Delivering physiotherapy outpatient assessment and treatment in a severe asthma clinic in the era of COVID-19

ABSTRACT

Introduction and ObjectivesThe global SARS-CoV-2 pandemic has forced clinicians to consider alternative methods of service provision to patients with respiratory conditions who were clinically vulnerable and/or advised to shield.Breathing pattern disorders (BPD) are a common comorbidity affecting approximately one third of patients with asthma. The respiratory physiotherapy team within the Portsmouth Severe Asthma Service (PSAS) recognised the need to continue to assess and deliver treatment for patients with BPD particularly at a time of heightened anxiety.Breathing retraining requires precise and highly specific assessment and treatment to ensure optimal outcomes and the decision to use a video conferencing platform was made to utilise the visual medium. To ensure quality service was being delivered, patients using the video conferencing platform to receive respiratory physiotherapy in the PSAS were asked for feedback.MethodsAt the end of every video consultation, written feedback was requested. Sixty-nine responses were received from July 2020-May 2021. Patients were asked to rate their physiotherapy consultation from very good to very poor;how they would prefer to receive treatment;if they would use this method of consultation again and the ease of use of the video consultation.ResultsOf the 69 responses68/69 (98%) would use the service again58/69 (84%) rated the service as very good35/69 (51%) would choose video over face to face appointments23/69 (33%) would prefer to be seen face to face63/69 (91%) felt that accessibility of the video platform could be improvedQualitative feedback was also gathered from patients and included statements suchExcellent quality and a very thorough appointment.It was helpful to actually see a clinician face to face via video instead of a phone callConclusionsVideo consultations have proven to be a feasible and successful way of assessing BPD in asthma patients. Despite feedback regarding the ease of accessing the online platform being suboptimal, overarching positive responses to video consultations was received. With 51% favouring being seen via video consultation rather than face to face, this has wider implications for patients and the NHS including reduced travel time to appointments and reduced waiting room pressures.