key: cord-0702701-jtzu8awu
authors: Dahiya, Monica; Olayinka, Lily; Kaplan, Gilaad; Reeb, Leanne; Ma, Christopher; Panaccione, Remo; Kroeker, Karen I.
title: Fr098 IMPACT OF COVID-19 PANDEMIC IN IBD PATIENT CARE
date: 2021-05-31
journal: Gastroenterology
DOI: 10.1016/s0016-5085(21)01261-0
sha: fad58a9c236f278f781e12d46f0b39be27f12930
doc_id: 702701
cord_uid: jtzu8awu

nan

BACKGROUND The COVID-19 pandemic is affecting patients and healthcare providers worldwide. During the first wave of the pandemic, healthcare delivery shifted from inperson to virtual clinics. Non-urgent and some emergent procedures, including endoscopies, surgeries, and imaging, were delayed to limit the spread and divert resources to . AIMS To assess the impact of the COVID-19 pandemic in care to IBD patients METHODS A survey study was conducted to assess the impact of the COVID-19 pandemic on IBD care. All patients had a virtual clinic appointment between March to July 2020 at either: University of Alberta Hospital or the University of Calgary Clinic. A section of the survey assessed patient experience of virtual clinics and delays in access to IBD care during the COVID-19 pandemic. RESULTS A total of 1581 patients were contacted to complete the survey. 628 patients agreed to participate in the survey, however not all patients completed each component. 423 patients reported which hospital they receive their care: 71.2% (301) were from the University of Alberta, 24.6% (104) were from the University of Calgary, and 2.9% (18) did not list either hospital. 429 patients provided a postal code, where 71.8% (308) were from either the Calgary or Edmonton metropolitan area. The mean age of patients who participated in the survey was 48 years (SD = 15.19) . 408 patients responded to satisfaction/future use questions: 84.3% (344) patients agree/strongly agree they were comfortable communicating to the physician using the remote system, 77.5% (316) of patients agree/strongly agree that virtual clinic is an acceptable way to receive healthcare services, 84.8% (346) of patients agree/strongly agree they would use virtual care services again, and 82.6% (337) agree/strongly agree they were satisfied with the telehealth system. Table 1 shows additional challenges experienced by patients. Overall, 17.3% of patients reported some type of delay in care by July 2020. Table 2 shows the proportion of patients with a delay by type of care and the median delay: 5.7% of patients with IBD had surgery delayed by a median of 10 weeks (8-16 weeks). Of note, 73.9% (51) of patients were from the University of Alberta, 23.2 (16) were from the University of Calgary, and 2.9% (2) patients did not associate with either hospital. Additionally, 75.4% (52) of patients who experienced delays live within the Calgary/Edmonton metropolitan area. CONCLUSION: While some delays in healthcare delivery occurred during the first wave of the pandemic, overall 82.7% of patients with IBD maintained their care without disruption. Sustaining healthcare delivery to the IBD community required adaptation to virtual care; however, patient satisfaction was overwhelming positive among patients with IBD. Background In light of the COVID-19 pandemic, gastroenterologists in Alberta moved to virtual care for many clinic visits. As the public health situation evolves, it is important to evaluate provider satisfaction with virtual care during these unprecedented times. Aim To assess healthcare provider (HCP) satisfaction with virtual care during the COVID-19 pandemic. Methods We administered a 20-item satisfaction survey that assessed the usefulness, ease of use, interface qualities, reliability, and overall satisfaction with virtual care tools for the delivery of care to patients with gastrointestinal diseases. One hundred and twenty-five gastroenterologists in Alberta were invited to participate via email. We used a modified Telehealth Usability Questionnaire (TUQ) which was open for response from June 19-August S-218 AGA Abstracts 30, 2020. Results The overall response rate was 19% (24/125) with 46% female respondents. Most respondents worked in an academic facility (63%) and had been in practice for a mean duration of 12.3 years. Respondents were from seven facilities within the South, Calgary, Central and Edmonton health zones. Virtual care reported was a hybrid model consisting of telephone and in-person (54%) or telephone and video consults (42%). Although 90% indicated that virtual care tools improved access to healthcare, provided location flexibility and were appropriate to meet healthcare needs, only 42% agreed that it saved time. Inconclusive virtual consultations due to the absence of physical examination and missing lab values was reported by 75% and 33% of HCPs, respectively. Ninety-five percent of HCPs who used video conferencing found it simple, easy to learn and were able to become productive quickly with it. Over 60% of HCPs reported that virtual care (irrespective of the platform used) was not the same as in-person visits. The mean overall satisfaction for healthcare providers who rarely or never had virtual care prior to the pandemic, was 0.57 points higher than those who often provided virtual care (4.36 vs 3.79; 95% CI: 0.26-0.88, p=0.001). Overall, 88% of providers were satisfied with virtual care and all respondents were willing to use it again (Figure 1 ). Identified areas of concern included patient safety, patient education on best practices, adequate remuneration, additional administrative duties, and challenges with providing care for new patients on virtual platforms. Conclusion This survey of GI providers in Alberta showed high satisfaction and acceptance with virtual care. However, the majority reported it to be less reliable than in-person visits. Access to Alberta Netcare to view investigations was deemed valuable. Areas of concern that needs to be addressed include patient education on virtual care best practices and provider resources to assist with new consultations on virtual platforms.

Andrea Costantino, Luca Elli, Daniele Noviello, Leda Roncoroni, Francesco Simone Conforti, Nicoletta Nandi, Stefano Mazza, Vincenza Lombardo, Maurizio Vecchi, Flavio Caprioli Background and Aim Telehealth includes both health care delivery (often identified as telemedicine) in terms of disease diagnosis or treatment and several other services, such as prevention, education and public health promotion. 1 During the recent COVID-19 pandemic, worldwide telemedicine has enabled many patients with chronic diseases to get access to remote assistance, since it has emerged as the ideal solution to overcome the restrictions to perform regular non-urgent follow-up visits to chronic patients and to continue patients' assistance. Some positive reports on the use of telemedicine in gastroenterology among healthcare providers and patients have been published, but a patient's trust perspective about video-consultations has been missing to date. [2] [3] [4] [5] Our study aimed at ascertaining our gastroenterological patients' trust in video-consultations during the COVID-19 pandemic. Material and Methods At our Gastroenterology Unit in Milan (Italy), which is a tertiary referral center for Inflammatory Bowel Diseases (IBD) and Celiac Disease (CeD), telemedicine was used in place of on-site follow-up visits scheduled but not provided during the COVID-19 pandemic: all IBD and CeD outpatients received a phone call, while video-consultations were performed to patients with mild-to-moderate symptoms, with bio-umoral alterations or as needed for those patients who requested it. The patient's trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire. 6 The primary endpoint was expressed as a percentage greater than 75% of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements about telemedicine. Results One hundred eighty-eight out of 218 scheduled (86.2%) video-consultations were performed. Among the 188 visits, 163 (86.7%) questionnaires were compiled. The primary endpoint of trust in the telemedicine service was achieved in 95.2%, 89.7% and 87.3% of the respondents for the three selected key statements (trust the service, its capability to solve clinical problems, ease to use). Conclusion During the COVID-19 pandemic our results showed that most of our IBD and CeD patients accepted and trusted video-consultations as an alternative to the traditional in-person examination.

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