Sorbonne Université, Department of Hepato-Biliary and Pancreatic Surgery, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
Sorbonne Université, Department of Nutrition, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
Obes Surg. 2023 Apr;33(4):1083-1091. doi: 10.1007/s11695-023-06485-7. Epub 2023 Feb 9.
The COVID-19 pandemic was initially responsible for a global restricted access to healthcare resources including the follow-up of at-risk populations such as bariatric patients. We substituted face-to-face bariatric follow-up outpatient clinics (FTFC) with teleclinics (TC) during the lockdown.
We retrospectively reviewed data collected on all patients scheduled for TC during the French lockdown period (March 15 to May 15, 2020) (N = 87). Our aims were to present the patients' outcomes at one and 2 years post-TC implementation and describe patient/practitioner satisfaction.
Seven (8%) patients required FTFC, and 80 (92%) underwent TC (study population) for preoperative bariatric assessment (N = 3) and postoperative follow-up (N = 77) after 23.6 ± 29 months following surgery. TC was performed with video and audio (N = 46; 57.5%) or audio alone when video was impossible (N = 34; 42.5%). Sixteen (20%) patients presented at least one complication identified at the first TC and were managed accordingly. There were no readmissions at 30/90 days post-TC. At 1-year after the first TC, overall follow-up rate was 94.9% (TC: 73% vs FTFC: 27%). Patients surveyed on the main advantages of TC over FTFC (N = 46) cited: saving time (97.8%) at a mean 3.9 ± 6.4 h saved per TC, work-advantages (94.3%), and comparable relevance of TC (84.8%). At 2 years post-TC implementation, follow-up rate was 93.5% and satisfaction rate was 80%, with 33% of patients preferring to return to FTFC.
TC is a satisfactory substitute for FTFC, enabling continued bariatric follow-up during and beyond the pandemic setting without compromising patient safety. However, the modest satisfaction outcomes at 2 years highlight a need to discuss follow-up preferences in order to achieve optimal outcomes.
COVID-19 大流行最初导致包括肥胖患者在内的高危人群的医疗资源全球受限，无法获得后续治疗。在封锁期间，我们用远程诊所（TC）代替了面对面的肥胖症随访门诊（FTFC）。
我们回顾性地分析了 2020 年 3 月 15 日至 5 月 15 日法国封锁期间所有计划进行 TC 的患者的数据（N=87）。我们的目的是报告 TC 实施后 1 年和 2 年患者的结局，并描述患者/医生的满意度。
7 例（8%）患者需要 FTFC，80 例（92%）接受 TC（研究人群）进行术前肥胖症评估（N=3）和术后随访（N=77），手术时间为 23.6±29 个月。TC 采用视频和音频（N=46；57.5%）或仅音频（N=34；42.5%）进行，当视频不可用时。16 例（20%）患者在首次 TC 时出现至少一种并发症，并进行了相应的处理。TC 后 30/90 天无再入院。首次 TC 后 1 年，总随访率为 94.9%（TC：73% vs FTFC：27%）。对 TC 优于 FTFC 的主要优势进行调查的 46 例患者表示：节省时间（97.8%），每次 TC 节省 3.9±6.4 小时，工作便利（94.3%），TC 的相关性相当（84.8%）。TC 实施后 2 年，随访率为 93.5%，满意度为 80%，33%的患者更愿意回到 FTFC。
TC 是 FTFC 的一种令人满意的替代方法，可在大流行期间和之后继续进行肥胖症随访，而不会危及患者安全。然而，2 年后的满意度结果中等，突出了需要讨论随访偏好，以实现最佳结局。
