Patient Experience Research Articles

The Urban Hospitalisation Experience of Rural People: A Scoping Review.

Hospitalisation is often typically a stressful experience, but in the face of admission into hospital at a distance from home, the experience can be particularly anxiety-provoking. To describe the urban hospitalisation experiences of rural patients and their relatives who have travelled and relocated for treatment and determine the scope and coverage of the literature on this issue. The review utilises a scoping review method. CINAHL, MEDLINE, PsycINFO and EMBASE were searched for primary studies dated from inception to October, 2022. Thirty-four articles were included in the review. Using an inductive narrative approach, data were extracted, collated and summarised into key themes. Six themes were identified: Rural Indigenous peoples' experience, the promise of urban quality, separation from support networks, interactions with staff, managing out-of-hospital responsibilities and transitioning home. Underpinned by isolation and unfamiliarity, hospitalisation away from one's local community entails significant psychological stress that compounds the stresses of illness that require admission into the hospital. Findings demonstrate the dynamic nature of the healthcare encounter, illustrating the multiplicity of the experience and how some aspects of the experience cut across others. This scoping review conceptualises the urban hospitalisation experiences of rural people and illustrates the impact of isolation and unfamiliarity on their in-hospital behaviours, perceptions and interactions. PRISMA Extension for Scoping Reviews (PRISMA-ScR). No Patient or Public Contribution.

Incorporating Patient and Family Perspectives into ICU Environmental Design: A Systematic Review and Narrative Synthesis of Existing Literature.

This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes. Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery. While architects historically dominated design decisions, there's no recognition of the necessity to integrate patient and family perspectives. However, such efforts remain rare despite professional guidelines advocating for multi-professional team involvement. This review summarises the published literature on built ICUs that have incorporated patient and family input into the design process. It evaluates methodologies used and measures patient-centric outcomes to identify successful examples and areas for improvement in future initiatives. The limited published literature identifies only three projects successfully integrating patient and family input into ICU design. Additionally, one project was identified in a search of the gray literature. However, these projects often lack rigorous evaluation of patient-centric outcomes, with initiatives involving patients and families remaining uncommon. The review underscores the need for more comprehensive evaluation and greater emphasis on patient and family involvement in ICU design. This review emphasizes the significance of integrating patient perspectives into ICU design to enhance outcomes and improve experiences. While progress has been made in recognizing their importance, more efforts are needed to prioritize patient and family involvement for creating conducive environments for healing and recovery.

Synthesis of existing literature on the colorectal surgery patients’ challenges during hospital-to-home transitions: a scoping review protocol

IntroductionDespite advances in innovation to improve patients’ transition experiences, it is unclear—in the context of colorectal surgery—what elements of patient education and care could provide the greatest benefit to patient...

Patient experiences of behavioural therapy for bipolar depression: A qualitative study.

Although multiple qualitative studies have explored participants' experiences of behavioural activation (BA) for unipolar depression, none have investigated the experiences of BA in people with bipolar depression. This is of particular interest because qualitative studies concerning the experience of receiving therapy can help inform the theory of change underpinning the intervention. The purpose of this study was to explore the experiences and perspectives of individuals with bipolar disorder who received a course of one-to-one BA for bipolar depression. We sought to explore participants' experience of the effects of BA therapy, both proximally and distally. Semi-structured interviews were conducted with nine individuals meeting research diagnostic criteria for bipolar I or II disorder who had received up to 20 sessions of BA adapted for bipolar depression. Thematic analysis using a framework approach was used to explore and describe the experiences of participants. Participants' perspectives on the impact of therapy were categorized under four subthemes: client behaviour inside and outside sessions, changes in clients' perspectives, the impact on symptoms and impact on life and functioning. Participants' accounts of the impact of therapy were broadly consistent with the theory underpinning a behavioural approach. Participants described a central role for perspective change, and particularly increased acceptance of the self and mood states, as facilitating behavioural changes and more distal benefits. Process evaluations embedded in future trials may include quantitative measures of key processes described by our participants, as well as those clearly implied by the behavioural theory of depression.

