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Bostan P, Çetin N, Altınışık G. A Retrospective Assessment of the Continuous Health Care Provided to COVID-19 Patients Consulted Via Videoconference. THORACIC RESEARCH AND PRACTICE 2023; 24:14-21. [PMID: 37503594 PMCID: PMC10765214 DOI: 10.5152/thoracrespract.2023.22058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/19/2022] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Telemedicine has been defined as a valuable tool in delivering care for COVID-19 patients. However, clinicians and policymakers should be convinced that traditional and new technological methods of clinical management may be equally effective. The purpose of this study was to generate some initial recommendations based on the clinical utility of videoconference consultation in forward triage and follow-up for COVID-19 patients. MATERIAL AND METHODS This retrospective cross-sectional study evaluated the medical records of 100 COVID-19 patients consulted using a videoconference program (Skype), from September 1, 2020, to February 3, 2021. The data were analyzed on demographic characteristics, disease history, the need for physical examination after videoconference consultation, pre-diagnostics and diagnostics, treatment decisions, number of videoconference consultation sessions in follow-up, duration of sessions, and final outcome. RESULTS The male COVID-19 patients constituted 54% of the total sample. The median age was 51 (42-61) years. The median duration of the initial videoconference consultation session was 16 (12-21) minutes. Following the initial videoconference consultation session, 14 patients required follow-up with all face-to-face visits; the remaining patients were primarily followed with videoconference consultation sessions. For 25 patients, it was sufficient to provide only videoconference consultation sessions; they were not required to be in the hospital for physical examination or any subsequent investigation at all. A total of 14 patients were hospitalized. There was no statistically significant difference between the high-risk group and the other patients according to the components of the disease management process via videoconference consultation. CONCLUSION Videoconference consultation enables a holistic assessment regardless of the patient's characteristics and allows for more time to be spent on each patient, particularly during the pandemic period without risk of contagion. It can be used as a forward triage and follow-up tool to identify patients in need of emergency hospitalization and continuous health care.
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Affiliation(s)
- Pınar Bostan
- İstanbul Bilgi University, Faculty of Health Sciences, İstanbul, Turkey
| | - Nazlı Çetin
- Department of Chest Diseases, Pamukkale University, Faculty of Medicine, Denizli, Turkey
| | - Göksel Altınışık
- Department of Chest Diseases, Pamukkale University, Faculty of Medicine, Denizli, Turkey
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Alici N, Suzer B, Ecemis M, Kasabali G, Dinler G, Sanli S, Kuzgun O, Nakipoglu A, Çimrin A. Awareness of occupational diseases among research assistants working in a medical faculty hospital: An exploratory study on a neglected area. EURASIAN JOURNAL OF PULMONOLOGY 2021. [DOI: 10.4103/ejop.ejop_110_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baha A, Kokturk N. Physician's attitude against COPD guidelines and the choice of first-line treatment for COPD. Respir Med 2020; 176:106273. [PMID: 33271467 DOI: 10.1016/j.rmed.2020.106273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/30/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
AIM Our aim was to evaluate changes in attitudes of pulmonologists in Turkey towards COPD guidelines and their choice of first-line treatments for COPD patients. MATERIAL-METHOD 333 physicians who completed the questionnaire were included in this cross-sectional questionnaire study. The questionnaire contained demographic data, professional information, extent of guideline use, rationales behind using or not using a guideline. The data was compared with the same survey conducted previously in 2011 and was analyzed by appropriate statistical methods. RESULTS 80 physicians were resident pulmonologists (24%), 250 physicians were specialists (75.1%). 298 (89.5%) physicians reported that they follow at least one guideline for selection of the appropriate treatment in COPD. The current application of guidelines when compared with the first survey in 2011, was found to be decreased, 91.2% and 89.5%, respectively (p = 0.07). 46.8% (n = 156) of participants thought that guidelines provided the physicians more legal protection (p < 0.001). The number of physicians who didn't follow the guidelines due to workload increased over this period of time (36.8% in 2011, 85.3% in 2018, p < 0.001). The number of physicians using inhaler steroid combinations as their first choice of treatment was found to be similar with the previous survey (p = 0.909). CONCLUSION According to the results of previous questionnaire, the application of COPD guidelines has decreased. The number of pulmonologists who declared they have no time for following or applying guidelines has profoundly increased since 2011. Despite the warnings of these guidelines, the use of inhaler steroid combination as a first treatment option in COPD is still common.
