The impact of a dedicated contact centre on the clinical outcome of patients with inflammatory bowel disease during the COVID-19 outbreak

Abstract

Background: With the interruption of elective activity during the coronavirus disease 2019 (COVID-19) pandemic, a reorganisation of health care for patients with inflammatory bowel disease (IBD) was warranted. We aimed to investigate the effectiveness of a dedicated contact centre service (CCS) on the reorganization of a high-volume IBD centre and on the continuity of care during the COVID-19 outbreak. Methods: We compared the CCS services provided to 3680 IBD patients and clinical outcomes before (January–February 2020) and during (March–April 2020) the COVID-19 period. We further included, as comparator, data from March to April of the previous year (2019). Results: During the outbreak, the CCS received an increase of 10.2% of contacts, from 881, in January–February 2020, to 971 (p = 0.02). An increase of 6% in CCS activities was also reported in comparison with March–April 2019 (from 914 to 971 in March–April 2020, p = 0.71). Before COVID-19, in both periods most contacts (67% in January–February 2020 and 60% in March–April 2019) required information about clinical activity, while fewer (33% in January–February 2020 and 40% in March–April 2019) requested logistic information. During the pandemic, most contacts (65.1%) asked to speak with a physician, 23.7% asked for information, while 11.1% wanted to cancel/postpone their appointments. Among all the information, 66% concerned COVID-19. In March–April 2020, 259 outpatient visits were booked, but were all replaced by phone consultations. No difference was detected in the number of intravenous biological administrations (307 versus 296, p = 0.64), surgeries (10 versus 9, p = 0.82) and urgent hospitalisations (10 versus 12, p = 0.67) before and during the COVID-19. Conclusion: The CCS was an effective tool in the reorganization of the IBD centre. Scheduled visits were replaced by phone calls. The main clinical outcomes were maintained in the COVID-19 period. Virtual follow-up using the CCS could be implemented after the pandemic to optimise the resources of the IBD centre.