Utilization and safety of telemedicine for pediatric lower urinary tract symptoms before and during the COVID-19 pandemic

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2023-07-13 DOI:10.1111/luts.12496

Abby L. Chen, Stav Spinzi, Gunjan Agrawal, Kathleen M. Kan

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引用次数: 0

Abstract

Objectives

Telemedicine for pediatric lower urinary tract symptoms (pLUTS) is a relatively new mode of delivering bladder health education with scant evidence supporting current practice. We aim to examine the safety of pLUTS-related telemedicine visits surrounding the COVID-19 pandemic.

Methods

We conducted a retrospective cohort study of new pLUTS referral diagnoses to our institution's pediatric urology clinics. Demographics, wait times, and referral diagnoses were captured and compared before and after March 2020 using χ²/Fisher exact tests and t-tests. A retrospective chart review was performed for an initial telemedicine visit followed by an in-person visit to identify missed radiology, lab, or physical exam findings.

Results

Six hundred twelve patients were included from September 2018 to August 2021. Most were 5–10 years old (62.3%), female (56.2%), English speaking (86.5%), White (39.4%), and had private insurance (67.2%). Wait times were shorter for telemedicine versus in-person visits (t₁₉₀ = −3.56, p < .001). After March 2020, patients with a urinary tract infection (UTI) and females utilized in-person visits more often (p < .001). After chart review (11 patients, mean = 10.4 years), 9 (81.8%) had comorbid conditions and/or family history of lower urinary tract symptoms. None had missed clinical findings that changed management.

Conclusions

pLUTS care can be delivered via telemedicine without a significant change in patient volume and population, though additional investigations will clarify the needs of patients with specific referral diagnoses and comorbid conditions. The in-person exam can be omitted safely with proper clinical history taking, supporting future virtual programs that address delays in care within local communities.

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COVID-19大流行之前和期间儿童下尿路症状远程医疗的使用和安全性

目的儿童下尿路症状远程医疗(pLUTS)是一种相对较新的膀胱健康教育模式，目前缺乏证据支持。我们的目标是在COVID-19大流行期间检查与ppluto相关的远程医疗就诊的安全性。方法我们进行了一个回顾性队列研究新的pLUTS转诊诊断到我们机构的儿科泌尿科诊所。使用χ2/Fisher精确检验和t检验，收集了2020年3月前后的人口统计数据、等待时间和转诊诊断并进行了比较。对首次远程医疗就诊进行回顾性病历回顾，随后进行亲自就诊，以确定遗漏的放射学、实验室或体检结果。结果2018年9月至2021年8月共纳入612例患者。大多数是5-10岁(62.3%)，女性(56.2%)，说英语(86.5%)，白人(39.4%)，有私人保险(67.2%)。与面对面就诊相比，远程医疗的等待时间更短(t190 = - 3.56, p < .001)。2020年3月之后，尿路感染(UTI)患者和女性更频繁地进行了亲自就诊(p < .001)。图表回顾(11例患者，平均10.4岁)，9例(81.8%)有合并症和/或下尿路症状家族史。没有人错过了改变治疗方法的临床发现。结论:通过远程医疗提供pLUTS治疗不会对患者数量和人群产生显著影响，但进一步的调查将明确具有特定转诊诊断和合并症的患者的需求。通过适当的临床病史记录，可以安全地省略现场检查，支持未来解决当地社区护理延误的虚拟项目。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.