SC4 - Telemedicine and teleconsulting in andrology at the time of COVID-19 pandemic: Is this the right way?

Abstract

Introduction: Starting from February 2019, a novel health-care emergency, caused by severe acute respiratory syndrome coronavirus-2 (COVID-19), generated a catastrophic health care system emergency in Italy with deferment of elective procedures, in particular for outpatients services Andrological practice has been considered as non-essential clinical services but the impact of andrological disease on the patient's quality of life is high, especially in the time of COVID-19 pandemic Italian people are forced stay home on the basis of Italian government's “I Stay Home” decree without any social or outdoor activities In our hospital, in line with the Italian government's “I Stay Home” decree, we have begun to offer telephone out-patient consultations to our urological and andrological patients Materials and methods: From 13th March 57 patients scheduled for andrological visits were contacted by phone by two experienced andrologists, in line with our new reorganized outpatients management In brief, the andrologist, during the telephone-based consultation, ask about the reason for the visit and the patients$$ symptoms, examined the past and present medical history and perform a teleconsulting about the diseases At the end of the consultation, the andrologist released written instructions and prescriptions available online through the Hospital Information System to the patient Moreover, the day after the telephone consultation, all patients were contacted again by another andrologist and were requested to answer a dedicated 4-questions patient satisfaction questionnaire (4qPSQ) Results: The analysis of the first 57 telephone-based consultation showed the following results: 38 patients (66 6%) reported a low level of satisfaction Thirty patients (52 6%) did not feel reassured by the telephonebased consultation (Q1) and 8 were disappointed by it (14%) Moreover, 35 patients (61 4%) did not feel satisfied by this service Finally, only 15 patients (26 3%) would recommended this service to a friend (Q4) Taking into account these data and opposing to what we thought, we decided to revise our clinical andrological practice From 30th March all andrological telephone-based consultations have been blocked and all andrological visits were directly canceled by secretaries1 A new andrological visit will be scheduled starting from the end of COVID-19 pandemic Conclusions: Several studies demonstrated that telemedicine and teleconsulting reported high level of satisfaction among patients also in urological setting In our experience, telephone-based consultation and teleconsulting are not the patients’ favored approaches in andrological setting However, we think that during COVID-19 outbreak or environment health emergencies, telephone-based consultation and teleconsulting have a limited interest in andrological setting due the psychological implications of andrological diseases requiring a face-to-face visits and the evaluation of nonverbal elements