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Vinadé Chagas ME, Cristina Jacovas V, de Campos Moreira T, Rodrigues Moleda Constant HM, Fernanda Rohden S, Stiehl Alves S, Santini F, Dall'Agnol S, König Klever E, Cezar Cabral F, da Silva Terres M. Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis. Telemed J E Health 2024. [PMID: 38436274 DOI: 10.1089/tmj.2023.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.
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Affiliation(s)
- Maria Eulália Vinadé Chagas
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Suelen Stiehl Alves
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Santini
- Universidade do Vale do Rio dos Sinos (Unisinos), Business School, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sara Dall'Agnol
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Emanuele König Klever
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mellina da Silva Terres
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Iguacel I, Antón I, Urcola F, Ariño M, Martínez-Jarreta B. Assessing patient satisfaction with telephone-based consultations before, during and after the COVID-19 pandemic in Spain. Aten Primaria 2024; 56:102792. [PMID: 37924620 PMCID: PMC10654540 DOI: 10.1016/j.aprim.2023.102792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVE To validate a questionnaire to analyze the perception of users of primary care (PC) with telephone consultation (TC), and to study the satisfaction with TC by users of PC services. DESIGN A two-phase study was conducted. Firstly, a questionnaire on satisfaction with telemedicine services was validated. Secondly, a cross-sectional study on satisfaction with TC was conducted. SETTING PC. PARTICIPANTS 405 users of PC services in Zaragoza (Spain). MAIN OUTCOME MEASURE Our main outcome was the satisfaction with telemedicine services PC services. Factor analysis was carried out using the exploratory factor analysis with Varimax rotation. The reliability of the dimensions obtained was analyzed using Cronbach's alpha. The inferential analysis was conducted using parametric tests. RESULTS The questionnaire was a valid and reliable tool (α>0.9) to assess the satisfaction of PC service users with telemedicine services. Before COVID-19, the satisfaction of the users with PC was adequate (mean=6111/10). However, during the COVID-19 the attention in PC centers became mostly telephone-based and satisfaction lowered as disappointing (mean=3555/10). Regarding the future of telemedicine, users considered it as unsatisfactory (mean=2977/10). Being a woman, being unemployed and belonging to an area of low vulnerability led to a worse perception of telemedicine. CONCLUSION This questionnaire was a valid and reliable tool to assess the satisfaction of PC service users with telemedicine services. Perceptions of patient satisfaction decreased during COVID-19. Thus, TC seems to be a good option when the patients consider it to be a complementary rather than a substitute tool to follow-up their conditions.
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Affiliation(s)
- Isabel Iguacel
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Isabel Antón
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; SAPIENF (B53_23R), Zaragoza, Spain
| | - Fernando Urcola
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; SAPIENF (B53_23R), Zaragoza, Spain.
| | - Miguel Ariño
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; SAPIENF (B53_23R), Zaragoza, Spain
| | - Begoña Martínez-Jarreta
- Scientific Research Group GIIS-063 of Aragon Institute of Health, Department of Occupational Medicine, University of Zaragoza, Zaragoza, Spain
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Saag JL, Danila MI. Remote Management of Osteoporosis. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2022; 8:143-151. [PMID: 36068838 PMCID: PMC9438367 DOI: 10.1007/s40674-022-00195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review Osteoporosis management has evolved significantly over the past decade, with telehealth emerging as an effective tool to manage bone health in a growing patient population. This review explores the advantages and disadvantages of telehealth use for osteoporosis management while highlighting recent studies of clinical importance. Recent Findings A wide variety of telehealth approaches are used today, from phone or video telemedicine appointments with physicians and advanced practice providers, to electronic systems for triage and consultation with osteoporosis specialists. Contemporary studies show that telehealth can facilitate health care access to underserved communities and enhance physician–patient communication, as well as provide patient education. However, barriers such as inexperience or lack of access to technology, suboptimal patient-clinician relationship building process, and difficulties with follow-up have limited the use of telehealth to certain situations. Summary Telehealth has proven to be an effective resource for managing and treating osteoporosis patients. As its use continues to grow, important limitations must be accounted for to avoid lapses in care. Further research should keep these factors in mind as the use of this technology progresses.
