Optimizing Therapy for IBD During COVID-19



Miguel Regueiro, MD: Doug, I was doing virtual visits with my patients earlier today about diet, lifestyle, and sleep. What are you telling patients who are scared to come in for their infusions, their colonoscopies, or their office visits if they need an exam? When they’re also asking a lot about lifestyle, so with deferred care, what are you saying about that? For lifestyle in general, what are you telling your patients during this time?

Douglas C. Wolf, MD: Those are great questions, and they do come in every day. Let me say that in March and April, there was a flurry of calls. People were canceling their infusions or just not showing and everything. Having this SECURE-IBD [Surveillance Epidemiology of Coronavirus Under Research Exclusion—Inflammatory Bowel Disease] data that biologics are safe, let alone potentially beneficial, is reassuring to doctors, other providers, and patients, especially that they should be staying on track and keeping their infusion appointments.

There’s not a lot of other social stuff that patients have to do but to keep optimizing their IBD [inflammatory bowel disease] treatment. This SECURE-IBD registry data are important for patients to help them stay on track. Fortunately, we just started doing telehealth at the end of April. It worked out great, and I love doing telehealth. I could have patients come in for face-to-face visits, but like you, I have many who travel a long distance, and finding a parking space can take more time than they have time with me.

I don’t have to, but I am currently doing about 90% of my visits as telehealth visits, and it works out great. It allows a lot more opportunity for low-level, short follow-ups to fine-tune patients. This era of telehealth where people don’t have to come in for a formal visit can allow improvement of care and true treat-to-target. Before, I might have been calling someone with a phone call, and how do you integrate that into your notes? Do you do a pass note?

Now we have a brief telehealth visit, and it helps us focus on better care and treat-to-target. That’s a real plus. With the more challenging patients, we have more telehealth visits, and it works well. Miguel, in your setting back in Pittsburgh and in Cleveland, you’ve been doing this in many ways for a long time, but now many of us are able to do it as well. With things like diet, nutrition, sleep, and psychological things, we’re able to achieve a lot of those things virtually as well.

Psychologists and psychiatrists are doing virtual care, and it’s honestly working out amazingly well. There is a major change, a major transition, and an improvement in many ways in the health care system with the allowance of telehealth nationwide, and I certainly hope it continues.

Transcript Edited for Clarity

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