P541 Efficacy, efficiency and aceptability of telemedicine for inflammatory bowel disease patients follow-up care during the COVID-19 pandemic lockdown

Abstract

Background During COVID-19 pandemic, numerous initiatives have been established to reduce disease transmission but ensure care for patients with inflammatory bowel disease (IBD). Ambulatory clinic visits were replaced by the implementation of telehealth modalities in most of IBD units during the pandemic lockdown. However, the efficacy, efficiency, and patient′s acceptability of using telemedicine by telephone consultation has not been evaluated. Methods A prospective cohort study was performed in IBD patients who underwent telephone consultation during lockdown due to COVID-19 pandemic between 16th march and 13th April 2020. To assess the efficacy of this telephone consultation (COVID-visit), change in disease′s activity and treatment, non-scheduled visits, emergency consultation, hospital admission and non-elective surgery from COVID-visit to the next scheduled consultation (postCOVID-visit) were checked. To evaluate efficiency, the time period between COVID-visit and postCOVID-visit were compared with previous consultation (preCOVID-visit). Only patients with a confirmed diagnosis of IBD, regular follow-up in our IBD unit and with full available requested test results were included. A telephone survey was designed (5 questions) and conducted in all patients to rate satisfaction for using telemedicine. Results Out of a total of 274 patients, 220 patients (52.2% male; mean age 49±16 years; crohn′s disease n=126/ ulcerative colitis n=83/ indeterminate colitis n=11) were included. During the COVID-visit 41% patients were using biologic agents, 15% had active disease and 6.8% changed treatment (40% initiated corticosteroids; 30% started immunomodulators or biologic agents; 30% upgraded usual treatment). Only 1 patient consulted at the emergency department, 11 patients needed to rearrange the visit and none patient underwent surgery before the scheduled post-COVID visit. The interval to post- COVID visit compared to pre-COVID visit was reduced in 28.6%, remained equal in 33.6% and increased in 37.7% of patients. The satisfaction survey (n=185) revealed that 81.1% patients rated care as excellent, 94.6% perceived it was effective and solved doubts in 96.2% of patients. However, 44.4% of patients rather prefer on-site consultation for follow-up and only 52% considered that incorporating video would improve care. Conclusion Telemedicine care during the lockdown and despite been abruptly and rapidly implemented in IBD units, shows to be effective and efficient to care IBD patients. In addition, telephone consultation is well accepted by patients for short follow-up periods. Further follow-up studies should be carried out to determine the patient profile that will benefit most from this monitoring.