Synchronous Telemedicine in Allergy: Lessons Learned and Transformation of Care During the COVID-19 Pandemic.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
01 2021
Historique:
received: 03 08 2020
revised: 16 09 2020
accepted: 01 10 2020
pubmed: 23 10 2020
medline: 2 2 2021
entrez: 22 10 2020
Statut: ppublish

Résumé

The outbreak of the COVID-19 pandemic facilitated a rapid transition to non-face-to-face models of care across the allergy services. To describe the outcomes of the use of synchronous telemedicine for outpatient consultations in a tertiary adult allergy center. We retrospectively reviewed all non-face-to-face appointments during the second month of the pandemic in the United Kingdom. A total of 637 non-face-to-face appointments for unique patients were booked between April 1 and 30, 2020; 91% were new consultations. Most referrals (81.5%) were related to nondrug reactions. The overall "Did Not Attend" rate was 15.7%. A total of 439 patients were assessed for nondrug reactions; 87% were new appointments. Food-related reactions (50.4%), urticaria/angioedema (23.2%), and rhinitis (18.1%) were the most common reasons for new referrals. Two hundred twenty-one (57.7%) of these patients required further allergy testing, primarily for suspected food allergy. More than 42% of the new patients, mainly referred for urticaria/angioedema, were discharged after their remote assessment. Less than 10% of the follow-up patients required additional testing. Ninety-seven new patients were assessed for a suspected drug reaction, predominantly to beta-lactam antibiotics (57.7%). Sixty-nine patients (71%) required further investigations, but a notable 29% did not require further allergy input. The overall experience was very good/good for most patients (85%). Telemedicine can transform the current models of allergy care. Screening criteria for selecting suitable new patients are required. A telemedicine-based drug allergy service model can be more time- and cost-effective, and improve patient access to specialist care.

Sections du résumé

BACKGROUND
The outbreak of the COVID-19 pandemic facilitated a rapid transition to non-face-to-face models of care across the allergy services.
OBJECTIVE
To describe the outcomes of the use of synchronous telemedicine for outpatient consultations in a tertiary adult allergy center.
METHODS
We retrospectively reviewed all non-face-to-face appointments during the second month of the pandemic in the United Kingdom.
RESULTS
A total of 637 non-face-to-face appointments for unique patients were booked between April 1 and 30, 2020; 91% were new consultations. Most referrals (81.5%) were related to nondrug reactions. The overall "Did Not Attend" rate was 15.7%. A total of 439 patients were assessed for nondrug reactions; 87% were new appointments. Food-related reactions (50.4%), urticaria/angioedema (23.2%), and rhinitis (18.1%) were the most common reasons for new referrals. Two hundred twenty-one (57.7%) of these patients required further allergy testing, primarily for suspected food allergy. More than 42% of the new patients, mainly referred for urticaria/angioedema, were discharged after their remote assessment. Less than 10% of the follow-up patients required additional testing. Ninety-seven new patients were assessed for a suspected drug reaction, predominantly to beta-lactam antibiotics (57.7%). Sixty-nine patients (71%) required further investigations, but a notable 29% did not require further allergy input. The overall experience was very good/good for most patients (85%).
CONCLUSION
Telemedicine can transform the current models of allergy care. Screening criteria for selecting suitable new patients are required. A telemedicine-based drug allergy service model can be more time- and cost-effective, and improve patient access to specialist care.

Identifiants

pubmed: 33091636
pii: S2213-2198(20)31124-7
doi: 10.1016/j.jaip.2020.10.013
pmc: PMC7571459
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

170-176.e1

Informations de copyright

Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Iason Thomas (I)

Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, King's College London, London, United Kingdom. Electronic address: iason.thomas@doctors.org.uk.

Leonard Q C Siew (LQC)

Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, King's College London, London, United Kingdom.

Krzysztof Rutkowski (K)

Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

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