{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:47:56Z","timestamp":1777880876244,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medicine"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The need for telemedicine was felt more than ever during the COVID-19 pandemic, which impacted health care worldwide. Therefore, this study aimed to determine the difficulties faced by patients in visiting the cardiac outpatient department during COVID-19, along with assessing the awareness and acceptability of telemedicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this cross-sectional study, selected patients presenting to outpatient department of a tertiary care cardiac hospital were interviewed regarding the difficulties faced by patients in visiting the outpatient department during COVID-19 and their awareness and acceptability of telemedicine using a self-designed structured questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 403 patients, 58.3% were male, the mean age was 53.04\u2009\u00b1\u200911.73\u2009years, and most (77.7%) were urban residents. Ischemic heart disease was present in 69.5%, followed by hypertension (38.7%) and heart failure (29.3%). A total of 26.6% required emergency room visits. Limited appointments (55.6%) was the most common problem faced by patients during COVID-19, followed by financial issues (17.1%), fear of acquiring infection (13.4%), and limited mobility due to lockdown (22.6%). Only 12.2% were aware of telemedicine, 4.5% had previously used it, and 41.2% were willing to opt for telemedicine in the future. No internet access (39.2%) was the key barrier to the usage of telemedicine, followed by a lack of free medicine (39%) and a lack of a smart device (31.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Limited appointments due to COVID-19 restrictions has made it difficult for patients to visit the clinics, which has led to increased emergency room visits. Telemedicine awareness was found to be limited; however, many patients were willing to adopt it provided their limitations could be overcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121231153755","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T02:34:58Z","timestamp":1675910098000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of COVID-19 on cardiovascular clinics: Are we ready for telemedicine?"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-342X","authenticated-orcid":false,"given":"Mustajab","family":"Mujtaba","sequence":"first","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sapna","family":"Kotwani","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-4176","authenticated-orcid":false,"given":"Danish","family":"Qayyum","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahir","family":"Saghir","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid Iqbal","family":"Bhatti","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Rahman","family":"Khalid","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Faisal","family":"Khanzada","sequence":"additional","affiliation":[{"name":"Dow Institute of Cardiology, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Aman","sequence":"additional","affiliation":[{"name":"Dr. Ruth K.M. Pfau Civil Hospital Karachi, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalil Ahmed","family":"Shaikh","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharfuddin","family":"Buraro","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7941-8191","authenticated-orcid":false,"given":"Musa","family":"Karim","sequence":"additional","affiliation":[{"name":"National Institute of Cardiovascular Diseases, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,2,8]]},"reference":[{"key":"bibr1-20503121231153755","unstructured":"Baclic DC, Murthy S, Emeriaud G, et al. Clinical management of patients with COVID-19\u20132nd interim guidance. https:\/\/www.cfpc.ca\/CFPC\/media\/PDF\/AMMI-CCCS-PHAC-clinical-guidance-Aug21-EN-FINAL.pdf (2020)."},{"key":"bibr2-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1016\/j.cytogfr.2020.05.010"},{"key":"bibr3-20503121231153755","unstructured":"World Health Organization. WHO Coronavirus (COVID-19) Dashboard https:\/\/covid19.who.int\/ (2022, accessed 30 December 2022)."},{"key":"bibr4-20503121231153755","unstructured":"World Health Organization. WHO Director-General\u2019s opening remarks at the media briefing on COVID-19. https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19\u201411-march-2020 (2022, accessed 12 March 2022)."},{"key":"bibr5-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1016\/j.chaos.2020.109926"},{"key":"bibr6-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000002094"},{"key":"bibr7-20503121231153755","unstructured":"Government of Pakistan. Pakistan Covid case details. https:\/\/covid.gov.pk\/stats\/pakistan (2022, accessed 30 December 2022)."},{"key":"bibr8-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2003539"},{"key":"bibr9-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1007\/s41649-020-00139-x"},{"key":"bibr10-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003042"},{"key":"bibr11-20503121231153755","doi-asserted-by":"publisher","DOI":"10.2196\/19284"},{"key":"bibr12-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-021-01471-3"},{"key":"bibr13-20503121231153755","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2021.v111i8.15786"},{"key":"bibr14-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2019.0284"},{"key":"bibr15-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-020-02299-z"},{"key":"bibr16-20503121231153755","doi-asserted-by":"crossref","unstructured":"Stankova M, Mihova P. Attitudes to telemedicine, and willingness to use in young people. InIntelligent Decision Technologies (pp. 329\u2013336). Singapore: Springer, 2019.","DOI":"10.1007\/978-981-13-8303-8_30"},{"key":"bibr17-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2020.29040.rb"},{"key":"bibr18-20503121231153755","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2020.0343"}],"container-title":["SAGE Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121231153755","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20503121231153755","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121231153755","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:25:00Z","timestamp":1777595100000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20503121231153755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":18,"alternative-id":["10.1177\/20503121231153755"],"URL":"https:\/\/doi.org\/10.1177\/20503121231153755","relation":{},"ISSN":["2050-3121","2050-3121"],"issn-type":[{"value":"2050-3121","type":"print"},{"value":"2050-3121","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"20503121231153755"}}