Pilot Observational Study of Patient Reported Outcome Measures for Long COVID Patients in Virtual Integrative Medical Group Visits

Jessica L Barnhill; Isabel J Roth; Vanessa E Miller; John M Baratta; Aisha Chilcoat; Bethany M Kavalakatt; Malik K Tiedt; Karla L Thompson; Paula Gardiner

doi:10.1177/27536130231174236

Pilot Observational Study of Patient Reported Outcome Measures for Long COVID Patients in Virtual Integrative Medical Group Visits

Glob Adv Integr Med Health. 2023 May 14:12:27536130231174236. doi: 10.1177/27536130231174236. eCollection 2023 Jan-Dec.

Authors

Jessica L Barnhill¹, Isabel J Roth¹, Vanessa E Miller², John M Baratta¹, Aisha Chilcoat¹, Bethany M Kavalakatt¹, Malik K Tiedt¹, Karla L Thompson¹, Paula Gardiner³

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
² Department of Injury Prevention Resource Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
³ Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA.

Abstract

Background: Long COVID is a common, debilitating post-infectious illness for which effective management is unknown. Integrative Medical Group Visits (IMGV) are effective interventions for chronic conditions and could benefit Long COVID patients. More information is needed regarding existing patient reported outcome measures (PROMs) to evaluate efficacy of IMGV for Long COVID.

Objective: This study assessed the feasibility of specific PROMS to evaluate IMGVs for Long COVID. Findings will inform future efficacy trials.

Methods: The Perceived Stress Scale (PSS-10), General Anxiety Disorder two-question tool (GAD-2), Fibromyalgia Symptom Severity scale (SSS), and Measure Yourself Medical Outcome Profile (MYMOP®) were collected pre- and post-group by teleconferencing platform or telephone and compared using paired t-tests. Patients were recruited from a Long COVID specialty clinic where they participated in 2-hour - 8 weekly IMGV sessions online.

Results: Twenty-seven participants enrolled and completed pre-group surveys. Fourteen participants were reachable by phone post-group and completed all pre and post PROMs (78.6% female, 71.4% non-Hispanic White, mean age 49). MYMOP® primary symptomatology was fatigue, shortness of breath and "brain fog". Symptoms decreased in interference when compared to pre-group levels (mean difference -1.3 [95% CI-2.2, -.5]). PSS scores decreased (-3.4 [95% CI -5.8, -1.1]), and GAD-2 mean difference was -1.43 (95% CI -3.12, .26). There were no changes in SSS scores of fatigue (-.21 [95% CI -.68,0.25]), waking unrefreshed (.00 [95%CI -.32, -.32]), or trouble thinking (-.21 [95% CI -.78,0.35]).

Conclusion: All PROMs were feasible to administer via teleconferencing platform or telephone. The PSS, GAD-2 and MYMOP® are promising PROMs to track Long COVID symptomatology among IMGV participants. The SSS, while feasible to administer, did not change compared to baseline. Larger, controlled studies are needed to determine the efficacy of virtual IMGVs to address the needs of this large and growing population.

Keywords: group visit; integrative; long COVID; telemedicine; whole person care.