Browsing by Subject "Occupational Health"

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Open Access
Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper.
(Hypertension (Dallas, Tex. : 1979), 2020-11) Omboni, Stefano; McManus, Richard J; Bosworth, Hayden B; Chappell, Lucy C; Green, Beverly B; Kario, Kazuomi; Logan, Alexander G; Magid, David J; Mckinstry, Brian; Margolis, Karen L; Parati, Gianfranco; Wakefield, Bonnie J
Telemedicine allows the remote exchange of medical data between patients and healthcare professionals. It is used to increase patients' access to care and provide effective healthcare services at a distance. During the recent coronavirus disease 2019 (COVID-19) pandemic, telemedicine has thrived and emerged worldwide as an indispensable resource to improve the management of isolated patients due to lockdown or shielding, including those with hypertension. The best proposed healthcare model for telemedicine in hypertension management should include remote monitoring and transmission of vital signs (notably blood pressure) and medication adherence plus education on lifestyle and risk factors, with video consultation as an option. The use of mixed automated feedback services with supervision of a multidisciplinary clinical team (physician, nurse, or pharmacist) is the ideal approach. The indications include screening for suspected hypertension, management of older adults, medically underserved people, high-risk hypertensive patients, patients with multiple diseases, and those isolated due to pandemics or national emergencies.
Open Access
Guidance to employers on integrating e-cigarettes/electronic nicotine delivery systems into tobacco worksite policy.
(J Occup Environ Med, 2015-03) Whitsel, Laurie P; Benowitz, Neal; Bhatnagar, Aruni; Bullen, Chris; Goldstein, Fred; Matthias-Gray, Lena; Grossmeier, Jessica; Harris, John; Isaac, Fikry; Loeppke, Ron; Manley, Marc; Moseley, Karen; Niemiec, Ted; OʼBrien, Vince; Palma-Davis, LaVaughn; Pronk, Nico; Pshock, Jim; Stave, Gregg M; Terry, Paul
In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.
Open Access
Steps to Health employee weight management randomized control trial: short-term follow-up results.
(J Occup Environ Med, 2015-02) Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca JN; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M
OBJECTIVE: To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System. METHODS: A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline. RESULTS: There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms. CONCLUSIONS: The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.
Open Access
Worksite medical home: health services use and claim costs.
(Am J Manag Care, 2015-07-01) Conover, Christopher; Namenek Brouwer, Rebecca; Adcock, Gale; Olaleye, David; Shipway, John; Østbye, Truls
OBJECTIVES: To examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals. STUDY DESIGN: The study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters. METHODS: Three years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC). RESULTS: After adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001). CONCLUSIONS: Employees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.