Follow-Up, Safety, and Satisfaction with Tele-bariatric Follow-Up Implemented During the COVID-19 French Lockdown: a 2-Year Follow-Up Study

Abstract

Background The COVID-19 pandemic was initially responsible for a global restricted access to healthcare resources including the follow-up of at-risk populations such as bariatric patients. We substituted face-to-face bariatric follow-up outpatient clinics (FTFC) with teleclinics (TC) during the lockdown. Material and MethodsWe retrospectively reviewed data collected on all patients scheduled for TC during the French lockdown period (March 15 to May 15, 2020) (N = 87). Our aims were to present the patients' outcomes at one and 2 years post-TC implementation and describe patient/practitioner satisfaction. Results Seven (8%) patients required FTFC, and 80 (92%) underwent TC (study population) for preoperative bariatric assessment (N = 3) and postoperative follow-up (N = 77) after 23.6 ± 29 months following surgery. TC was performed with video and audio (N = 46; 57.5%) or audio alone when video was impossible (N = 34; 42.5%). Sixteen (20%) patients presented at least one complication identified at the first TC and were managed accordingly. There were no readmissions at 30/90 days post-TC. At 1-year after the first TC, overall follow-up rate was 94.9% (TC: 73% vs FTFC: 27%). Patients surveyed on the main advantages of TC over FTFC (N = 46) cited: saving time (97.8%) at a mean 3.9 ± 6.4 h saved per TC, work-advantages (94.3%), and comparable relevance of TC (84.8%). At 2 years post-TC implementation, follow-up rate was 93.5% and satisfaction rate was 80%, with 33% of patients preferring to return to FTFC. Conclusions TC is a satisfactory substitute for FTFC, enabling continued bariatric follow-up during and beyond the pandemic setting without compromising patient safety. However, the modest satisfaction outcomes at 2 years highlight a need to discuss follow-up preferences in order to achieve optimal outcomes.

The development of evaluation scale of the patient satisfaction with telemedicine: a systematic review

“…The included studies were all the cross-sectional study, and each study was about telemedicine that delivered through video/audio visits. Most of included studies ( n = 32) were conducted in United States [ 17 – 48 ], and a few were conducted in Italy ( n = 3) [ 49 – 51 ], Spain ( n = 2) [ 52 , 53 ], Egypt ( n = 1) [ 54 ], Australia ( n = 1) [ 55 ], India ( n = 1) [ 56 ], United Kingdom ( n = 1) [ 57 ], Canada( n = 1) [ 58 ], France ( n = 1) [ 59 ], Colombia ( n = 1) [ 60 ]. The vast majority included studies ( n = 38) reported on the types of participants’ diseases, which includes head and neck otolaryngology ( n = 1) [ 17 ], pediatric ( n = 1) [ 52 ], physical, occupational, and speech therapy ( n = 1) [ 18 ], orthopaedic ( n = 1) [ 19 ], pediatric pulmonary ( n = 1) [ 20 ], cancer ( n = 4) [ 21 , 30 , 50 , 58 ], neurology ( n = 1) [ 22 ], pediatric urology ( n = 1) [ 24 ], rhinology (n = 1) [ 25 ], neuromuscular disorder ( n = 1) [ 26 ], allergy ( n = 1) [ 27 ], pediatric diabetes ( n = 1) [ 28 ], epilepsy (n = 1) [ 56 ], prechemotherapy ( n = 1) [ 29 ], pediatric rheumatology ( n = 1) [ 32 ], neurosurgery (n = 1) [ 33 ], cystic fibrosis ( n = 1) [ 35 ], pediatric and young adult type 1 diabetes ( n = 1) [ 49 ], shoulder arthroscopy ( n = 1) [ 36 ], pediatric surgery ( n = 1) [ 53 ], vascular surgery ( n = 1) [ 57 ], maternal mental health and substance use disorder treatment ( n = 1) [ 38 ], referral ( n = 1) [ 39 ], dermatology ( n = 1) [ 40 ], endovascular neurosurgery ( n = 1) [ ...…”

“…While the remaining studies ( n = 6) did not limit the patient types [ 23 , 31 , 34 , 37 , 54 , 55 ]. For the evaluation questionnaire, there are part of studies ( n = 16) using existing questionnaires [ 17 , 22 , 26 , 28 , 30 , 32 – 34 , 42 , 46 , 47 , 50 , 55 , 56 , 58 , 59 ], a few of studies’ questionnaire ( n = 3) were designed based on different studies [ 21 , 24 , 49 ], several studies ( n = 7) evaluating by self-developed questionnaires [ 19 , 25 , 29 , 39 , 51 , 57 , 60 ], and some ( n = 18) studies did not mension the specific questionnaires used [ 18 , 20 , 23 , 27 , 31 , 35 – 38 , 40 , 41 , 43 – 45 , 48 , 52 – 54 ]. In addition, the questionnaires used in several studies ( n = 18) were divided into various dimensions [ 17 , 20 , 23 , 24 , 26 , 32 , 34 , 37 , 38 , 44 , 47 , 49 – 51 , 53 – 55 , 57 ].…”

“…Nineteen studies involved usefulness, which includes the benefits of telemedicine [ 17 , 20 , 22 , 24 , 26 , 32 , 34 , 36 – 38 , 44 , 46 , 47 , 49 , 50 , 54 – 57 ]. Eight study involved privacy and security, which includes the security of personal privacy when patients use telemedicine [ 26 , 41 , 42 , 44 , 48 , 50 , 57 , 59 ]. Thirty-nine studies involved overall satisfaction, which is the patient’s general evaluation on telemedicine [ 17 – 39 , 41 – 44 , 47 – 52 , 54 , 56 – 60 ].…”

“… [ 26 , 44 , 47 , 53 ] 4 My doctor gives me a clear and understandable explain. [ 20 , 22 , 26 , 30 , 31 , 34 , 43 , 44 , 46 , 51 , 59 , 60 ] 12 My doctor explains diagnosis and treatment in a clear and understandable way. [ 26 , 34 , 38 ] 3 My medical staff is skillful and knowledgeable.…”

“… [ 19 , 20 , 24 , 27 , 32 , 33 , 35 – 38 , 42 , 45 , 46 , 48 , 50 – 53 , 57 – 60 ] 22 My telemedicine visit is as good as in-person visit. [ 17 , 28 , 30 , 31 , 33 , 37 , 41 , 45 , 59 ] 9 I would use telemedicine services again. [ 17 , 18 , 20 , 23 – 25 , 28 – 33 , 35 – 37 , 40 , 42 , 45 , 47 , 48 , 50 – 53 , 56 – 59 ] 28 I would recommend the telemedicine option to other patients.…”