Background: To quantify the effects of COVID-19 on our inflammatory bowel disease (IBD) unit, including service provision, prescribing practices and use of therapeutic drug monitoring (TDM). Methods: We performed a single centre retrospective observational cohort study.
Background and Aim
Patients with chronic diseases are believed to be at increased risk of mental health conditions during the COVID‐19 pandemic. We aimed to assess the incidence of psychological morbidity in inflammatory bowel disease (IBD) patients during the COVID‐19 pandemic, explore for association with risk of severe COVID‐19 and other factors, and establish patients' interest in psychological support.
Methods
A survey including the Patient Health Questionnaire‐9, General Anxiety Disorder‐7, and Perceived Stress Scale tools for depression, anxiety, and stress was administered to IBD patients from a tertiary center in London, United Kingdom, in June 2020.
Results
Two hundred seventy‐four patients responded to the survey (57% response rate), with 271 (99%) completing it. Moderate–severe depression was observed in 61 (22.5%), while 49 (18%) had moderate–severe anxiety; 39 (14%) had both diagnoses. Mean (SD) stress score was 16.2 (7.4). There was no association between degree of severe COVID‐19 risk and psychological morbidity. Flare symptoms and fatigue were associated with worse psychological morbidity, while accessibility of information regarding COVID‐19 risk and reducing that risk was protective for depression (odds ratio [OR] 0.56 [0.33–0.94], P = 0.03), anxiety (OR 0.62 [0.4–0.96], P = 0.03), and stress (standardized β‐coefficient −0.15 [−0.28 to −0.03], P = 0.02). Seventy‐nine (30%) respondents were interested in receiving psychological support during the pandemic, while 200 (76%) expressed interest beyond the pandemic.
Conclusions
Although depression, anxiety, and stress among IBD patients during the pandemic were common, their frequency was similar to pre‐pandemic rates and recent general population levels. Ensuring easy access to personalized risk information with targeted psychological support may mitigate psychological burden as patients reintegrate into society and deal with future COVID‐19 waves.
Aims and MethodThe National Institute for Health and Care Excellence recommends involving the families of patients admitted to psychiatric hospital care, without specific guidance on how to do it. To improve family involvement in a National Health Service psychiatric intensive care unit, a relatives' and carers' clinic was set up. Fifty family members attended and completed questionnaires. Nine went on to take part in interviews, the results of which were analysed using thematic analysis.ResultsFamilies felt more informed and found the increased access to information useful. They felt that the process showed respect for them and their family member, and that their contribution was valued. Running throughout the interviews was the contrast with previous experiences; families reported feeling heard and understood and attributed this in part to timing and environment.Clinical implicationsThe clinic was viewed positively by families and met the trust's commitment to including carers, as well as national guidance which suggests it should be part of routine practice.
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