Factors associated with preference for in-person versus remote consultations in inflammatory bowel disease in the United Kingdom: secondary analysis of an online survey.

Abstract

Introduction: The coronavirus disease 2019 pandemic accelerated use of remote consultations as an alternative to in-person inflammatory bowel disease (IBD) care. However, factors associated with preference for remote or in-person follow-up remain poorly understood.

Methods: We undertook a retrospective analysis of an electronic follow-up survey completed by patients who had previously used an online IBD self-assessment tool during the early pandemic. Respondents with prior experience of remote consultations were included. Preference for future consultation modality was categorised as strong in-person preference ('Never by telephone or video'), strong remote preference ('Mostly by telephone or video'), or no preference. Survey domains included sociodemographics, comorbidities, home restriction, mobility, support, IBD-Control Questionnaire, patient reported outcome-2 symptoms, and satisfaction with IBD care. Associations with preference were examined using binary logistic regression and ordinal logistic regression across ordered preference categories from remote to no preference to in-person.

Results: Among 5833 eligible respondents, 65% reported no preference, 25% a strong remote preference, and 10% a strong in-person preference. Stronger in-person preference was associated with older age, male gender, greater area deprivation, Asian ethnicity compared with White ethnicity, two or more comorbidities, Crohn's disease compared with ulcerative colitis, poorer IBD-specific patient-reported outcome measures, higher patient reported outcome-2 symptom scores, and dissatisfaction with care. Associations with strong remote preference were generally opposite, including younger age, lower deprivation, fewer comorbidities, ulcerative colitis, better patient reported outcome measure scores, and greater satisfaction; gender and ethnicity were not significant. Home restriction, mobility, and support were not significantly associated. Negative IBD-Control-8 responses increased progressively from remote preference to no preference to in-person preference.

Conclusion: Sociodemographic and clinical factors influence consultation preferences in IBD. These findings may support equitable integration of remote care models.