Top

World Journal of Surgery

Published in:

01-02-2020 | Endocrine Surgery | Surgery in Low and Middle Income Countries

Smartphone-Based Application for Tele-follow-up of Patients with Endocrine Disorders in Context of a LMIC: A Compliance, Satisfaction, Clinical Safety and Outcome Assessment

Authors: Sanjay Kumar Yadav, Chandan Kumar Jha, Saroj Kanta Mishra, Anjali Mishra

Published in: World Journal of Surgery | Issue 2/2020

Abstract

Background

Remote video consultations are increasingly used in clinical practice, and a lot of data are emerging on its feasibility and acceptability. This study aims to bring out qualitative and quantitative data which will enhance our understanding of strengths and limitations of this media in the setting of a low- and middle-income country (LMIC).

Materials and methods

This was a prospective study conducted from January 2017 to May 2018, at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India. A total of 107 patients were selected who chose remote follow-up care through social media (WhatsApp). Data were analyzed on feasibility, clinical safety, satisfaction and economic burden.

Results

A total of 107 postoperative patients were followed up using a social media tool. A total of 396 tele-sessions were held. The average number of tele-consultations per patient was 3.7 (range 2–6). Reasons for tele-follow-up included: confirmation of histology report (n = 92), medication dosage adjustments (n = 148), wound evaluation (n = 102), reporting of serum TSH and serum calcium levels (n = 296) and medical fitness certificate (n = 13). Wound evaluation through tele-follow-up was on par with the outpatient department (OPD) follow-up as no patient had to report to OPD for wound infection. Satisfaction level was excellent in 55% of patients and very good in 25%. 20% of the patients reported an average satisfaction level. If all of these 107 patients would have come to our OPD follow-up, they would have traveled 613.2 miles (908 km) per patient on an average, apart from losing work hours. Average cost and workdays saved per visit were $78 and 5.4 days, respectively.

Conclusion

Video consultation using social media tools is clinically safe and cost effective. Economic benefits far outweigh the risk of missing an adverse event, especially in the setting of low- and middle-income countries.

Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978 (2004) Development 47:159. https://doi.org/10.1057/palgrave.development.1100047

GBD 2016 Healthcare Access and Quality Collaborators (2018) Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet 391(10136):2236–2271. https://doi.org/10.1016/s0140-6736(18)30994-2 CrossRef

Pakhare A, Kumar S, Goyal S, Joshi R (2015) Assessment of primary care facilities for cardiovascular disease preparedness in Madhya Pradesh, India. BMC Health Serv Res 23(15):408. https://doi.org/10.1186/s12913-015-1075-x CrossRef

Bindu T, Kumar SS, Ratheesan K, Balasubramanian S (2017) Factors associated with survival and lost to follow-up of cervical cancer patients in a tertiary cancer centre in rural Kerala. Indian J Public Health 61(1):43–46. https://doi.org/10.4103/0019-557x.200254 CrossRefPubMed

Rajpal S, Kumar A, Joe W (2018) Economic burden of cancer in India: evidence from cross-sectional nationally representative household survey, 2014. PLoS ONE 13(2):e0193320. https://doi.org/10.1371/journal.pone.0193320 CrossRefPubMedPubMedCentral

Montgomery DA, Krupa K, Wilson C, Cooke TG (2008) Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study. Br J Cancer 99(5):704–710. https://doi.org/10.1038/sj.bjc.6604567 CrossRefPubMedPubMedCentral

Grunfeld E, Julian JA, Pond G, Maunsell E, Coyle D, Folkes A et al (2011) Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol 29(36):4755–4762. https://doi.org/10.1200/jco.2011.36.8373 CrossRefPubMed

McLean S, Protti D, Sheikh A (2011) Telehealthcare for long term conditions. BMJ 3(342):d120. https://doi.org/10.1136/bmj.d120 CrossRef

McFarlane K, Dixon L, Wakeman CJ, Robertson GM, Eglinton TW, Frizelle FA (2012) The process and outcomes of a nurse-led colorectal cancer follow-up clinic. Colorectal Dis 14(5):e245–e249. https://doi.org/10.1111/j.1463-1318.2011.02923.x CrossRefPubMed

10.

