TELEMEDICINE IN GASTROENTEROLOGY: A STUDY ON FEASIBILITY AND PATIENTS’ TRUST DURING COVID-19 PANDEMIC

Background and Aim Telehealth includes both health care delivery (often identified as telemedicine) in terms of disease diagnosis or treatment and several other services, such as prevention, education and public health promotion.1 During the recent COVID-19 pandemic, worldwide telemedicine has enabled many patients with chronic diseases to get access to remote assistance, since it has emerged as the ideal solution to overcome the restrictions to perform regular non-urgent follow-up visits to chronic patients and to continue patients’ assistance. Some positive reports on the use of telemedicine in gastroenterology among healthcare providers and patients have been published, but a patient’s trust perspective about video-consultations has been missing to date.2-5 Our study aimed at ascertaining our gastroenterological patients’ trust in video-consultations during the COVID-19 pandemic. Material and Methods At our Gastroenterology Unit in Milan (Italy), which is a tertiary referral center for Inflammatory Bowel Diseases (IBD) and Celiac Disease (CeD), telemedicine was used in place of on-site follow-up visits scheduled but not provided during the COVID-19 pandemic: all IBD and CeD outpatients received a phone call, while video-consultations were performed to patients with mild-to-moderate symptoms, with bio-umoral alterations or as needed for those patients who requested it. The patient’s trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) question-naire.6 The primary endpoint was expressed as a percentage greater than 75% of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements about telemedicine.Results One hundred eighty-eight out of 218 scheduled (86.2%) video-consultations were performed. Among the 188 visits, 163 (86.7%) questionnaires were compiled. The primary endpoint of trust in the telemedicine service was achieved in 95.2%, 89.7% and 87.3% of the respondents for the three selected key statements (trust the service, its capability to solve clinical problems, ease to use).Conclusion During the COVID-19 pandemic our results showed that most of our IBD and CeD patients accepted and trusted video-consultations as an alternative to the traditional in-person examination.References: 1) Ray Dorsey E et al. N. Engl. J. Med. 2016;375:154–161. 2) Lauren A. G., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3) De Jong, M. J. et al. Clinical Gastroenterology and Hepatology 2020;18:1744–1752 4) Lees CW et al. Gastroenterology. 2020 Sep;159(3):805-808.e1. 5) Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883. 6) Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58.(Figure presented)

THE EMERGING ROLE OF TELEMEDICINE IN GASTROENTEROLOGY DURING THE COVID-19 PANDEMIC: A STUDY ON ITS FEASIBILITY AND PATIENTS’ TRUST

Background and aim: During the on-going COVID-19 pandemic telemedicine has enabled many patients with chronic diseases worldwide to get access to remote assistance. Telemedicine has emerged as the ideal solution to overcome the restrictions in place on performing regular non-urgent follow-up visits for chronic patients and continuing patients’ assistance. Some positive reports on the use of telemedicine in gastroenterology among healthcare providers and patients have been published, but a patient’s trust perspective about televisits has so far been unavailable. Our study aimed at ascertaining telemedicine feasibility and gastroenterological patients’ trust in televisits during the COVID-19 pandemic. Materials and methods: At our Gastroenterology Unit in Milan (Italy), which is a tertiary referral center for Inflammatory Bowel Diseases (IBD) and Celiac Disease (CeD), telemedicine was used in place of on-site follow-up visits scheduled but not provided during the COVID-19 pandemic. All IBD and CeD outpatients were contacted by phone and televisits were arranged for patients with mild-to-moderate symptoms, with bio-umoral alterations or as needed for those who requested it. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire. The primary endpoint was expressed patient’s trust as assessed through the questionnaire. The secondary endpoint was feasibility and acceptance of televisits. Results: A total 188 out of 218 scheduled (86.2%) televisits were performed and among these a total of 163 (86.7%) questionnaires compiled was accomplished. The primary endpoint of trust in the telemedicine service was achieved in 95.2%, 89.7% and 87.3% of the respondents for the three selected key statements about trust in the telemedicine service, its capability to solve clinical problems and ease to use, respectively.(figure presented) Conclusions: Our results showed that during the COVID-19 pandemic televisits were feasible for most of our patients with chronic gastroenterological diseases, and that most patients accepted and trusted televisits as an alternative to the traditional in-person examination

TELEMEDICINE IN IBD: GOOD TRUST FROM OUTPATIENTS DURING THE COVID-19 PANDEMIC IN MILAN (LOMBARDY)

Background and Aim: During the recent COVID-19 pandemic, telemedicine has enabled many IBD patients worldwide to get access to remote assistance. Some positive reports on the use of telemedicine among patients and healthcare providers have been published1-4, but a patient’s trust perspective is not available yet. The aim of our study was to verify IBD patients’ trust in telemedicine. This study was approved by our local Ethics Committee. Material and Methods: At our Gastroenterology Unit in Milan (Italy), 123 video-consultations were delivered to IBD patients with mild or moderate disease, in place of follow-up visits scheduled but not provided during the general lockdown (March-April 2020). Video-calling solutions from Google (Hangouts or Meet) or Microsoft Teams were used according to the patient’s preference. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire.5 The primary endpoint was expressed as a >75% percentage of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements: “I can trust video-consultation”, “I can trust that possible problems with the telemedicine service will be solved properly” and “I feel at ease when working with this website”. The questionnaire was formulated through the EUSurvey platform, widely used for clinical research questionnaires in Europe. Results: One-hundred-fifteen (93.4%) video-consultations were performed out of the 123 scheduled. Among the 115 consultations, 100 questionnaires were completed (86.9%). The primary endpoint of trust in the telemedicine service was achieved in 95%, 90% and 84% of patients for the three selected key statements about the trust in the telemedicine service, its capability to solve clinical problems and its ease to use. While clinical outcomes were beyond our intentions, we reported no drugs withdrawal in this cohort nor major events. Conclusion: Our results showed that during the COVID-19 pandemic most of our IBD patients accepted to receive a video-consultation in spite of the traditional in-person visit and trusted the video-consultation. References: 1. Bezzio C. et al. Gut 2020;69:1213–1217 2. George L.A., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3. Lees C. W. et al. Gastroenterology 2020;2020 May 28 4. Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883 5. Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58. [Formula presented]