Effects of COVID-19 Pandemic on the Management of Pulmonary Hypertension

25 Pages Posted: 10 Aug 2022

See all articles by Christine Yang Zhou

Christine Yang Zhou

University of Cincinnati - Department of Internal Medicine

Sandeep Sahay

Houston Methodist Hospital

Oksana Shlobin

Inova Health System - Inova Fairfax Hospital

Francisco J. Soto

University of Tennessee Medical Center

Stephen C. Mathai

Johns Hopkins University

Lana Melendres-Groves

University of New Mexico

Christopher J. Mullin

Brown University - Warren Alpert Medical School

Deborah J. Levine

University of Texas Health Science Center at San Antonio

Dana Kay

University of Cincinnati

Kristin Highland

Cleveland Clinic

Eduardo Bossone

Cardarelli Hospital

Abby Poms

Poms Research Consultants

Humna Memon

Spectrum Health

Vijay Balasubramanian

University of California, San Francisco (UCSF) - UCSF Medical Center

Mary Jo S. Farmer

University of Massachusetts Worcester - UMass Chan Medical School

Franck Rahaghi

Mayo Clinic - Florida - Department of Pulmonary Medicine

Jean M. Elwing

University of Cincinnati

Abstract

The coronavirus of 2019 (COVID-19) disrupted delivery of healthcare. Patients with pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), require significant resources for both diagnosis and management and are at high risk for decompensation due to disruption in their care. A survey consisting of 47 questions related to the care of patients with PH was designed by the American College of Chest Physicians 2020-2021 Pulmonary Vascular Disease (PVD) NetWork Steering Committee and sent to all members of the PVD NetWork, as well as the multiple other professional networks for PH. Participation was voluntary and anonymous. Responses were collected from November 2020 through February 2021. Ninety-five providers responded to this survey. The majority (93%) believe that care of PH patients has been affected by the pandemic. Sixty-seven percent observed decreased referrals for PH evaluation. Prior to the pandemic, only 15% used telemedicine for management of PH patients compared to 84% during the pandemic. Telemedicine was used most for follow up of selected low-risk patients (49%). While 22% respondents were completely willing to prescribe new PAH therapy via telemedicine, 11% respondents were completely unwilling. Comfort levels differed based on type of medication being prescribed. Over 90% of providers experienced disruptions in obtaining testing and 31% experienced disruptions in renewal or approval of medications. Overall, the COVID-19 pandemic caused significant disruption of care for PH patients. Telemedicine utilization increased but was used mostly in low-risk patients. Some providers had a decreased level of comfort prescribing PAH therapy via telemedicine encounters.

Note:

Funding Information: There was no funding for this project

Declaration of Interests: None of the authors have conflicts of interest to disclose on the topic of this pulmonary hypertension survey.

Ethics: missing: This project was a quality improvement project; it did not require IRB approval. The survey was anonymous and no identifying information was recorded or provided.

Keywords: Pulmonary hypertension, pulmonary arterial hypertension, COVID-19 pandemic, practice patterns

Suggested Citation

Zhou, Christine Yang and Sahay, Sandeep and Shlobin, Oksana and Soto, Francisco J. and Mathai, Stephen C. and Melendres-Groves, Lana and Mullin, Christopher J. and Levine, Deborah J. and Kay, Dana and Highland, Kristin and Bossone, Eduardo and Poms, Abby and Memon, Humna and Balasubramanian, Vijay and Farmer, Mary Jo S. and Rahaghi, Franck and Elwing, Jean M., Effects of COVID-19 Pandemic on the Management of Pulmonary Hypertension. Available at SSRN: https://ssrn.com/abstract=4169755 or http://dx.doi.org/10.2139/ssrn.4169755

Christine Yang Zhou

University of Cincinnati - Department of Internal Medicine ( email )

Sandeep Sahay

Houston Methodist Hospital

6621 Fannin St
Houston, TX 77030
United States

Oksana Shlobin

Inova Health System - Inova Fairfax Hospital ( email )

VA
United States

Francisco J. Soto

University of Tennessee Medical Center ( email )

Stephen C. Mathai

Johns Hopkins University ( email )

Lana Melendres-Groves

University of New Mexico ( email )

107 Humanitites Building
Albuquerque, NM 87131-1221
United States

Christopher J. Mullin

Brown University - Warren Alpert Medical School ( email )

Deborah J. Levine

University of Texas Health Science Center at San Antonio ( email )

Dana Kay

University of Cincinnati ( email )

Kristin Highland

Cleveland Clinic ( email )

9500 Euclid Ave.
Cleveland, OH 44195
United States

Eduardo Bossone

Cardarelli Hospital ( email )

Abby Poms

Poms Research Consultants ( email )

Humna Memon

Spectrum Health ( email )

Vijay Balasubramanian

University of California, San Francisco (UCSF) - UCSF Medical Center ( email )

Mary Jo S. Farmer

University of Massachusetts Worcester - UMass Chan Medical School ( email )

Franck Rahaghi

Mayo Clinic - Florida - Department of Pulmonary Medicine ( email )

Jean M. Elwing (Contact Author)

University of Cincinnati ( email )

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