Telemedicine in the tertiary liver unit: A feasibility study.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-12 DOI:10.5114/ceh.2024.145492
Daniel J Havaj, Svetlana Adamcová-Selčanová, Klaudia Mesíková, Janka Vnenčáková, Daniela Žilinčanová, Natália Kubánek, Karolína K Šulejová, Zuzana Mesárošová, Juraj Šváč, Radovan Lapuník, Viktória Ďurajová, Ľubomír Skladaný
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引用次数: 0

Abstract

Aim of the study: Chronic liver disease is a global cause of morbidity and mortality. Slovakia has a high prevalence but an inadequate hepatology network. The COVID-19 pandemic catalysed telemedicine (TM) as a potential solution, which we aimed to investigate.

Material and methods: We conducted a retrospective cohort study to evaluate the feasibility and benefits of TM for liver cirrhosis and posttransplant patients, consisting of two phases, TM1 and TM2. The main outcomes were 1) cumulative endpoint of feasibility, uptake/acceptance, adherence (TM1), and fidelity (TM1, TM2), 2) the potential to reduce the length of hospital stay, avert unnecessary hospital admissions, and expedite the search/recall process in case of serious signals mediated by TM. Although not analysed in this study, we have recorded variables necessary for investigating associations of TM use with clinical outcomes and healthcare expenditure.

Results: The study included 95 patients. The adherence documented by the termination of monitoring at the designated time was higher in TM2 (81.7% vs. 58.3%). The proportion of patients terminated due to death or the physician's decision decreased (16.9% vs. 29.2%) and was based on their discretion, unrelated to any health complications (1.4% vs. 12.5%). The clinical impact was reflected in the hospitalization rate, particularly shortened hospitalization in 11.3%, averted/prevented hospital admissions in 14.1%, and accelerated rehospitalization in 11.3% in the subsequent phase with alert-based interventions.

Conclusions: This study showed that adherence to TM was high and integrating TM helps to reduce hospitalization rates. Despite the identified limitations, TM has the potential to improve the quality and substantially reduce the cost of care.

三级肝单元远程医疗的可行性研究。
研究目的:慢性肝病是一种全球性的发病和死亡原因。斯洛伐克的流行率很高,但肝病学网络不完善。COVID-19大流行促进了远程医疗(TM)作为一种潜在的解决方案,我们旨在对此进行研究。材料和方法:我们通过回顾性队列研究,评估TM治疗肝硬化和移植后患者的可行性和益处,分为TM1期和TM2期。主要结局为:1)可行性、吸收/接受、依从性(TM1)和保真度(TM1, TM2)的累积终点;2)缩短住院时间、避免不必要住院以及在TM介导的严重信号情况下加快搜索/回忆过程的潜力。虽然没有在本研究中进行分析,但我们记录了调查TM使用与临床结果和医疗保健支出之间关系所必需的变量。结果:纳入95例患者。在指定时间终止监测记录的依从性在TM2中更高(81.7%对58.3%)。由于死亡或医生决定而终止的患者比例下降(16.9%对29.2%),并且基于他们的判断,与任何健康并发症无关(1.4%对12.5%)。临床影响反映在住院率上,特别是11.3%的患者缩短了住院时间,14.1%的患者避免了住院,11.3%的患者在后续阶段通过预警干预加速了再次住院。结论:本研究显示中医依从性高,整合中医有助于降低住院率。尽管存在已知的局限性,但TM仍有可能提高医疗质量并大幅降低医疗成本。
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来源期刊
Clinical and Experimental Hepatology
Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
0.00%
发文量
32
期刊介绍: Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.
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