Pediatric inflammatory bowel disease and the effect of COVID-19 pandemic on treatment adherence and patients' behavior.


Journal

Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714

Informations de publication

Date de publication:
09 2021
Historique:
received: 19 09 2020
accepted: 22 11 2020
revised: 16 11 2020
pubmed: 16 1 2021
medline: 16 11 2021
entrez: 15 1 2021
Statut: ppublish

Résumé

The coronavirus disease (COVID-19) pandemic affects medical care worldwide, including patients with inflammatory bowel disease (IBD). Thus, we aimed to assess its impact on health care provision, fear of infection, adherence to medical treatment, and compliance with preventative instructions in children and adolescents with IBD. A cross-sectional telephonic survey using a Likert scale-based questionnaire was conducted among all pediatric patients with IBD from a single tertiary medical center. A total of 244 pediatric patients with IBD were included in the study, reporting a high rate of fear of severe COVID-19 infection due to IBD or IBD medications (198, 81.1%). Most of the patients obeyed the Ministry of Health instructions (228, 93.4%), while almost 50% took additional protective measures including avoidance of school and complete lockdown. Concerns regarding the attendance of regular clinics (116, 47.5%) and emergency room in case of IBD exacerbation (178, 73%) were frequently reported. Only 7 patients (2.9%) changed or discontinued their IBD treatment due to COVID-19. We noted several distinct features of the COVID-19 pandemic effect on pediatric patients with IBD including a high rate of fear of severe COVID-19 infection, fear of attending necessary medical facilities, and high rate of avoidance of social activities. Pediatric patients with IBD have a high rate of fear of severe COVID-19 infection, fear of attending necessary medical facilities, and a high rate of avoidance of social activities. Medication adherence rate in pediatric patients with IBD during the pandemic is similar to the adherence rate among adults with IBD. Almost 50% of pediatric patients with IBD took additional protective measures including avoidance of school and voluntary lockdown during the COVID-19 pandemic.

Sections du résumé

BACKGROUND
The coronavirus disease (COVID-19) pandemic affects medical care worldwide, including patients with inflammatory bowel disease (IBD). Thus, we aimed to assess its impact on health care provision, fear of infection, adherence to medical treatment, and compliance with preventative instructions in children and adolescents with IBD.
METHODS
A cross-sectional telephonic survey using a Likert scale-based questionnaire was conducted among all pediatric patients with IBD from a single tertiary medical center.
RESULTS
A total of 244 pediatric patients with IBD were included in the study, reporting a high rate of fear of severe COVID-19 infection due to IBD or IBD medications (198, 81.1%). Most of the patients obeyed the Ministry of Health instructions (228, 93.4%), while almost 50% took additional protective measures including avoidance of school and complete lockdown. Concerns regarding the attendance of regular clinics (116, 47.5%) and emergency room in case of IBD exacerbation (178, 73%) were frequently reported. Only 7 patients (2.9%) changed or discontinued their IBD treatment due to COVID-19.
CONCLUSION
We noted several distinct features of the COVID-19 pandemic effect on pediatric patients with IBD including a high rate of fear of severe COVID-19 infection, fear of attending necessary medical facilities, and high rate of avoidance of social activities.
IMPACT
Pediatric patients with IBD have a high rate of fear of severe COVID-19 infection, fear of attending necessary medical facilities, and a high rate of avoidance of social activities. Medication adherence rate in pediatric patients with IBD during the pandemic is similar to the adherence rate among adults with IBD. Almost 50% of pediatric patients with IBD took additional protective measures including avoidance of school and voluntary lockdown during the COVID-19 pandemic.

Identifiants

pubmed: 33446913
doi: 10.1038/s41390-020-01312-6
pii: 10.1038/s41390-020-01312-6
pmc: PMC7807409
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

637-641

Informations de copyright

© 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

Références

WHO. Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 . Accessed 6 Jul 2020.
Leshem, E., Afek, A. & Kreiss, Y. Buying time with COVID-19 outbreak response, Israel. Emerg. Infect. Dis. 26, 2251–2253 (2020).
doi: 10.3201/eid2609.201476
CDC. What to do if you are sick. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html . Accessed 6 Jul 2020.
Monteleone, G. & Ardizzone, S. Are patients with inflammatory bowel disease at increased risk for Covid-19 infection? J. Crohns Colitis 14, 1334–1336 (2020).
doi: 10.1093/ecco-jcc/jjaa061
Turner, D. et al. Corona virus disease 2019 and paediatric inflammatory bowel diseases: global experience and provisional guidance (March 2020) from the Paediatric IBD Porto Group of European Society of Paediatric Gastroenterology, Hepatology, and Nutrition. J. Pediatr. Gastroenterol. Nutr. 70, 727–733 (2020).
doi: 10.1097/MPG.0000000000002729
Grunert, P. C., Reuken, P. A., Stallhofer, J., Teich, N., & Stallmach, A. Inflammatory Bowel Disease in the COVID-19 Pandemic: the Patients’ Perspective. Journal of Crohn’s and Colitis. jjaa126, https://doi.org/10.1093/ecco-jcc/jjaa126 (2020).
D’Amico, F., Rahier, J.-F., Leone, S., Peyrin-Biroulet, L. & Danese, S. Views of patients with inflammatory bowel disease on the COVID-19 pandemic: a global survey. Lancet Gastroenterol. Hepatol. 5, 631–632 (2020).
doi: 10.1016/S2468-1253(20)30151-5
Hong, Z. et al. Telemedicine during the COVID-19 pandemic: experiences from Western China. J. Med. Internet Res. 22, e19577 (2020).
doi: 10.2196/19577
Hjelm, N. M. Benefits and drawbacks of telemedicine. J. Telemed. Telecare 11, 60–70 (2005).
doi: 10.1258/1357633053499886
Snapiri, O. et al. Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic. Acta Paediatr. 109, 1672–1676 (2020).
doi: 10.1111/apa.15376

Auteurs

Lev Dorfman (L)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel. levdorfman@gmail.com.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. levdorfman@gmail.com.

Raouf Nassar (R)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.
Pediatric Gastroenterology Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Be'er-Sheva, Israel.

Dalit Binjamin Ohana (D)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.

Ilan Oseran (I)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.

Manar Matar (M)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Raanan Shamir (R)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Amit Assa (A)

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

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