Telemedicine in monitoring pediatric LT patients before and during COVID‐19 pandemic

Abstract

Background The delivery of healthcare services by telemedicine decreases costs of traveling for patients, is less time‐consuming, and most importantly permits the connection between highly skilled specialists and patients. However, whether the use of telemedicine (text messaging) for LT patients was affected by the COVID‐19 pandemic is unknown. Methods We collected data (following consent from patients and parents) from 57 patients (33 male/24 female) with a median age of 47 (IQR: 9–91) months, whom we followed up with text messaging between September 2019 and September 2020, spanning the 6 months prior to COVID‐19 and during this period. Results In total, 723 text message mediated consultations occurred during this period, henceforth simply referred to as “messages.” Three hundred and twenty‐eight (45%) messages occurred during the 6 months up to the start of the pandemic. Following the COVID‐19 outbreak, the number of messages increased to 395 (55%). The three most common reasons of messaging were post‐liver‐LT follow‐up messages ( n = 215/723, 29.7%), consultations for drug use ( n = 157/723, 21.7%), and medication prescriptions ( n = 113/723, 15.6%). Protocol biopsy discussions ( n = 33/723, 4.6%) and fever ( n = 27/723, 3.7%) were among others (vaccination, rash, diarrhea, cough, fatigue, acne). During the COVID‐19 outbreak, only post‐LT follow‐up messages increased significantly to 132/395 (33%) from 83/328 (25%) ( p ‐value: .02). Conclusions We found that the pandemic resulted in an increase in the total number of text message mediated consultations and specifically for the use of post‐LT follow‐up. Messaging was effective for post‐LT follow‐ups and all patients were at least satisfied.

The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

“…A detailed explanation of the inclusion/exclusion process can be found in Figure 17 (PRISMA fig). A total of 12 studies [50][51][52][53][54][55][56][57][58][59][60][61] were conducted in the adult population, and 1 study focused on children 62 with a total of 2216 telehealth consultations. As there were a limited number of studies with consistent outcomes measures of telehealth, pooled analysis could not be performed.…”

“…As there were a limited number of studies with consistent outcomes measures of telehealth, pooled analysis could not be performed. Overall, there were 4/13 studies that reported high medical adherence rate (>70%), [50][51][52]61 6/13 studies reported excellent or high satisfaction rates from both patients and physicians, [53][54][55][56]60,62 and 2/13 studies highlighted the ability to obtain accurate BP, weight, and other measurements (77.45%). 57,63 With most consultation appointments able to be conducted virtually, only a handful of patients needed in-person followup visitations, specifically 33/197 patients (two studies).…”

“…Thirteen studies focused on the delivery of post‐transplant care by telehealth suggest increased medical adherence, higher satisfaction rates, and increased ability to obtain measurements (weight, BP, etc.) 50–58,61–63,81 . Telehealth has been shown to facilitate creation of an enduring long‐term relationship between patients and physicians, which can promote self‐management, increased flexibility in healthcare, and thus better individualized care resulting in higher medical adherence rates 82 …”

“…Thirteen studies focused on the delivery of post-transplant care by telehealth suggest increased medical adherence, higher satisfaction rates, and increased ability to obtain measurements (weight, BP, etc.). [50][51][52][53][54][55][56][57][58][61][62][63]81 Telehealth has been shown to facilitate creation of an enduring long-term relationship between patients and physicians, which can promote self-management, increased flexibility in healthcare, and thus better individualized care resulting in higher medical adherence rates. 82 According to a survey performed on patients experiencing telemedicine as a consultation choice, patients appeared satisfied with the level of privacy during the consultation and with the quality of professional patient health care.…”

A Teleconsultation Device, Consult Station, for Remote Primary Care: Multisite Prospective Cohort Study (Preprint)

“…The year 2020 was seriously impacted by the global spread of COVID-19, which necessitated the promotion of new health care initiatives and a reorganization of telemedicine to meet patients' expectations for broader access [10][11][12][13][14]. The unstructured and opportunistic implementations of many telemedicine devices and protocols during the pandemic have cast light on the urgent need for standardization [15,16].…”