The impact of a dedicated inflammatory bowel disease contact center on clinical outcome of patients during the covid 19 outbreak

Introduction: Given the significant interruption of elective activity in the COVID-19 era and thereby the resetting of clinical priorities, a reorganisation of health care for patients with inflammatory bowel disease (IBD) is warranted 1 Aims & Methods: In the COVID-19 context, we aimed to investigate the impact of an IBD dedicated contact center service (CCS), held at an italian tertiary academic centre, on IBD team reorganization and on the major clinical outcomes We conducted an observational study evaluating the CCS activities offered to 3680 IBD patients followed-up at our IBD unit by comparing the pre COVID- 19 (January-February 2020) to the COVID-19 era (March-April 2020) and to the same period of the year 2019 We further analysed the following clinical outcomes: the number of intravenous biological therapy , hospitalizations and surgical procedures in the same three periods Data were analysed by STATA statistical software The differences between means before and after COVID-19 era were determined using the two-sample Student's t-test and chi-square when appropriate All differences were considered significant in presence of p < 0 05 Results: In the COVID-19 period, our CCS received a total of 971 contacts in comparison to 881 related to the two months pre-COVID-19 (26% vs 23%;p=0 02),while we registered a decrease of CCS activity (26% vs 33%;p< 0 01) in respect to the same period of 2019 During the COVID-19 outbreak the majority (65,1%) of inbound calls aimed to talk with a physician belonging to our IBD team, 23,7% of patients called to ask logistics information, while 11,1% wanted to change their visits date or book new appointments Among all the requested information, 66% concerned COVID-19 With regard to the major clinical outcomes, no significant difference was detected in the rate of intravenous biological therapy pre- and during COVID-19 period (296 vs 307;p =n s );whereas comparing the number of intravenous biological therapy during the outbreak to the same period of 2019 we reported an increase rate of 19,4% (from 257 to 307 ;p=n s ) In addition there was a significant reduction in terms of the rate of hospitalization before and during the COVID-19 periods (158 vs 96;4% vs 2%;p< 0 01) Conversely , the rate of surgery did not differ significantly between pre-COVID-19 and during COVID-19 periods (10 vs 9;p=n s ) Finally, regarding the patient's satisfaction, 95% of patients stated to be highly satisfied from CCS, while 5% moderately satisfied As far as the feeling of relief concerned, 78% felt reassured and 21,8% more confident to interact with physicians using the CCS Conclusion: We are seeing the dawn of a new era of home patient management replacing follow up visits and controls Our results can provide the basis for implement an IBD dedicated contact service in clinical practice in the post COVID-19 era Hence, we can achieve high quality of care even at home for IBD patients