Browsing by Author "Tonelli, Marcello"
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- ItemCapacity and willingness of patients with chronic noncommunicable diseases to use information technology to help manage their condition: a cross-sectional study.(2014-07-31) Afshar, Arash Ehteshami; Weaver, Robert G; Lin, Meng; Allan, Michael; Ronksley, Paul E; Sanmartin, Claudia; Lewanczuk, Richard; Rosenberg, Mark; Manns, Braden; Hemmelgarn, Brenda; Tonelli, Marcello; ,BACKGROUND Health care providers have shown considerable interest in using information technologies such as email text messages and video conferencing to facilitate the management of chronic noncommunicable diseases such as hypertension diabetes mellitus and vascular disease We sought to determine whether these technologies are available and appealing to the target population METHODS We analyzed cross sectional data from a computer assisted telephone survey conducted by Statistics Canada in February and March 2012 of western Canadian adults with at least 1 chronic condition Survey respondents were asked about their capacity e g Do you own a mobile phone and willingness to use each of 3 information technologies email text messages and video conferencing to interact with health care providers For all analyses Statistics Canada s calibrated design weights and bootstrap weights were used to obtain population level point estimates for proportions and odds ratios RESULTS In total 1849 79 8 of 2316 eligible people participated Of the 1849 participants 81 9 had hypertension 26 2 had diabetes 21 4 had heart disease and 7 9 had stroke 32 2 had more than 1 of the 4 chronic conditions of interest High proportions of respondents owned a computer with Internet access 76 4 95 confidence interval CI 73 3 79 3 or a mobile phone 73 9 95 CI 70 7 76 8 About two thirds of respondents were interested in using email to interact with a specialist 66 3 95 CI 63 0 69 5 respondents were less enthusiastic about using text messages 44 9 95 CI 41 2 48 7 Enthusiasm for video conferencing was more pronounced among those residing further from medical specialists than among those living closer Among respondents who were potentially interested in video conferencing almost 50 of remote dwellers would use this technology if it saved more than 60 minutes of travel time INTERPRETATION Many people were interested in using electronic technologies especially video conferencing and email based methods to help manage their chronic condition The effectiveness and cost implications of using email and video conferencing in the management of chronic disease deserve further consideration
- ItemImpact of Telehealth Interventions on Processes and Quality of Care for Patients With ESRD.(0000-00-00) Lunney, Meaghan; Lee, Raymond; Tang, Karen; Wiebe, Natasha; Bello, Aminu K; Thomas, Chandra; Rabi, Doreen; Tonelli, Marcello; James, Matthew TCaring for patients with end stage renal disease ESRD requiring dialysis is intensive and expensive Telehealth may improve the access and efficiency of ESRD care For this perspective we systematically reviewed studies that examined the effectiveness of telehealth versus or in addition to usual care for ESRD management 10 studies were identified including 7 randomized trials and 3 cohort studies Study populations modes of delivery including telephone telemetry or videoconferencing and the outcomes evaluated varied substantially between studies Two studies examined telehealth interventions versus standard ESRD care and demonstrated mixed results on processes of care no differences in laboratory surrogate markers of ESRD care and reduced or similar rates of hospitalization Eight studies evaluated the addition of telehealth to usual care and demonstrated no significant improvements in processes of care or surrogate laboratory measures variable impacts on hospitalization rates and mixed impacts on some domains of quality of life including improvement in mental health Although potential benefits of telehealth in ESRD care have been reported optimal designs for delivery and elements of care that may be improved through telehealth remain uncertain