ABSTRACT
Objectives: During the COVID-19 pandemic, telehealth was rapidly implemented to mitigate disruptions in HIV care services. However, participation in and benefits from telehealth were not distributed equally among people living with HIV (PWH). The acceptability of alternative telehealth options in HIV care remains understudied. This study aims to assess the relative importance of telehealth features among HIV care providers and PWH. Method(s): We compiled a comprehensive list of 21 telehealth features from the literature and formative research. Telehealth features were grouped into four domains with 4-6 features each: administrative (5), technology (6), visit-related (6), and other (4) features. 22 purposively selected participants (10 HIV care providers, 12 PWH) from South Carolina were asked to rank these features within domains and the domains themselves according to their perceived relative importance. Ranking data was analyzed through count analysis. Result(s): Domain rankings indicated that visit-related features such as a prior relationship with the provider and multidisciplinary virtual visits were most important. Administrative features such as scheduling modalities (e.g., virtual walk-in options) and the waiting time for an appointment were second most important, followed by technological features such as the type of provider (artificial intelligence vs. human provider) and type of telehealth (video, voice-only, or email). Other features such as the availability of technical support and the location where telehealth visits take place were least important to our participants. Across telehealth features, the relationship to the provider was most often ranked first (14 out of 22 participants) followed by out-of-pocket cost (9 out of 22 participants). Conclusion(s): Our findings highlight the importance of visit-related and administrative features of telehealth. A pre-existing relationship with the telehealth provider was particularly important to many providers and patient participants. Findings may inform telehealth HIV care options to meet the needs of PWH and HIV care providers.Copyright © 2023
ABSTRACT
Objectives: Social distancing requirements and lockdowns due to COVID-19 resulted in a rapid integration of telehealth into HIV care. To maximize patient retention and ensure quality of care, it is vital to understand patient perspectives and preferences for various attributes of telehealth. This study aims to identify preference-relevant features of telehealth. Method(s): A review of PubMed and Embase was conducted in September 2022. Search terms describing telehealth (e.g., telehealth, telemedicine) and its features (e.g., attribute, characteristic) were combined for the search. Duplicate and non-English records, as well as irrelevant records, were removed. Literature was analyzed and synthesized using meta-synthesis and thematic synthesis methodology. Result(s): 10 records were included in the review (5 qualitative studies, 1 mixed-methods study, 4 discrete choice experiments). No HIV-specific studies were identified that described preference-relevant telehealth features. Studies primarily reported telehealth features in primary care, oncology, and rheumatology settings. Data synthesis revealed four domains of preference-relevant telehealth features: administration, technology, visit-related, and other features. Administrative features included waiting time for and during an appointment, scheduling flexibility, and out-of-pocket costs. Technology features included hardware and software used for telehealth visits, extent of privacy, and type of telehealth (e.g., video or voice-only). Visit-related features included relationship to the provider, consultation purpose, and severity of the patient's health concern. Other features included technological support options, convenience, and ease of telehealth use. Continuity of care with a patient's regular provider was the most often reported feature of telehealth within the identified literature. Conclusion(s): While there is no HIV-specific literature, preference-relevant administrative, technology, visit-related, and other features were identified in non-HIV-related literature. Future research needs to assess the importance of identified features to people living with HIV and which tradeoffs they are willing to make. This will inform tailored telehealth options addressing patients' needs and preferences for optimal utilization and care.Copyright © 2023
ABSTRACT
Background. Convalescent plasma (CP) may be obtained from patients who have recovered from the novel coronavirus disease, COVID-19, caused by the virus SARS-CoV-2. Although not FDA approved, preliminary data suggests patients who receive convalescent plasma from recovered donors may have shortened recovery time and symptom reduction. The purpose of the study is to detail learner recruitment of convalescent plasma donation (CPD) for treating hospitalized COVID-19 patients. Methods. Prisma Health Midlands formed a multidisciplinary CP donation team, consisting of seven COVID-19-certified pharmacy learner volunteers, two pharmacists, and two providers. Primary eligibility criteria were SARS-CoV-2 polymerase chain reaction (PCR) positivity at least 28 days prior to donation and asymptomatic for a minimum of 14 days. Donors were excluded based on FDA guidelines for CPD, limiting ineligible contact. Team learners were trained on call techniques and subsequently contacted, educated, and requested candidates donate through this program. Willing donors were then linked to The Blood Connection to circulate CP back into the Prisma Health System, creating a self-sustaining and closed-loop donation cycle. Results. In total, 253 recovered adult patients with positive SARS-CoV-2 PCR test results were evaluated. 195 patients met baseline inclusion criteria for contact. This pre-screen reduced call and travel time for ineligible candidates. 108 patients were successfully reached. Of the 108, n=79 (73.14%) accepted referral to The Blood Connection, and n=29 (26.85%) were no longer candidates primarily due to patient communicated new exclusionary factors, such as active COVID-19 symptoms. The program allowed for rapid, internal access to CP for patients hospitalized with COVID-19 at Prisma Health Midlands. Conclusion. Interest and awareness in COVID-19 CPD was successfully increased upon direct communication from the team and was felt to represent a personnel intense but successful model for recruiting potential CP donors. This program educated and utilized learners during this pandemic to enhance Prisma Health's ability to obtain CP for hospitalized patients using a closed system.