The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

McLean, Susannah; Sheikh, Aziz; Cresswell, Kathrin; Nurmatov, Ulugbek; Mukherjee, Mome; Hemmi, Akiko; Pagliari, Claudia

doi:10.1371/journal.pone.0071238

Cited by 220 publications

(176 citation statements)

References 92 publications

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“…In the future it is highly likely that the trend will shift towards the fabrication of unit dosage forms closer to patients; at the point of dispensing, or even at the point of use. This is in line with current trends which encourage the provision of efficient outpatients' services which can be controlled digitally and remotely (McLean et al, 2013). The demand for versatile and adjustable manufacturing technologies that are capable of overcoming the rigidity and the high cost of traditional manufacturing methods of individualised oral tablets for a limited number of patients is also rising (Yang et al, 2016;Yu et al, 2015).…”

supporting

confidence: 59%

Adaptation of pharmaceutical excipients to FDM 3D printing for the fabrication of patient-tailored immediate release tablets

Sadia

Sośnicka

Arafat

et al. 2016

International Journal of Pharmaceutics

268

147

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Abstract*Corresponding author: MAlbedAlhnan@uclan.ac.uk This work aims to employ fused deposition modelling 3D printing to fabricate immediate release pharmaceutical tablets with various model drugs. It investigates the addition of nonmelting filler to methacrylic matrix to facilitate FDM 3D printing and explore the impact of i) the nature of filler, ii) compatibility with the gears of the 3D printer and, and iii) polymer: filler ratio on the 3D printing process. A specially developed filament based on pharmaceutically approved methacrylic polymer (Eudragit E) and thermally stable filler, TCP (tribasic calcium phosphate) was optimised. Four model drugs (with different physicochemical properties were included into ready-to-use mechanically stable tablets with immediate release properties. Amongst the investigated fillers in this work, directly compressible lactose, spray-dried lactose and microcrystalline cellulose showed a level of degradation at 135 o C whilst talc and TCP allowed consistent flow of the filament and a successful 3D printing of the tablet. Following the two thermal processes (hot melt extrusion (HME) and fused deposition modelling (FDM) 3D printing), drug contents were 94.22%, 88.53%, 96.51% and 93.04% for 5-ASA, captopril, theophylline and prednisolone respectively. XRPD indicated that a fraction of 5-ASA, theophylline and prednisolone remained in the crystalline form whilst captopril was in amorphous form. By combining the advantages of thermally stable pharmaceutically approved polymers and fillers, this unique approach provides a low cost production method for on demand manufacturing of individualised dosage forms.

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supporting

confidence: 59%

Adaptation of pharmaceutical excipients to FDM 3D printing for the fabrication of patient-tailored immediate release tablets

Sadia

Sośnicka

Arafat

et al. 2016

International Journal of Pharmaceutics

268

147

View full text Add to dashboard Cite

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“…report : "it was not clear whether adverse events did not occur or whether there was a lack of reporting". They did not come across any studies that explicitly examined impacts of telehealthcare on patient safety [35]. Our findings confirm that we still hardly know if there are adverse effects or that the issue of adverse effects is simply not addressed.…”

Section: Comparison With Other Literaturementioning

confidence: 53%

eHealth Apps Replacing or Complementing Health Care Contacts: Scoping Review on Adverse Effects (Preprint)

Stevens¹,

Sande²,

Beijer³

et al. 2018

Preprint

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Background:The use of eHealth has increased tremendously in recent years. eHealth is generally considered to have a positive effect on healthcare quality and to be a promising alternative for face-to-face healthcare contacts. Surprisingly little is known about possible adverse effects of eHealth applications. Objective:We conducted a scoping review on empirical research into adverse effects of eHealth applications that aim to deliver healthcare on a distance. We investigated if adverse effects were reported and the nature and quality of research into these possible adverse effects. Methods:For this scoping review, we followed the five steps of Arksey and O'Malley's scoping review methodology. We examined the literature between December 2012 and August 2017 in the following databases: PubMed, CINAHL, Web of Science and the Cochrane Library. Each paper was independently screened by at least two authors; differences were resolved through consensus development. Study characteristics were extracted. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) lists. Results related to the research question were described and categorized. Results:Our search identified 79 papers that were potentially relevant; 11 studies met our inclusion criteria after screening. These studies differed in many ways and the majority was characterized by small research populations and low study quality. Despite the shortage of solid research, we found some indications of possible adverse effects Conclusions:There is a lack of high-quality empirical research on adverse effects of eHealth applications replacing or complementing face-to-face care. While the development of eHealth applications is ongoing, the knowledge with regard to possible adverse effects is limited. The available research focuses often on efficacy, added value, implementation issues, use and satisfaction, whereas adverse effects are underexposed. A better understanding of possible adverse effects might be a starting point to improve the positive impact of eHealth-based health care delivery.

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“…This is particularly challenging within a community context as GPs may work in isolated settings, with varied access to educational opportunities and peer review of practice. New or innovative approaches employing eHealth strategies pose a potential solution to these issues, but most studies of telemedicine are methodologically weak and often focus on feasibility and acceptability to patients rather than discrete clinical outcomes such as mortality or hospitalizations 12. There may also be unintended consequences.…”

Section: Discussionmentioning

confidence: 99%

Heart Failure Virtual Consultation: bridging the gap of heart failure care in the community ‐ A mixed‐methods evaluation

et al. 2017

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AimsWe undertook a mixed‐methods evaluation of a Web‐based conferencing service (virtual consult) between general practitioners (GPs) and cardiologists in managing patients with heart failure in the community to determine its effect on use of specialist heart failure services and acceptability to GPs.Methods and resultsAll cases from June 2015 to October 2016 were recorded using a standardized recording template, which recorded patient demographics, medical history, medications, and outcome of the virtual consult for each case. Quantitative surveys and qualitative interviewing of 17 participating GPs were also undertaken. During this time, 142 cases were discussed—68 relating to a new diagnosis of heart failure, 53 relating to emerging deterioration in a known heart failure patient, and 21 relating to therapeutic issues. Only 17% required review in outpatient department following the virtual consultation. GPs reported increased confidence in heart failure management, a broadening of their knowledge base, and a perception of overall better patient outcomes.ConclusionsThese data from an initial experience with Heart Failure Virtual Consultation present a very positive impact of this strategy on the provision of heart failure care in the community and acceptability to users. Further research on the implementation and expansion of this strategy is warranted.

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The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

Cited by 220 publications

References 92 publications

Adaptation of pharmaceutical excipients to FDM 3D printing for the fabrication of patient-tailored immediate release tablets

Adaptation of pharmaceutical excipients to FDM 3D printing for the fabrication of patient-tailored immediate release tablets

eHealth Apps Replacing or Complementing Health Care Contacts: Scoping Review on Adverse Effects (Preprint)

Heart Failure Virtual Consultation: bridging the gap of heart failure care in the community ‐ A mixed‐methods evaluation

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