Activities related to inflammatory bowel disease management during and after the coronavirus disease 2019 lockdown in Italy: How to maintain standards of care.


Journal

United European gastroenterology journal
ISSN: 2050-6414
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807

Informations de publication

Date de publication:
12 2020
Historique:
pubmed: 20 10 2020
medline: 29 12 2020
entrez: 19 10 2020
Statut: ppublish

Résumé

Restructuring activities have been necessary during the lockdown phase of the coronavirus disease 2019 (COVID-19) pandemic. Few data are available on the post-lockdown phase in terms of health-care procedures in inflammatory bowel disease (IBD) care, and no data are available specifically from IBD units. We aimed to investigate how IBD management was restructured during the lockdown phase, the impact of the restructuring on standards of care and how Italian IBD units have managed post-lockdown activities. A web-based online survey was conducted in two phases (April and June 2020) among the Italian Group for IBD affiliated units within the entire country. We investigated preventive measures, the possibility of continuing scheduled visits/procedures/therapies because of COVID-19 and how units resumed activities in the post-lockdown phase. Forty-two referral centres participated from all over Italy. During the COVID-19 lockdown, 36% of first visits and 7% of follow-up visits were regularly done, while >70% of follow-up scheduled visits and 5% of first visits were done virtually. About 25% of scheduled endoscopies and bowel ultrasound scans were done. More than 80% of biological therapies were done as scheduled. Compared to the pre-lockdown situation, 95% of centres modified management of outpatient activity, 93% of endoscopies, 59% of gastrointestinal ultrasounds and 33% of biological therapies. Resumption of activities after the lockdown phase may take three to six months to normalize. Virtual clinics, implementation of IBD pathways and facilities seem to be the main factors to improve care in the future. Italian IBD unit restructuring allowed quality standards of care during the COVID-19 pandemic to be maintained. A return to normal appears to be feasible and achievable relatively quickly. Some approaches, such as virtual clinics and identified IBD pathways, represent a valid starting point to improve IBD care in the post-COVID-19 era.

Sections du résumé

BACKGROUND AND AIMS
Restructuring activities have been necessary during the lockdown phase of the coronavirus disease 2019 (COVID-19) pandemic. Few data are available on the post-lockdown phase in terms of health-care procedures in inflammatory bowel disease (IBD) care, and no data are available specifically from IBD units. We aimed to investigate how IBD management was restructured during the lockdown phase, the impact of the restructuring on standards of care and how Italian IBD units have managed post-lockdown activities.
METHODS
A web-based online survey was conducted in two phases (April and June 2020) among the Italian Group for IBD affiliated units within the entire country. We investigated preventive measures, the possibility of continuing scheduled visits/procedures/therapies because of COVID-19 and how units resumed activities in the post-lockdown phase.
RESULTS
Forty-two referral centres participated from all over Italy. During the COVID-19 lockdown, 36% of first visits and 7% of follow-up visits were regularly done, while >70% of follow-up scheduled visits and 5% of first visits were done virtually. About 25% of scheduled endoscopies and bowel ultrasound scans were done. More than 80% of biological therapies were done as scheduled. Compared to the pre-lockdown situation, 95% of centres modified management of outpatient activity, 93% of endoscopies, 59% of gastrointestinal ultrasounds and 33% of biological therapies. Resumption of activities after the lockdown phase may take three to six months to normalize. Virtual clinics, implementation of IBD pathways and facilities seem to be the main factors to improve care in the future.
CONCLUSION
Italian IBD unit restructuring allowed quality standards of care during the COVID-19 pandemic to be maintained. A return to normal appears to be feasible and achievable relatively quickly. Some approaches, such as virtual clinics and identified IBD pathways, represent a valid starting point to improve IBD care in the post-COVID-19 era.

Identifiants

pubmed: 33070758
doi: 10.1177/2050640620964132
pmc: PMC7724532
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1228-1235

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Auteurs

Simone Saibeni (S)

Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy.

Ludovica Scucchi (L)

Department of Systems Medicine, GI Unit, Policlinico Tor Vergata, University of Tor Vergata, Rome, Italy.

Gabriele Dragoni (G)

Gastroenterology Unit, Careggi University Hospital Florence, Italy.

Cristina Bezzio (C)

Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy.

Agnese Miranda (A)

Gastroenterology and Endoscopy Unit, University of Campania 'L. Vanvitelli', Naples, Italy.

Davide Giuseppe Ribaldone (DG)

Department of Medical Sciences, University of Turin, Turin, Italy.

Angela Bertani (A)

Department of Gastroenterology, IBD Unit, Policlinico Hospital, Modena, Italy.

Fabrizio Bossa (F)

Division of Gastroenterology, IRCCS "Casa Sollievo della Sofferenza" Foundation, San Giovanni Rotondo, Italy.

