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PATIENT-RELATED FACTORS INFLUENCING REMOTE CONSULTATIONS IN RHEUMATOLOGY - LESSONS FROM A COVID-19 INITIATIVE
Rheumatology (United Kingdom) ; 61(SUPPL 1):i75, 2022.
Article in English | EMBASE | ID: covidwho-1868396
ABSTRACT
Background/Aims The COVID19 pandemic significantly altered healthcare provision. Our department switched immediately to remote consultations without suspending service, including telephone and video consultations. In this analysis we aimed to explore the role of patient-related factors in influencing the process and outcome of remote consultations with a view to improving the quality of service provision. Methods A data collection form was developed and offered to all clinicians to complete after each remote consultation. Information on age, gender, new or follow up status and interpreter use were collected. Clinicians were asked to rate the effectiveness of specific components of the consultation process (time adequate, relevant history, physical examination, management plan and communication quality) as compared to the usual face to face appointments on Numerical Rating Scales (NRS, 00). Data were collated in a Microsoft Access database. Statistical analysis was performed using SPSS version 25. Results In total, 285 valid forms were evaluated. 193 (67.7%) were women. Patients registered for new appointments (n=51, 18%) were significantly younger (mean±SD 52.9 ± 19.7 vs 60.6 ± 17.2 years, P=0.012). There were no significant correlations with age or any significant differences with gender in mean scores of NRS. New patients scored lower on NRS for relevant history (8.0 ± 1.1 vs 8.9 ± 1.2, P<0.001), management plan (4.8 ± 2.5 vs 7.8 ± 2.0, P<0.001) and communication quality (6.6 ± 2.0 vs 8.4 ± 1.6, P<0.001). Interpreter usage (n=9, 3.4%) had lower scores for relevant history (7.1 ± 2.4 vs 8.8 ± 1.1, P=0.012) and communication quality (5.4 ± 2.6 vs 8.1 ± 1.8, P=0.002). There was no significant association of age or gender with subsequent follow up appointment requested as face-to-face or remote. New patients were significantly more likely than follow-up patients to be offered a face-to-face follow up appointment (univariate regression, odds ratio (OR) 5.49, 95% CI 2.7-11.1, P<0.001). However, once adjusted for management plan in multivariate regression, new patients were no longer significantly associated with subsequent follow up face-to-face appointment (adjusted OR 1.19, 0.48-2.92, P=0.71). Conclusion Our study is one of the first in the UK to explore patient-specific factors influencing remote consultations in rheumatology. In our cohort, patient age or gender was not a limiting factor in utilising remote consultation. New consultations and interpreter use pose challenges for remote consultations, and further studies are needed to address these to see if any measures such as appropriate selection at triaging new appointments may be possible, to improve outcomes.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Rheumatology (United Kingdom) Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Rheumatology (United Kingdom) Year: 2022 Document Type: Article