Implementation of telemedicine in times of SARS-CoV-2 in gynecology and obstetrics: Results of a nationwide cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Stefan Hertling ◽  
Franziska Loos ◽  
Isabel Graul

BACKGROUND In the COVID-19 pandemic, many consultations had to be cancelled, postponed or converted to a virtual format. Telemedicine in gynaecology (telegynaecology) could support gynaecologists and obstetricians. OBJECTIVE This study analyses the use and perception of telemedicine applications among gynaecologists in Germany. METHODS This prospective cross-sectional study was based on a survey of gynaecologists in Germany during the COVID-19 pandemic. Descriptive statistics were calculated and regression analyses were performed to show correlations. RESULTS The physicians expect telemedicine to be used in gynecology and obstetrics. 76. 4% (365/478) of the respondents rated their knowledge of telemedicine as insufficient. The majority of respondents (437/478, 91. 6%) said they did not currently use telemedicine, although 67. 3% (321/478) would like to do so. Obstacles to the introduction of telemedicine include the purchase of technical equipment (325/478, 68. 1%), administration (305/478, 64. 0%) and poor reimbursement (233/478, 48. 9%). Doctors surveyed would prefer telemedicine to communicate directly with other doctors (388/478, 81. 2%) rather than to communicate with patients (228/478, 47. 8%). In the treatment phases, 73. 2% (349/478) of the respondents would use telemedicine during follow-up. Half of the respondents would choose tele-culting as a specific approach to improving care (246/478, 51. 5%). CONCLUSIONS Telemedicine in gynecology finds little use but high acceptance among doctors. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in telegynecology is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.

2021 ◽  
Author(s):  
Stefan Hertling

BACKGROUND Background: The global incidence of treating people in the field of sports medicine is increasing. The COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed or converted to a virtual format. Telemedicine in sports medicine could support physicians. OBJECTIVE The study analyses the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany. METHODS This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. Regression analyses were performed to show correlations. RESULTS We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Physicians as well as patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine, although would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine is considered to be helpful for follow-up monitoring and prevention by both groups. CONCLUSIONS Telemedicine in Sports medicine finds limited use but high acceptance among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in tele-sportsmed is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.


2021 ◽  
Author(s):  
Stefan Hertling ◽  
Doreen Hertling

BACKGROUND The global incidence in the treatment of transident people is increasing. In the COVID-19 pandemic, many consultations had to be cancelled, postponed or converted to a virtual format. Telemedicine in Transgender Health Care management could support physicians. OBJECTIVE This study analyses the Acceptance, Use and Barriers of Telemedicine in times of SARS-CoV-2 in Transgender Health Care in Germany. METHODS This prospective cross-sectional study was based on a survey of gynecological endocrinologists and transident patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated and regression analyses were performed to show correlations. RESULTS We analyzed the responses of 269 transident patients and 202 gynaecological endocrinologists treating transident patients. Most believed that telemedicine was useful. Physicians as well as patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine, although would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. In the treatment phases, 74.4% (150/202) of the respondents would use telemedicine during follow-up. Half of the respondents would choose telecounseling as a specific approach to improving care (128/202, 63.2%). Obstacles to the introduction of telemedicine include the purchase of technical equipment (132/202, 65.3%), administration (124/202, 61.2%) and poor reimbursement (106/202, 52.4%). CONCLUSIONS Telemedicine in Transgender Health Care finds limited use but high acceptance among doctors and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in teleendogynaecology is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.


2020 ◽  
Author(s):  
Felix Muehlensiepen ◽  
Johannes Knitza ◽  
Wenke Marquardt ◽  
Jennifer Engler ◽  
Axel Hueber ◽  
...  

BACKGROUND The worldwide burden of musculoskeletal diseases is increasing. The number of newly registered rheumatologists has stagnated. Primary care, which takes up a key role in early detection of rheumatic disease is working at full capacity. COVID-19 and its containment impede rheumatological treatment. Telemedicine in rheumatology (telerheumatology) could support rheumatologists and general practitioners. OBJECTIVE To investigate acceptance and preferences related to the use of telerheumatology care among German rheumatologists and general practitioners. METHODS A nationwide cross-sectional, self-completed, paper-based survey on telemedicine in rheumatology care was conducted among outpatient rheumatologists and general practitioners (pre-COVID-19). RESULTS A total of 73% (349/476) of survey participants rated their knowledge of telemedicine as unsatisfactory, poor, or very poor. The majority of survey participants (358/480, 75%) answered that they do not currently use telemedicine, although 62% would like to (291/467). Barriers to the implementation of telemedicine include the purchase of technology equipment (182/292, 62%), administration (181/292, 62%) and poor reimbursement (156/292, 53%). Seventy percent (117/168) of the surveyed physicians reckoned telemedicine could be used in rheumatology. Surveyed physicians would prefer to use telemedicine to communicate directly with other physicians (370/455, 81%), than to communicate with patients (213/455, 47%). Among treatment phases, 64% of participants would choose to use telemedicine during ‘follow-up’ (291/452). Half of the participants would choose 'telecounseling' as a specific approach to improve rheumatology care (91/170, 54%). CONCLUSIONS Before COVID-19 appeared, our results indicated generally low use but high acceptance of the implementation of telerheumatology among physicians. Participants indicated that the lack of a structural framework was a barrier to the effective implementation of telerheumatology. Training courses should be introduced to address the limited knowledge of physicians in the use of telemedicine. More research into telerheumatology is required. This includes large scale RCTs, economic analyses and the exploration of the user preferences. CLINICALTRIAL


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2393-PUB
Author(s):  
KENICHIRO TAKAHASHI ◽  
MINORI SHINODA ◽  
RIKA SAKAMOTO ◽  
JUN SUZUKI ◽  
TADASHI YAMAKAWA ◽  
...  

2021 ◽  
Vol 10 (6) ◽  
pp. 1211
Author(s):  
Li-Te Lin ◽  
Kuan-Hao Tsui

The relationship between serum dehydroepiandrosterone sulphate (DHEA-S) and anti-Mullerian hormone (AMH) levels has not been fully established. Therefore, we performed a large-scale cross-sectional study to investigate the association between serum DHEA-S and AMH levels. The study included a total of 2155 infertile women aged 20 to 46 years who were divided into four quartile groups (Q1 to Q4) based on serum DHEA-S levels. We found that there was a weak positive association between serum DHEA-S and AMH levels in infertile women (r = 0.190, p < 0.001). After adjusting for potential confounders, serum DHEA-S levels positively correlated with serum AMH levels in infertile women (β = 0.103, p < 0.001). Infertile women in the highest DHEA-S quartile category (Q4) showed significantly higher serum AMH levels (p < 0.001) compared with women in the lowest DHEA-S quartile category (Q1). The serum AMH levels significantly increased across increasing DHEA-S quartile categories in infertile women (p = 0.014) using generalized linear models after adjustment for potential confounders. Our data show that serum DHEA-S levels are positively associated with serum AMH levels.


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Desalew Tilahun ◽  
Abebe Abera ◽  
Gugsa Nemera

Abstract Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.


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