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Piskorz D, Alcocer L, López Santi R, Puente Barragán A, Múnera A, Molina DI, Galván Oseguera H, Barroso WS, Palomo S, Díaz-Díaz E, Cardona-Muñoz E, Wyss F, Ponte Negretti C, Rosas Peralta M, Chávez Mendoza A, Alvares López H, Patiño EP, Guerra López A, Escudero X, Enciso JM. Blood pressure telemonitoring and telemedicine, a Latin America perspective. Blood Press 2023; 32:2251586. [PMID: 37635629 DOI: 10.1080/08037051.2023.2251586] [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: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE To share a Latin-American perspective of the use of telemedicine, together with blood pressure measurements outside the medical office, as a potential contribution to improving access to the health system, diagnosis, adherence, and persistence in hypertension treatment. MATERIAL AND METHODS A document settled by a Writing Group of Mexico Hypertension Experts Group, Interamerican Society of Hypertension, Epidemiology and Cardiovascular Prevention Council of the Interamerican Society of Cardiology, and National Cardiologist Association of Mexico. RESULTS In almost all Latin American countries, the health sector faces two fundamental challenges: (1) ensure equitable access to quality care services in a growing population that faces an increase in the prevalence of chronic diseases, and (2) optimise the growing costs of health services, maintaining equity, accessibility, universality, and quality. Telehealth proposes an innovative approach to patient management, especially for chronic conditions, intending to provide remote consultation, education, and follow-up to achieve measurements and goals. It is a tool that promises to improve access, empower the patient, and somehow influence their behaviour about lifestyle changes, improving prevention and reducing complications of hypertension. The clinical practitioner has seen increased evidence that the use of out-of-office blood pressure (BP) measurement and telemedicine are helpful tools to keep patients and physicians in contact and promote better pharmacological adherence and BP control. A survey carried out by medical and scientific institutions showed that practitioners are up-to-date with telemedicine, had internet access, and had hardware availability. CONCLUSIONS A transcendent issue is the need to make the population aware of the benefits of taking blood pressure to avoid complications of hypertension, and in this scenario, promote the creation of teleconsultation mechanisms for the follow-up of patients diagnosed with hypertension.
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Affiliation(s)
| | - Luis Alcocer
- Mexico Institute of Cardiovascular Health, Mexico City, Mexico
| | | | | | - Ana Múnera
- Rosario Tesoro Clinic-Cardioestudio, Medellin, Colombia
| | | | | | | | - Silvia Palomo
- Group of Mexico Hypertension Experts Group, Mexico City, Mexico
| | | | | | - Fernando Wyss
- Cardiovascular Services and Technology of Guatemala, Guatemala, Guatemala
| | | | | | - Adolfo Chávez Mendoza
- Cardiology Hospital, National Medical Center XXI Century, Mexico Institute of Social Security, Mexico City, Mexico
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Paixão LC, Abreu MHNG, Ribeiro-Sobrinho AP, Martins RC. Factors Associated with Avoiding Referrals by Dental Teleconsulting Sessions in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5104. [PMID: 36982011 PMCID: PMC10049715 DOI: 10.3390/ijerph20065104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
This cross-sectional analytical study assessed the frequency of avoided referrals of primary care to other care levels by dental teleconsulting and its association with individual and contextual variables using a multilevel approach. It appraised asynchronous dental teleconsulting sessions from the secondary database of the Monitoring and Evaluation System of the Telehealth Results during 2020, during the COVID-19 pandemic. The outcome was "whether referral to secondary care was avoided". Individual variables were related to teleconsulting and professionals that requested it: sex, dental specialty, and dentistry field. Contextual variables were related to each municipality that requested responses: Municipal Human Development Index, oral health teams (OHTs) in primary health care coverage, dental specialty centers coverage, illiteracy rate, Gini index, longevity, and per capita income. A descriptive analysis was made using the Statistical Package for the Social Sciences. Hierarchical Linear and Nonlinear Modeling software was used to perform multilevel analyses to assess the association of individual and contextual variables with avoiding patient referral to other care levels. Most teleconsulting sessions avoided patient referral to other care levels (65.1%). Contextual variables explained 44.23% of the variance in the outcome. Female dentists were more likely to avoid patient referrals than male dentists (OR = 1.74; CI = 0.99-3.44; p = 0.055). In addition, an increase of one percentage point in OHT/PHC coverage of municipalities increased the likelihood of avoiding patient referral by 1% (OR = 1.01; CI = 1.00-1.02; p = 0.02). Teleconsulting sessions efficiently avoided patient referral to other care levels. Both contextual and individual factors were associated with avoided referrals by teleconsulting sessions.
