Individuals with IBD who report higher perceived stress, lower perceived social support, greater number of relapses, or are female may be at increased risk for decreased HRQOL. Prospective studies should investigate how interventions addressing these factors may lead to improved HRQOL.
Objective: The objective of this investigation was to assess whether a new electronic health (e-health) platform, combining mobile computing and a content management system, could effectively deliver modular and ''just-in-time'' education to older patients following cardiac surgery. Subjects and Methods: Patients were provided with iPad Ò (Apple Ò , Cupertino, CA) tablets that delivered educational modules as part of a daily ''to do'' list in a plan of care. The tablet communicated wirelessly to a dashboard where data were aggregated and displayed for providers. Results: A surgical population of 149 patients with a mean age of 68 years utilized 5,267 of 6,295 (84%) of education modules delivered over a 5.3-day hospitalization. Increased age was not associated with decreased use. Conclusions: We demonstrate that age, hospitalization, and major surgery are not significant barriers to effective patient education if content is highly consumable and relevant to patients' daily care experience. We also show that mobile technology, even if unfamiliar to many older patients, makes this possible. The combination of mobile computing with a content management system allows for dynamic, modular, personalized, and ''just-in-time'' education in a highly consumable format. This approach presents a means by which patients may become informed participants in new healthcare models.
Greater IBD knowledge appears to be associated with the use of more adaptive coping strategies in patients with IBD, suggesting that providing disease-related patient education may enhance coping in this population. Future studies should explore the utility of formal disease-related patient education in improving these and other outcomes.
BACKGROUND: Radiation exposure from medical imaging can cause appreciable long-terms risks for patients. Approximately 2% of all future cancers may be attributable to CT imaging. Patients with certain conditions, including inflammatory bowel disease (IBD), are likely to receive more CT imaging than others. Abdominal CT scans expose patients to a radiation dose of 10 millisieverts. Although guidelines have not been established, the recommended maximum annual radiation dose for the general public is 1 millisievert. This study examined abdominal CT ordering by medical specialties caring for IBD patients who received excess radiation exposure, defined as ≥3 CT scans over a 3.5 year period. METHODS: A retrospective medical record review of inflammatory bowel disease patients managed at an urban university during a 3.5 year period was performed using a multispecialty electronic health record. All patients age ≥18 were included. There were no exclusion factors. Patient age, gender, disease type, number of abdominal CTs scans, and the specialty of the ordering physician for each scan were obtained. A database, maintaining patient confidentiality, was created. Statistical analysis was performed using repeated-measures ANOVA with significance set at P < 0.05. The study was approved by the university institutional review board. RESULTS: Three hundred sixteen medical records (189 women, 127 men, with a mean age of 41.8 years) were reviewed. One hundred seventy-one patients had Crohn's disease, 143 with ulcerative colitis, and 2 with indeterminate colitis. Twenty-two (7.6%) of these patients had ≥3 CTs during the study period. A total of 125 CTs were performed on the 22 patients, for a mean of 5.7 CTs per patient. Of the CTs, 56 (44.4%) were ordered by general internists, averaging 2.5 CTs per patient; 30 CTs (23.8%) were ordered by emergency medicine physicians, averaging 1.4 CTs per patient; 20 CTs (15.9%) were ordered by surgeons, averaging 0.9 CTs per patient; 12 CTs (9.5%) were ordered by gastroenterologists, averaging 0.5 CTs per patient, 8 CTs (6.3%) ordered by physicians of other specialties, averaging 0.4 CTs per patient. There was a significant difference in the rate at which physicians of different specialties ordered abdominal CT scans on inflammatory bowel disease patients (P ¼ 0.002). Nineteen of 22 patients (86.7%) had CTs ordered by multiple departments. Patients receiving ≥3 CTs had a CT ordered from an average of 2.6 physicians of different specialties (SD 1.2). CONCLUSIONS: Patient with IBD are likely to receive imaging studies, such as abdominal CTs, during the course of their illness. There has been speculation that some inflammatory bowel disease patients receive excess radiation exposure from frequent CT scans. This study revealed that approximately 7% of IBD patients received ≥3 abdominal CT scans, with an average of 5.7 CTs, within 3.5 years.Internists and emergency medicine physicians ordered the largest proportion of abdominal CT scans. Gastroenterologists ordered <10% of these studies, suggesting t...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.