Abstract
ObjectiveTo describe a remote approach used with patients with voice prosthesis after laryngectomy during the COVID-19 pandemic and the resulting clinical outcomes in terms of voice prosthesis complications management, oncological monitoring, and psychophysical well-being.Study DesignProspective cohort study.SettingOtolaryngology Clinic of the University Polyclinic A. Gemelli, IRCCS Foundation.Subjects and MethodsAll patients with voice prosthesis who underwent laryngectomy followed by our institute were offered enrollment. Patients who agreed to participate were interviewed to inquire about the nature of the need and to plan a video call with the appropriate clinician. Before and 1 week after the clinician’s call, patients were tested with the Hospital Anxiety and Depression Scale. Degrees of satisfaction were investigated with a visual analog scale. A comparison between those who accepted and refused telematic support was carried out to identify factors that influence patient interest in teleservice.ResultsVideo call service allowed us to reach 37 (50.68%) of 73 patients. In 23 (62.16%) of 37 cases, the video call was sufficient to manage the problem. In the remaining 14 cases (37.83%), an outpatient visit was necessary. Participants who refused telematic support had a significantly shorter time interval from the last ear, nose, and throat visit than patients who accepted (57.95 vs 96.14 days, P = .03). Video-called patients showed significantly decreased levels of anxiety and depression (mean Hospital Anxiety and Depression Scale total score pre– vs post–video call: 13.97 vs. 10.23, P < .0001) and reported high levels of satisfaction about the service.ConclusionRemote approach may be a viable support in the management of patients with voice prosthesis rehabilitation.
Highlights
Remote approach may be a viable support in the management of patients with voice prosthesis rehabilitation
On March 11, 2020, the World Health Organization stated that a new coronavirus for severe acute respiratory syndrome, called SARS-CoV-2 and identified as a microbial agent that causes viral pneumonia, could be characterized as a pandemic.[1]
Linked to Wuhan (Hubei province, China), coronavirus disease (COVID-19) has progressively involved many countries, including Italy with 204,576 confirmed cases and 26,049 deaths according to the data of the Istituto Superiore di Sanitaon May 1, 2020.2
Summary
Patients who agreed to participate were interviewed to inquire about the nature of the need and to plan a video call with the appropriate clinician. A comparison between those who accepted and refused telematic support was carried out to identify factors that influence patient interest in teleservice. This is a prospective cohort study including all patients who underwent a laryngectomy with VP and were followed in the Otolaryngology Clinic of our institute. Patients were tested with the Hospital Anxiety and Depression Scale (HADS), and a semistructured interview was conducted to inquire about the nature of the need (VP-related trouble, medical/surgical issue, or psychological aid). Our COVID-19 point-of-care protocol before VP replacement included a self-declaration form (see Supplemental Appendix A, available online), gloves, and FFP2 mask for patients; a temperature check at the service entrance with an infrared thermometer; and a direct path to a dedicated outpatient room without staying in the waiting room
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