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Affiliation(s)
- Ayse Baha
- Near East University Faculty of Medicine, Department of Pulmonary Medicine, Mersin-10, Turkey.
| | - Nurdan Kokturk
- Gazi University Faculty of Medicine, Department of Pulmonary Medicine, Ankara, Turkey
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Gemicioğlu B, Mungan D, Bavbek S, Yıldız F, Polatlı M, Naycı S, Erkekol FÖ, Türker H, Günen H, Çamsarı G, Abadoğlu Ö, Çımrın A, Dursun AB, Göksel Ö, Özdemir SK, Börekci Ş, Aydın Ö, Ocaklı B, Gür A, Baygul A, Mısırlıgil Z. Validity and Reliability of the Assessment Tool for Asthma (ATA) Questionnaire: the ATA Study. Turk Thorac J 2020; 21:93-99. [PMID: 32202998 DOI: 10.5152/turkthoracj.2019.180186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/14/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES A multicenter trial was designed to validate the "Assessment Tools for Asthma (ATA)" questionnaire, a newly developed questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument. MATERIALS AND METHODS This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100 randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses symptomatic control criteria, and the remaining section, queries the flare-up of asthma, control of comorbidities, treatment adherence, and inhaler technique. RESULTS The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According to the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flare-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach's alpha coefficient=0.683). ACT, ATA1, and two specialists' evaluations using VAS correlated strongly with the ATA total scores (Spearman correlation coefficient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specificity=82.40%). CONCLUSION The validated ATA questionnaire may be a practical tool for physicians in asthma management.
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Affiliation(s)
- Bilun Gemicioğlu
- Department of Pulmonary Diseases, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Dilşad Mungan
- Department of Pulmonary Diseases, Division of Allerrgy and Immunology, Ankara University School of Medicine, Ankara, Turkey
| | - Sevim Bavbek
- Department of Pulmonary Diseases, Division of Allerrgy and Immunology, Ankara University School of Medicine, Ankara, Turkey
| | - Füsun Yıldız
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Mehmet Polatlı
- Department of Pulmonary Diseases, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Sibel Naycı
- Department of Pulmonary Diseases, Mersin University School of Medicine, Mersin, Turkey
| | - Ferda Öner Erkekol
- Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey
| | - Hatice Türker
- Süreyyapasa Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Hakan Günen
- Süreyyapasa Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Güngor Çamsarı
- Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Öznur Abadoğlu
- Department of Pulmonary Diseases, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Arif Çımrın
- Department of Pulmonary Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - A Berna Dursun
- Department of Internal Medicine, Division of Allergy and Immunology, Recep Tayip Erdoğan University School of Medicine, Rize, Turkey
| | - Özlem Göksel
- Department of Pulmonary Diseases, Division of Allerrgy and Immunology, Ege University School of Medicine, İzmir, Turkey
| | | | - Şermin Börekci
- Department of Pulmonary Diseases, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Ömür Aydın
- Department of Pulmonary Diseases, Division of Allerrgy and Immunology, Ankara University School of Medicine, Ankara, Turkey
| | - Birsen Ocaklı
- Süreyyapasa Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Aygün Gür
- Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Arzu Baygul
- Department of Biostatistics, Beykent University, İstanbul, Turkey
| | - Zeynep Mısırlıgil
- Department of Pulmonary Diseases, Division of Allerrgy and Immunology, Ankara University School of Medicine, Ankara, Turkey
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Kilinc O, Konya A, Akgun M, Uzaslan E, Sayiner A. A case scenario study for the assessment of physician's behavior in the management of COPD: the WHY study. Int J Chron Obstruct Pulmon Dis 2018; 13:2751-2758. [PMID: 30233165 PMCID: PMC6130535 DOI: 10.2147/copd.s154616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =−0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions.
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Affiliation(s)
- Oguz Kilinc
- Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey,
| | - Aylin Konya
- Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey
| | - Metin Akgun
- Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey
| | - Esra Uzaslan
- Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey
| | - Abdullah Sayiner
- Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey
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