Background COVID-19 presented great challenges for not only those in the field of health care but also those undergoing medical training. The burden on health care services worldwide has limited the educational opportunities available for medical students due to social distancing requirements. Objective In this paper, we describe a strategy that combines telehealth and medical training to mitigate the adverse effects of the COVID-19 pandemic. Methods A toll-free telescreening service, Telecoronavirus, began operations in March 2020. This service was operated remotely by supervised medical students and was offered across all 417 municipalities (14.8 million inhabitants) in the Brazilian state of Bahia. Students recorded clinical and sociodemographic data by using a web-based application that was simultaneously accessed by medical volunteers for supervision purposes, as well as by state health authorities who conducted epidemiological surveillance and health management efforts. In parallel, students received up-to-date scientific information about COVID-19 via short educational videos prepared by professors. A continuously updated triage algorithm was conceived to provide consistent service. Results The program operated for approximately 4 months, engaging 1396 medical students and 133 physicians. In total, 111,965 individuals residing in 343 municipalities used this service. Almost 70,000 individuals were advised to stay at home, and they received guidance to avoid disease transmission, potentially contributing to localized reductions in the spread of COVID-19. Additionally, the program promoted citizenship education for medical students, who were engaged in a real-life opportunity to fight the pandemic within their own communities. The objectives of the education, organization, and assistance domains of the Telecoronavirus program were successfully achieved according to the results of a web-based post-project survey that assessed physicians’ and students’ perceptions. Conclusions In a prolonged pandemic scenario, a combination of remote tools and medical supervision via telehealth services may constitute a useful strategy for maintaining social distancing measures while preserving some practical aspects of medical education. A low-cost tool such as the Telecoronavirus program could be especially valuable in resource-limited health care scenarios, in addition to offering support for epidemiological surveillance actions.
Aim: To report the development of an educational booklet for adult patients with asthma. Methods: Experience report on the development of an educational booklet, from March to July 2019, considering four main steps: i) survey of topics necessary for an adequate management of asthma, ii) literature review, iii) elaboration of the educational booklet in dialogue format and iv) review and printing of the material. Results: The educational booklet entitled “Tenho asma, e agora? (I have asthma, what now?)” contains 32 pages and 11 topics that address the concept of the disease, triggering factors, use of medications and inhaler devices, symptoms and action plan in case of an exacerbation. The development of this educational technology required the team to review the literature based on scientific evidence, interdisciplinary articulation, creativity and active listening until reaching the final product. Conclusion: The construction of educational booklets should value clinical practice, users' doubts and identifiable language among users. Educational booklets contribute to better health outcomes.
Aim: systematic review of the literature on the cost-effectiveness of telemedicine in the follow-up of asthmatics. Method: Systematic review of the PUBMED / MEDLINE, LILACS and Cochrane Central databases. Articles published in English, Portuguese or Spanish were considered in the period from 2005 to 2018 according to the PRISMA guidelines. Results: A total of 1363 articles were identified, of which 59 were read in their entirety. Only five met the eligibility criteria, and all were made in European countries and totaled 2,497 participants. The interventions were performed by nurses (4 of 5 studies), remaining from 16 weeks to 12 months. Telemedicine costs were similar or slightly lower compared to usual treatments. Telemedicine had a beneficial effect on asthma control (1 of 5 studies), quality of life (3 out of 5 studies) and hospitalizations (1 of 5 studies). Conclusion: Telemedicine slightly reduces costs with asthma management and may have an impact on morbidity indicators
UNSTRUCTURED Introduction Throughout 2020, COVID-19 has been imposing great challenges for both health care practices and medical training. Here the authors described a strategy combining telehealth and medical training to mitigate the impacts of COVID-19. Approach The authors coordinated a toll-free telescreening service (Telecoronavirus) operated remotely by supervised medical students aimed at advising potential COVID-19 patients to stay at home or to seek further medical assistance, depending on the results from a constantly updated triage algorithm. The service, offered for all 417 municipalities of Bahia, Brazil (14.8 million inhabitants), intended to decrease virus spread by reducing unnecessary circulation of patients with mild symptoms. Students recorded clinical and social demographic data in a web application simultaneously accessed by medical volunteers for supervision purposes, as well as state health authorities for epidemiological surveillance and health management efforts. In parallel, students received up-to-date scientific information about COVID-19 by short educational videos prepared by faculty members. Outcomes The program operated for about 4 months, engaging 1,396 medical students and 133 physicians. In total, 111,965 individuals residing in 343 municipalities contacted the service. Almost 70,000 were advised to stay at home and received guidance to avoid disease transmission, possibly contributing to reducing local virus spread. Additionally, this project promoted citizenship education for medical students, who were engaged in a real-life experience to fight the pandemic in their community. The education, organization and assistance domains of the Telecoronavirus program were successfully realized according to physicians' and student’s opinions registered in a survey. Conclusion In a scenario of prolonged pandemic, a combination of remote tools with medical supervision and telehealth service may be a useful strategy for keeping social distancing while preserving some practical aspects of medical education. This low-cost tool can be especially valuable under limited health care resources, and to support epidemiological surveillance actions.
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