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https://doi.org/10.2196/17417
Title: | Evaluating safety and efficacy of follow-up for patients with abdominal pain using video consultation (SAVED Study): Randomized controlled trial | Authors: | Gunasekeran, D.V. Liu, Z. Tan, W.J. Koh, J. Cheong, C.P. Tan, L.H. Lau, C.S. Phuah, G.K. Manuel, N.D.A. Chia, C.C. Seng, G.S. Tong, N. Huin, M.H. Dulce, S.V. Yap, S. Ponampalam, K. Ying, H. Ong, M.E.H. Ponampalam, R. |
Keywords: | Abdominal pain Digital health Emergency department Primary care Teleconsultation Telereview Video consultation |
Issue Date: | Jun-2020 | Publisher: | JMIR Publications Inc. | Citation: | Gunasekeran, D.V., Liu, Z., Tan, W.J., Koh, J., Cheong, C.P., Tan, L.H., Lau, C.S., Phuah, G.K., Manuel, N.D.A., Chia, C.C., Seng, G.S., Tong, N., Huin, M.H., Dulce, S.V., Yap, S., Ponampalam, K., Ying, H., Ong, M.E.H., Ponampalam, R. (2020-06). Evaluating safety and efficacy of follow-up for patients with abdominal pain using video consultation (SAVED Study): Randomized controlled trial. Journal of Medical Internet Research 22 (6) : e17417. ScholarBank@NUS Repository. https://doi.org/10.2196/17417 | Rights: | Attribution 4.0 International | Abstract: | Background: The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. Objective: The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. Methods: The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). Results: A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (P>.99) and efficacy (P>.99) between the two groups. Conclusions: The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. © 2020 Journal of Medical Internet Research. All rights reserved. | Source Title: | Journal of Medical Internet Research | URI: | https://scholarbank.nus.edu.sg/handle/10635/198666 | ISSN: | 14388871 | DOI: | 10.2196/17417 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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