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Affiliation(s)
- Jordan L. Saag
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd., Orlando, FL 32827 USA
| | - Maria I. Danila
- Geriatric Research Education and Clinical Center (GRECC) Birmingham VA Medical Center, 700 19th St. S., Birmingham, AL 35233 USA
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Rodríguez-Vargas GS, Nieto-Zambrano PD, Rubio-Rubio JA, Santos-Moreno P, Rojas-Villarraga A. Artritis reumatoide y telemedicina en tiempos de COVID-19. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La artritis reumatoide es una afección autoinmune, crónica y multisistémica que requiere manejo multidisciplinar, siendo la supervisión continua fundamental para controlar su progresión. Tanto la artritis como el tratamiento generan un estado inmunosupresor que predispone a sufrir infecciones. Por la actual emergencia sanitaria ocasionada por el Sars-Cov2, los pacientes con estas enfermedades crónicas e inmunológicas son más susceptibles de contagio, por ello se ha requerido el uso de nuevas tecnologías como la telemedicina, que en los años previos a la pandemia venía incrementándose su uso, para permitir el control de patologías crónicas. El objetivo del presente estudio es revisar qué implicaciones ha tenido el uso de la telemedicina en el manejo de la artritis reumatoide durante la actual pandemia COVID-19 y cuál ha sido la importancia de la implementación de estas tecnologías en la enfermedad.
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Pego-Reigosa JM, Peña-Gil C, Rodríguez-Lorenzo D, Altabás-González I, Pérez-Gómez N, Guzmán-Castro JH, Varela-Gestoso R, Díaz-Lambarri R, González-Carreró-López A, Míguez-Senra O, Bóveda-Fontán J, Charle-Crespo Á, Caramés-Casal FJ, Barbazán-Álvarez C, Hernández-Rodríguez Í, Maceiras-Pan F, Rodríguez-López M, Melero-González R, Rodríguez-Fernández JB. Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology. BMC Health Serv Res 2022; 22:60. [PMID: 35022061 PMCID: PMC8754366 DOI: 10.1186/s12913-021-07455-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. METHODS The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation. RESULTS The program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period). CONCLUSION A careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology.
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Affiliation(s)
- José María Pego-Reigosa
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
- IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Carlos Peña-Gil
- Cardiology Department, Santiago de Compostela Health Area, Santiago de Compostela, Spain
- Service of Research, Education, and Innovation, Galician Health Service, Santiago de Compostela, Spain
| | | | - Irene Altabás-González
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
- IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Naír Pérez-Gómez
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
- IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - John Henry Guzmán-Castro
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | | | | | | | | | | | | | | | - Ceferino Barbazán-Álvarez
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Íñigo Hernández-Rodríguez
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Francisco Maceiras-Pan
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
- IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Marina Rodríguez-López
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
| | - Rafael Melero-González
- Rheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200 Vigo, Spain
- IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, Alto do Meixoeiro s/n, 36200 Vigo, Spain
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Pinte L, Caraiola S, Balaban DV, Badea C, Mazilu D, Ionescu GD, Iosub MI, Bălan ES, Negoi F, Dumitrescu B, Mateescu B, Ionescu R, Parvu MI, Baicus C. COVID-19 Impact and Vaccination Willingness among Romanian Patients with Autoimmune/Immune-Mediated Diseases. Healthcare (Basel) 2021. [DOI: doi.org/10.3390/healthcare9121707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: During the COVID-19 pandemic, patients with immune diseases are a vulnerable population. We aimed to evaluate their access to medical care, as well as their awareness and willingness to obtain the vaccine after a year of the SARS-CoV-2 pandemic. Methods: A cross-sectional, multicenter study was conducted on a questionnaire basis, handled both online as well as in person. Results: 651 patients with autoimmune or immune mediated diseases were enrolled. More than half (339/641 [53%]) reported difficulties in obtaining medical care throughout the pandemic and 135/651 ([21%]) of them were confirmed with COVID-19; 442/651, ([68%]) expressed their willingness to be vaccinated against SARS-CoV-2. The factors associated with an increased probability of vaccination were the male gender (OR = 2.01, CI95% 1.2–3.7, p = 0.001), the patient’s opinion that she/he was well informed (OR = 3.2, CI 95% 2.1–6.01, p < 0.001), physician’s advice (OR = 2.1, CI 95% 1.3–3.5, p < 0.001), and flu vaccination in the past (OR = 1.5, CI 95% 1.1–2.3, p < 0.001), while those associated with a decreased probability of vaccination were COVID-19 disease in the past medical history (OR = 0.7, CI 95% 0.3-0.95, p = 0.02), and the opinion that patients with autoimmune diseases are at increased risk for adverse reactions (OR = 0.7, CI95% 0.53–0.89, p = 0.001). Conclusions: Given the fact that considering themselves informed regarding vaccination is the most important factor in order to be immunized against SARS-CoV-2, effective information campaigns would substantially increase willingness.