Mariangela Allocca (M)

IBD Centre, Gastroenterology, Humanitas Clinical and Research Centre - IRCCS, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Andrea Buda (A)

Department of Gastrointestinal Oncological Surgery, Gastroenterology and Endoscopy Unit, S. Maria del Prato Hospital, Feltre, Italy.

Gianmarco Mocci (G)

Gastroenterology Unit, Brotzu Hospital, Cagliari, Italy.

Alessandra Soriano (A)

Gastroenterology Division, Azienda USL Arcispedale S. Maria Nuova - IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Silvia Mazzuoli (S)

Gastroenterology and Artificial Nutrition Unit, Monsignor R. Dimiccoli Hospital, ASL BT, Barletta, Italy.

Lorenzo Bertani (L)

Gastroenterology and Digestive Endoscopy Department of Medical Specialties Apuane Hospital - Tuscany North-West ASL, Massa, Italy.

Flavia Baccini (F)

Digestive Disease Unit, Sant'Andrea University Hospital, Rome, Italy.

Erika Loddo (E)

Gastroenterology Unit, University Hospital, AOU Cagliari, Cagliari, Italy.
Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.

Antonino Carlo Privitera (AC)

IBD Unit, 'Cannizzaro' Hospital, Catania, Italy.

Alessandro Sartini (A)

Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, AUSL della Romagna, Rimini, Italy.

Angelo Viscido (A)

Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Laurino Grossi (L)

G. D'Annunzio University - Digestive Physiopathology, Ospedale Spirito Santo, Pescara, Italy.

Valentina Casini (V)

A.S.S.T. Bergamo EST, Gastroenterology Unit, Seriate Hospital, Bergamo, Italy.

Viviana Gerardi (V)

Department of Medicine, Gastroenterology and Endoscopy, Poliambulanza foundation, Brescia, Italy.

Marta Ascolani (M)

Gastroenterology Unit, Santa Maria di Ca Foncello Hospital, Treviso, Italy.

Mirko Di Ruscio (MD)

IBD Unit, IRCCS Sacro Cuore Don Calabria, Negrar, Italy.

Giovanni Casella (G)

ATS Brianza, Limbiate, Monza Brianza, Italy.

Edoardo Savarino (E)

Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.

Davide Stradella (D)

Gastroenterology Unit, A.O.U. Maggiore della Caritá, Novara, Italy.

Rossella Pumpo (R)

Endoscopy Unit P.O. S.G. Bosco, ASLNA1, Naples, Italy.

Claudio Camillo Cortelezzi (CC)

Gastroenterology and Endoscopy Unit, A.S.S.T. Sette Laghi, Varese, Italy.

Marco Daperno (M)

Gastroenterology Unit, Mauriziano Hospital, Turin, Italy.

Valeria Ciardo (V)

Gastroenterology Unit, S. Antonio Hospital, San Daniele del Friuli, Italy.

Olga Maria Nardone (OM)

Gastroenterology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

Flavio Caprioli (F)

Gastroenterology and Endoscopy Unit, IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico Foundation, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Giovanna Vitale (G)

Gastroenterology and Endoscopy Unit, 'San Carlo' Hospital, Potenza, Italy.

Maria Cappello (M)

IBD Clinic, Gastroenterology Section, Promise, University of Palermo, Palermo, Italy.

Michele Comberlato (M)

IBD Unit, Department of Gastroenterology, Bolzano, Italy.

Patrizia Alvisi (P)

Paediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.

Stefano Festa (S)

IBD Unit, S. Filippo Neri Hospital, Rome, Italy.

Michele Campigotto (M)

Academic Surgical and Health Sciences Department, Trieste University, Trieste, Italy.

Giorgia Bodini (G)

Gastroenterology chair, Internal Medicine Department, Genoa University, Italy.

Paola Balestrieri (P)

Unit of Digestive Disease of Campus Bio Medico, University of Rome, Rome, Italy.

Anna Viola (A)

IBD Unit, Department Clinical and experimental Medicine, Policlinico Messina, Messina, Italy.

Daniela Pugliese (D)

CEMAD - IBD Unit, Internal and Gastroenterology Unit, Academic Policlinic Foundation 'A. Gemelli' IRCCS, Rome, Italy.

Alessandro Armuzzi (A)

CEMAD - IBD Unit, Internal and Gastroenterology Unit, Academic Policlinic Foundation 'A. Gemelli' IRCCS, Rome, Italy.

Massimo C Fantini (MC)

Gastroenterology Unit, University Hospital, AOU Cagliari, Cagliari, Italy.
Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.

Gionata Fiorino (G)

IBD Centre, Gastroenterology, Humanitas Clinical and Research Centre - IRCCS, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.

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