"I rather talk on the phone": Factors affecting compliance with outpatient visits during COVID-19 Pandemic

ABSTRACT

Introduction: The COVID-19 pandemic presented a global publichealth crisis that demanded healthcare to adapt at an unprecedented pace. While challenging, it also created opportunities for the advancement of novel electronic-treatment-modalities. Telepsychiatry has emerged as an effective method to ensure continuity of care and ensure social distancing.1 Studies indicate that mentalhealth patients have higher rates of noncompliance to follow-up,1 thus finding means to increase compliance is critical. Objective(s) The objectives of this study are to determine the impact of telepsychiatry on compliance to follow-up and to identify numbers of psychiatric/medical emergency-room visits, most common contributing factors for admission, and compliance in terms of diagnosis. Method(s) This IRB approved study is a retrospective chart-review, that aims to study children/adolescents (5-18 years) who presented to the Child&Adolescent-Psychiatry Outpatient-clinic from July- December 2020 and engaged in telepsychiatry, compared to a group of patients presented in July-December 2019-Pre-Covid19-Pandemic. A review of clinical characteristics including diagnosis, demographic information, medication, and treatment compliance will be compared as well as admissions to inpatient-psychiatry/ emergency-room visits. Result(s) Our total sample (N=252) included patients from 2019- Pre-COVID19 (N=111) and 2020 Telehealth during COVID19- Pandemic (N=141). Our data analysis using SPSF and T-test has shown that Telehealth has significantly increased follow-up compliance (Two-tailed P-value=0.04);2019-Pre-COVID outreach mean=0.06, 2020-Telehealth-during COVID outreach mean=0.02);significantly decreased ER/CPEP visits (Pvalue= 0.02), and decreased In-patient-unit admissions (Pvalue= 0.02). Conclusion(s) According to the presented study, the incorporation of telepsychiatry has increased the compliance to psychiatric-care in outpatient and decreased the emergency-room visits and inpatient admission. Sufficient resources and steps need to be taken to further strengthen telehealth services.