Telemedicine in hepatology and patient satisfaction: Lessons from the covid-19 pandemic

Introduction: The COVID-19 pandemic poses a massive challenge to healthcare systems and an opportunity for them to reinvent themselves Telephone consultation (TC) seems a reasonable approach, being recommended by different societies as an alternative to assist patients with liver disease during pandemic crisis 1 Despite physicians' concerns related to uncertain prognostic consequences of using telemedicine, it is also important to understand patient's perspective about TC Aims & Methods: Outpatients followed in hepatology consultation submitted to TC during an initial period of 5 weeks were contacted again and invited to answer an adapted version of the Telemedicine and Satisfaction Questionnaire2 and open-ended questions regarding patient global assessment of TC Only patients with at least one outpatient face-to-face consultation (FFC) were considered The recorded data included demographic and clinical characteristics, survey answers, distance from home to hospital and working time usually missed in FFC Primary endpoints were the frequency of satisfied patients with TC and patients' availability to be assisted through TC in the future (answered 'agreed' or 'strongly agreed' on 4-point Likert scale) Secondary endpoints were the possible factors associated with better satisfaction with TC and patients' burden in FFC Results: From a total of 78 outpatients submitted to TC, 68 (87 2%) answered the call and agreed to respond to the survey (35 [51 5%] were men;median age was 59 5 years [IQR 54 3-69 5]) Alcoholic liver disease, nonalcoholic fatty liver disease and primary biliary cholangitis were the most common diagnosed liver diseases: 28 (41 1%), 9 (13 2%) and 8 (11 7%), respectively Sixty-one (89 7%) patients were satisfied with TC and 46 (67 6%) considered TC as a reasonable way to be attended to in the future A higher educational level (secondary and higher education vs primary education) was associated with more availability for assistance through TC in the future (83 3% vs 55 2%, p=0 014) Median distance from home to hospital was 39 5 km (IQR 20 0-61 5) and 29 4% (20) of the patients (or their caregivers) usually have to miss work (13 2% [9] need to take a day off) to go for a FFC Cost savings, decreased travel and waiting times were the main advantages pointed out by patients;lack of face-to-face interaction the main disadvantage Intercalate TC and FFC was the main patients' suggestion regarding this topic Conclusion: These results suggest that patients with liver disease were generally satisfied with TC and most of them would consider to be assisted this way in the future Further efforts to investigate physicians' TC perceptions, patients' prognostic outcomes and what kind of patients are appropriate to be assisted through TC should be explored