Specialty COPD care during COVID-19: patient and clinician perspectives on remote delivery

Wu, Frances M.; Burt, Jenni; Chowdhury, Teena; Fitzpatrick, Ray; Martin, Graham; Scheer, Jan W van der; Hurst, John R.

doi:10.1136/bmjresp-2020-000817

Cited by 43 publications

(52 citation statements)

References 16 publications

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“…This suggests that irrespective of the advantages of remote care, patients rely on the personal contact with physicians at regular intervals, especially as there are differences between physicians and patients regarding the perception and evaluation of clinical state. [16] On the other hand, in our study COPD patients with high symptom burden and exacerbation risk reported to avoid contact with physicians in favour of tele-consultation. This indicate that remote care should be tailored to the specific needs of a certain group of patients.…”

Section: Discussionmentioning

confidence: 50%

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

et al. 2021

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BackgroundInfection control measures for COVID-19 might have affected management and clinical state of patients with chronic obstructive pulmonary disease (COPD). We analysed to which extent this common notion is fact-based.MethodsPatients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2, 3 at 0, 3 and 6 months). The questionnaires comprised behaviour, clinical and functional state and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.ResultsOverall, 594 patients were contacted and 375 patients (58% males, FEV1 61±22%predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with SARS-CoV-2. Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas GOLD D patients were more amenable to tele-consultation.ConclusionIn well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular women and GOLD D patients should be actively contacted by physicians to identify deteriorations.

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Section: Discussionmentioning

confidence: 50%

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

et al. 2021

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“…It is therefore plausible that COVID-19 restrictions could reduce the incidence of COPD exacerbations [ 9 ]. However, shielding and other restrictions can have a negative impact on patients’ physical and mental health, and limit access to health care services [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Oyelade²,

et al. 2021

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Background Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44–0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period.

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“…Overall, people with severe chronic lung diseases used TH apps more often than those without chronic lung diseases (OR and 95% CI: 1.23, 1.04 to 1.45) [68]. A recent study reported that clinicians were able to evaluate symptom severity (95%), promote smoking cessation (84%) and signpost to other healthcare resources (80%) [69]. Also, patients involved in the study reported that assessment of COPD severity and starting new prescriptions were being fully addressed via TH.…”

Section: Telehealth Applicationsmentioning

confidence: 99%

Key toolkits of non-pharmacological management in COPD: during and beyond COVID-19

Alqahtani

Alghamdi

Aldhahir

et al. 2021

Front Biosci (Landmark Ed)

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Specialty COPD care during COVID-19: patient and clinician perspectives on remote delivery

Cited by 43 publications

References 16 publications

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Key toolkits of non-pharmacological management in COPD: during and beyond COVID-19

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