P660 The impact of COVID-19 on the provision of care for patients with Inflammatory Bowel Disease: A cross sectional survey
Malhi, G.(1);Mikail, M.(1);Chambers, J.(1);Khanna, R.(2);Wilson, A.(3);
(1)Western University, Medicine, London, Canada;(2)Western University, Division of Gastroenterology, London, Canada;(3)Western University, Physiology & Pharmacology- Divisions of Clinical Pharmacology- and Gastroenterology, London, Canada
Background
COVID-19 was declared a worldwide pandemic in March of 2020. Since its onset, the focus of many healthcare systems shifted toward limiting non-essential visits to hospitals in order to prioritize and allocate resources toward treating those affected by COVID-19. Those with Inflammatory Bowel Disease (IBD) have been particularly impacted. We aimed to survey IBD patients to determine how they have been affected by changes to the provision of care due to the COVID-19 pandemic.
Methods
A mixed methods survey was conducted with patients with an IBD diagnosis who received care for their IBD since March 17, 2019 in Canada. The primary aims of the survey were to evaluate any differences in access to or usage of IBD-related care including medications, clinic visits in addition to patient experience with virtual care.
Results
A total of 135 complete or partial responses were received, of which 90 responses were included for having answered >50% of questions. The majority of respondents were from Ontario, with a mean age of 42 years, and over 75% being female. 67% had Crohn’s Disease, and 69% were on a biologic.
Three percent of respondents stopped taking all IBD-related medications without the advice of their gastroenterologist due to pandemic-related concerns while 8% reported difficulty obtaining their medications. Thirty-eight percent reported a delay in being able to see their gastroenterologist, with a majority reporting a delay >4 weeks (n=21). Twenty-three percent required a visit to the emergency department due to IBD-related concerns, and 13% of participants were admitted to hospital. 33% reported a delay in endoscopy, with a majority reporting a delay greater than 3 months (n=17).
Thirty-eight percent reported receiving poorer care since the pandemic began, while 36% reported no change. 76% of respondents used Telehealth for their appointments. 66% reported they were able to speak with their gastroenterologist within 15 minutes of their appointment time. Thirty percent preferred telehealth appointments to in-person visits. Half reported no change with their quality of interaction with their gastroenterologists.
Conclusion
Preliminary data highlight that patients have experienced significant delays in IBD care during the COVID-19 pandemic, with more than one third reporting a reduction in the quality of that care. Interestingly, only a minority of patients stopped medication or had reduced access during the pandemic. Further studies will help define whether there were a significant change in the number of hospitalizations due to this delay. Virtual care is a useful tool during the pandemic, but its mixed feedback raises questions about how it can be effectively utilized in the future.