ABSTRACT
Introduction: The COVID-19 pandemic prompted a rapid shift to telehealth for care delivery. We aimed to assess satisfaction with and preferences for telehealth to improve care experiences for patients with irritable bowel syndrome (IBS). Methods: We conducted a prospective survey-based cross-sectional study from September 29 to November 9, 2020 in a diverse, community-based integrated healthcare system in Southern California. We included members age 18-90 with an International Classification of Diseases 9, 10 code for IBS from an office-based encounter between June 1, 2018 to June 1, 2020. A specifically developed survey (TIBS-CoV2) was emailed to patients. We collected demographic and clinical data from the electronic medical record. We assessed satisfaction via 5-point Likert scale (“strongly agree and agree” was defined as satisfied;“strongly disagree and disagree” as dissatisfied). Using Chi-square and Wilcoxon Rank Sum tests, we compared demographic and clinical characteristics of those who were satisfied and dissatisfied with telehealth in patients with ROME IV IBS. We used multivariate logistic regression to identify predictors for telehealth satisfaction. Results: Of 44,789 surveys sent, 2598 (5.8%) patients responded, 1473 (56.7%) completed the entire survey (median age 60.0 [42.4-71.2], 80.1% female;66.3% non-Hispanic white, 22.1% Hispanic, 5.0% black, 4.0% Asian) and 744 (28.6%) had ROME IV confirmed IBS. 651 (87.5%) patients with IBS used telehealth for their care: 436 (67.0%) were satisfied, 62 (9.5%) were dissatisfied and 153 (23.5%) felt neutral about their experience. No significant differences were seen in sex, race/ethnicity, BMI, marital status, income, IBS subtype or severity between satisfied and dissatisfied groups (Table 1). Telehealth satisfaction was associated with full-time employment (188, 43.1%, p>0.001), a college degree or higher (244, 56.0%, p=0.01), or daily social media use (338, 77.5%, p=0.01). Dissatisfaction was associated with older age (59.2±17, p<0.01), retirement (26, 41.9%, p=0.02) and low self-perceived health literacy (4, 6.5%, p=0.008). Satisfied patients would consider telehealth over a face-to-face visit for a travel time of 30-59 minutes (170, 39.0%, p=0.01);dissatisfied patients did not consider travel time a factor (23, 37.1%, p>0.001). Multivariate analysis confirmed age, a college degree, daily use of social media and travel time of 30-59 minutes as independent predictors of telehealth satisfaction (Table 2). Conclusions: A majority of patients with IBS are satisfied with telehealth and are more likely to use telehealth since the COVID-19 pandemic. Factors including age, available time, education level, health literacy and comfort with technology likely influence satisfaction with telehealth in IBS and may help to identify patients who would be most responsive to a focused IBS-telehealth program.(Table presented) (Table presented)