Telemedicine medical evaluation of low-risk patients with dengue during an outbreak may be an option in reducing the need for on-site physicians

Carlos H.S. Pedrotti, Tarso A.D. Accorsi, Flavio Tocci Moreira, Karine De Amicis Lima, Karen Francine Köhler, Marcus V.B. Gaz, Murilo Chiamolera, Gustavo A. Cunha, Ary Serpa Neto, Renata A. Morbeck, Eduardo Cordioli

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Abstract

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.

Original languageEnglish
Pages (from-to)106-111
Number of pages6
JournalInternational Journal of Infectious Diseases
Volume121
DOIs
Publication statusPublished - Aug 2022
Externally publishedYes

Keywords

  • Dengue Fever
  • Digital Health
  • Emergency Medical Services
  • Outbreak
  • Telemedicine
  • Tropical Diseases

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