The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, Cambridgeshire, UK.
Audit and Accreditation, Royal College of Physicians, London, UK.
BMJ Open Respir Res. 2021 Jan;8(1). doi: 10.1136/bmjresp-2020-000817.
The COVID-19 pandemic has impacted specialty chronic obstructive pulmonary disease (COPD) care. We examined the degree to which care has moved to remote approaches, eliciting clinician and patient perspectives on what is appropriate for ongoing remote delivery.
Using an online research platform, we conducted a survey and consensus-building process involving clinicians and patients with COPD.
Fifty-five clinicians and 19 patients responded. The majority of clinicians felt able to assess symptom severity (n=52, 95%), reinforce smoking cessation (n=46, 84%) and signpost to other healthcare resources (n=44, 80%). Patients reported that assessing COPD severity and starting new medications were being addressed through remote care. Forty-three and 31 respondents participated in the first and second consensus-building rounds, respectively. When asked to rate the appropriateness of using remote delivery for specific care activities, respondents reached consensus on 5 of 14 items: collecting information about COPD and overall health status (77%), providing COPD education and developing a self-management plan (74%), reinforcing smoking cessation (81%), deciding whether patients should seek in-person care (72%) and initiating a rescue pack (76%).
Adoption of remote care delivery appears high, with many care activities partially or completely delivered remotely. Our work identifies strengths and limitations of remote care delivery.
COVID-19 大流行对专科慢性阻塞性肺疾病(COPD)的治疗产生了影响。我们研究了治疗方法向远程方式转变的程度,征求了临床医生和 COPD 患者对哪些治疗方法适合远程持续开展的意见。
我们使用在线研究平台,对临床医生和 COPD 患者进行了调查和共识建立过程。
55 名临床医生和 19 名患者做出了回应。大多数临床医生认为能够评估症状严重程度(n=52,95%)、加强戒烟(n=46,84%)和向其他医疗保健资源转介(n=44,80%)。患者报告说,正在通过远程护理来评估 COPD 严重程度和启动新的药物治疗。43 名和 31 名受访者分别参加了第一轮和第二轮共识建立过程。当被要求对使用远程护理进行特定护理活动的适宜性进行评分时,受访者就 14 项中的 5 项达成共识:收集关于 COPD 和整体健康状况的信息(77%)、提供 COPD 教育和制定自我管理计划(74%)、加强戒烟(81%)、决定患者是否应寻求亲自就诊(72%)和启动救援包(76%)。
远程护理的采用率似乎很高,许多护理活动部分或完全通过远程方式进行。我们的工作确定了远程护理的优缺点。