Telemedicine in primary healthcare for the quality of care in times of COVID-19: a<i>scoping review</i>protocol

Silva, Cícera Renata Diniz Vieira; Lopes, Rayssa Horácio; Júnior, Osvaldo de Góes Bay; Fuentealba-Torres, Miguel; Arcêncio, Ricardo Alexandre; Uchôa, Severina Alice da Costa

doi:10.1136/bmjopen-2020-046227

Cited by 8 publications

(9 citation statements)

References 28 publications

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“…This scoping review is the first to broadly map evidence regarding the use of remote strategies in PHC and its impacts on quality of care in the context of COVID-19. The study met the criteria for scoping reviews [ 24 , 109 ], and followed methodological references, checklists, and published protocols [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The study was approved by the research ethics committee of the Faculty of Health Sciences of Trairí, Federal University of Rio Grande do Norte (CAAE: 47473121.3.0000.5568), and direct participation of participants involved in the study occurred only during consultation with stakeholders. The methodology used was previously reported in a protocol [ 23 ]. The term “telemedicine” used in the protocol [ 23 ] was replaced by “digital health” in this scoping review since it was considered to be more appropriate to reflect the broad scope of the study.…”

Section: Methodsmentioning

confidence: 99%

“…The methodology used was previously reported in a protocol [ 23 ]. The term “telemedicine” used in the protocol [ 23 ] was replaced by “digital health” in this scoping review since it was considered to be more appropriate to reflect the broad scope of the study.…”

Section: Methodsmentioning

confidence: 99%

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Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review

Silva¹,

Lopes²,

Júnior³

et al. 2022

JMIR Hum Factors

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Background The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. Objective The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. Methods We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. Results A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. Conclusions The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review

Silva¹,

Lopes²,

Júnior³

et al. 2022

JMIR Hum Factors

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“…In the UK, the urgent need for infection control drove NHS services to rapidly redesign care delivery 1 . In primary care this involved introducing digital triage and expanding remote consultations 2,3 . In secondary care, outpatient clinics transitioned from face-to-face consultations to digital modalities, and appointments were guided by remote monitoring and patient-initiated follow-up.…”

Section: Introductionmentioning

confidence: 99%

Vaccine hesitancy and access to psoriasis care in the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey

Bechman

Cook

Dand

et al. 2022

Preprint

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Background: COVID-19 vaccination is efficacious at protecting against severe COVID-19 outcomes in the general population. However, vaccine hesitancy (unwillingness for vaccination despite available vaccination services) threatens public health. Individuals taking immunosuppression for psoriasis have been prioritised for COVID-19 vaccination, however there is a paucity of information on vaccine hesitancy in this population, including contributing factors. While global healthcare has been severely disrupted in the pandemic, the impact on access to psoriasis care and whether this may negatively influence vaccine uptake, is underexplored. Objectives: To explore organisational and individual factors associated with COVID-19 vaccine hesitancy in individuals with psoriasis. Methods: Individuals with psoriasis, identified through global patient organisations and social media, completed a cross-sectional self-reported online survey. The primary outcome was COVID-19 vaccine hesitancy. Logistic regression was used to examine the association between predictor variables (organisational and individual factors) and outcome. Results: Self-reported data from 802 individuals with psoriasis across 89 countries were available (65.6% female, median age 51 years [IQR 37-61], 43.7% taking systemic immunosuppression). Eight percent (n=63) reported vaccine hesitancy. Those reporting vaccine hesitancy were younger, more likely to be of non-white ethnicity, non-UK resident, have a lower BMI, not taking systemic immunosuppression and with shorter disease duration compared to those not reporting vaccine hesitancy. The commonest reasons for vaccine hesitancy were concerns regarding vaccine side-effects, that the vaccine is too new or that psoriasis may worsen post-vaccination. Forty percent (n=322) reported that their psoriasis care had been disrupted by the pandemic. These individuals were younger, of non-white ethnicity, with shorter duration and more severe psoriasis. Disruption to psoriasis care was associated with vaccine hesitancy (unadjusted OR 2.97 (95%CI 1.23-7.13), p=0.015), although not statistically significant in the adjusted model. Conclusion: A minority of individuals with psoriasis from our study reported COVID-19 vaccine hesitancy. Similar to general population trends, vaccine hesitancy in our psoriasis sample is most common in younger age and ethnic minority groups. Our data highlight patient concerns regarding COVID-19 vaccination, which are important to address during patient-clinician interactions to help optimise vaccine uptake and mitigate risks from the ongoing pandemic in individuals with psoriasis.

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“…HBPC was used to reduce attendance at emergency services and the iatrogenic effects of going to health services, to increase testing, and ensure that chronic medical problems were treated, within the home environment, to prevent their worsening [10,11]. Faced with the challenges in PHC from COVID-19, the use of Information and Communication Technologies (ICT) such as the internet, cell phones, computers, software, social networks and other media applications and services which allow to access, retrieve, store, transmit and manipulate information in digital format, and which were already being implemented, became even more prominent [12,13,14]. The use of ICT configures digital health, a series of services and systems, which include medical and health informatics, telehealth, care monitoring, as well as so-called e-learning and mobile health [15].…”

Section: Introductionmentioning

confidence: 99%

Digital Health Interventions and Quality of Home-based Primary Care for Older Adults: A Scoping Review Protocol

Silva

Lopes

et al. 2022

Preprint

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IntroductionDigital health strategies have expanded in home care, particularly in home-based primary care (HBPC) following the increase in the older adult population and the need to respond to the higher demand of chronic conditions and health frailties of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this group considered at risk. The objective of this study is to map digital health strategies and analyze their impacts on the quality of home-based primary care for older adults around the world.Methods and analysisThis is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed in the theoretical perspective of Arksey and O’malley, with updates by Levac et al. and Peters et al., based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, PubMed, Scopus, Web of Science, CINAHL and Embase; while Google Scholar will be used for gray literature. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of study findings, identification of gaps, effective dissemination strategies and suggestions for future studies.Ethics and disclosureStakeholder consultation was approved by the Research Ethics Committee of Hospital Onofre Lopes, Federal University of Rio Grande do Norte, CAEE 54853921.0.0000.5292, and will not involve direct patient participation. It is registered in the Open Science Framework (OSF) (https://osf.io/vgkhy/). The results will be disseminated through publication in open access scientific journals, in scientific events and academic and community journals.Scoping review registration OSF:https://osf.io/vgkhy/. DOI 10.17605/OSF.IO/VGKHY.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Strengths and limitations of this studyThis scoping review will be the first to explore the types, uses and impacts of digital health strategies on home-based primary care (HBPC) for older adults around the world.The geographic mapping of the studies will provide a global overview of the use of digital health strategies in providing home care.The search strategy for studies will be broad, including the main multidisciplinary health databases and gray literature.The expansion of the use of digital health strategies during COVID-19 may be a limiting factor to the scientific quality of studies.A large number of publications in the gray literature may imply an important limitation of the study but also meaning that digital home care still lacks maturity.

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Telemedicine in primary healthcare for the quality of care in times of COVID-19: ascoping reviewprotocol

Cited by 8 publications

References 28 publications

Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review

Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review

Vaccine hesitancy and access to psoriasis care in the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey

Digital Health Interventions and Quality of Home-based Primary Care for Older Adults: A Scoping Review Protocol

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