Virtual paediatric cystic fibrosis clinics in response to the COVID-19 pandemic and the patient response;An Irish single centre experience

ABSTRACT

Background: The COVID-19 pandemic posed unique challenges in the delivery of patient care across all subspecialties, including the paediatric cystic fibrosis (CF) service. In our Irish tertiary centre we sought to utilise technology to deliver the same standard of care to our patients whilst minimising their COVID-19 exposure risk. Methods: We established virtual CF outpatient appointments consisting of a consultant phone-call and subsequent contact with the different members of the multi-disciplinary team (MDT). Our "Drop-In" review service continued, with COVID-19 precautions added. Patient experiences of these clinics were evaluated using a five-point online questionnaire issued to parents at the end of 2020. Results: We achieved a response rate of 82 out of 125 (65.6%). A total of 50/82 (61%) found it "easy" to maintain contact with the CF team, with 7/82 describing it as either "somewhat difficult" or "difficult". In terms of OPD satisfaction as an alternative to face-to-face medical review, 67/82 (81.7%) described themselves as either "satisfied" or "somewhat satisfied" with the clinics. Only 2/82 (2.4%) were "dissatisfied" with the OPDs. A total of 66/82 (80.5%) felt it would be helpful to retain an element of the clinics going forward. The majority of respondents, 53/82 (64.6%), said that the pandemic had "no real effect" on their likelihood of attending for an in-person medical review, with 14/82 (17.1%) saying they were "much less likely" to attend. Only 3/82 were "more likely" to attend. Individualised comments were varied, with the increased use of technology, anxiety regarding COVID-19 exposure, and a desire to avoid the hospital, all frequent themes. Conclusion: Our results and feedback indicated a consistent parental desire to avoid the hospital and the perceived infection risk during the pandemic. However, our clinic arrangements did not increase parental feelings of isolation. The potential use of these clinics in conjunction with face-to-face visits should be considered as a viable option in paediatric CF outpatient management.