted a universal healthcare model in which access is mediated by the primary care level. However, difficulties have emerged in the coordination of care between the primary and specialized levels. Telehealth was thus proposed as a means to overcome this challenge. This article describes initiatives developed by a large Brazilian program, TelessaúdeRS/UFRGS, in the fields of teleconsultation, telediagnosis, tele-education, and information technology development to support the public healthcare system...
April 20, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Aung Z Win
There is a raising demand for unscheduled care in the United Kingdom. Minor Ailments Schemes (MAS) were introduced to reduce the burden of minor ailments on higher cost settings such as general practices and emergency departments. The number of visits for minor ailments at GPs often declined following the implementation of MAS. Retail clinics in America employ nurse practitioners (NPs) and physician assistants (PAs) who can diagnose and treat minor illness, and minor injuries. Similar to the retail clinics, MAS can merge with walk-in centres...
March 15, 2016: Primary Health Care Research & Development
Paula Rejane Beserra Diniz, Fernando José Ribeiro Sales, Magdala de Araújo Novaes
BACKGROUND: Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. MATERIALS AND METHODS: Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings...
August 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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