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Inflammatory Bowel Disease in the COVID-19 Pandemic - the Patients' Perspective.

ABSTRACT: BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic is affecting lives worldwide. The influence of inflammatory bowel disease (IBD) medication and IBD itself on COVID-19 is controversial. Additionally, IBD focused guidance is scarce. OBJECTIVE:To determine COVID-19 prevalence/exposure, perception and information sources, medication compliance, patient behaviour and physician contact among patients with IBD compared with non-IBD controls. METHODS:A cross-sectional anonymous survey of patients with IBD (N=415) at one university IBD clinic and one gastroenterology practice, matched 4:1 with control participants (N=116), was performed. RESULTS:Patients with IBD had high fear of infection. The fear was more pronounced in patients taking immunosuppressants and it extended to hospitals, private practices and public places, such as supermarkets. IBD patients reported leaving their homes less frequently than their peers without IBD. A total of 90% of patients with IBD reported washing their hands more frequently. Patients taking immunosuppressants were concerned about interactions between medication and COVID-19, whereas patients taking 5-aminosalicylates were not. Nonetheless, 96.4% of patients adhered to continuing their medication. Patients sought guidance primarily from television and internet news sites. Video consultations were found to be a suitable solution for a subset of patients who are young, have a high level of fear and leave their home less frequently than their peers, whereas overall acceptance of video consultations was limited. CONCLUSION:Patients with IBD are significantly more affected by the COVID-19 pandemic than their non-IBD peers, but they continue to adhere to their medication regimens. IBD focused COVID-19 information should be actively conveyed.

SUBMITTER: Grunert PC

PROVIDER: S-EPMC7337669 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Inflammatory Bowel Disease in the COVID-19 Pandemic: the Patients' Perspective.

Grunert P C PC Reuken P A PA Stallhofer J J Teich N N Stallmach A A

Journal of Crohn's & colitis 20201201 12

<h4>Background</h4>The coronavirus disease 2019 [COVID-19] pandemic is affecting lives worldwide. The influence of inflammatory bowel disease [IBD] medication and IBD itself on COVID-19 is controversial. Additionally, IBD-focused guidance is scarce.<h4>Objective</h4>Our aims were to determine COVID-19 prevalence/exposure, perception and information sources, medication compliance, patient behaviour and physician contact among patients with IBD compared with non-IBD controls.<h4>Methods</h4>A cros ...[more]

PMID: 32564068

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Project description:IntroductionPatients with inflammatory bowel disease (IBD) do not seem to be at increased risk of infection by SARS-CoV-2, but there is a concern whether immunosuppressive therapy may be associated with more severe disease. Several clinical practice recommendations have been published to help guide IBD care during the COVID-19 pandemic. Nonetheless, few studies have addressed patients' perspectives and fears. We aimed to evaluate Portuguese IBD patients' perspectives on the clinical management of their disease during the SARS-CoV-2 pandemic as well as the impact on their professional life.MethodsAn anonymous electronic survey was created using REDCap and was distributed by the Portuguese Association of Inflammatory Bowel Disease (APDI) between May and August 2020. Patients' perspectives on immunosuppressive therapy, disease management, interaction with gastroenterology departments, and the impact of the pandemic in their professional life were assessed. Patients' proposals to improve medical care were also evaluated. Descriptive analysis and logistic regression were performed.ResultsA total of 137 participants answered the survey (79.6% females, mean age 41.7 ± 12.1 years). Although having IBD and receiving treatment with immunosuppressors (thiopurines, steroids, or biologics) were considered promotors of anxiety, most patients (85.4%) agreed that disease remission was a priority and only a minority of patients interrupted their treatment during the pandemic. In multivariate analysis, active disease, biologic treatment, and use of corticosteroids in the last 3 months were perceived by the patients as high-risk features for increased risk of SARS-Cov-2 infection and more severe disease. Fifty-nine patients (44%) believed that their follow-up was influenced by the pandemic and only 58.8% felt that they had the opportunity to discuss their therapeutic options with their doctor. Sixty-three patients (46.0%) were working from home during the pandemic, although this decision was related to IBD and immunosuppressive therapy in only 36.5 and 39.7% of the cases, respectively. Areas where care could have been improved during the pandemic were identified by patients, namely enhancement of the communication with IBD professionals, conciliation of telemedicine with face-to-face appointments, and facilitation of the interaction between patients and employers.ConclusionMost patients agreed that maintaining IBD remission is crucial, and only a minority of the patients stopped their treatment as per their own initiative. IBD status only had a small influence on patients' professional activity during the COVID-19 outbreak, with most changes being related to the pandemic itself.

Dataset Information

Inflammatory Bowel Disease in the COVID-19 Pandemic - the Patients' Perspective.

Publications

Inflammatory Bowel Disease in the COVID-19 Pandemic: the Patients' Perspective.

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