Needs of people with kidney transplantation during the COVID 19 pandemic and its confinement, and the role of communication technologies through the “patient experience”

ABSTRACT

Purpose: During the COVID-19 pandemic, healthcare services have focused on the care of acute processes and there is a risk of not meeting the needs of complex chronic high-risk patients, such as kidney transplant patients(KT). Our goal is to understand the unmet needs/problems of KT during COVID-19 lock-down from the “patient experience” perspective, and to analyze the role of communication technologies. Methods: Development of a survey through concepts grouped into categories (units of meaning) and synthesized into metacategories extracted after interviews with 3 stable and confined KT focus groups (videoconference;verbal informed consent). Verbatim transcription of the conversation and analysis with MAXQDA software(https//www.maxqda.com/). After validation, the surveys were compared with those of the group of CJ Atchison et al in the UK general population (authorization in order). Results: Out of 1528 KTs, 947 answered (response rate63%). 64.2% men, and 55% over 55years. Post-TR time3m-5a. 115 concepts, 21 categories and 3 meta-categories were identified (in order of importance for patients Role of technology (69%), Impact of lock-down (19%) and Contact with professionals(12%)). Our KTs have a serious concern about the disease (if infection, 38% believe that their life would be at risk;and 48% think that the infection would be serious), but not about their kidney disease (20.6%), 99.7% of KTs have taken measures of social distancing, and lock-down has not meant a change in their lifestyle (sleep, diet, exercise, and family or social relationships). On a scale of 1-6 (1 little-6 a lot), for the KTs the global impact has been 1.69, very different from that of the UK (p<0.05). Regarding healthcare needs, 27.7% reported having received information from the hospital, but not very useful;42.3% have stopped doing some medical control, but only 1.92% have stopped the medication. During the pandemic, 55% contacted a specialist, by telemedicine in a 84.7% (preferring by video-call). KTs understand that technology does not replace all face-to-face technology and positively value group videoconferences (therapeutic education, dietary recommendations, physical activity). Conclusions: KTs are people at risk, and they have serious concern about the disease, so they comply with lock-down, although this has not led to a significant change in their lifestyle. KTs value having easy access to professionals, information from the center, and consider technology a key role during lock-down. These learnings should profoundly change the way health professionals relate to patients, allowing an increase in the number of contacts and reducing face-to-face visits.