Stone Katherine L, Kulekofsky Emma, Hudesman David, Kozloff Samuel, Remzi Feza, Axelrad Jordan E, Katz Seymour, Hong Simon J, Holmer Ariela, McAdams-DeMarco Mara A, Segev Dorry L, Dodson John, Shaukat Aasma, Faye Adam S
New York University Langone Medical Center, New York, NY, USA.
NYU Grossman School of Medicine, New York University Langone Medical Center, New York University, 305 East 33rd Street, New York, NY 10016, USA.
Therap Adv Gastroenterol. 2023 Apr 25;16:17562848231158231. doi: 10.1177/17562848231158231. eCollection 2023.
The COVID-19 pandemic led to the urgent implementation of telehealth visits in inflammatory bowel disease (IBD) care; however, data assessing feasibility remain limited.
We looked to determine the completion rate of telehealth appointments for adults with IBD, as well as to evaluate demographic, clinical, and social predictors of incomplete appointments.
We conducted a retrospective analysis of all patients with IBD who had at least one scheduled telehealth visit at the NYU IBD Center between 1 March 2020 and 31 August 2021, with only the first scheduled telehealth appointment considered.
Medical records were parsed for relevant covariables, and multivariable logistic regression was used to estimate the adjusted association between demographic factors and an incomplete telehealth appointment.
From 1 March 2020 to 31 August 2021, there were 2508 patients with IBD who had at least one telehealth appointment, with 1088 (43%) having Crohn's disease (CD), 1037 (41%) having ulcerative colitis (UC), and 383 (15%) having indeterminate colitis. Of the initial telehealth visits, 519 (21%) were not completed, including 435 (20%) among patients <60 years as compared to 84 (23%) among patients ⩾60 years ( = 0.22). After adjustment, patients with CD had higher odds of an incomplete appointment as compared to patients with UC [adjusted odds ratio (adjOR): 1.37, 95% confidence interval (CI): 1.10-1.69], as did females (adjOR: 1.26, 95% CI: 1.04-1.54), and patients who had a non-first-degree relative listed as an emergency contact (adjOR: 1.69, 95% CI: 1.16-2.44). While age ⩾60 years was not associated with appointment completion status, we did find that age >80 years was an independent predictor of missed telehealth appointments (adjOR: 2.92, 95% CI: 1.12-7.63) when compared to individuals aged 60-70 years.
Patients with CD, females, and those with less social support were at higher risk for missed telehealth appointments, as were adults >80 years. Engaging older adults telehealth, particularly those aged 60-80 years, may therefore provide an additional venue to complement in-person care.
2019年冠状病毒病（COVID-19）大流行促使炎症性肠病（IBD）护理中紧急实施远程医疗问诊；然而，评估其可行性的数据仍然有限。
我们旨在确定IBD成年患者远程医疗预约的完成率，并评估未完成预约的人口统计学、临床和社会预测因素。
我们对2020年3月1日至2021年8月31日期间在纽约大学IBD中心至少有一次预约远程医疗问诊的所有IBD患者进行了回顾性分析，仅考虑首次预约的远程医疗问诊。
分析医疗记录以获取相关协变量，并使用多变量逻辑回归来估计人口统计学因素与未完成远程医疗预约之间的校正关联。
2020年3月1日至2021年8月31日期间，有2508例IBD患者至少进行了一次远程医疗问诊，其中1088例（43%）患有克罗恩病（CD），1037例（41%）患有溃疡性结肠炎（UC），383例（15%）患有不确定性结肠炎。在最初的远程医疗问诊中，519例（21%）未完成，其中60岁以下患者中有435例（20%）未完成，而60岁及以上患者中有84例（23%）未完成（P = 0.22）。调整后，与UC患者相比，CD患者未完成预约的几率更高[校正优势比（adjOR）：1.37，95%置信区间（CI）：1.10 - 1.69]，女性（adjOR：1.26，95% CI：1.04 - 1.54）以及将非一级亲属列为紧急联系人的患者（adjOR：1.69，95% CI：1.16 - 2.44）也是如此。虽然60岁及以上与预约完成状态无关，但我们确实发现，与60 - 70岁的个体相比，80岁以上是错过远程医疗预约的独立预测因素（adjOR：2.92，95% CI：1.12 - 7.63）。
CD患者、女性以及社会支持较少的患者错过远程医疗预约的风险较高，80岁以上的成年人也是如此。因此，让老年人参与远程医疗，特别是60 - 80岁的老年人，可能会提供一个补充面对面护理的额外途径。
