Telehealth Beyond Communicable Diseases: Are We Ready to Embrace It?
| Autor: | Nauman, Chaudary |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
ETI
elexacaftor/tezacaftor/ivacaftor+ivacaftor telehealth BMI Body mass index Communicable Diseases Cystic fibrosis antibiotic use BMI CFRD Cystic fibrosis-related diabetes CFTR Cystic fibrosis transmembrane conductance regulator HS Home spirometry COVID-19 Coronavirus disease of 2019 Humans %FEV1 Percent predicted forced expiratory volume in one second PVP Pre-visit planning Original Research SARS-CoV-2 IDC-TM Interdisciplinary telemedicine pandemic COVID-19 lung function exacerbation rate Telemedicine clinical outcomes RT Respiratory therapist HIPAA Health Insurance Portability and Accountability Act EMR Electronic medical record CF Cystic fibrosis PY Pandemic year PPY Pre-pandemic year |
| Zdroj: | Chest |
| ISSN: | 1931-3543 |
| Popis: | Background During the COVID-19 pandemic, the University of Virginia adult cystic fibrosis (CF) center transitioned from in-person clinical encounters to a model that included interdisciplinary telemedicine. The pandemic presented an unprecedented opportunity to assess the impact of the interdisciplinary telemedicine model on clinical CF outcomes. Research Question:What are the clinical outcomes of a care model that includes interdisciplinary telemedicine (IDC-TM) compared to in-person clinical care for persons with cystic fibrosis during the COVID-19 pandemic? Study Design and Methods Adults with CF were included. Pre-pandemic year (PPY) was defined as March 17, 2019 through March 16, 2020 and pandemic year (PY) as March 17, 2020 through March 16, 2021. Subjects were enrolled starting in PY. Pre-pandemic data were gathered retrospectively. Telemedicine visits were defined as clinical encounters via secured video communication. Hybrid visits were in-person evaluations by physician, with in-clinic video communication by other team members. In-person visits were encounters with in-person providers only. All encounters included pre-visit screening. Outcomes were lung function, BMI, exacerbations, and antibiotic use. %FEV1, exacerbations, and antibiotic use were adjusted for the effect of elexacaftor/ tezacaftor/ ivacaftor (ETI). Results 124 subjects participated. 110 subjects were analyzed (mean age 35, range 18-69). 95% had access to telemedicine (n=105). Telemedicine visits accounted for 64% of encounters (n=260), hybrid visits with telemedicine support 28% (n=114), and in-person visits 7% (n=30). There was no difference in lung function or exacerbation rate during PY. BMI increased from 25 to 26 (t100 = -4.72, P < 0.001). Antibiotic use decreased from 316 episodes to 124 (z = 8.81, P < 0.0001). Interpretation This CF care model which includes IDC-TM successfully monitored lung function and BMI, identified exacerbations, and followed guidelines-based care during the pandemic. A significant decrease in antibiotic use suggests social mitigation strategies were protective. |
| Databáze: | OpenAIRE |
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