Right test, right time: Ensuring timely renal function monitoring in individuals taking PrEP

Background: Remote consultations have been upscaled as part of the NHS COVID-19 response and our service has swapped to a predominantly telephone based model of care for routine HIV follow up. A survey was conducted of HIV clinic attenders and HIV healthcare professionals (HCPs) with the aim of exploring their views and experiences of telephone consultations (TCs) during the COVID-19 outbreak. Method: Parallel web-based anonymous surveys of HIV clinic attenders and HCPs were developed in collaboration with patient representatives and were available online via hyperlink and QR-codes. Data were analysed in Excel using descriptive statistics. Results: Thirty-four HCPs and 38 patients participated. Of patient respondents 76% were older than 45 years and 89% spoke English as their main language. The majority of HCPs and patients agreed that TCs allow them to discuss important issues (59% and 61% respectively), including private/ sensitive issues (59% and 58% respectively), and they felt secure and confidential (53% and 63% respectively). Advantages of TCs, identified by HCPs, included improved convenience for patients (cited by 89%) and improved ability to review patients who infrequently attend clinic (cited by 71%). Drawbacks included concerns about language and communication barriers (cited by 85%) and the inability to examine patients (68%). Additionally, only 29% of HCPs felt TCs were convenient for themselves, explanations for this may include difficulties with technology or patients not answering their phone which were also highlighted as areas of concern. Sixty-eight percent of patients liked that TCs require less travel and 68% also feel safer having TCs during the COVID-19 outbreak. The commonest concern from patients, expressed by 45%, was that TCs waste time as they need to attend clinic for blood tests anyway and 31% were worried about blood tests being missed or delayed. Overall 82% of HCPs and 68% of patients felt future routine HIV care should be through a combination of face-to- face and TCs or video-calling. Conclusion: TCs are generally acceptable to HCPs and patients, however it will be important to encourage a bilateral flow of communication between key stakeholders to ensure the service continues to evolve in a mutually acceptable way and to address highlighted concerns.