Walmsley Sharon L, Nabipoor Majid, Martel-Laferriere Valerie, Loutfy Mona, Cooper Curtis, Vachon Marie-Louise, Boyachuk Bryan, Aldebes Pamela, Klein Marina B
University of Toronto, Infectious Diseases, Toronto, Canada.
University Health Network, The Biostatistics Research Unit (BRU), Toronto, Canada.
PLOS Digit Health. 2025 May 12;4(5):e0000857. doi: 10.1371/journal.pdig.0000857. eCollection 2025 May.
The COVID pandemic necessitated shifting to virtual care. Our aim was to describe, and identify the challenges and satisfaction with the virtual care experience of a subset of participants from two established Canadian Trials Network (CTN) cohorts: CTN 222 (HIV/HCV coinfection) and CTN 314: CHANGE HIV (Correlates of Healthy Aging in geriatric HIV infection) - persons > 65 years age. We hypothesized that vulnerable populations could face challenges with virtual care related to age, mental health or drug addiction. Consenting participants provided demographic information, completed a non-validated 18-item self- administered questionnaire on their virtual care experience, and reported HIV specific laboratory collection and prescription refills during the COVID pandemic. Data on CD4 T lymphocyte counts and HIV viral loads were extracted from medical records. A total of 454 individuals participated between February 2021 and March 2023, including 133 from CTN 314 and 321 from CTN 222. Overall, 55.3% engaged in virtual care. In multivariable regression models (analysis with SAS and R software) use of virtual care was higher in the aging cohort (p < .0001) but did not vary with current alcohol, drug use or self-reported depression (p > .05). The most common reason for not engaging was that it was failure to offer. Of those who engaged, 55% reporting being very satisfied, 36.3% somewhat satisfied, and 8.8% not satisfied. Ten percent of the older and 16% of the HCV cohort, reported technology difficulties as a barrier to use. Those with a detectable HIV viral load were more likely to engage in virtual care, p < .05. 81.3% of participants had HIV blood tests as frequently as before the COVID-19 pandemic. Despite high satisfaction, the majority (80%) prefers in person visits. When offering virtual care, clinics need to ensure all eligible patients are aware of how to access the services and consider patient needs and preferences.
新冠疫情使得医疗模式不得不转向虚拟医疗。我们的目的是描述并确定来自加拿大两个既定试验网络（CTN）队列的一部分参与者的虚拟医疗体验所面临的挑战和满意度：CTN 222（HIV/HCV合并感染）和CTN 314：CHANGE HIV（老年HIV感染患者健康老龄化的相关因素）——年龄大于65岁的人群。我们假设弱势群体在虚拟医疗方面可能面临与年龄、心理健康或药物成瘾相关的挑战。同意参与的参与者提供了人口统计学信息，完成了一份未经验证的关于其虚拟医疗体验的18项自填问卷，并报告了新冠疫情期间HIV特定实验室检查和处方续签情况。CD4 T淋巴细胞计数和HIV病毒载量数据从医疗记录中提取。2021年2月至2023年3月期间共有454人参与，其中133人来自CTN 314，321人来自CTN 222。总体而言，55.3%的人参与了虚拟医疗。在多变量回归模型（使用SAS和R软件进行分析）中，老年队列中虚拟医疗的使用率更高（p <.0001），但与当前饮酒、药物使用或自我报告的抑郁情况无关（p >.05）。不参与的最常见原因是未提供虚拟医疗服务。在参与的人群中，55%的人表示非常满意，36.3%的人表示有些满意，8.8%的人表示不满意。10%的老年参与者和16%的HCV队列参与者报告称技术困难是使用虚拟医疗的障碍。HIV病毒载量可检测到的参与者更有可能参与虚拟医疗，p <.05。81.3%的参与者进行HIV血液检测的频率与新冠疫情前一样。尽管满意度很高，但大多数（80%）人更喜欢面对面就诊。在提供虚拟医疗服务时，诊所需要确保所有符合条件的患者都知道如何获取服务，并考虑患者的需求和偏好。
