Doumit Michael, Strachan Roxanne, Lazarus Raynuka, Middleton Peter, Dentice Ruth, Marouvo Jessica, Jeffrey Laura, Selvadurai Hiran, Sivam Sheila, Pacey Verity, Jaffe Adam, Gray Kelly
Department of Health Sciences, Macquarie University, Sydney, NSW, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
Health Serv Insights. 2023 Oct 16;16:11786329231205145. doi: 10.1177/11786329231205145. eCollection 2023.
Standard of care recommend that patients with cystic fibrosis (CF) require screening investigations to assess for complications. Changing models of care due to the COVID19 pandemic may have impacted completion of recommended screening.
To compare the frequency of screening investigations completed in people with CF before and after the onset of the COVID19 pandemic.
Medical records were reviewed at 4 CF-specialist centers to identify screening investigations completed in the 12-months before and after pandemic onset.
Records of 625 patients were reviewed. Prior to pandemic onset, there was between center variability in completion of screening investigations. There was greatest baseline variation between centers in performing oral glucose tolerance test (OGTT); range 38%-69%, exercise tests; 3%-51% and sputum screening for non-tuberculous mycobacteria; 53%-81%. Following pandemic onset, blood tests, and sputum cultures were maintained at the highest rates. Exercise testing, CXR and OGTT exhibited the greatest declines, with reductions at individual centers ranging between 10%-24%, 22%-43%, and 20%-26%, respectively. Return to in-person visits following pandemic onset was variable, ranging from 16% to 74% between centers.
Completion of screening investigations varies between CF centers and changes in models of care, such as increased virtual care in response to COVID19 pandemic was associated with reduction in completion of investigations. Centers would benefit from auditing their adherence to standards of care, particularly considering recent changes in care delivery.
护理标准建议囊性纤维化（CF）患者需进行筛查检查以评估并发症。由于新冠疫情导致的护理模式变化可能影响了推荐筛查的完成情况。
比较新冠疫情爆发前后CF患者完成筛查检查的频率。
对4个CF专科中心的病历进行回顾，以确定疫情爆发前后12个月内完成的筛查检查。
共回顾了625例患者的记录。在疫情爆发前，各中心之间筛查检查的完成情况存在差异。在进行口服葡萄糖耐量试验（OGTT）方面，各中心的基线差异最大；范围为38%-69%，运动试验为3%-51%，非结核分枝杆菌痰筛查为53%-81%。疫情爆发后，血液检查和痰培养的完成率保持在最高水平。运动试验、胸部X光检查和OGTT的下降幅度最大，各中心的降幅分别在10%-24%、22%-43%和20%-26%之间。疫情爆发后恢复面对面就诊的情况各不相同，各中心之间的范围为16%至74%。
CF中心之间筛查检查的完成情况各不相同，护理模式的变化，如因新冠疫情而增加的虚拟护理，与检查完成率的降低有关。各中心将受益于审核其对护理标准的遵守情况，特别是考虑到近期护理提供方式的变化。