Sood S, Mbarika V, Jugoo S, Dookhy R, Doarn CR, Prakash N, Merrell RC (2007) What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings. Telemed J E Health 13(5):573–590CrossRef

11.

Kapoor L, Mishra SK, Singh K (2005) Telemedicine: experience at SGPGIMS, Lucknow. J Postgrad Med 51(4):312–315PubMed

12.

Mishra A, Kapoor L, Mishra SK (2009) Post-operative care through tele-follow up visits in patients undergoing thyroidectomy and parathyroidectomy in a resource-constrained environment. J Telemed Telecare 15(2):73–76. https://doi.org/10.1258/jtt.2008.080808 CrossRefPubMed

13.

Singh IP, Kapoor L, Daman R, Mishra SK (2008) Comparative study of connectivity in telemedicine. Telemed E-Health 14:846–850. https://doi.org/10.1089/tmj.2008.0095 CrossRef

14.

Gulliford T, Opomu M, Wilson E, Hanham I, Epstein R (1997) Popularity of less frequent follow up for breast cancer in randomised study: initial findings from the hotline study. BMJ 314(7075):174–177CrossRef

15.

Kimman ML, Bloebaum MM, Dirksen CD, Houben RM, Lambin P, Boersma LJ (2010) Patient satisfaction with nurse-led telephone follow-up after curative treatment for breast cancer. BMC Cancer 30(10):174. https://doi.org/10.1186/1471-2407-10-174 CrossRef

16.

Armfield NR, Bradford M, Bradford NK (2015) The clinical use of Skype—for which patients, with which problems and in which settings? A snapshot review of the literature. Int J Med Inform 84(10):737–742. https://doi.org/10.1016/j.ijmedinf.2015.06.006 CrossRefPubMed

17.

Armfield NR, Gray LC, Smith AC (2012) Clinical use of Skype: a review of the evidence base. J Telemed Telecare 18(3):125–127. https://doi.org/10.1258/jtt.2012.SFT101 CrossRefPubMed

18.

Gentles SJ, Lokker C, McKibbon KA (2010) Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: a scoping review. J Med Internet Res 12(2):e22. https://doi.org/10.2196/jmir.1390 CrossRefPubMedPubMedCentral

Title: Smartphone-Based Application for Tele-follow-up of Patients with Endocrine Disorders in Context of a LMIC: A Compliance, Satisfaction, Clinical Safety and Outcome Assessment
Authors: Sanjay Kumar Yadav
Chandan Kumar Jha
Saroj Kanta Mishra
Anjali Mishra
Publication date: 01-02-2020
Publisher: Springer International Publishing
Keywords: Endocrine Surgery
Endocrine Surgery
Published in: World Journal of Surgery / Issue 2/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05212-7

At a glance: The STEP trials

Springer Medicine

Smartphone-Based Application for Tele-follow-up of Patients with Endocrine Disorders in Context of a LMIC: A Compliance, Satisfaction, Clinical Safety and Outcome Assessment

Abstract

Background

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2020

Cardiovascular Incidence in 6900 Patients with Differentiated Thyroid Cancer: a Swedish Nationwide Study

Correlating the Bethesda System for Reporting Thyroid Cytopathology with Histology and Extent of Surgery: A Review of 21,746 Patients from Four Endocrine Surgery Registries Across Two Continents

Printing a Three-Dimensional Patient-Specific Safety Device for Reducing the Potential Risk of Mental Nerve Injury During Transoral Thyroidectomy

Should 68Ga-DOTATATE PET/CT be Performed Routinely in Patients with Neuroendocrine Tumors Before Surgical Resection?

Does the ATA Risk Stratification Apply to Patients with Papillary Thyroid Microcarcinoma?

Mastery in Endocrine Surgery