TY - JOUR
T1 - Telemedicine medical evaluation of low-risk patients with dengue during an outbreak may be an option in reducing the need for on-site physicians
AU - Pedrotti, Carlos H.S.
AU - Accorsi, Tarso A.D.
AU - Moreira, Flavio Tocci
AU - Lima, Karine De Amicis
AU - Köhler, Karen Francine
AU - Gaz, Marcus V.B.
AU - Chiamolera, Murilo
AU - Cunha, Gustavo A.
AU - Neto, Ary Serpa
AU - Morbeck, Renata A.
AU - Cordioli, Eduardo
N1 - Funding Information:
The authors have no competing interests to declare. None. This study was approved by the Hospital Israelita Albert Einstein review board (CAAE 44937621.2.0000.0071). The authors want to thank Hospital Israelita Albert Einstein for the information technology support relating to the relevant services (telemedicine) provided.
Publisher Copyright:
© 2022 The Authors
PY - 2022/8
Y1 - 2022/8
N2 - Objective: To analyze the effectiveness of telemedicine consultations during an outbreak in reducing the need for face-to-face consultations at a field hospital for patients with dengue. Methods: We performed a retrospective unicentric study between April and May 2015 with 4626 patients (≥15 years old) who spontaneously sought care at an emergency field hospital (Sāo Paulo/Brazil). A nurse initially assessed all patients with dengue through rapid diagnostic testing, automated complete blood count, and risk stratification. During overcrowded situations, a video-based telemedicine consultation was provided as an option to all low-to-moderate risk patients who tested positive. The management was carried out according to current dengue guidelines. The primary end point was a referral to immediate face-to-face medical evaluation. Results: Of all patients suspected of dengue infection, 2003 presented positive testing, 1978 were classified as low-moderate risk, and 267 patients with dengue were evaluated by telemedicine. The mean age was 38.17 ± 13.7 years (54.6% female). Oral medications were recommended in 169 (63.3%), intravenous hydration or symptomatic drugs in 96 (36%), 252 (94.4%) were discharged after telemedicine assessment, and only 15 (5.6%) were referred to immediate face-to-face medical evaluation. No adverse events were recorded. Conclusion: Telemedicine medical assessment of low-to-moderate risk patients with dengue previously screened by nursing triage is effective in replacing the face-to-face evaluation in a field hospital. Telemedicine may be reinforced in epidemiological outbreak scenarios as a cost-effective strategy for the initial assessment of acute patients.
AB - Objective: To analyze the effectiveness of telemedicine consultations during an outbreak in reducing the need for face-to-face consultations at a field hospital for patients with dengue. Methods: We performed a retrospective unicentric study between April and May 2015 with 4626 patients (≥15 years old) who spontaneously sought care at an emergency field hospital (Sāo Paulo/Brazil). A nurse initially assessed all patients with dengue through rapid diagnostic testing, automated complete blood count, and risk stratification. During overcrowded situations, a video-based telemedicine consultation was provided as an option to all low-to-moderate risk patients who tested positive. The management was carried out according to current dengue guidelines. The primary end point was a referral to immediate face-to-face medical evaluation. Results: Of all patients suspected of dengue infection, 2003 presented positive testing, 1978 were classified as low-moderate risk, and 267 patients with dengue were evaluated by telemedicine. The mean age was 38.17 ± 13.7 years (54.6% female). Oral medications were recommended in 169 (63.3%), intravenous hydration or symptomatic drugs in 96 (36%), 252 (94.4%) were discharged after telemedicine assessment, and only 15 (5.6%) were referred to immediate face-to-face medical evaluation. No adverse events were recorded. Conclusion: Telemedicine medical assessment of low-to-moderate risk patients with dengue previously screened by nursing triage is effective in replacing the face-to-face evaluation in a field hospital. Telemedicine may be reinforced in epidemiological outbreak scenarios as a cost-effective strategy for the initial assessment of acute patients.
KW - Dengue Fever
KW - Digital Health
KW - Emergency Medical Services
KW - Outbreak
KW - Telemedicine
KW - Tropical Diseases
UR - http://www.scopus.com/inward/record.url?scp=85130579854&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.04.059
DO - 10.1016/j.ijid.2022.04.059
M3 - Article
C2 - 35504552
AN - SCOPUS:85130579854
SN - 1201-9712
VL - 121
SP - 106
EP - 111
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -