[Diabetes control and visits to the family doctor during the COVID-19 pandemic: a multicenter study in primary care]

OBJECTIVES

To determine whether in patients with type 2 diabetes (DM2) the changes in their relationship with family doctors during the COVID-19 pandemic, in-person (iPC) and telematic (TC) consultations, were associated with control of their disease.

DESIGN

Multicentric study of retrospective follow-up.

SETTING

Seven health centers in Tenerife, Spain.

PARTICIPANTS

3543 patients with DM2.

MAIN MEASUREMENTS

Sex, age, iPC, TC and DM2 control using glycosylated hemoglobin (A1c) during the period 2019-2021. Logistic regression models were fitted with DM2 control as an effect, and with the other measurements as independent variables.

RESULTS

50% were women. 38% were less than 65 years old. A1c was measured in 84% of patients in 2019, 68% in 2020, and 77% in 2021. 58.4% had good control in 2019, 46.1% in 2020, and 50.3% in 2021. Median iPC were 7 in 2019, 4 in 2020 and 5 in 2021 (p<0.001). The OR(95%CI) of good control in 2019 were 1.04(1.04-1.05) per year of age and 1.03(1.01-1.04) for each iPC; In 2020 they were 1.04 (1.03-1.05) per year of age, 1.05 (1.04-1.07) for each iPC and 1.04 (1.02-1.07) for each TC; in 2021 they were 1.04 (1.04-1.05) per year of age, 1.05 (1.03-1.06) for each iPC and 1.02 (1.00-1.04) for each TC.

CONCLUSIONS

The control of patients with DM2 during the period 2019-2021 had a direct relationship with the change in the frequency of consultations at the health center, with differences depending on the type of consultation and the age of the patient.

[Evaluation of the telematic consultation in endocrine surgery during confinement due to COVID-19]

BACKGROUND

The coronavirus disease pandemic of 2019 (COVID-19) made necessary to remodel the hospital's clinical consultations.

OBJECTIVE

To evaluate the telematic consultation in endocrine surgery, as well as to select the group of patients susceptible to perform a telematic consultation in the future according to this assessment.

METHODS

The study population were patients who had a clinical consultation by telephone. The evaluation was made with the Net Promoter Score (NPS).

STATISTICAL ANALYSIS

SPSS v.28, X² test and a multivariate analysis.

RESULTS

55 patients were analyzed. The NPS was +16, 24 promoters (43.6%) and 15 detractors (27.2%). There were differences between those whose main reason for consultation was malignant pathology (OR 4.5; p = 0.033). The NPS between malignant vs. non-malignant pathology was -13 vs. +38 (p > 0.001). The evaluation of the telematic consultations for the future was: telephone (83% very well), video call (58%), videoconference (19%).

CONCLUSIONS

The evaluation of the telephone consultation has been good, finding a better assessment among patients with non-malignant pathology. Its future implementation could be necessary, being the telephone the preferred way.

The result of the use of remote consultation in orthopaedic and trauma surgery during the COVID-19 pandemic

The COVID pandemic has made telematic consultations a basic tool in daily practice.

Aims

The main objective of the study is to assess the results of the application of telematic consultations to limit the mobility of patients.

The operational objectives are; to propose a consultation plan, to know how attendance limits consultations and to define which pathologies benefit the most from this plan.

Methods

A scheme is proposed with the creation of pre-scheduled clinic to assess suitability and the possibility of carrying them out in a single non face-to-face act.

Results

Phone call to 5619 patients were made with a lack of response of 19%

The cases of 74% of the patients that answered were resolved virtually. There is a difference between units, obtaining a higher answering rate from patients appointed to specific clinic units, OR = 0.60, or to general trauma ones, OR = 0.67. The lowest answering rate was obtained from those derived from the emergency department.

Twenty per cent of the consultations were not accompanied by complementary tests that would have favored the resolution in a single act. The general trauma consultations, OR = 0.34, postoperative control, OR = 0.49, and specific unit ones, OR = 0.40, were the ones that better met this requirement.

Out of the remaining patients, the general trauma consultations, OR = 0.50, and those referred to units, OR = 0.54, were the ones that had a higher resolution rate without in- person consultation.

Conclusions

The cases of 74% of the patients who answered the phone call were resolved virtually.

Cases of 20% of the patients cannot be solved in a single act because they are derived without complementary tests.

Osteosynthesis and postoperative arthroscopic follow-up consultations are the ones that need to be carried out in person the most.

Result of the implementation of telematic consultations in orthopaedic surgery and traumatology during COVID-19 laparoscopic surgery

La pandemia COVID ha hecho de las consultas telemáticas una herramienta básica en la práctica diaria. El objetivo principal del estudio es valorar los resultados de la aplicación de consultas telemáticas para limitar la movilidad de los pacientes.

Son objetivos operativos: proponer un plan de consultas, conocer cómo limita la asistencia a las consultas, definir qué patologías se benefician más con este plan.

Material y métodos

Se propone un esquema con la creación de consultas previas a las agendadas para valorar idoneidad y posibilidad de realizarla en acto único no presencial.

Resultados

Se han realizado 5.619 consultas con una falta de respuesta telefónica del 19%. El 74% de los pacientes fueron resueltos de forma virtual. Existe diferencia entre unidades, siendo más probable la respuesta telefónica para las consultas de unidad, OR = 0,60 o de traumatología general, OR = 0,67 y menos para los derivados desde urgencias.

El 20% de las consultas no se acompañaban de pruebas complementarias. Las consultas de traumatología general, OR = 0,34, control postoperatorio, OR = 0,49, y unidades, OR = 0,40, cumplieron mejor este requisito. De los pacientes restantes, las consultas de traumatología general, OR = 0,50, y las derivadas a unidades, OR = 0,54 fueron las que más se resolvieron sin acudir presencialmente.

Conclusiones

Se han resuelto de forma no presencial el 74% de los pacientes que atendieron a la llamada telefónica. El 20% de los pacientes acuden a la visita sin pruebas complementarias. Las consultas de seguimiento de osteosíntesis y postoperatorio de cirugía artroscópica son las que más precisan de ser realizadas de forma presencial.