A Qualitative Study on the Experiences of Patients with Pulmonary Hypertension Undergoing Polypharmacy

Aims/Background Pulmonary hypertension (PH) is a severe progressive disease characterized by elevated blood pressure in the lungs. Medications are a critical form of treatment for patients with PH. This study aims to explore the experiences of patients with PH undergoing polypharmacy, thereby providing a more concrete foundation for formulating targeted intervention measures. Methods A purposive sampling method was used to select 13 PH patients treated in a grade III hospital in Zhejiang Province from December 2023 to February 2024 as the research subjects. This study is a descriptive qualitative research design, where the patients were interviewed face-to-face in a semi-structured manner. The data were analyzed, summarized and extracted using the traditional content analysis method. Results There were five themes and ten sub-themes surrounding the polypharmacy experiences of the PH patients: (1) Negative emotional experience of multidrug use, including lack of disease-related medication knowledge and insufficient ability to obtain medication information; (2) Complex physical testing of multiple drugs, including adverse reactions and complex dose titration; (3) Economic burden; (4) Coping difficulties, including insufficient drug safety, excessive reliance on medical personnel, and lack of opportunities for deep participation; (5) Desire for supports, including professional and social support, as well as those from family, colleagues and classmates. Conclusion Disease, treatment, psychological factors, and social customs affect PH patients’ drug use post-diagnosis, with varying experiences and degrees. Healthcare providers must offer tailored care and practical strategies for managing multiple drug use, considering patients’ unique experiences and needs.

Beyond pathology: Patient experiences of laparoscopy for persistent pelvic pain with no identifiable cause found.

Laparoscopy has often been considered a core part of the workup for pelvic pain. However, many of these laparoscopies find no pathology. To evaluate the experiences of patients following laparoscopy for pelvic pain when there is no diagnosis found. This descriptive qualitative study reviewed patients who underwent a diagnostic laparoscopy for persistent pelvic pain with no pathology found. Participants completed a written questionnaire and an in-depth semi-structured interview. Interview data were thematically analysed. Fifteen patients were interviewed with a median age of 30 years. Six themes were identified: desire for a diagnosis, hope as a coping strategy, inadequate communication, having 'next steps' of management offered, mental health impacts, and system issues. Participants wanted a diagnosis to help understand their condition, to enable connection with others, and believed that clinicians viewed pain with a diagnosis more seriously. Participants who were confident preoperatively that laparoscopy would lead to a diagnosis reported this contributing to poorer postoperative mental health. Participants discussed diagnoses not listed in the medical records, which provided hope for future management options. Participants reported worse mental health following the laparoscopy. This study provides insight into the experiences of patients following a laparoscopy without an identifiable diagnosis. It highlights the importance of pre- and postoperative counselling, including discussing the potential for no findings at laparoscopy; the language used around other potential diagnoses; and the value in considering a patient's pre-existing mental health. The findings of this study are relevant for all clinicians counselling people with persistent pelvic pain where endometriosis is suspected.

Pulmonary and Physical Virtual Reality Exercises for Patients With Blunt Chest Trauma: Randomized Clinical Trial.

Adequate pain relief, early restoration of breathing, and rapid mobilization pose a clinical challenge in patients with blunt chest trauma. Virtual reality (VR) has the potential to achieve these 3 interrelated treatment objectives with enhanced self-efficacy and autonomy of patients and limited support by clinicians. This study aimed to assess the effectivity of breathing and physical exercises using VR on the pulmonary recovery of patients with blunt chest trauma at the ward. A pilot randomized controlled trial was performed. The control group received usual physiotherapy consisting of protocolized breathing exercises (8 times daily for 10 minutes) and physical exercises (2 times daily for 10 minutes). The VR group was instructed to perform these exercises using VR. The primary outcome was vital lung capacity at day 5 or earlier at discharge. Secondary outcomes were patient mobility (time standing, lying, and sitting), clinical outcomes (length of hospital stay, pulmonary complications, transfer to intensive care unit, and readmission within 30 days), pain, activities of daily living, patient-reported outcome measures (satisfaction and quality of recovery). Patient experiences and barriers and facilitators toward implementation were assessed through interviews. The study was prematurely ended due to enrollment failure combined with poor protocol adherence to exercises in both groups. A total of 27 patients were included, of which 19 patients completed 3 or more days. Vital lung capacity at 5 days (or last measurement) was equal between groups with 1830 (SD 591) mL and 1857 (SD 435) mL in the control and VR groups, respectively. No marked differences were observed in secondary outcomes. Patient interviews showed positive attitudes toward the use of VR, describing that visualization of the exercises helped patients to perform the exercises correctly and to continue the exercises for a longer duration. Also, patients experienced the immersiveness of VR as an analgesic. However, patients did not experience added value over usual care and reported that better integration in treatment and the hectic hospital environment could improve the use of the VR exercises. The suitability of patients to use virtual reality therapy (VRx) in a hospital (trauma) ward setting is lower than generally expected. Effective application of VRx requires professional guidance and needs thorough alignment with clinical practice. For future research, we recommend to chart adherence to study protocol before designing a VR clinical trial. Patient-reported experiences need to be prioritized in evaluating VR acceptance, usability, and effectiveness. In line, we recommend performing a systematic analysis (eg, using the technology acceptance model) on the acceptance before pilot or main effectiveness studies. Finally, the eligibility of patients and exclusion of patients due to the inability to use VRx should be routinely reported. ClinicalTrials.gov NCT05194176; https://tinyurl.com/2bzh4tzx.

