1
|
Soltany KA, Segovia Molina R, Pappo C, Thomson S, Pring K, Cox S, Merrill R, Fishman E, Ambrosini A, Bognet G, Dodenhoff K, Munger Clary H, Strauss L, Graham R, Guzik AK, Strowd RE. Interest and Satisfaction of Telemedicine Use Among Ambulatory Neurology Patients in Western North Carolina During the COVID-19 Pandemic. Telemed J E Health 2024; 30:e1071-e1080. [PMID: 37883644 DOI: 10.1089/tmj.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
Introduction: During the COVID-19 pandemic, care shifted from exclusively telemedicine to hybrid models with in-person, video, and telephone visits. We explored how patient satisfaction and visit preferences have changed by comparing in-person versus virtual visits (telephone and video) in an ambulatory neurology practice across three time points. Methods: Patients who completed a virtual visit in March 2020 (early-pandemic), May 2020 (mid-pandemic), and March 2021 (later-pandemic) were contacted. Patients were assessed for visit satisfaction and desire for future telemedicine. Univariate and multivariable logistic regression analysis was conducted to determine factors independently associated with video visit completion. Results: Four thousand seven hundred seventy-eight the number of ambulatory visits (n = 4,778) were performed (1,004 early; 1,265 mid; and 2,509 later); 1,724 patients (36%) assented to postvisit feedback; mean age 45.8 ± 24.4 years, 58% female, 79% white, and 56% with Medicare/Medicaid insurance. Patient satisfaction significantly increased (73% early, 79% mid, 81% later-pandemic, p = 0.008). Interest in telemedicine also increased for patients completing telephone visits (40% early, 50% mid, 59% later, p = 0.027) and video visits (52% early, 59% mid, 62% later, p = 0.035). Patients satisfied with telemedicine visits were younger (p < 0.001). White patients were more interested in future telemedicine (p = 0.037). Multivariable analysis showed that older patients (for each 1 year older), Black patients, and patients with Medicare/Medicaid were 2%, 45%, and 54% less likely to complete a video visit than telephone, respectively. Discussion: Patients, especially younger ones, have become more satisfied and more interested in hybrid care models during the COVID-19 pandemic. Barriers to conducting video visits persist for older, Black patients with Medicare or Medicaid insurance.
Collapse
Affiliation(s)
- K Alexander Soltany
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Reyna Segovia Molina
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Carly Pappo
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sharon Thomson
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kelly Pring
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Siobhan Cox
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Rebecca Merrill
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Emily Fishman
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Alexander Ambrosini
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Gabby Bognet
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kristen Dodenhoff
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Heidi Munger Clary
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Lauren Strauss
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Rachel Graham
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Amy K Guzik
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Roy E Strowd
- Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
2
|
Oliveira A, Fabbri G, Gille T, Bargagli E, Duchemann B, Evans R, Pinnock H, Holland AE, Renzoni E, Ekström M, Jones S, Wijsenbeek M, Dinh-Xuan AT, Vagheggini G. Holistic management of patients with progressive pulmonary fibrosis. Breathe (Sheff) 2023; 19:230101. [PMID: 37719243 PMCID: PMC10501708 DOI: 10.1183/20734735.0101-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/18/2023] [Indexed: 09/19/2023] Open
Abstract
Progressive pulmonary fibrosis (PF) is a complex interstitial lung disease that impacts substantially on patients' daily lives, requiring personalised and integrated care. We summarise the main needs of patients with PF and their caregivers, and suggest a supportive care approach. Individualised care, education, emotional and psychological support, specialised treatments, and better access to information and resources are necessary. Management should start at diagnosis, be tailored to the patient's needs, and consider end-of-life care. Pharmacological and non-pharmacological interventions should be individualised, including oxygen therapy and pulmonary rehabilitation, with digital healthcare utilised as appropriate. Further research is needed to address technical issues related to oxygen delivery and digital healthcare. Educational aims To identify the main needs of patients with PF and their caregivers.To describe the components of a comprehensive approach to a supportive care programme for patients with PF.To identify further areas of research to address technical issues related to the management of patients with PF.
