Mason Matthew C, Vedhanayagam Kriti, Jernigan John A
Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA.
Department of Internal Medicine, Jackson Hospital, Montgomery, USA.
Cureus. 2021 Jul 29;13(7):e16711. doi: 10.7759/cureus.16711. eCollection 2021 Jul.
Background and aims The COVID-19 pandemic has led to significant changes in healthcare delivery. In response to these changes, patients have increasingly reduced healthcare utilization in several ways, such as medication compliance, cancer screenings, and routine wellness appointments. This study aims to quantify patient adherence rates to routine and symptom indicated colonoscopies during the COVID-19 and to assess patient medication compliance and utilization of healthcare facilities. Methods A cross-sectional study was performed at a single-center internal medicine clinic from January 2021 to April 2021. A 28-item survey was administered to patients to evaluate for adherence rates to routine and symptom indicated colonoscopies. Patients were also evaluated for rates of healthcare facility usage and medication compliance. Results Among 103 participants, 30.8% of patients who were due for routine colonoscopy either missed, refused, or rescheduled, while 16.7% of patients did so for symptom indicated colonoscopies. Nearly all respondents (94.2%) reported no change to medication compliance when compared to pre-COVID. A significant portion (36.9%) of patients reported missing a healthcare appointment at some point during the pandemic, and of the respondents who felt sick enough to visit the emergency department, 23.1% decided not to go. Conclusions During the COVID-19 pandemic, patients are deferring colorectal cancer surveillance, reducing the usage of acute care facilities, and missing routine healthcare appointments. It is important for providers to address the risks and benefits of delaying colorectal cancer screenings as well as identify physical and psychosocial barriers to patient utilization of both acute and chronic healthcare facilities. As COVID-19 restrictions inevitably continue to ease, medical providers should be aware of these potential lapses in cancer screenings and healthcare visits and be vigilant in catching patients up on their preventative health screenings.
新冠疫情导致了医疗服务提供方式的重大变化。为应对这些变化，患者通过多种方式减少了医疗服务的使用，如药物依从性、癌症筛查和常规健康检查。本研究旨在量化新冠疫情期间患者对常规和症状提示结肠镜检查的依从率，并评估患者的药物依从性和医疗设施的使用情况。方法：2021年1月至2021年4月在一家单中心内科诊所进行了一项横断面研究。对患者进行了一项包含28个项目的调查，以评估对常规和症状提示结肠镜检查的依从率。还对患者的医疗设施使用率和药物依从性进行了评估。结果：在103名参与者中，30.8%应进行常规结肠镜检查的患者错过、拒绝或重新安排了检查，而16.7%症状提示结肠镜检查的患者也如此。与新冠疫情前相比，几乎所有受访者（94.2%）报告药物依从性没有变化。很大一部分患者（36.9%）报告在疫情期间的某个时候错过了医疗预约，在感觉病情严重到足以去急诊室就诊的受访者中，23.1%决定不去。结论：在新冠疫情期间，患者推迟结直肠癌监测，减少了急性护理设施的使用，并错过常规医疗预约。对于医疗服务提供者来说，重要的是要解决推迟结直肠癌筛查的风险和益处，并识别患者使用急性和慢性医疗设施的身体和社会心理障碍。随着新冠疫情限制措施不可避免地继续放宽，医疗服务提供者应意识到癌症筛查和医疗就诊方面的这些潜在失误，并警惕让患者补上预防性健康筛查。