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Affiliation(s)
- Lígia C. Paixão
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Mauro Henrique N. G. Abreu
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Antônio P. Ribeiro-Sobrinho
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Renata C. Martins
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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Paixão LC, Ferreira EF, Ribeiro-Sobrinho AP, Martins RC. National analysis of dental teleconsulting of the Brazilian Telehealth Program. Braz Oral Res 2022; 36:e110. [PMID: 35946738 DOI: 10.1590/1807-3107bor-2022.vol36.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 05/16/2022] [Indexed: 11/21/2022] Open
Abstract
This cross-sectional study nationally evaluated asynchronous dental teleconsulting services offered by the Telehealth Brazil Networks Program, using the 2019 Telehealth Results Monitoring and Evaluation System database and considering Brazilian regional differences. The following teleconsulting variables were collected: dentist's sex and specialty, date/time of question and answer, response time; dental specialty, professional satisfaction, and patient referral. Five Brazilian regions were socioeconomically characterized according to the Human Development Index, estimated population, Gini coefficient, coverage of dental specialty centers, oral health teams in Family Health Strategy, and oral health teams in primary health care (PHC). In total, 2,703 teleconsulting sessions occurred in Brazil in the analyzed period. The Southeast exhibited the highest demand (49.1%). Most dentists were female (60.6%) and were dental surgeons from the Family Health Strategy (61.3%). Most teleconsulting sessions occurred during working hours (85.5%) and questions were answered within 72 hours (66.7%). Level of satisfaction and avoidance of referral yielded rates of 90.9% and 66.8%, respectively, among dentists who answered about these topics. Semiology was the most frequently demanded area in teleconsulting (33.9%). The different demands from the regions reflected regional differences. The most frequently demanded specialties represent the Brazilian PHC scenario. Professionals incorporated teleconsulting into their work routine and most teleconsultants responded within the stipulated timeframe. Professional feedback should be encouraged.
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Affiliation(s)
- Lígia Cristelli Paixão
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Belo Horizonte , MG , Brazil
| | - Efigênia Ferreira Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
| | - Antônio Paulino Ribeiro-Sobrinho
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Restorative Dentistry , Belo Horizonte , MG , Brazil
| | - Renata Castro Martins
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
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Garcia Saiso S, Marti MC, Malek Pascha V, Pacheco A, Luna D, Plazzotta F, Nelson J, Tejerina L, Bagolle A, Savignano MC, Baum A, Orefice PJ, Haddad AE, Messina LA, Lopes P, Rubió FS, Otzoy D, Curioso WH, Luna A, Medina FM, Sommer J, Otero P, De Quiros FGB, D'Agostino M. [Implementation of telemedicine in the Americas: Barriers and facilitatorsBarreiras e facilitadores para a implementação da telemedicina nas Américas]. Rev Panam Salud Publica 2021; 45:e131. [PMID: 34703460 PMCID: PMC8530000 DOI: 10.26633/rpsp.2021.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Con millones de personas en el mundo en situación de distanciamiento físico por el COVID-19, las tecnologías de la información y comunicaciones (TICs) se han posicionado como uno de los medios principales de interacción y colaboración. Ya al inicio de este milenio se empezaban a mencionar las siguientes ventajas: mayor acceso a la información y a la prestación de servicios; fortalecimiento educativo; control de calidad de los programas de detección y reducción de los costos de la atención de en salud. Sin embargo, entre las principales barreras de adopción de la telemedicina se encuentran las de índole: tecnológicas; humanas y sociales; psico-sociales y antropológicas; de Gobernanza y económicas. En estos 20 años se logró un aumento en los recursos y capacidad técnica, una mejora en la educación digital, un empoderamiento del paciente en su tratamiento y un mayor interés público en esta área. En especial se considera exitosa la conformación de equipos interdisciplinarios, las redes académicas y profesionales y las consultas médicas virtuales. Después de revisar el estado de la telemedicina en la Región de las Américas, los autores recomiendan adoptar medidas urgentes para poner en práctica políticas y programas nacionales de telemedicina, incluyendo el marco normativo y presupuesto necesario, cuya implementación se realice de manera integral e interoperable y que se sustente de redes académicas, de colaboración e instituciones especializadas. Dichas políticas deben generar un contexto habilitante que den sostenibilidad al avance logrado, considerando los aspectos mencionados en las posibles barreras.