Collapse
Affiliation(s)
- Ana Oliveira
- Lab 3R Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), IBMED Aveiro PT, Aveiro, Portugal
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Gaia Fabbri
- Respiratory Diseases and Lung Transplantation Unit, Department of Medical and Surgical Sciences and Neuro-Sciences, University of Siena, Siena, Italy
| | - Thomas Gille
- Inserm U1272 “Hypoxia & the Lung”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
- Service Physiologie et Explorations Fonctionnelles, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique – Hôpitaux de Paris, Bobigny, France
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation Unit, Department of Medical and Surgical Sciences and Neuro-Sciences, University of Siena, Siena, Italy
| | - Boris Duchemann
- Inserm U1272 “Hypoxia & the Lung”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
- Service d'oncologie médicale et thoracique, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique – Hôpitaux de Paris, Bobigny, France
| | - Rachel Evans
- Department of Respiratory Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Anne E. Holland
- Central Clinical School, Monash University and Department of Physiotherapy, Alfred Health, Melbourne, Australia
| | - Elisabetta Renzoni
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Diseases, NHLI, Imperial College, London, UK
| | - Magnus Ekström
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund, Sweden
| | - Steve Jones
- European Pulmonary Fibrosis Federation, Brussels, Belgium
| | - Marlies Wijsenbeek
- Centre for Expertise for Interstitial Lung Disease and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Anh Tuan Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Guido Vagheggini
- Department of Internal Medicine and Medical Specialties, Respiratory Failure Pathway, Azienda USL Toscana Nordovest, Pisa, Italy
- Fondazione Volterra Ricerche ONLUS, Volterra (PI), Italy
| |
Collapse
|
3
|
Tikellis G, Corte T, Glaspole IN, Goh N, Khor YH, Wrobel J, Symons K, Fuhrmeister L, Glenn L, Chirayath S, Troy L, Holland AE. Understanding the telehealth experience of care by people with ILD during the COVID-19 pandemic: what have we learnt? BMC Pulm Med 2023; 23:113. [PMID: 37024848 PMCID: PMC10078026 DOI: 10.1186/s12890-023-02396-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a rapid transformation of health services. This study aimed to understand the experiences of healthcare by people with interstitial lung disease (ILD), to inform future service delivery. METHODS Four specialist clinics in tertiary centres in Australia (Victoria:2 sites; New South Wales: 1 site; Western Australia: 1 site) recruited patients with ILD during an 8-week period from March 2021. Participants completed a COVID-specific questionnaire focused on health-related experiences during 2020. RESULTS Ninety nine (65% of 153) participants completed the questionnaire. 47% had idiopathic pulmonary fibrosis or connective tissue disease-associated ILD, 62% were female and the average age was 66 years. Whilst 56% rated their overall health in 2020 as the same as months prior, 38% indicated a worsening in health attributed to reduced physical activity and fear of contracting the virus. Access to healthcare professionals was 'good' in 61%, and 'fair-to-poor' for 37% due to missed respiratory assessments, with telehealth (mainly telephone) being perceived as less effective. 89% had contact with respiratory physicians, 68% with general practitioners, predominantly via telephone, with few video consultations. High satisfaction with care was reported by 78%, with lower satisfaction attributed to delays in assessments, disruption to usual services such as pulmonary rehabilitation, and dissatisfaction with telehealth. CONCLUSION People with ILD were generally satisfied with their care during 2020, however reduced access to healthcare professionals was challenging for those experiencing a deterioration in health. Telehealth was largely well received but did not always meet the needs of people with ILD particularly when unwell.
Collapse
Affiliation(s)
- Gabriella Tikellis
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, VIC, Australia.
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Sydney, Australia.
- Department of Allergy, Clinical Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.
| | - Tamera Corte
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
- Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Ian N Glaspole
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, VIC, Australia
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Sydney, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, VIC, Australia
| | - Nicole Goh
- Department of Respiratory Medicine, Alfred Health, Melbourne, VIC, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, VIC, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Yet H Khor
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, VIC, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, VIC, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
| | - Jeremy Wrobel
- Fiona Stanley Hospital, Perth, WA, Australia
- School of Medicine, University of Notre Dame, Fremantle, WA, Australia
| | - Karen Symons
- Department of Respiratory Medicine, Alfred Health, Melbourne, VIC, Australia
| | - Lisa Fuhrmeister
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, VIC, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
| | - Laura Glenn
- Royal Prince Alfred Hospital, Sydney, Australia
- Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | | | - Lauren Troy
- Royal Prince Alfred Hospital, Sydney, Australia
- Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Anne E Holland
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, VIC, Australia
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Sydney, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Australia
| |
Collapse
|
4
|
Holland AE, Glaspole I. Lockdown as the mother of invention: disruptive technology in a disrupted time. Lancet Respir Med 2023; 11:9-11. [PMID: 36206781 PMCID: PMC9531920 DOI: 10.1016/s2213-2600(22)00291-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Anne E Holland
- Department of Respiratory Medicine, The Alfred, Melbourne, VIC, Australia; Department of Physiotherapy, The Alfred, Melbourne, VIC, Australia; Central Clinical School, Monash University, Melbourne 3004, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.
| | - Ian Glaspole
- Department of Respiratory Medicine, The Alfred, Melbourne, VIC, Australia,Central Clinical School, Monash University, Melbourne 3004, VIC, Australia
| |
Collapse
|