Transitioning to Remote Clinic Visits in a Smoking Cessation Trial During the COVID-19 Pandemic: Mixed Methods Evaluation.
Transitioning to Remote Clinic Visits in a Smoking Cessation Trial During the COVID-19 Pandemic: Mixed Methods Evaluation.
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DOI：
10.2196/25541
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发表时间：
2021-04-30
影响因子：
2.2
通讯作者：
Hawk LW
中科院分区：
文献类型：
--
作者：
Mahoney MC;Park E;Schlienz NJ;Duerr C;Hawk LW
导致COVID-19的SARS-CoV-2大流行已经导致正在进行的临床试验中断，预计将加速人们对远程研究的兴趣。采用准实验混合方法来检查参加正在进行的戒烟临床试验的参与者的访问完成率以及意见和经验，由于COVID-19大流行，这些参与者被要求从亲自诊所就诊改为使用视频或电话会议的远程就诊。为了进行定量比较，我们采用了准实验设计，将大流行期间随访的参与者队列（n=23， COVID-19队列）与2018年和2019年日历年类似时间段随访的参与者队列（n=51， COVID-19前队列）进行比较，以检查计划就诊和生物标本采集的完成率。对于定性部分，与经历了从面对面访问到远程访问过渡的参与者进行了访谈。COVID-19队列的参与者平均完成了83.6%的远程诊所就诊（95% CI 73.1%-91.2%），与前COVID-19队列的现场完成率89.8%无显著差异。COVID-19队列的参与者平均返回了93.2% （95% CI 83.5%-98.1%）的远程诊所就诊唾液标本，这与COVID-19前队列的现场唾液标本完成率100%没有显著差异。定性数据中出现了两大主题：(1)远程访问的好处；(2)与面对面咨询相比，远程咨询面临的挑战。尽管在这一过渡之前远程保健的经验有限，但大多数与会者表示愿意在未来进行远程访问。即使在因COVID-19大流行而必须从亲自就诊迅速过渡到远程就诊的背景下，就诊完成率和生物标本归还率仍然很高。与会者普遍接受这种转变。需要进一步的研究来确定大流行背景之外面对面和远程访问的最佳组合，并更好地了解这些变化如何影响研究结果。ClinicalTrials.gov NCT03262662;https://clinicaltrials.gov/ct2/show/study/NCT03262662
The pandemic of SARS-CoV-2, which causes COVID-19, has caused disruptions in ongoing clinical trials and is expected to accelerate interest in conducting research studies remotely. A quasi-experimental, mixed methods approach was used to examine the rates of visit completion as well as the opinions and experiences of participants enrolled in an ongoing clinical trial of smoking cessation who were required to change from in-person clinic visits to remote visits using video or telephone conferencing due to the COVID-19 pandemic. For quantitative comparisons, we used a quasi-experimental design, comparing a cohort of participants followed during the pandemic (n=23, COVID-19 cohort) to a comparable cohort of participants followed over a similar time period in the calendar years 2018 and 2019 (n=51, pre–COVID-19 cohort) to examine the rates of completion of scheduled visits and biospecimen collection. For the qualitative component, interviews were conducted with participants who experienced the transition from in-person to remote visits. Participants in the COVID-19 cohort completed an average of 83.6% of remote clinic visits (95% CI 73.1%-91.2%), which was not significantly different than the in-person completion rate of 89.8% in the pre–COVID-19 cohort. Participants in the COVID-19 cohort returned an average of 93.2% (95% CI 83.5%-98.1%) of saliva specimens for remote clinic visits completed, which was not significantly different than the in-person saliva specimen completion rate of 100% in the pre–COVID-19 cohort. Two broad themes emerged from the qualitative data: (1) the benefits of remote visits and (2) the challenges of remote counseling compared to in-person counseling. Despite limited experience with telehealth prior to this transition, most participants expressed a willingness to engage in remote visits in the future. Even in the context of a rapid transition from in-person to remote visits necessitated by the COVID-19 pandemic, rates of visit completion and return of biospecimens remained high. Participants were generally accepting of the transition. Further research is needed to identify the optimal mix of in-person and remote visits beyond the pandemic context and to better understand how these changes may impact study outcomes. ClinicalTrials.gov NCT03262662; https://clinicaltrials.gov/ct2/show/study/NCT03262662