Using Learning Health System Principles to Embed Patient Experience Data in Primary Care: A Qualitative Investigation.

Though an important component of high-quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university-affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators. A co-designed qualitative case study was conducted with academic researchers and staff from a university-affiliated general practice in Australia. Semi-structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five-domain learning health systems framework, and with additional codes capturing barriers and facilitators. Eighteen (53%) practice staff were interviewed, including general practitioners (n=11), a practice nurse (n=1), and administrative staff (n=6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement. This study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.

Patients’ Perceptions of Cannabis Contamination in Florida's Medical Program

Introduction As medical cannabis becomes more accessible, product quality must be evaluated. Researchers identified a social media community where Florida medical cannabis patients discuss personal experiences. The objective of this study was to analyze posts in this community to understand patient experience with products purchased from Florida medical dispensaries they believed to be contamination, perceptions of product quality, and desired changes to the Florida program. Methods Social networking theory acted as the underlying framework, and we employed a qualitative case study design to identify mentions of possible contamination and understand patient perceptions of contamination and the Florida medical cannabis program from the Reddit community FLMedicalTrees. The lead researcher conducted a social media analysis of posts identified as containing discussions relevant to product contamination. Constant comparison methods were used to code data, arrive at themes, and maintain validity and reliability of interpretation of coded themes. Results Of 300 post mentions of contamination, 98 posts were identified as relevant following review. Key results were: 1. Multiple mentions of possible contamination for products from medical cannabis dispensaries reported by Florida program patients. 2. Patients sought second opinions when concerned about possible contamination and shared personal experiences as well as advice on what concerned patients should do if they believe they have contaminated products. 3. Some patients expressed feelings of anxiety and worry about health, safety, and quality control, while others that described possible product contamination did not express concern. 4. Patients wanted changes regarding vertical integration, company accountability, state oversight, and home grow law. Conclusions Medical cannabis patients and providers could benefit from education on responding to possible contamination within medical cannabis products. Policymakers should consider these findings when setting regulations around contamination testing thresholds, dispensary oversight, and other regulations that directly impact patient safety like allowing patients to see products before purchase.

Patients' Experiences of Healthcare Professionals' Competence in Digital Counselling in Healthcare Settings-A Qualitative Systematic Review.

To critically appraise and synthesise qualitative evidence about patients' experiences of healthcare professionals' competence in digital counselling in healthcare settings. A qualitative systematic review. The review followed the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. The review included studies that focused on patient experiences of healthcare professionals' competence in digital counselling and were published in English, Finnish or Swedish, with no time limits. Study selection, quality appraisal and data extraction were performed by two independent reviewers. Findings from the studies included were pooled using the meta-aggregation method. Eight databases (Web of Science, CINAHL, Scopus, PsycArticles, Medic, Medline (Ovid), EBSCO Open Dissertations and MedNar) were systematically searched on 25 September 2023. Sixteen studies (published between 2009 and 2023) were included in the review, from which 42 findings were extracted and organised into eight categories based on their meaning. Three synthesised findings were identified: (1) Competence to provide efficient digital counselling, (2) competence to support patient self-management during digital counselling and (3) competence in establishing a reciprocal relationship in digital counselling. The evidence from the review can be used to support healthcare professionals' competence in digital counselling. It was found that competence in digital counselling includes the competence to provide digital counselling that is efficient and enables counselling to be implemented in health care, supports patients to self-manage and establishes a reciprocal counselling relationship in a digital environment. Recognising healthcare professionals' competence in digital counselling can enhance their motivation and professional growth, potentially improving the quality of services and patient outcomes. These findings can inform the development of healthcare education, fostering the training of more competent healthcare professionals and digital counsellors. The review was undertaken and reported using the PRISMA guidelines. PROSPERO CRD42024499509. No Patient or Public Contribution.

Customizing subcutaneous immunoglobulin administration in primary antibody deficiency: patient-centric care perspectives.

This report delves into the challenges and potential solutions associated with flexible, customized subcutaneous immunoglobulin (SCIG) infusion regimens for patients with primary antibody deficiency disease (PAD). Advances in the treatment of inborn errors of immunity, particularly PAD, have converted fatal diseases into chronic, complex, long-term conditions that make adherence to treatment a critical issue. Conventional SCIG infusion regimens, while clinically effective, may not always align with the varied lifestyles, changing lifestyles and commitments of patients which can lead to missed doses, diminishing adherence thus posing potential health risks and compromising the overall effectiveness of treatment. For these reasons, it's important to develop flexible infusion regimens tailored to meet individual patient needs. Patient-centric strategies that promote shared decision-making and awareness of patient status not only promote medical efficacy but also enhance the overall patient experience. The authors of this report call attention for a need to shift toward more adaptable and individualized SCIG treatment plans for PAD patients whose needs may change over the long-term course of treatment.

Patient and carer experiences of hospital-based hybrid virtual medical care: a qualitative study.

To understand patients' and carers' experiences of virtual medical care delivered into rural and remote hospitals. Qualitative study using semi-structured interviews. Interviews were conducted between 7 June 2022 and 21 February 2023. Participants were people who had received a virtual medical service from the Virtual Rural Generalist Service (VRGS), and their carers, in rural and remote hospitals within the Western NSW Local Health District. Acceptability of, access to, quality of and appropriateness of care provided by the VRGS. We interviewed 43 patients and carers about their experiences of VRGS services received in an emergency department or inpatient setting. About half of our participants thought that virtual medical care (supported by in-person nursing staff) was highly acceptable and equivalent to in-person care. For the remaining participants, virtual care was seen as being an acceptable alternative if in-person care was not available. Patients reported that the model met their immediate needs, even if the virtual delivery mode was not their preference. VRGS doctors were generally seen as skilled and personable, and acceptability of virtual care increased with more experience of it. A key perceived benefit of virtual care was increased access to medical care without the need to travel long distances. Hospital-based virtual care was not considered less appropriate for older adults or children. Virtual care in a rural hospital setting, such as that delivered by the VRGS, is broadly acceptable to patients and carers. While most would prefer to have a doctor physically present, patients and carers are accepting of the need for virtual care to supplement in-person care in rural and remote areas. Patients and carers who experience hospital-based virtual care perceive that it can provide good quality medical care and meet many of their needs.

Patients' experience on waiting for spinal arthrodesis: a qualitative study.

A number of studies have explored patients' subjective experience of waiting for spinal surgery, however, they did so through an investigation conducted post-operatively. Thus, the aim of this study was to explore the experience of patients while still on the waitlist for lumbar spinal arthrodesis. This qualitative study of semi-structured interviews was conducted at an orthopedic research institute in Italy. The interview track was developed by a team of professionals (physiotherapists, orthopedic surgeon, psychologist) and consisted of 40 questions. Fifteen patients, 10 females and 5 males aged between 23 and 80years, waiting for spinal arthrodesis were interviewed. The interviews were performed, transcribed and analyzed by the multiprofessional team through thematic analysis using a reflexive approach. Five main themes were generated: (1) Impact of persistent pain on patients' physical and psychological functioning; (2) Fear of the unknown and uncertainties; (3) Hope and regaining normality; (4) The impact of the unpredictability of the waiting time; (5) Need for better communication and information on the care pathway. Two minor themes were also produced. These findings highlighted that patients on the waiting list for spinal arthrodesis need more certainty about waiting times, better communication with hospital staff, more thorough information about their care pathway. This could help patients feel more confident and may lead to more adequate expectations before surgery. The study protocol was registered on ClinicalTrials.gov database on 14/03/2022 with ID number NCT06323694.

Experience of patients and healthcare practitioners with interdisciplinary care in immune-mediated inflammatory diseases with skin manifestations: A systematic scoping review.

Immune-mediated inflammatory diseases with skin manifestations (skIMIDs) may affect multiple organs. Interdisciplinary care (IC) can overcome the fragmented knowledge used in the management of skIMIDs. In skIMIDs-care, patient and healthcare practitioner (HCP) satisfaction with IC is unknown. Yet, patient experience influences adherence and medical outcomes. Moreover, HCP experience influences professional satisfaction, perception of care quality and autonomy. Thus, measuring patient and HCP experience can identify areas for improvement in care delivery. The aim of this scoping review was to gather evidence on patient- and HCP perceptions on skIMID-IC and their measurement. We systematically searched on 30 August 2023 PubMed/EMBASE/Cinahl/Web of Science. Eligible studies had to address explicitly experience of IC by patients or HCPs. A conceptional synthesis appraised how experiences were measured and IC was perceived by patients and HCPs. The database search resulted in 21 eligible studies. Fourteen described positive patient and HCP experiences with a specific IC programme. These studies were heterogenous on the levels of IC models, medical conditions, measurement methods and outcomes. Despite that patients and HCPs rated such tailored IC models positively, seven studies on a geographically broader region reported less satisfaction with IC. A conceptual analysis identified domains deemed as important regarding IC: 'general satisfaction', 'patient-HCP interaction', 'information', 'functioning of IC', 'benefits of IC'. For patients, 'access to care' and 'disease management' were added. For HCPs 'illness perception' was deemed relevant. The heterogeneous way in how IC experience is captured hinders strong conclusions, which mandates the development of standardized analysis tools. Experience with IC in skIMIDs strongly depends on the context of the provided IC and patient experience seems to be better in local IC programmes than systems rolled out in larger geographical regions. Future need is to develop a core IC outcome set including medical outcomes, process indicators, financial indicators, plus patient and HCP care experience measures.

Implementation of Diabetic Remote Patient Monitor for Underserved Population.

A nurse-led interprofessional clinic adopted the use of remote patient monitoring (RPM) for glucose monitoring to better serve their patient population of uninsured patients with uncontrolled diabetes. The adoption of the RPM system required an infrastructure design to connect multiple data points and adapt to the needs of the clinic's unique patient population for a seamless provider and patient experience. Implementation requirements were addressed in three phases: protocol adaptation, enrollment workflow, and clinic management of RPM patients.

The role of cultural competence in health care to improve communication between immigrant patients and health-care providers in Ottawa, Canada

Purpose Cultural competence has been recognized as an essential process in reducing racial and ethnic health-care disparities and improving equity in health care. Recent immigrants to Canada encounter a different and unfamiliar health-care system. This study aims to focus on examining the role of cultural competence in improving communication between immigrant patients and their health-care providers. Design/methodology/approach Using an exploratory approach, four focus group discussions with a sample of recent immigrants were conducted to gain insights from immigrant patients’ perspectives with regard to communicating with their health-care providers. The focus group discussions were analyzed using a thematic analysis approach. Campinha-Bacote’s Cultural Competence Model was used for this study as its theoretical framework. Findings The focus group findings revealed that the lack of cultural competence among health-care providers and language barriers are major issues that impact the health-care experiences of immigrant patients. Health-care organizations may use these findings to better inform their decision-making with regard to effective patient–provider communication. Originality/value This study advances the line of research that examines patient–provider communication by adding diverse immigrant patients’ perspectives. The findings can inform the design of cultural competence strategies for health-care organizations.

Human–Computer Interaction in Healthcare: A Bibliometric Analysis with CiteSpace

Background/Objectives: Studies on the application and exploration of human–computer interaction (HCI) technologies within the healthcare sector have rapidly expanded, showcasing the immense potential of HCI to enhance medical services, elevate patient experiences, and advance health management. Despite this proliferating interest, there is a notable shortage of comprehensive bibliometric analyses dedicated to the application of HCI in healthcare, which limits a thorough comprehension of the growth trends and future trajectories in this area. Methods: To bridge this gap, we employed bibliometric methods using the CiteSpace tool to systematically review and analyze the current state and trends of HCI research in healthcare. A meticulous topic search of Web of Science yielded 3598 papers published between 2004 and 2023. Results: Through literature analysis, the most productive researchers, institutes, and countries/territories and the collaboration networks among authors and countries within the field were analyzed. Additionally, by conducting a co-citation analysis, journals and literature with high citation rates and influence within the academic community in this field were revealed. Through a cluster analysis based on literature co-citations and keyword burst analyses, we further explored the main research themes and hot topics within the fields of healthcare and HCI. Conclusions: In summary, through a comprehensive and systematic bibliometric analysis, this study provides a solid knowledge foundation for HCI in the healthcare research community, thereby fostering the development of innovative research and the optimization of practical applications in the field.

Voluntarily Stopping Eating and Drinking: Systematic Review of Empirical Studies.

Objective: To systematically review studies presenting quantitative data on the experiences of patients and providers engaged in VSED. Background: Voluntarily stopping eating and drinking (VSED) to purposefully accelerate the end of life is uncommon but likely accounts for thousands of deaths per year. A single systematic review of literature was published in 2014. Methods: We systematically searched English-language articles and books in MEDLINE/PubMed and reference lists of retrieved articles and books. Studies that provided empirical results from surveys or qualitative studies were selected. We obtained from each study publication year, study type, country, population source, sample size, outcomes, and results, and graded each on quality. Results: Of the 17 empirical publications not included in the 2014 review, 3 were conducted in the US. Eight surveys were rated as moderately high/high quality and six as moderately low/low quality. Incidence estimates ranged from 0.4%-1.7% of all deaths. VSED was generally attempted among the elderly, often 80+ year-olds. About half of participants had dementia or other conditions that would make them ineligible for medical aid in dying. Incapacitating depression was rare. The mean time to death was 10 days with a range of one to two weeks. Most experiences were considered satisfactory by the patient. Caregivers often found preparation for and the emotional toll from VSED challenging. Theoretical support for VSED was ubiquitous among health care professionals in Europe, who expressed the importance of palliative support. However, professional experience was lacking. Conclusion: VSED, albeit uncommon, still accounts for many, typically satisfactory, deaths. Little research to guide best practice is available, particularly in the United States. Caregivers and health care providers generally indicate support however, extensive preparation and caregiver assistance make the practice challenging. Practitioners express a need for training.

A new telemedicine-based sleep service using WatchPAT® ONE for patients with suspected OSA: what does the patient experience?

Obstructive Sleep Apnea is a widespread disease but is very underdiagnosed and undertreated. The aim of this study is to assess the effectiveness and patient satisfaction of using the WatchPAT® ONE, a disposable home sleep apnea test device, within a telemedicine-based management pathway. All patients who used the telemedicine services for OSA diagnosis using the WatchPAT® ONE were prospectively enrolled in the study. Patients receive the device at home and download its associated application to learn how to perform the test autonomously at night. Clinicians then review automated results transmitted by the cloud and conduct the follow-up visit via telemedicine, providing diagnostic and therapeutic guidance. The study included 167 patients (78% male; mean age 55 ± 14 years; BMI: 27.5 ± 4.5kg/cm²), with a mean distance of 147.29 ± 172.35km from our hospital. The median time from test request to result delivery was 5 working days. The study cohort showed a median pAHI of 16.7 events/h, a median pODI was 7.9 events/h, and an pRDI of 20.7 events/h. 99% of respondents were satisfied with the remote management. Half of the subjects found both the application installation and the device operation extremely easy, and 60% of them were willing to recommend the use of WatchPAT® ONE. The telemedicine pathway represents an efficient and patient-friendly method for diagnosing OSA. This approach improves diagnostic ease and accessibility while reducing time to diagnosis and societal and healthcare costs. Further large-scale studies are necessary to confirm these results.

Transcatheter mitral valve replacement to treat rheumatic mitral stenosis: a case series

BackgroundRheumatic mitral stenosis (RMS) is a common valvular heart disease in developing countries. We sought to evaluate the early experience of patients with RMS undergoing transcatheter mitral valve replacement (TMVR).MethodsIn this retrospective study, a total of 5 RMS patients accepted TMVR. All patients underwent computed tomography and echocardiography before having the procedure. After the preprocedural comprehensive evaluations, the surgeons planned to use the Prizvalve (a novel balloon-expandable transcatheter aortic valve system which is now under the clinical registration study) for TMVR. Clinical data were collected at baseline, before discharge, and at the 30-day follow-up.ResultsThe median age of the 5 RMS patients was 61 years (range 60–77 years); 60% were male, and the median Society of Thoracic Surgeons score was 13.3% (range 6.2–17.1%). TMVR was successful in all patients. Postoperative transesophageal echocardiography showed that 60.0% (n = 3) of the patients had no paravalvular leakage and 40.0% (n = 2) had trace paravalvular leakage. The median postoperative peak velocity decreased to 1.4 m/s (range 1.1–1.7 m/s), and the median pressure gradient decreased to 3 mmHg (range 2–3 mmHg). No deaths occurred at the 30-day follow-up, and all patients had an improvement of ≥1 on the New York Heart Association functional rating.ConclusionsOur early experience with TMVR in RMS patients suggests that it is a safe and feasible procedure. The early results of the procedure are acceptable and provide bright prospects and directions for the precision treatment of RMS. Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT02917980).