Abstract
IntroductionEnforced social distancing (i.e. lockdowns) greatly facilitated control of Coronavirus Disease 2019 (COVID-19). Whilst access to hospitals was restricted, outpatient care continued remotely. At our institute, the biologic therapy for asthma is only prescribed after evaluation by a pulmonologist specializing in severe asthma. The treatment is administered on site by specialist nurses who follow manufacturers’ recommendations. The aim of this study was to determine the satisfaction of patients with severe asthma with telemedicine, and the impact of COVID-19 lockdown on their receipt of biologics and other treatments for asthma.MethodsA cross-sectional survey of 58 patients with severe asthma scheduled to receive biologic therapy at our hospital during the lockdown was performed with ethical approval.ResultsFifty-four patients participated (F 37; mean age 46.7 years; response rate 93.1%). Their experience of biologic therapy, medication supply, and telemedicine are displayed in table 1. Mean time since diagnosis was 19.2 years (SD 11.5 years). All had been on biologic therapy Omalizumab (45), Mepolizumab (7), or Dupilumab (2) for over three months (mean 38.4 months± SD 26.5 months).Fifty (92.6%) had telephone follow-up, 31 (57.4%) were satisfied with telemedicine, 45 (81.4%) agreed that biologic therapy improved their asthma, and 40 (74.1%) received scheduled biologic therapy. Of the 45 patients living in the city, nine did not receive biologic therapy, two cited the lockdown as the reason for this; two did not receive an appointment; two did not perceive any benefit; two had other reasons. Five of the nine patients living outside the city did not receive biologic therapy, 3 because of the lockdown, and 1 for fear of acquiring COVID-19. Alarmingly, 16 (29.6%) suggested that they had insufficient medications, and 27 (50%) reported difficulty obtaining medications.Abstract P149 Table 1Patient perceptions on availability of medications, telemedicine and biologic therapy Statement Strongly Disagree Disagree Neutral Agree Strongly Agree Asthma improved with biologic 4 3 2 8 37 Sufficient medications 7 9 3 11 24 Difficulty obtaining medication 21 9 7 10 17 Satisfied with telemedicine 2 3 18 14 17 ConclusionsMany patients were satisfied with telemedicine, so this could be used to deliver routine outpatient tertiary care post-pandemic. However, during the lockdown, some patients did not receive scheduled biologic therapy and had insufficient medications. Thus, logistics around supplying medications, and biologics must be considered in plans preparing for a second wave of COVID-19. Teaching patients to self-inject biologic therapy should be considered.