A pragmatically before-after trial of tele-visits vs face-to-face visits for chronic patients during the COVID-19 pandemic: patient-reported adherence

Tele-Medical Nutrition Therapy to Promote Healthy Eating and Nutrition Adherence of Chronic Patients in the COVID-19 Pandemic: A Pragmatically Before-After Trial

Background and Aims

Patients find it difficult, during the pandemic, to receive appropriate nutrition services because of the limited access to health services. This study assessed the effectiveness of a tele-consulting nutrition intervention on the nutrition adherence of patients with diabetes and hypertension.

Methods

A tele-medical nutrition therapy (MNT) intervention was conducted as a one-group before-after trial. The estimated sample size was 314. Of these, 183 patients were selected from Hefdah-e-Shahrivar and 131 from Farabi Hospital. Patients were asked to complete an adapted version of the nutrition adherence self-reported instrument to compare nutrition adherence when they received face-to-face therapy versus tele MNT.

Results

In total, 166 completed all phases of the study. The results showed that the nutrition adherence score significantly increased compared to before the intervention. Hedges's g effect size also confirmed the high efficacy of telenutrition therapy. The magnitude of differences was within a high range (effect size 3.76 [CI: 3.40-4.12]).

Conclusions

The present findings showed that providing teleconsulting nutrition services to diabetic and hypertensive patients can positively affect their nutrition adherence. Telenutrition to promote a healthy diet can contribute to effectively controlling diseases in chronic patients during/after the pandemic with no gaps or failures.

Trial Registration

This study was a tele-nutrition intervention. In this study, we provided consultation on regular food consumption and did not order any chemical substances or nutritional supplements. Furthermore, we did not perform any treatment or invasive intervention, we assumed that a registration number was unnecessary, so we did not apply for clinical trial registration.

Nonadherence to Immunosuppressants Among Transplant Recipients: Emotional Intelligence as a Predictive Factor During COVID-19 Pandemic

Purpose

To evaluate the association between emotional intelligence and fear of COVID-19 on self-reported adherence, based on a cross-sectional design.

Patients and Methods

Transplants recipient of both sexes aged 23-75 years old were evaluated at the Organ Transplant Unit, University Hospital of Catania, Italy. Data were analyzed using frequency, descriptives, Spearman and Pearson correlations, Chi-square goodness of fit test, and linear regression. Self-reported adherence was estimated with the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). Emotional intelligence and fear of COVID were, respectively, measured with the Emotional Intelligence Scale (EIS) and Multidimensional Assessment of COVID-19 Related Fears Scale (MAC-RF). This was a cross-sectional study of kidney transplant recipients. In reporting this study the authors followed the STROBE guidelines.

Results

A correlation was found between EIS and MAC and between EIS and adherence but there was no correlation between MAC and adherence. A linear regression model was also conducted using a stepwise method, which indicated that EIS was a significant predictor of adherence (p <0.05).

Conclusion

This study was found that EIS is a predictor of adherence to treatment in transplant patients. Fear of COVID, while positively correlated to EIS, is not correlated to the adherence's outcome, possibly due to the proper follow-up performed to the patients. Indeed, according to these results, we suggest to provide good follow-ups with recipients, with interviews also based on self-regulation and awareness.