Pandemic COVID-19 has put unprecedented pressure on NHS providers to offer non face-to-face consultation. This study aims to assess acceptability of patients and clinicians towards teleconsultation in oral and maxillofacial surgery compared with an expected face-to-face assessment. 340 telephone clinic patient episodes were surveyed over the initial 7-week period of pandemic-related service restriction. Appointment outcomes from a further 420 telephone consultations were additionally scrutinised. A total of 59.1% of patients expressed a strong preference for teleconsultation with only 13.1% stating a moderate or strong preference for face-to-face assessment. Diagnostic accuracy was highlighted as a concern for both clinicians and patients due to inherent inability to conduct a traditional clinical examination, notable in 43.5% of qualitative comments. Logistical concerns, communications needs and other individual circumstances formed the other emerging themes. The majority of remote consultations (59.5%) were outcomed as requiring further review. A total of 29.3% of patients were discharged. These findings suggest that the increasing use of remote follow-up in carefully selected subgroups can facilitate efficient and acceptable healthcare delivery. Although 'in-person' clinical appointments will continue to be regarded as the default safe and gold standard management modality, OMFS departments should consider significant upscaling of teleconsultation services.
Purpose Many public institutions and settings have taken action to limit exposure to and slow the spread of the novel coronavirus (COVID-19). We sought to characterize the impact of stay-at-home orders on our study of cerebral autoregulation and its association with developmental delays in infants with congenital heart disease compared with healthy controls. Design and methods We calculated the number of participants recruited (i.e., not enrolled in the study) and assessed (i.e., currently enrolled) before March 2020 (pre-COVID-19) and the number of participants that we could not recruit or assess between March and July 2020 (missed due to COVID-19), separately for congenital heart disease and healthy control infants, in reference to the impacts of COVID-19. We used negative binomial regressions to determine incidence rate ratios which compared participants recruited and assessed pre-COVID-19 and missed due to COVID-19. Results Recruitment and assessments significantly decreased following the pandemic, i.e., participants were more likely to be recruited or be assessed pre-COVID-19 compared to during the pandemic. Study participants were 3.3 times as likely to have assessments performed pre-COVID-19 compared to during the COVID-19 pandemic ( p < 0.001). Clinical implications Clinical research teams may consider making protocol modifications such as virtual visits or video recordings explaining the study, for example, to adjust to the restrictions caused by COVID-19. Conclusion The COVID-19 pandemic drastically reduced recruitment and assessments completed in our study. Study teams will need to continue to modify procedures for recruitment and assessments that align with COVID-19 regulations to facilitate research progress during the pandemic.
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