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Pinte L, Caraiola S, Balaban DV, Badea C, Mazilu D, Ionescu GD, Iosub MI, Bălan ES, Negoi F, Dumitrescu B, Mateescu B, Ionescu R, Parvu MI, Baicus C. COVID-19 Impact and Vaccination Willingness among Romanian Patients with Autoimmune/Immune-Mediated Diseases. Healthcare (Basel) 2021; 9:healthcare9121707. [PMID: 34946433 PMCID: PMC8700907 DOI: 10.3390/healthcare9121707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, patients with immune diseases are a vulnerable population. We aimed to evaluate their access to medical care, as well as their awareness and willingness to obtain the vaccine after a year of the SARS-CoV-2 pandemic. METHODS A cross-sectional, multicenter study was conducted on a questionnaire basis, handled both online as well as in person. RESULTS 651 patients with autoimmune or immune mediated diseases were enrolled. More than half (339/641 [53%]) reported difficulties in obtaining medical care throughout the pandemic and 135/651 ([21%]) of them were confirmed with COVID-19; 442/651, ([68%]) expressed their willingness to be vaccinated against SARS-CoV-2. The factors associated with an increased probability of vaccination were the male gender (OR = 2.01, CI95% 1.2-3.7, p = 0.001), the patient's opinion that she/he was well informed (OR = 3.2, CI 95% 2.1-6.01, p < 0.001), physician's advice (OR = 2.1, CI 95% 1.3-3.5, p < 0.001), and flu vaccination in the past (OR = 1.5, CI 95% 1.1-2.3, p < 0.001), while those associated with a decreased probability of vaccination were COVID-19 disease in the past medical history (OR = 0.7, CI 95% 0.3-0.95, p = 0.02), and the opinion that patients with autoimmune diseases are at increased risk for adverse reactions (OR = 0.7, CI95% 0.53-0.89, p = 0.001). CONCLUSIONS Given the fact that considering themselves informed regarding vaccination is the most important factor in order to be immunized against SARS-CoV-2, effective information campaigns would substantially increase willingness.
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Affiliation(s)
- Larisa Pinte
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
- Correspondence:
| | - Simona Caraiola
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Daniel Vasile Balaban
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Gastroenterology and Internal Medicine Departments, “Dr. Carol Davila” Central Military Emergency University Hospital, 01082 Bucharest, Romania
| | - Camelia Badea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Diana Mazilu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Rheumatology and Internal Medicine, Sf. Maria Clinical Hospital, 011172 Bucharest, Romania
| | - Georgeta Daniela Ionescu
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Maria-Ilinca Iosub
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Elena-Sabina Bălan
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Florentina Negoi
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Bianca Dumitrescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Rheumatology Department, Ion Stoia Clinical Centre of Rheumatic Diseases, 030167 Bucharest, Romania
| | - Bogdan Mateescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Ruxandra Ionescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Rheumatology and Internal Medicine, Sf. Maria Clinical Hospital, 011172 Bucharest, Romania
| | - Magda Ileana Parvu
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
| | - Cristian Baicus
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.C.); (D.V.B.); (C.B.); (D.M.); (B.D.); (B.M.); (R.I.); (C.B.)
- Internal Medicine, Rheumatology and Gastroenterology Departments, Colentina Clinical Hospital, 072202 Bucharest, Romania; (G.D.I.); (M.-I.I.); (E.-S.B.); (F.N.); (M.I.P.)
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