P077 E-Messaging and Telemedicine Visits by IBD Patients During the COVID Pandemic

BACKGROUND: During the COVID pandemic, electronic messaging and telemedicine visits between patients and physicians became vital tools through which chronic disease management is conducted. While an increased number of clinicians have engaged in virtual healthcare, there is limited research on the use of e-communication and telemedicine visits in inflammatory bowel disease (IBD) patients. This study evaluated the use of electronic communication, messaging content and telemedicine visits by IBD patients during the COVID pandemic. METHODS: A retrospective chart review was conducted of all IBD patients seen during the past 3 years in a university gastroenterology clinic. There were no exclusion criteria. Patient gender, age, ethnicity, IBD subtype, medications were obtained. E-messaging and content via FollowMyHealth portal application during March – August 2020 of the COVID pandemic were evaluated. A confidential database was created using Microsoft Excel with statistical analysis set at <0.05. This study was IRB approved. RESULTS: We evaluated 295 medical records of IBD patients. There were 130 (43.7%) males and 165 (56.3%) females, with a mean age of 45.7 years. 76 (25.8%) had Crohn's disease (CD) and 208 (70.5%) had ulcerative colitis (UC). There were 155 (52.5%) White, 83 (28.1%) African American (AA), 24 (8.1%) Hispanic, 10 (3.4%) Asian, and 22 (7.46%) ethnically un-identified patients. 53 (18.0%) IBD patients engaged in secure e-communication. There was a significant difference in the rate of e-messaging based on gender (56.6% males vs 43.4% females; P = 0.0478), race (Whites 71.7% vs AA 17.0%; P = 0.0109) and medication regimen (biologic 54.7% vs non-biologic 45.3; P < 0.001). There was no difference in the use of e-messaging based on age (66% in patients <50 years vs 34% in patients >50; P = 1.00) or IBD subtype (79.3% in UC vs 15.1% in CD; P = 0.0774). The most common messages included concerns regarding SARS-CoV-2 risk with immunosuppressive medications (18.9%), home infusion arrangements to avoid potential exposure (15.1%), and refill requests (18.9%). There was no significant difference in the rate of COVID inquiries based on gender (P = 0.7199), age (P = 0.7186), race (P = 0.6631), or biologic use (P = 0.7297). 56 patients (19.0%) had a telemedicine visit during the pandemic. There was no significant difference in the rate of telemedicine visits based upon gender (53.6% males vs 46.4% females; P = 0.1349), race (50.0% W vs 35.7% AA; P = 0.3099), age (64.3% < 50 y vs 35.7% > 50 y; P = 0.8765), IBD subtype (67.9% UC vs 28.6% CD; P = 0.6106), or medication regimen (41.1% on biologic therapy vs 58.9% on non-biologic therapy; P = 0.0512). CONCLUSION: Although virtual platforms have been increasingly used for IBD management during the COVID pandemic, this study reveals disparities in the utilization of electronic communication. Males, whites and those on biologic medications more frequently used portal messaging. While this study revealed differences in e-messaging use, disparities in televisits based upon gender, age and medication regimen were not apparent for telemedicine visits. Further research is warranted to evaluate the use and benefit of virtual clinical engagement.