Adaptative strategies implemented by an OPO in argentina for the protection of transplant patients and the OPO's own staff in the context of the SARS-coV-2 pandemic
Luis Daniel Rojas1, Graciela I Bosch1, Liliana M Pierini1, Dora V Cabezas1, María A Fariña1, Paula Echandy1, Macarena Yriarte1, Cecilia V Ficher1, Nicolás R Vecchiarelli1.
1Medical Department, Ente Autárquico Instituto de Trasplante, Ciudad Autónoma de Buenos Aires, Argentina
Introduction: The SARS-CoV-2 Pandemic has been a threat to human health, but specially for transplant patients, who are immunosuppressed, as the virus could increase the case-fatality rate among them. Because of this, strict home confinement was recommended for transplant patients in 2020 and 2021. In this context, the Transplant Institute of the City of Buenos Aires (EAIT), Argentina, developed a series of strategies to mitigate the negative impact caused by the confinement. The two core measures were implemented by the Pharmacy and Psychosocial Areas.
Method: Descriptive, cross-sectional, observational, and retrospective design. The strategies were monitored through anonymous surveys using the Google Forms platform, WhatsApp messages, and calls. The Pharmacy Area created a medicine delivery and pharmacotherapeutic follow-up system for transplant patients under the public healthcare system, to whom the State supplies immunosuppressive drugs for free. The Psychosocial Area held supporting meetings, and virtual workshops, and made arrangements for patients and families.
Results: Pharmacy Area: Total number of consultations: 3110. Average number of consultations per patient: 15.32. Problems solved: 93.8% (2917). Patients under active monitoring: 59.89% (109). Consultations via WhatsApp: 93.5% (2909). