Digital primary care visits designed for different patient segments in the pre-pandemic era: A scoping review

Digital healthcare services have been implemented increasingly during and after the COVID-19 pandemic. They have been expected to improve access, reduce inefficiencies, improve the quality of care, lower the cost of healthcare, and provide more personalised care. This study focuses on digital visits: digital health care services that replace a general practitioner (GP) appointment in primary care. The aim of this review is to assess the perspectives used in studying digital visits, and to describe the services studied in terms of modalities used and patient segments targeted. We aim to find how digital visits were studied prior to their becoming a necessity during the COVID-19 pandemic. This is a scoping review of English language papers published between 1.1.2010-31.5.2020. The papers were eligible for the review if they focused on a digital primary care visit which replaced a face-to-face appointment with a GP. In total, 36 papers were included. Ten of the studies described services tailored to the needs of a patient segment. The rest of the studies (26/36) did not differentiate between patient segments. The most often-used perspective was that of the clinician (16/36 studies). Fifteen studies were descriptive. The costs and outcomes were rarely utilised as a perspective: the costs were used in only one study and outcomes in six. Patient experience was the perspective chosen in 11 studies. Among all the interventions, the most common modality was by phone call (20), and the second most common was asynchronous messaging and video consultation (10 each). Prior to the COVID-19 pandemic, digital visits had mostly been developed for the entire population instead of a particular segment of patients. We argue that developing them to fit the needs of a patient segment would help make them more acceptable and suitable for patients. More studies from the patient perspective are needed to develop these services to better fit the needs of patients. The situation is likely to have changed during the pandemic, as a large number of studies has been published since May 2020

Eturauhasen näytepalojen ottamisen jälkeiset tulehdukset

English summaryPeer reviewe

Reaction Time and Visual Memory in Connection with Alcohol Use in Schizophrenia and Schizoaffective Disorder

The purpose of this study was to explore the association between cognition and hazardous drinking and alcohol use disorder in schizophrenia and schizoaffective disorder. Cognition is more or less compromised in schizophrenia, and schizoaffective disorder and alcohol use might aggravate this phenomenon. The study population included 3362 individuals from Finland with diagnoses of schizophrenia or schizoaffective disorder. Hazardous drinking was screened with the AUDIT-C (Alcohol Use Disorders Identification Test for Consumption) screening tool. Alcohol use disorder (AUD) diagnoses were obtained from national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: The Five-Choice Serial Reaction Time Task (5-CSRTT) or the reaction time (RT) test and the Paired Associative Learning (PAL) test. The association between alcohol use and the RT and PAL tests was analyzed with log-linear regression and logistic regression, respectively. After adjustment for age, education, housing status, and the age at which the respondents had their first psychotic episodes, hazardous drinking was associated with a lower median RT in females and less variable RT in males, while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores (TEASs) in females. Our findings of positive associations between alcohol and cognition in schizophrenia and schizoaffective disorder are unique