Telehealth during and beyond the COVID-19 Pandemic: Evidence from Licensed Dietitians in an Emerging Economy

Abstract

Background: The SARS-Cov-2 pandemic (COVID-19) sudden onset disrupted the direct access to face-to-face nutrition consultation fostering the rapid adoption of Telehealth by dietitians. Objective: This study investigates Telehealth use among Lebanese Licensed Dietitians (LDs) amid COVID-19, in the absence of national Telehealth practical guidelines (TPG), and offers insights on Telehealth application under uncertainties of pandemic event, economic crisis, and destructed infrastructure occurring simultaneously in Lebanon. Design: A cross-sectional study during March 2023, using an anonymous online survey (44 questions), diffused through the Lebanese Order of Dietitians and social media platforms. Participants: The sample (n=94) consisted mostly of females (98.9%) and young dietitians (mean(SD) age: 30.54(6.41) years) having a mean(SD) of 7.89(5.7) years of experience. Most respondents identified clinical nutrition as their primary practice area (87.2%), mostly in weight management (84%). Main outcome measures: Telehealth experience amid COVID-19 including tools utilized in remote consultations, barriers, facilitators, and perspectives of Telehealth use. Statistical analyses: Descriptive analysis (counts, frequencies) using SPSS version 28. Results: Although 48.4% of LDs reported using Telehealth prior COVID-19, this proportion increased to 97.8% during the pandemic. The most common tools used were WhatsApp (90.3%), Zoom (72.0%), and E-mails (41.9%). Reported barriers included bad internet connection (74.2%), patients preferring face-to-face consultation (61.3%), and patients lacking technical literacy (33.3%); benefits included scheduling and time flexibility (83.9%), decrease in practice-related costs (77.4%), and compliance with social distancing measures (53.8%). The majority agreed that Telehealth is needed (78.5%) and applicable in the Lebanese context (64.6%) and expressed the need for Telehealth trainings (78.5%) and TPG for nutrition care (74.2%). Conclusions: This study recognizes increasing use of Telehealth in Lebanon, warranting the development of Telehealth nutrition care infrastructure comprising national regulations and evidence-based practical guidelines to respond to the innovation in the healthcare industry, and to assure Telehealth sustainability in LDs’ routine practice.