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
{"title":"Telemedicine in the tertiary liver unit: A feasibility study.","authors":"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","doi":"10.5114/ceh.2024.145492","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim of the study: </strong>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.</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10281,"journal":{"name":"Clinical and Experimental Hepatology","volume":"10 4","pages":"261-270"},"PeriodicalIF":1.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022612/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Hepatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/ceh.2024.145492","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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.
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.