Document Type
Article
Publication Date
4-25-2024
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic exacerbated barriers to care for people living with human immunodeficiency virus (HIV) (PLWH). The quick uptake of telemedicine in the outpatient setting provided promise for care continuity. In this study, we compared appointment and laboratory no-show rates in an urban outpatient HIV clinic during three time periods: (1) Pre-COVID-19: 9/15/2019-3/14/2020 (predominately in-person), (2) "Early" COVID-19: 3/15/2020-9/14/2020 (predominately telemedicine), and (3) "Later" COVID-19: 9/15/2020-3/14/2021 (mixed in-person/telemedicine). Multivariable logistic regression models evaluated the two study hypotheses: (i) equivalence of Period 2 with Period 1 and of Period 3 with Period 1 and (ii) improved outcomes with telemedicine over in-person visits. No-show rates were 1% in Period 1, 4% in Period 2, and 18% in Period 3. Compared to the pre-pandemic period, individuals had a higher rate of appointment no-shows during Period 2 [OR (90% CI): 7.67 (2.68, 21.93)] and 3 [OR (90% CI): 30.91 (12.83 to 75.06). During the total study period, those with telemedicine appointments were less likely to no-show than those with in-person appointments [OR (95% CI): 0.36 (0.16-0.80), p = 0.012]. There was no statistical difference between telemedicine and in-person appointments for laboratory completion rates. Our study failed to prove that no-show rates before and during the pandemic were similar; in fact, no-show rates were higher during both the early and later pandemic. Overall, telemedicine was associated with lower no-show rates compared to in-person appointments. In future pandemics, telemedicine may be a valuable component to maintain care in PLWH.
Recommended Citation
Cox, Avery Lin; Tsang, Daniel; Spacek, Lisa A.; Daskalakis, Constantine; and Coppock, Dagan, "The Impact of Telemedicine on Human Immunodeficiency Virus (HIV)-Related Clinical Outcomes During the COVID-19 Pandemic" (2024). Division of Infectious Diseases and Environmental Medicine Faculty Papers. Paper 18.
https://jdc.jefferson.edu/didem/18
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Language
English
Comments
This article is the author’s final published version in AIDS and Behavior, Volume 28, 2024, Pages 2438–2443.
The published version is available at https://doi.org/10.1007/s10461-024-04342-x. Copyright © The Author(s) 2024.
Publication made possible in part by support through a transformative agreement between Thomas Jefferson University and the publisher.