24/Jun/2024
Multidrug stewardship and adherence to guidelines in >200,000 direct-to-consumer Telemedicine encounters
DOI: 10.31744/einstein_journal/2024AO0707
Highlights Up to 75% of COVID-19 telemedicine patients receive unnecessary drugs; this highlights the need for research. This study assessed the effect of guideline training and feedback on 200,000 telemedicine visits in Brazil. Under 2% of patients with COVID-19 received non-guideline recommended antimicrobials, reflecting high adherence rates. Targeted interventions significantly enhance guideline compliance for safer telemedicine prescriptions. ABSTRACT Objective: The quality of care and safety for Telemedicine-discharged patients with suspected respiratory infections are closely related to low rates of prescriptions […]
Keywords: Communicable diseases; Coronavirus infections; COVID-19; Drug prescriptions; Guideline adherence; Patient discharge; Prescriptions; Quality Indicators, Health Care; Referral and consultation; Respiratory tract infections; Telemedicine
19/Dec/2022
Mobile application-based oximetry: a potential tool for appropriate referral of patients with respiratory symptoms examined via telemedicine
einstein (São Paulo). 19/Dec/2022;21:eAO0025.
View Article19/Dec/2022
Mobile application-based oximetry: a potential tool for appropriate referral of patients with respiratory symptoms examined via telemedicine
DOI: 10.31744/einstein_journal/2023AO0025
Highlights The evaluated method showed moderate reproducibility when compared to the gold standard practice. This new method had a high specificity and a low sensitivity. The observed high range of SpO2 levels between the methods could lead to a wrong patient referral. The use of telemedicine to assess oxygen saturation in patient with dyspnea is a viable resource, although requiring improvement. ABSTRACT Objective To calculate the positive likelihood ratio to determine whether telemedicine is able to optimize referral to […]
Keywords: Artificial intelligence; Dyspnea; Oximetry; Referral and consultation; Respiratory tract diseases; Signs and symptoms; Telemedicine
18/May/2022
Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial
einstein (São Paulo). 18/May/2022;20:eAO6800.
View Article18/May/2022
Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial
DOI: 10.31744/einstein_journal/2022AO6800
ABSTRACT Objective To analyze telemedicine diagnostic accuracy in patients with respiratory infections during COVID-19 pandemic compared to face-to-face evaluation in the emergency department. Methods Randomized, unicentric study between September 2020 and November 2020 in patients with any respiratory symptom (exclusion criteria: age >65 years, chronic heart or lung diseases, immunosuppressed). Patients were randomized 1:1 for brief telemedicine followed by face-to-face consultation or direct face-to-face evaluation. The primary endpoint was the International Classification of Diseases code. The secondary analysis comprised length […]
Keywords: Coronavirus infections; COVID-19; Emergency medical services; Referral and consultation; Respiratory tract infections; Telemedicine
22/Mar/2022
Clinical outcome analysis in surgical patients enrolled in a Second Opinion Program in spine surgery
DOI: 10.31744/einstein_journal/2022AO5791
ABSTRACT Objective To analyze pain, functional capacity, quality of life, anxiety and depression outcomes in patients undergoing lumbar spine surgery following use of the Second Opinion Program, and to present disagreements regarding diagnoses and therapeutic indications between the first and second opinions. Methods A prospective, observational cohort study with 100 patients enrolled in the Second Opinion Program who underwent lumbar spine surgery. Questionnaires addressing pain intensity, level of disability, quality of life, anxiety and depression were applied prior to and […]
Keywords: Anxiety; Arthrodesis; Depression; Low back pain; Pain management; Quality of life; Referral and consultation; Spinal diseases/surgery; Treatment outcome
13/Oct/2021
Barriers to enrollment in pulmonary rehabilitation: medical knowledge analysis
DOI: 10.31744/einstein_journal/2021AO6115
ABSTRACT Objective To assess clinicians’ knowledge about pulmonary rehabilitation, and identify the barriers faced when referring patients with health insurance to pulmonary rehabilitation. Methods This was a survey-based cross-sectional study conducted in 2019, at a private reference hospital in São Paulo, Brazil. Eligible participants were physicians registered with the following specialties: internal medicine, geriatrics, cardiology, pulmonology or thoracic surgery. Results We collected 72 responses, and 99% of participants recognized chronic obstructive pulmonary disease as a potential indication for pulmonary rehabilitation; […]
Keywords: Delivery of health care; Health Knowledge, Attitudes, Practice; Lung diseases; Patient compliance; Referral and consultation; Rehabilitation
26/Nov/2020
Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral
einstein (São Paulo). 26/Nov/2020;18:eAO6106.
View Article26/Nov/2020
Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral
DOI: 10.31744/einstein_journal/2020AO6106
ABSTRACT Objective: To characterize variables associated with referral to the emergency department following Telemedicine consultation during the COVID-19 pandemic. Methods: Cross-sectional retrospective study conducted between March and May 2020, with a sample of 500 adult patients. The inclusion criterion was the manifestation of respiratory symptoms, regardless of type. Results: The mean age of patients was 34.7±10.5 years, and 59% were women. Most patients (62.6%) perceived their own health status as malaise and some (41.4%) self-diagnosed COVID-19. Cough (74.4%), rhinorrhea (65.6%), […]
Keywords: Coronavirus infections; Pandemics; Referral and consultation; Respiratory tract infections; Telemedicine
15/Jun/2018
What are the most frequent diagnoses in adolescence? The reality of an Adolescent Medicine Clinic
DOI: 10.1590/S1679-45082018AO4225
ABSTRACT Objective To characterize the care flow and the primary diagnoses of an Adolescent Medicine Clinic. Methods A retrospective descriptive study, with analysis of clinical processes of adolescents (10-18 years) seen at the Adolescent Medicine Clinic, from January 2006 to December 2013. The following variables were analyzed: sex, age, number of visits, referring service and primary diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. As to the variable age, the adolescents were divided into two […]
Keywords: Adolescent health; International Classification of Diseases; Referral and consultation