COVID‐19 pandemic and inflammatory bowel disease from patients' perspective: A survey from COVID epicenter in India

Abstract

Background and Aim The COVID pandemic and countrywide lockdown has had significant impact on patients with inflammatory bowel disease (IBD), with delay in diagnosis, difficulty in access to healthcare and unavailability of drugs. We conducted a telephonic survey to assess this impact. Methods Out of 350, 302 participated in the survey. Demographic data, disease severity at the time of survey, extent of disease, details of therapy, and adherence were noted. A validated questionnaire addressing information source, perception of COVID‐19 situation, contact with healthcare, and adherence to standard precautions was administered telephonically. Results Out of 350 contacted patients, 302 (86.28%) patients participated in the survey. Median age of cohort was 39 years. Ulcerative colitis (UC) constituted 79%, 16% Crohn's disease (CD), and 5% IBD‐unclassified. At the time of survey, 86.98% patients with UC were in clinical remission and 75.75% of CD patients were generally well. A total of 115 (38%) cases were nonadherent to therapy due to unavailability of medicines (66.38%), financial constraints (25.21%) and inability to reach healthcare facility (3.6%). Disease flare was seen in 14.2% and correlated well with nonadherence. Existing drug therapy was switched to alternative drug in 70 (23.17%) cases due to unavailability (74%). Social media (52.3%) and television (40.4%) were the common sources of information about the pandemic. Telemedicine platforms (WhatsApp and telephone) were used by 180 (59.6%) patients for consultation with good acceptance (81.6%). 87 (28.8%) patients failed to contact healthcare. Apprehension regarding severe COVID infection was noted in 80% while 29% thought that IBD therapy could increase infection risk. Adherence to wearing mask, hand washing, and social distancing was 100%. Conclusion Pandemic resulted in disruption of healthcare visits and medication supply. Majority were concerned about increased risk of COVID‐19 infection and adhered to standard precautions. Mobile phone‐based formats for patient care may be an alternative due to patient acceptance and convenience.

The Impact of the COVID-19 Pandemic on Patients with Ulcerative Colitis: Results from a Global Ulcerative Colitis Narrative Patient Survey

“…Telemedicine was a pivotal component of disease management during periods of lockdown, and patients were reportedly broadly satisfied with the transition [ 14 , 18 – 20 ]. During the COVID-19 pandemic, surveys carried out among patients with IBD reported that access to remote health care delivery systems can help to reduce disease-related concerns and suggest that telemedicine could remain a viable approach to disease management in the post-pandemic era [ 21 , 22 ].…”

“…However, it is important to consider that not all patients will be able to benefit from the telemedicine model. In India, for example, nearly 30% of patients with IBD were unable to contact their health care provider by any means during the pandemic [ 18 ].…”

Perception and Attitude of Lebanese IBD Patients During the COVID-19 Pandemic

“…In fact, social media platforms, television, and public health organization were cited as the main source of information. 12 , 13 , 18 , 23 This is also a consequence of the ease of access to treating physicians in Lebanon, with specialized care being readily available. Furthermore, these numbers highlight the trust that patients have in their gastroenterologist and the importance of that relationship, as it is the main source of relief and information.…”

“…11 Several studies have evaluated their perceptions regarding the outbreak in different countries. 5,[12][13][14][15][16][17][18][19][20] In this paper, we aim to evaluate IBD patients' perceptions and behaviors regarding the SARS-Cov-2 pandemic for the first time in Lebanon.…”

Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future?

“…Additionally, in an Indian survey, patients reported similar fears aimed at patients in remission in most or all-controlled clinical activities in which telemedicine methods had also been applied in most of the sample[ 24 ]. The authors reported reduced involuntary adherence (due to the unavailability of medication, financial constraints, and difficulty in reaching dedicated health facilities) with increased disease activity.…”