An International Survey of Clinicians' Experience Caring for Patients Receiving Home Parenteral Nutrition for Chronic Intestinal Failure During the COVID-19 Pandemic.

Abstract

BACKGROUND:

This survey of centers caring for patients receiving home parenteral nutrition (HPN) was conducted to assess the impact of the coronavirus disease 2019 (COVID-19) crisis on the management of these patients regarding provision of care, monitoring, regular follow-up, and any changes to service infrastructure.

METHODS:

A survey was devised and publically published on the Research Electronic Data Capture database management system, with individual centers responding to a public link.

RESULTS:

A total of 78 adult and pediatric centers worldwide contributed to the survey, representing ≥3500 patients' experiences. Centers reported infrastructure maintenance for Parenteral Nutrition (PN) bag deliveries to patients (60, 76.92%) or delivery of ancillary items (57, 73.08%), home delivery and HPN administration (65, 83.33%), and home care nurse shortages (25, 32.05%). Routine follow-up of HPN patients changed to either all telemed or mixed with emergency clinic review (70, 89.74%). In 26 centers (33.33%), HPN for newly discharged patients with benign conditions was reduced or stopped. Based on clinical history, the centers reported psychological distress for patients (52, 66.67%), with anxiety, worry, concern, and apprehension reported most frequently (37 of 52, 71.15%) but also fear (10 of 52, 19.23%), depression (5 of 52, 9.62%), and issues related to isolation/confinement (12 of 52, 23.08%).

CONCLUSIONS:

The COVID-19 pandemic was reported by clinicians to have had a far-reaching adverse impact on patients receiving HPN, especially their safety in terms of provision of personal protective equipment, PN bags, available nursing staff, and psychological well-being. Healthcare systems responded to the challenge and presented new ways of working.

• Authors: Philip J Allan, Loris Pironi, Francisca Joly, Simon Lal, André Van Gossum, Home Artificial Nutrition & Chronic Intestinal Failure special interest group of ESPEN
• Journal: JPEN. Journal of parenteral and enteral nutrition (JPEN J Parenter Enteral Nutr) Vol. 45 Issue 1 Pg. 43-49 (01 2021) ISSN: 1941-2444 [Electronic] United States
• PMID: 33241555 (Publication Type: Journal Article)
• Copyright: © 2020 American Society for Parenteral and Enteral Nutrition.

Topics

• COVID-19 (prevention & control)
• Humans
• Intestinal Diseases (epidemiology, therapy)
• Pandemics
• Parenteral Nutrition, Home (adverse effects)
• Patient Care
• Physicians (psychology)
• SARS-CoV-2