IDDF2022-ABS-0110 Cuagain: providing care in the covid era, a randomized trial of video assisted virtual, in-person, telephone appointments in gastroenterology patients

Background COVID-19 spurred a dramatic shift from in-person patient visits toward virtual care. To date, there are no prospective studies randomizing patients to different styles of appointment and assessing their perspectives on the type of visit. We aimed to identify preferred styles of appointments across various patient factors to inform decisions regarding the optimal appointment style for patients. Methods We randomized Inflammatory Bowel Disease (IBD) patients’ follow-up appointments to either in-person, telehealth (video+audio), or telephone and subsequent appointments to the alternate appointment types in a single-centre study. Participants completed surveys after each appointment style to minimize bias. We collected anthropometric data and analyzed average scores assessing for potential associations. We used standard regression analyses and T-scores for the assessment of statistical significance. Results Fifty-two surveys were completed, 20 in-person, 17 telephones, and 15 telehealth, for a total of 56 participants (more data to come). The average age was 45.0 ±16yrs and 59% were female. The overall patient score by appointment type (out of ten) was 9.2 ±0.7 for in-person, 8.3 ±1.4 for telephone, and 7.3 ±2.4 for telehealth (IDDF2022-ABS-0110 Figure 1. Ratings of key elements by appointment type). The percentage of patients who would have preferred an alternate appointment style was 25.0% for in-person, 52.9% for telephone, and 33.0% for telehealth (IDDF2022-ABS-0110 Figure 2. Appointment preferences and requirements). The highest-rated factors for preference for an in-person appointment were optimal communication and interaction with the care provider (86.4%) (IDDF2022-ABS-0110 Figure 3. Factors contributing to preferred appointment type). Among participants who would have preferred telehealth appointments 62.5%, and 37.5% cited time savings and cost savings as reasons respectively, and 60.0% and 33.3% for the same reasons for telephone-based appointments. In-person appointments were associated with a higher cost and longer time commitment. Conclusions In our study randomizing IBD patients to telehealth, telephone or in-person visits, it is clear that all appointment styles have their merits. Despite the increased cost and time commitment, there was a trend toward the preference for in-person appointments, though not statistically significant. As we shift away from in-person patient visits, we suggest that providers should consider patient preferences in choosing a style of appointment.

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