학술논문

Telemedicine During the COVID-19 Pandemic: A Paradigm Shift in Non-Communicable Disease Management? – A Cross-Sectional Survey from a Quaternary-Care Center in South India
Document Type
article
Source
Patient Preference and Adherence, Vol Volume 15, Pp 2715-2723 (2021)
Subject
covid-19
telemedicine
chronic disease
patient compliance
india
Medicine (General)
R5-920
Language
English
ISSN
1177-889X
Abstract
Sisira Ullas,1 Manu Pradeep,2 Sandeep Surendran,3 Anjali Ravikumar,4 Anna Maria Bastine,1 Ayush Prasad,1 Aravind Mohan1 1Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India; 2Department of Pharmacology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India; 3Department of Rheumatology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India; 4Department of General Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaCorrespondence: Manu PradeepDepartment of Pharmacology, Amrita Institute of Medical Sciences, Ponekkara, P.O Kochi, Kerala, 682041, IndiaTel +91 9947568919Email drmanupradeep24@gmail.comPurpose: This study aims to gauge the perception and adoption rates of telemedicine amongst patients with non-communicable diseases (NCD) as opposed to in-person consultations in a quaternary care center in South India.Patients and Methods: A web-hosted 21-item cross-sectional survey was distributed to 220 randomly selected patients with a routine appointment in one of the seven departments caring for NCDs in the study center. Descriptive analysis and inferential analyses were done. Paired samples T-test and Pearson’s Chi-square test were used study associations.Results: In-person consultations decreased by 1.9± 4.47 visits per year, in 2020 vs 2019. Most participants reported “fear of COVID-19” as the primary reason for this decline. Participants also reported that their consultation times had significantly decreased (OR=6.43, 95% CI=1.7– 24.08, p=0.006). The decreased consultations time, difficulty in obtaining in-person appointments, along with the reduced physical examination during consultations have made participants more open to the idea of teleconsultations (OR=3.88, 95% CI=1.21– 12.47, p=0.022). Eighty-five (38.63%) participants had already adopted telemedicine for their routine consultations during the pandemic. Whilst participants felt that telemedicine was an adequate surrogate for in-person consultations, a significant difficulty in obtaining medications was noted (OR=6, 95% CI=1.34– 26.81, p=0.019).Conclusion: In-person consultations were decreased primarily due to the perception of significant risk of COVID-19 exposure in the present scenario. Telemedicine adoption in the private sector may be sustainable throughout the pandemic and beyond, if patients are offered to continue their routine consultations with their regular doctors and ensured medicine availability. Integration of telemedicine by the public and private health sector of India into routine NCD care delivery is the need of the hour, but further studies are required to estimate the effectiveness of the systems.Keywords: COVID-19, telemedicine, chronic disease, patient compliance, India