Telemedicine During the COVID-19 Pandemic: A Paradigm Shift in Non-Communicable Disease Management? – A Cross-Sectional Survey from a Quaternary-Care Center in South India

Figures & data

Table 1 Demographics of Study Population (N=220)

Demographics	Categories	N	Percentage (%)
Gender	Female	75	34.09
	Male	144	65.45
	Other	1	0.45
Age (years)	0–20	12	5.45
	21–40	34	15.45
	41–60	134	60.90
	61 and above	40	18.18
Native State	Kerala	117	53.18
	Non- Keralite	103	46.81
NCDs, risk factors, and comorbidities	Cancer	25	11.36
	Cardiovascular diseases	17	7.72
	Chronic Respiratory diseases	21	9.54
	T2DM	81	36.81
	Dyslipidaemia	47	21.36
	Obesity	24	10.90
	Chronic Kidney disease	5	2.27
	Misc. Endocrine and G.I disorders	45	20.45
Co-morbidity count	Single comorbidity	150	68.18
	Multiple comorbidities	70	31.81
Departments	General Medicine	33	15
	Geriatric Medicine	35	15.9
	Endocrinology	29	13.2
	Cardiology	32	14.5
	Gastroenterology	29	13.2
	Rheumatology	34	15.5
	Respiratory Medicine	28	12.7

Table 2 Responses of the Survey (N=220)

Section 2: Characteristics of Current Consultation	Mode (Response)	Percentage
1. How often did you used to go for in person consultation in 2019?	Once in a year (79)	35.90%
2. How often did you go to hospitals for in person consultations in 2020?	No visits (157)	71.36%
3. What is/are the disease(s) that you are diagnosed with?	T2DM (81)	36.81%
4. When were you last diagnosed for the above-mentioned disease?	More than 2 years (87)	39.54%
5. Do you think there has been any difficulty in consulting your doctor since the onset of the COVID-19 pandemic?	Yes (145)	65.90%
6. If yes, what are the difficulties you face?	Fear of COVID-19 (97)	44.09%
Section 3: Perceptions about Consultations during the Pandemic
7. Do you feel that your visits are not as comfortable as it used to be earlier as compared to your visits in 2019?	Agree (84)	38.18%
8. Do you feel that the treatment of your disease by your regular doctor has been affected by the COVID-19 pandemic?	Agree (91)	41.36%
9. Do you think your doctor has decreased the examination time with you since the onset of the COVID-19 pandemic?	Agree (75)	34.09%
10. Do you think your doctor is physically distant from you since the onset of the COVID-19 pandemic?	Agree (95)	43.18%
11. Is there any difficulty in obtaining your regular medications during the COVID-19 pandemic?	Agree (87)	39.54%
12. Do you think that your disease has worsened during this COVID-19 pandemic?	Not sure (87)	39.54%
13. Have you used telemedicine for your consultation during this COVID- 19 pandemic?	No (136)	61.81%
14. If yes, do you feel telemedicine is an adequate substitute/surrogate for in-person consultations?	Not Sure (72)	32.72%
15. Are you comfortable with telemedicine?	Agree (84)	38.18%
16. Are you satisfied with the routine care (Telemedicine/In-person) being provided now?	Agree (111)	50.45%

Figure 1 Responses from patients who chose in-person consultation (n=135), *Question only asked to the in-person group.

Figure 2 Responses from patients who chose telemedicine consultation (n = 85), **Question only asked to the telemedicine group.

Table 3 Correlations Between Patients That Opted for an in-Person Consultation Since the COVID-19 Pandemic (N=135)

Patients who had difficulty in consulting their doctor since the onset of the COVID-19 pandemic	Participant Responses	Z statistic	Odds Ratio	95% CI	df	p-value
	Gender	0.58	0.730	0.25–2.12	1	0.56
	Co-morbidity count	0.804	0.65	0.23–1.85	1	0.421
	Decreased examination Time	2.76	6.43	1.7–24.08	2	0.006*
	Obtaining medicines	0.92	1.9	0.48–7.44	2	0.357
	Worsening of NCD	1.27	2.41	0.62–9.49	2	0.205
	Comfortable with Telemedicine	2.28	3.88	1.21–12.47	2	0.022

Notes: df, Degrees of Freedom, *p-value<0.05 is significant with 95% CI, NCD, Non-communicable diseases.

Table 4 Correlations Between Patients That Used Telemedicine for Consultation During the COVID-19 Pandemic (N=85)

Patients that felt telemedicine is an adequate surrogate/substitute for in-person consultations.	Participant Responses	Z statistic	Odds Ratio	95% CI	df	p-value
	Gender	0.202	0.90	0.31–2.57	1	0.84
	Co-morbidity count	0.927	0.61	0.22–1.72	1	0.354
	Difficulty in consultation	0.37	0.80	0.24–2.62	1	0.354
	Treatment of NCD affected	0.081	0.94	0.20–4.47	2	0.71
	Obtaining Medicines	2.35	6.00	1.34–26.81	2	0.019*
	Worsening of disease	0.88	1.85	0.47–7.32	2	0.38

Notes: df, Degrees of Freedom, *p-value<0.05 is significant with 95% CI, NCD, Non-communicable diseases.

Figure 3 Responses to Q6: What are the difficulties in consulting your doctor since the onset of the COVID-19 pandemic? (N=220).