Role of telemedicine in management of adult egyptian thalassaemia patients during covid-19 pandemic;Patients survey
Authors: R. Rawi, N. M. El Husseiny, N. Tawfik, M. Salah, M. Mattar
Journal: HemaSphere (2021)

Background: COVID-19 caused a massive damage to the whole world. Telemedicine (TM) is an excellent, safe,effective method to follow Adult B-thalassemia patients which are experiencing a chronic morbidity. Aims: Evaluating medical service administrated to Adult B-thalassemia patients after 3 months of online follow up. Methods: Since April 2020, follow up of our patients done via audio visual calls & whats app group which was created during the pandemic to follow thalassemia patients.Our clinic serves patients in an area range of about 1000 Km2, and out of 100 adult B-thalassemia (major and intermedia) who are regularly following in haematology clinic only 30 patients were able to connect through whats app group with the physician. After Three months (in July 2020) a simple Arabic questionnaire was given to our patients. Questionnaire asked about gender, degree of education, and whether the patient from urban or rural area. The patients were asked if the application was easy to use & time saving, and was the online consultations were effective.They were asked about the new labs they performed and if their treatment was modified accordingly, & how often this happened. Whether their condition required attendance to casuality & for what reason. Regarding COVID-19, patients were asked if the pandemic affected their routine medical service and receiving their treatment. In addition there were inquiries about any suspicious symptoms they suffered from since the start of the pandemic, if they notified the physician once they have these symptoms, if they performed COVID-19 swab,and what is the treatment they were prescribed. Finally, we have asked about attendance to the hospital despite of TM service and for what reason. Results: Thirty patients included in this study, 24(80%) females & 6(20%) males with median age of 29.5(17-50) years. Twenty-five (83%) patients were educated to higher school or more while 5 of patients were not educated. Twenty (67%) patients lived in urban areas &10 (33%) patients lived in rural areas. Twenty-eight (93.3%) patients found the application easy while 2(6.7%) patients found it difficult. The application was time saving & consultations were efficient for 29 (97%) patients while it was not in only 1(3%) patient. Twenty-four (80%) patients didn't attend the casuality department while 6(20%) patients attended for blood transfusion. Nineteen (63.3%) patients were asked to do new labs. Five (16.6%) patients needed to change their treatment, 2 of them changed it one time and 3 patients changed it more than one time. Twenty-five (83.4%) patients contacted consultant more than one time.TM consultations increased since the start of whats app group for 25 (83.4%)patients with no change in 4(13.3%) patients while it decreased in one (3.3%) patient only. As regard to COVID-19, Ten(33.3%) patients had suspicious symptoms as fever or sore throat, 8 of them notified their consultant with description of Azithromycin to all of them. Despite TM, 21(70%) patients attended to the hospital, 14 of them to get monthly treatment, 6 patients for examination & treatment, and one patient for examination only. About 70 consultations had been sent through whats app group before the survey and about 115 laboratory results sent during the 3 months of online follow up. Summary/Conclusion: Current evidence supports that telemedicine can be a fast, safe, and effective tool to increase care for adult thalassemia patients during pandemic time.