Evaluation of Remote Pharmacist-Led Outpatient Service for Geriatric Patients on Rivaroxaban for Nonvalvular Atrial Fibrillation During the COVID-19 Pandemic

Li, Xiaoye; Zuo, Chengchun; Lü, Wenjing; Zou, Ye; Xu, Qi; Li, Xiaoyü; Lv, Qianzhou

doi:10.3389/fphar.2020.01275

Cited by 16 publications

(15 citation statements)

References 36 publications

(37 reference statements)

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“…Additionally, reducing clinical visits when not necessary is critical during periods with highly infectious diseases (eg, COVID-19 or the annual flu season). Under the special situation of the COVID-19 pandemic, minimizing unnecessary in-person visits and conducting remote discussions are particularly valuable [48][49][50]. Based on the results of this study, these features may further encourage the use of EHR systems and help patients remain connected to their health care providers.…”

Section: Principal Findingsmentioning

confidence: 86%

Examining How Internet Users Trust and Access Electronic Health Record Patient Portals: Survey Study

2021

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Background Electronic health record (EHR) patient portals are designed to provide medical health records to patients. Using an EHR portal is expected to contribute to positive health outcomes and facilitate patient-provider communication. Objective Our objective was to examine how portal users report using their portals and the factors associated with obtaining health information from the internet. We also examined the desired portal features, factors impacting users’ trust in portals, and barriers to using portals. Methods An internet-based survey study was conducted using Amazon Mechanical Turk. All the participants were adults in the United States who used patient portals. The survey included questions about how the participants used their portals, what factors acted as barriers to using their portals, and how they used and how much they trusted other web-based health information sources as well as their portals. A logistic regression model was used to examine the factors influencing the participants’ trust in their portals. Additionally, the desired features and design characteristics were identified to support the design of future portals. Results A total of 394 participants completed the survey. Most of the participants were less than 35 years old (212/394, 53.8%), with 36.3% (143/394) aged between 35 and 55 years, and 9.9% (39/394) aged above 55 years. Women accounted for 48.5% (191/394) of the survey participants. More than 78% (307/394) of the participants reported using portals at least monthly. The most common portal features used were viewing lab results, making appointments, and paying bills. Participants reported some barriers to portal use including data security and limited access to the internet. The results of a logistic regression model used to predict the trust in their portals suggest that those comfortable using their portals (odds ratio [OR] 7.97, 95% CI 1.11-57.32) thought that their portals were easy to use (OR 7.4, 95% CI 1.12-48.84), and frequent internet users (OR 43.72, 95% CI 1.83-1046.43) were more likely to trust their portals. Participants reporting that the portals were important in managing their health (OR 28.13, 95% CI 5.31-148.85) and that their portals were a valuable part of their health care (OR 6.75, 95% CI 1.51-30.11) were also more likely to trust their portals. Conclusions There are several factors that impact the trust of EHR patient portal users in their portals. Designing easily usable portals and considering these factors may be the most effective approach to improving trust in patient portals. The desired features and usability of portals are critical factors that contribute to users’ trust in EHR portals.

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Section: Principal Findingsmentioning

confidence: 86%

Examining How Internet Users Trust and Access Electronic Health Record Patient Portals: Survey Study

2021

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“…In the third and final subcategory we find surveys targeting both patients and practitioners in a variety of specializations. From remote management of geriatric patients with heart conditions [232] and the effects of NPIs on transplant recipients/donors [233] to the changes adopted by several hospitals in academic centers [235] , hearing and emergency care [231] , [234] . Overall the observations on patients point to the interim efficacy of telemedicine and to high level of awareness about the risk of infection.…”

Section: Surveysmentioning

confidence: 99%

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

2021

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Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travels bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 348 articles written by more than 2518 of authors in the first 12 months of the emergency. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities.

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“…193 Remote anticoagulation management/monitoring for elderly patients with NVAF receiving NOACs during the COVID-19 pandemic was associated with a reduction in bleeding complications and delays in the first outpatient revisit after discharge. 194 COVID-19 is associated with a prothrombotic state, perhaps due to cytokines and immunothrombosis. 195 For patients already treated with NOACs or VKA and infected with COVID-19 and particularly in the case of severe infection requiring hospitalization, patients should ideally continue their anticoagulation rather than discontinue, although outcome data are conflicting.…”

Section: Oac Use In Af Patients During the Covid-19 Pandemicmentioning

confidence: 99%

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

et al. 2021

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The consensus of the Asia Pacific Heart Rhythm Society (APHRS) on stroke prevention in atrial fibrillation (AF) has been published in 2017 which provided useful clinical guidance for cardiologists, neurologists, geriatricians, and general practitioners in the Asia-Pacific region. In these years, many important new data regarding stroke prevention in AF were reported. The practice guidelines subcommittee members comprehensively reviewed updated information on stroke prevention in AF, and summarized them in this 2021 focused update of the 2017 consensus guidelines of the APHRS on stroke prevention in AF. We highlighted and focused on several issues, including the importance of the AF Better Care pathway, the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) for Asians, the considerations of use of NOACs for Asian AF patients with single one stroke risk factor beyond gender, the role of lifestyle factors on stroke risk, the use of oral anticoagulants during the “coronavirus disease 2019” pandemic, etc. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician's decision remains the most important factor in the management of AF.

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Evaluation of Remote Pharmacist-Led Outpatient Service for Geriatric Patients on Rivaroxaban for Nonvalvular Atrial Fibrillation During the COVID-19 Pandemic

Cited by 16 publications

References 36 publications

Examining How Internet Users Trust and Access Electronic Health Record Patient Portals: Survey Study

Examining How Internet Users Trust and Access Electronic Health Record Patient Portals: Survey Study

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

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