PERCEPTIONS OF ACCESSING CARE AMONG IBD PATIENTS DURING THE COVID-19 PANDEMIC

ABSTRACT

Introduction The COVID-19 pandemic has globally impacted public health and the world economy. This has related, in part, to challenges in accessing medical care including procedures, hospitalizations and/or surgeries that would have been otherwise warranted in their disease management. Access to care was affected during the pandemic as most providers were not seeing patients in person, but providing virtual care. Patients' perceptions of their access to care may cause significant stress and anxiety, in a population in which many already have existing mental health conditions. Methods Participants in the populationbased University of Manitoba IBD Research Registry (n=2833) were invited to participate in a survey regarding their experiences with COVID-19, during autumn 2020, just prior to and during the second pandemic wave in Manitoba. The survey included background sociodemographic and disease information (e.g., symptom severity, medication use), COVIDrelated personal and health circumstances and coping. Results There were 1384 respondents (48.9%), of which 46.9% had Crohn's disease, 40.8% had ulcerative colitis, 3.2% had ulcerative proctitis, 2.8% had IBD-U and 2.2% had an ileoanal pouch. The mean age of respondents was 57.8 years, 40.6% were male. Mean duration of disease was 24.8 years. 38.3% said the pandemic was affecting them extremely, or a lot, while 15.6% said not at all or a little. 65.5% and 62.1% of respondents felt they had good access to their non-IBD provider to discuss non-IBD health care issues, and IBD issues, respectively. Only 53% felt they had good access to their gastroenterologist to discuss their IBD. 45.3% of respondents had increased stress about accessing their physician or nurse, while 19.9% had increased stress about accessing their prescription IBD medications. 901 (65.1%) patients were on some form of IBD therapy;12.5% of IBD-medication users adjusted their IBD medications on their own, while 13.8% had a provider adjust their IBD therapy. Conclusion Our survey revealed that over half of respondents did not feel they had good access to their gastroenterologist, or had increased stress associated with accessing care or their IBD medications 9-10 months into the pandemic. Some adjusted their IBD therapies on their own. Perception regarding access to care is integral for patients with IBD, and further research is needed to understand if perceptions regarding limited access to care changed and whether or not care was in fact limited as the pandemic evolved.