P039 IBD Patients' and Clinicians' Perceptions of Care Delivery during the COVID-19 Pandemic.

Abstract

BACKGROUND: Both IBD patients and health care professionals (HCPs) are concerned about the effects of the COVID-19 pandemic on care delivery. We seek to determine patient and HCP perceptions on IBD care during the pandemic. METHODS: Between March and May 2021, surveys were administered to HCPs and IBD patients from 6 participating clinics that are part of a large gastroenterology group in the Mid-Atlantic. The surveys were administered before and after patient education sessions that focused on IBD care in the context of COVID-19. The surveys included items on disease history, experience with COVID-19, medication adherence, access to care, and patient-HCP communication. RESULTS: Surveys were collected from 11 HCPs (55% physicians, 45% nurse practitioners/physician assistants) and 94 of their IBD patients (66% female, average age 49 years). The clinicians had an average of 10 years of experience caring for patients with IBD. WPatients exhibited low levels of knowledge about various aspects of IBD care and COVID-19; HCPs were fairly accurate in estimating the patients’ knowledge in these areas. Eighty-eight percent of patients and 82% of HCPs agreed that the pandemic impacted patients’ emotional well-being. Only 39% of patients indicated that they fully disclose to their IBD care team the impact that the pandemic and/or IBD has had on their life. The most common reason given by patients for not sharing was that their IBD care team did not ask them (32%), while HCPs most believed that patients did not think the information was relevant to share (46%). Similar proportions of patients and HCPs (77% and 82%, respectively) believed that the pandemic did not affect overall adherence to IBD treatment. However, HCPs underestimated the ability of patients to keep up with many other aspects of their IBD care. For example, 64% of HCPs believed the patients were not able to undergo routine follow-up, while only 22% of patients reported that they were unable to do so. Only 57% of IBD patients and 45% of HCPs felt that patients were very much or extremely involved in decisions regarding their IBD care during the pandemic. The two most common barriers to engaging patients in shared decision-making (SDM) during the pandemic that HCPs reported were not enough time (64%) and lack of staff to support SDM (36%). Actions that IBD patients planned to take following the educational session included keeping up with overall preventative care (81%) and keeping up with appointments, tests, and procedures (76%). Approximately one-half of IBD patients planned to use telehealth to keep up with their follow-up IBD care following the session. Actions that HCPs planned to take were educating their patients about COVID-19 (43%) and how to manage their IBD during the pandemic (86%). CONCLUSION: Despite challenges posed by the COVID-19 pandemic, the IBD patients in this study were able to keep up with their care. However, perceptions of communication differed between patients and HCPs, especially around disclosure of quality of life impacts and emotional well-being. These discordances in communication will help inform IBD care moving forward, beyond the pandemic.