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Switching to Teleconsultation for Rheumatology in the Wake of the COVID-19 Pandemic: Feasibility and Patient Response in India
14 Pages Posted: 7 May 2020
More...Abstract
Objectives: The emergent COVID-19 pandemic dictates an urgent switch to teleconsultation. India has high patient to rheumatologist ratio, and patients have limited concepts about telemedicine. Thus, we attempted to find the feasibility and acceptance of patients in switching to teleconsultation.
Methods: The CARE rheumatology clinic at Kerala, India caters to average 170(140-240) patients per day. Patients with prefixed appointments had two level screening for eligibility for teleconsultation. Those eligible were given the option for teleconsultation on the widely available WhatsApp app. Of those who completed teleconsultations, 100 were chosen at random to provide feedback.
Results: In the first 7 days, out of 1469 appointments, 975 were found eligible for teleconsultation. Of these, 723(74%) opted for it. The average footfall in the clinic was reduced from 170(range:140-240) to 67(range: 29-117). The proportion of patients accepting teleconsultations increased with time. Amongst 100 respondents, median satisfaction was 9 (IQR:8-10) and recommendation for continuing was 9.5(IQR:8-10) on a 0-10 scale. Multivariate analysis showed the recommendation score was dependent on beliefs about social distancing, perceptions about clinical examination and the satisfaction score of the first teleconsultation. Age, sex, availability of personal video conferencing app or of vehicles did not independently influence this score. Without teleconsultation facilities, three-fourths of the respondents would have stopped drugs or self-medicated.
Conclusions: The switch was feasible and accepted by patients. It enabled quick reduction in the number of persons traveling to the centre. Not making the switch could have deprived approximately three-quarters of these patients of proper medical care.
Funding Statement: None.
Declaration of Interests: All authors declare that they have no conflict of interest, including no relationship with pharmaceutical companies.
Ethics Approval Statement: This article is based on the results of an audit, and being a quality assurance service, does not qualify for ethical review.
Keywords: telemedicine; telerheumatotology; COVID-19; rheumatology practice; patient perception; Indian rheumatology
Suggested Citation: Suggested Citation