P385 Results of a teleconsultation campaign for Inflammatory Bowel Disease (IBD) patients to check their treatment adherence and assess their level of anxiety during the first COVID-19 lockdown
Paupard, T.(1);richez, C.(2);verlynde, J.(1);zaharia, O.(1);quartier, G.(1);hudziak, H.(1);delhoustal, L.(1);
(1)Centre Hospitalier, Service d'Hépato-Gastroentérologie, Dunkerque, France;(2)Centre Hospitalier, Service d'Addictologie, Dunkerque, France
Background
Long-term treatment adherence of patients treated for IBD is quite low, around 50% according to literature. Patients are often suspicious of the infectious risks vis-à-vis immunosuppressants and in particular biotherapies.
Methods
Analysis of the treatment adherence and the level of anxiety of IBD patients treated by immunosuppressants during the first French COVID-19 lockdown.
Monocentric prospective observational study.
Teleconsultations were made by the same gastroenterologist not usually involved in patient care, using randomly an active file of 96 IBD patients monitored in a database (Focus MICI®). Treatments: Corticosteroids n = 0; Azathioprine n = 2; Adalimumab n = 9; Infliximab n= 44 (53%); Golimumab n = 1; Vedolizumab n = 11; Tofacitinib n = 0; Methotrexate n = 3; Ustekinumab n = 5; Combotherapy n = 20.
Results
Calls from 09/4 to 07/5 2020. 13/96 (13.5%) unreachable patients (answering machine, wrong number, no answer, working, etc.). No call was refused when patients were reached. Analysis on 83 patients. Average age: 41.7 years; M / F (55/41) [20-80]. Crohn / RCH: 72/24. Call duration: 5 to 22 minutes. Clinical remission estimated by the patient: Yes / No: 73/10 (88%). Clinical signs possibly linked to Covid: 9/86 (10.4%); discontinuation of treatment: 2/9 (22%). Finally, the treatment was stopped for 11/83 (13%) patients in this IBD population, most of them were in remission. Only 2/9 (22%) with potential Covid symptoms had stopped their treatment. On an anxiety scale from 1 to 10, 41% of patients were moderately to very worried. Among the main fears: increased risk of Covid-19 infection during treatment and fear of coming to the hospital during the epidemic (nosocomial risk). None of the patients spontaneously took the initiative to call first their referent gastroenterologist to discuss the situation. For the others (87%), continuation of treatment with an adherence estimated between 8 and 10 on a scale from 1 to 10.
Results of the call: the phone call was generally much appreciated by IBD patients. Most of the patients were reassured and convinced to continue their treatment and to contact their referent gastroenterologist.
Conclusion
Our results show that the first Covid-19 lockdown was responsible for a high level of anxiety among patients (41%) and a negative effect on patient compliance (not necessarily potential Covid + patients). Advantages of teleconsultation: good acceptability, excellent effectiveness in terms of reassurance and treatment adherence. The cessation of the treatment was in most cases hidden to the doctor. We think that there is a subsequent interest in maintaining tele/visio consultations in addition to face-to-face consultations.