Evaluation of virtual communications in the all wales adult cystic fibrosis center for the provision of future CF care

Background: Guidelines recommend all adults with CF in the UK attend their specialist center at least four to six times a year Hospital appointments require a significant period of time, which can compound disruption of education, employment and personal life Virtual communications (VC) have the potential to address these issues The COVID-19 pandemic necessitated an immediate change to UK outpatient care To continue with service provision we established four VC: multi-disciplinary team (MDT) clinic, psychology sessions, gym/physiotherapy (PT) and a weekly patient question and answer (Q+A) session with the CF MDT Objective: To evaluate patient response to VC and determine how to incorporate into future CF care Methods: We created ten fixed response and four free-text Smart- Survey questions, and sent a link valid for 14 days to all recorded All Wales Adult CF Center (AWACFC) patient email accounts The anonymized data were exported to Microsoft Excel 2013, inputted to SPSS version 23 and analyzed The independent samples t-test and one-way ANOVA calculated statistical significance in regards to age, sex, travel distance and employment status on VC use Free text was analyzed by the authors and coded using a systematic thematic analysis to precis the content Results: Survey response rate was 26% (72/274;37 female, 35 male) A total of 82% reported accessing MDT clinic, 14% psychology, 32% gym/ PT and 28% Q+A MDT clinic was reported as extremely or very helpful by 86%;89% reported psychology sessions as extremely or very helpful;83% reported gym/PT as extremely or very helpful;67% reported Q+A as extremely or very helpful Emerging themes on the advantages of VC were;the ability to interact with other CF patients, reduction in appointment burden, infection risk, travel time and disruption to personal life Disadvantages were;connectivity and technical issues, lack of human interaction, physical examination, tests and procedures All patients were asked about engagement with VC post-COVID-19;89% reported they would use MDT clinic in the future, 84% of these reported previous use A total of 36% reported they would use psychology in the future, 70% of these reported previous use;52% reported they would engage with gym/PT in the future, 90% of these reported previous use A total of 39% reported they would engage with Q+A in the future, 85% of these reported previous use Patients who had engaged with gym/PT, psychology or Q+A were more likely to want to engage in the future (p <0 01) Females were more likely to engage with psychology currently and in the future (p<0 01) Patients with a greater travel distance were more likely to engage with gym/PT currently (p <0 04) and in the future (p<0 01) Conclusion: Our evaluation demonstrates a positive patient response to VC, and desire for future access We continue to refine the VC service and improve technical issues Patients who had already engaged with VC were more likely to report future use, therefore we will continue encouraging patients to trial multiple modalities Where appropriate we will offer alternate virtual and face-to-face MDT clinics as part of routine care The aim is to establish a more patient-centered approach, improve concordance and ultimately outcomes