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Affiliation(s)
- Sebastian Garcia Saiso
- Organización Panamericana de la Salud Washington D.C. Estados Unidos Organización Panamericana de la Salud, Washington D.C., Estados Unidos
| | - Myrna C Marti
- Consultora internacional Argentina Consultora internacional, Argentina
| | | | - Adrian Pacheco
- CENETEC Ciudad de México México CENETEC, Ciudad de México. México
| | - Daniel Luna
- Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Plazzotta
- Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Jennifer Nelson
- Banco Interamericano de Desarrollo Washington D.C. Estados Unidos Banco Interamericano de Desarrollo, Washington D.C., Estados Unidos
| | - Luis Tejerina
- Banco Interamericano de Desarrollo Washington D.C. Estados Unidos Banco Interamericano de Desarrollo, Washington D.C., Estados Unidos
| | - Alexandre Bagolle
- Banco Interamericano de Desarrollo Washington D.C. Estados Unidos Banco Interamericano de Desarrollo, Washington D.C., Estados Unidos
| | - Maria Celeste Savignano
- Hospital de Pediatría "Prof Dr. Juan P. Garrahan" Ciudad Autónoma de Buenos Aires Argentina Hospital de Pediatría "Prof Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina
| | - Analia Baum
- Ministerio de Salud de la Ciudad Autónoma de Buenos Aires Argentina Ministerio de Salud de la Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Ana Estela Haddad
- Universidad de Sao Paulo San Pablo Brasil Universidad de Sao Paulo, San Pablo, Brasil
| | - Luiz Ary Messina
- Rede Nacional de Ensino e Pesquisa Rio de Janeiro Brasil Rede Nacional de Ensino e Pesquisa, Rio de Janeiro, Brasil
| | - Paulo Lopes
- Rede Nacional de Ensino e Pesquisa Rio de Janeiro Brasil Rede Nacional de Ensino e Pesquisa, Rio de Janeiro, Brasil
| | - Francesc Saigí Rubió
- Universitat Oberta de Catalunya Barcelona España Universitat Oberta de Catalunya, Barcelona, España
| | - Daniel Otzoy
- Red Centroamericana de Informática en Salud Guatemala Red Centroamericana de Informática en Salud, Guatemala, Guatemala
| | - Walter H Curioso
- Universidad Continental Lima Perú Universidad Continental, Lima, Perú
| | - Antonio Luna
- Hospital de Pediatría "Prof Dr. Juan P. Garrahan" Ciudad Autónoma de Buenos Aires Argentina Hospital de Pediatría "Prof Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Janine Sommer
- Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Paula Otero
- Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernán González Bernaldo De Quiros
- Ministerio de Salud de la Ciudad Autónoma de Buenos Aires Argentina Ministerio de Salud de la Ciudad Autónoma de Buenos Aires, Argentina
| | - Marcelo D'Agostino
- Organización Panamericana de la Salud Washington D.C. Estados Unidos Organización Panamericana de la Salud, Washington D.C., Estados Unidos
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