REIMAGINING CARE AFTER THE ICU: LEVERAGING TELEMEDICINE FOR PATIENTS WITH COVID-19 IN THE ICU

ABSTRACT

SESSION TITLE What Lessons Will We Take From the Pandemic? SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 pm PURPOSE: Post-intensive care syndrome (PICS) affects 50% of ICU survivors leading to significant healthcare utilization. COVID-19 survivors are at higher risk for developing PICS given the prolonged duration of critical illness. The aim of this study was to determine the feasibility and acceptability of using telemedicine (TM) for the transitional care (TC) of post ICU COVID-19 survivors. METHODS: This prospective randomized un-blinded controlled study was conducted from July 2021 to January 2022. Adults admitted to the ICU with a diagnosis of acute respiratory distress syndrome secondary to COVID-19 infection and discharged home were included. Those who lacked communication and internet services, and had pre-morbid conditions preventing independent self-care were excluded. 40 patients were recruited with 20 patients in each arm. The study group (SG) underwent a telemedicine (TM) visit within 2 weeks of discharge, where vital signs logs (VSL), virtual six-minute walk test (v6MWT), and EuroQoL 5-Dimension (EQ-5D) questionnaire were reviewed. The control group (CG) received a TM visit within 6 weeks of discharge and completed the EQ-5D questionnaire. This study was approved by the WVU IRB (#2104284924). RESULTS: Both groups had similar baseline characteristics. Completion rate of the VSL and v6MWT was 50% in the SG. 39% of SG came off oxygen supplementation compared to 33% in the CG. There was less anxiety/depression, increased request, and compliance to follow-up in pulmonary clinic noted in SG compared to CG, however this difference was not statistically significant. All readmissions were non- preventable (n=3;2 CG, 1 SG). 100% survival rate was noted in both groups at 30-days. 5% of patients were lost to follow up in both groups due to non-working communication devices and lack of response despite multiple attempts made for the TM visit. 67% (2/3) of primary care physicians (PCP) felt that this intervention helped establish continuity of care. 83% (5/6) of participants felt that an intensivist led TC visit provided closure for their ICU hospitalization. CONCLUSIONS: There was no significant difference noted in outcomes between the 2 groups, however, this is likely due to underpowered sample sizes. This form of TC is well received by both PCP and patients in screening and mitigation of PICS. CLINICAL IMPLICATIONS This pilot study is the first in the region to show the acceptability and feasibility of using TM for the TC of ICU COVID survivors. It is vital to ensure ICU survivors receive targeted multidisciplinary management to prevent PICS. TM can be utilized in the future for the TC of all ICU survivors. DISCLOSURES No relevant relationships by Ariful Alam No relevant relationships by Bathmapriya Balakrishnan No relevant relationships by Lucas Hamrick No relevant relationships by Sunil Sharma Consultant relationship with Res Med Please note 7/2021-Present Added 03/31/2022 by Robert Stansbury, value=Consulting fee No relevant relationships by Jesse Thompson