CROSS-SECTIONAL AND LONGITUDINAL ASCERTAINMENT OF PATIENTS WITH IBD'S PERCEPTIONS AND EXPERIENCES DURING COVID-19: CLAPPED COVID-19

ABSTRACT

Background - Patients with Inflammatory Bowel Disease (IBD) require long-term followup and potentially immunosuppressive medications. We sought to assess these patients' experiences during the COVID-19 pandemic as well as the pandemic's impact on patients' access to and behavior around seeking clinical care. We hypothesized that the COVID-19 pandemic had a significant impact on how patients with IBD seek and prefer to obtain health care. Methods - We conducted a repeated cross-sectional survey within the IBDPARTNERS Internet-based cohort from April 2020 to June 2021. Follow-up surveys occurred at weeks 2, 4, 6, 8, 26, and 52. Surveys included questions about residence, demographics, experience with telemedicine, COVID vaccination status, health care behavioral changes, and medication changes throughout the pandemic. Statistical Analysis - Descriptive statistics were used to summarize the cohort. Ordered logistic regression was used to examine the associations between baseline characteristics and levels of concern regarding the pandemic. Logistic regression was used to examine the relationships between levels of concern and changing patient behaviors. Due to the repeated longitudinal nature of the data and potential intra-subject correlation, all regression analysis was done on panel data. Results - A total of 2,121 patients (Table 1) completed the baseline survey with a response rate of >90% for each follow-up survey. The general level of concern regarding the pandemic and the level of concern regarding IBD medications during the pandemic decreased significantly over the survey period (Figures 1A-1B). Older age, female sex, higher education, higher Patient- Reported Outcomes Measurement Information System (PROMIS) scores, presence of non- IBD comorbidities, and COVID vaccination were significantly associated with levels of general concern regarding COVID (Figure 1C). The overall perception of telemedicine was positive (Figure 1D), although preferences for telemedicine or in-person visit varied based on the type of care (routine visit, IBD medication change, addressing IBD flare, etc.) needed. While news media and the CDC remained the most common sources of coronavirus information, patient websites such as Crohn's and Colitis Foundation increased slightly over the study period. Conclusion - During the study period (April 2020 - June 2021), the general and IBD-specific levels of concern among adults with IBD decreased significantly. Preferences for telemedicine or in-person care varied based on the reasons for seeking care. These data give clinically relevant insights that can inform immediate and future adjustments regarding patient care, such as investing in the development of telemedicine and improving the accessibility of patient websites, as we move the practice of gastroenterology into the post- COVID-19 era. (Table Presented) (Figure Presented) Figure 1. Each of the panel figures (1A-1D) highlights a major finding of the study.