key: cord-0064347-2rpti0bp
authors: Dewitte, G; Geldof, J; Truyens, M; Lobaton, T
title: N06 Patient perspectives on the role of the IBD nurse and telemedicine during COVID-19 pandemic: results from a Belgian tertiary IBD unit
date: 2021-05-27
journal: J Crohns Colitis
DOI: 10.1093/ecco-jcc/jjab074.820
sha: 49d8f2ea598a5f6782c71c32e749b340609c9cd6
doc_id: 64347
cord_uid: 2rpti0bp

BACKGROUND: Many inflammatory bowel disease (IBD) patients experienced additional stress due to the COVID-19 pandemic. Concerns for COVID-19 disease increased the risk of immunomodulatory or biologic treatment discontinuation. Furthermore, lockdown threatened the continuity of chronic care delivery. To guarantee the continuity of care our IBD unit rapidly adapted and developed new ways of remote communication. This included telephonic clinics and telephonic pre-admission screening before every appointment at the dayclinic. In this process the IBD nurse played a pivotal role. The aim was to assess patients’ concerns during the first COVID-19 wave and their acceptance of telemedicine. METHODS: A cross-sectional study was performed using an anonymous electronic questionnaire (REDCap®) to assess IBD patients’ satisfaction regarding care delivery at the IBD unit of the Ghent University Hospital during the first COVID-19 wave. RESULTS: A total of 274 patients participated. Mean age was 47.5 years (SD ± 15.4). According to patients’ answers, 57.2% had Crohn’s disease, 34.5% ulcerative colitis and 8.3% reported ‘other’. During the first wave, 43.6% of patients contacted their IBD nurse; usually questions regarding medication (20.6%), appointments (18.4%) or SARS-CoV2 infection risk (6%). For the majority of patients (96.5%) these contacts were sufficient. In person follow-up consultation was scheduled for 178 patients. From those, 31 considered cancelling their consultation due to the pandemic and 18 effectively cancelled (Fig 1). [Image: see text] Half of the population (51.6%) received intravenous therapy at the day clinic. Telephonic pre-admission screening the day before was done for all patients and well received in most of them (98.5%). During the first wave, endoscopy was planned in 31.5% of the responding patients. A minority (11.1%) postponed or cancelled endoscopic appointments. From those, 55.6% reported that the main reason was fear of the coronavirus. Ninety-four (39.2%) of responders had a telephonic consultation during the first wave. Different aspects regarding satisfaction and acceptance of telemedicine were also assessed (Fig 2–3). [Image: see text] [Image: see text] For further follow-up, 60.2% preferred balanced combination of telephonic and face-to-face consultations. CONCLUSION: Remote ways of care delivery were generally well received during the first wave of the pandemic. Only a minority of patients cancelled appointments without discussion with the medical team. The most frequent patient concerns were about medications and appointments. The challenges in continuity of care during the pandemic created a window for new ways of care delivery in the future.

M. Iizawa* 1 , L. Hirose 1 , A. Tairaka 1 , N. Maya 2 1 Takeda Pharmaceutical Company Limited., Japan Medical Office, Tokyo, Japan, 2 Mukogawa Women's University, School of Nursing, Hyogo, Japan Background: Patients with inflammatory bowel disease (IBD) have to deal with abdominal symptoms for a long time because the disease often develops at a young age, and radical treatment has not been established. To prevent worsening of symptoms associated with IBD and delay the progression of the disease, and lead a better daily life, patients must self-manage in their daily lives. At this moment, it is not clear which kinds of self-management are effective for IBD patients. Therefore, we conducted a systematic literature review (SLR) to clarify the present status and efficacy of self-management for IBD patients and find out the effective methods of self-management intervention.

The SLR was conducted in accordance with the methods recommended by the Cochrane Collaboration Handbook7, to reduce the risk of bias and errors. The searches were performed in Embase, Medline, and Cochrane databases. Additionally, the PsychInfo and the cumulative index of nursing and allied health literature (CINAHL) databases were searched, and relevant articles were included as other sources. Abstracts and full texts were screened to select relevant articles based on the inclusion criteria. A quality assessment was undertaken by using the Cochrane risk of bias tool checklist. Results: Fifty studies met the inclusion criteria and were finally included in this review. In 31 studies, the overall population of IBD patients was included. Fourteen studies included only UC patients, 5 studies included only CD patients. Among 50 studies, 33 studies have statistically significant differences in the outcomes. We categorized the interventions and outcomes of all the studies based on Barlow's study in 2002 and analyzed the efficacy of the intervention on the outcomes. The most common intervention was informational, subsequently management of psychological effects. The most common outcome was Inflammatory Bowel Disease Questionnaire (IBDQ). We found that psychological management and interventions related to problem-solving, goal setting, action plan, and coping skills had a positive effect on the body and psychology of IBD patients. There were six studies that investigated the effects of intervention by online medical care. Half of the online intervention showed an improvement in the use of medical services. Conclusion: It is important for IBD patients and health care providers to work together to share the problem, followed by setting goals and decide on an action plan. To succeed in this process, multidisciplinary collaboration is necessary and continuous support by health care providers will be meaningful for IBD patients.

Patient perspectives on the role of the IBD nurse and telemedicine during COVID-19 pandemic: results from a Belgian tertiary IBD unit G. Dewitte* 1 , J. Geldof 1,2 , M. Truyens 1,2 , T. Lobaton 1,2 1 UZ Gent, Gent, Belgium, 2 Ghent University, Ghent, Belgium Background: Many inflammatory bowel disease (IBD) patients experienced additional stress due to the COVID-19 pandemic. Concerns for COVID-19 disease increased the risk of immunomodulatory or biologic treatment discontinuation. Furthermore, lockdown threatened the continuity of chronic care delivery. To guarantee the continuity of care our IBD unit rapidly adapted and developed new ways of remote communication. This included telephonic clinics and telephonic pre-admission screening before every appointment at the dayclinic. In this process the IBD nurse played a pivotal role. The aim was to assess patients' concerns during the first COVID-19 wave and their acceptance of telemedicine. Methods: A cross-sectional study was performed using an anonymous electronic questionnaire (REDCap®) to assess IBD patients' satisfaction regarding care delivery at the IBD unit of the Ghent University Hospital during the first COVID-19 wave. Results: A total of 274 patients participated. Mean age was 47.5 years (SD ± 15.4). According to patients' answers, 57.2% had Crohn's disease, 34.5% ulcerative colitis and 8.3% reported 'other'. During the first wave, 43.6% of patients contacted their IBD nurse; usually questions regarding medication (20.6%), appointments

For the majority of patients (96.5%) these contacts were sufficient. In person follow-up consultation was scheduled for 178 patients. From those, 31 considered cancelling their consultation due to the pandemic

During the first wave, endoscopy was planned in 31.5% of the responding patients. A minority (11.1%) postponed or cancelled endoscopic appointments. From those, 55.6% reported that the main reason was fear of the coronavirus. Ninety-four (39.2%) of responders had a telephonic consultation during the first wave. Different aspects regarding satisfaction and acceptance of telemedicine were also assessed (Fig 2-3). For further follow-up, 60.2% preferred balanced combination of telephonic and face-to-face consultations. Conclusion: Remote ways of care delivery were generally well received during the first wave of the pandemic. Only a minority of patients cancelled appointments without discussion with the medical team. The most frequent patient concerns were about medications and appointments