Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study
Objective The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic...
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| Format: | Article |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e056408.full |
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| author | Dorairaj Prabhakaran Kavita Singh Ambuj Roy Bishav Mohan Rohit Tandon Abhishek Goyal Bhupinder Singh Shibba Takkar Chhabra Naved Aslam Gurpreet Singh Wander Nitish Naik Gurbhej SIngh Shivaansh Aggarwal Aftabh Saini |
| author_facet | Dorairaj Prabhakaran Kavita Singh Ambuj Roy Bishav Mohan Rohit Tandon Abhishek Goyal Bhupinder Singh Shibba Takkar Chhabra Naved Aslam Gurpreet Singh Wander Nitish Naik Gurbhej SIngh Shivaansh Aggarwal Aftabh Saini |
| author_sort | Dorairaj Prabhakaran |
| collection | DOAJ |
| description | Objective The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction.Design, setting and participants We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient’s clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations.Results Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient’s treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07).Conclusion This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician’s burden. |
| format | Article |
| id | doaj-art-f211d35e554c4a45807c0f93c8b80c3b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-f211d35e554c4a45807c0f93c8b80c3b2025-01-31T06:15:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-056408Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility studyDorairaj Prabhakaran0Kavita Singh1Ambuj Roy2Bishav Mohan3Rohit Tandon4Abhishek Goyal5Bhupinder Singh6Shibba Takkar Chhabra7Naved Aslam8Gurpreet Singh Wander9Nitish Naik10Gurbhej SIngh11Shivaansh Aggarwal12Aftabh Saini13Centre for Chronic Disease Control, New Delhi, Delhi, IndiaHeidelberg Institute of Global Health, Heidelberg University, Heidelberg, GermanyDepartment of Cardiology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaCardiology, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Cardiology, Dayanand Medical College and Hospital, Ludhiana, IndiaObjective The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction.Design, setting and participants We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient’s clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations.Results Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient’s treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07).Conclusion This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician’s burden.https://bmjopen.bmj.com/content/12/7/e056408.full |
| spellingShingle | Dorairaj Prabhakaran Kavita Singh Ambuj Roy Bishav Mohan Rohit Tandon Abhishek Goyal Bhupinder Singh Shibba Takkar Chhabra Naved Aslam Gurpreet Singh Wander Nitish Naik Gurbhej SIngh Shivaansh Aggarwal Aftabh Saini Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study BMJ Open |
| title | Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study |
| title_full | Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study |
| title_fullStr | Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study |
| title_full_unstemmed | Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study |
| title_short | Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study |
| title_sort | impact of a nurse led teleconsultation strategy for cardiovascular disease management during covid 19 pandemic in india a pyramid model feasibility study |
| url | https://bmjopen.bmj.com/content/12/7/e056408.full |
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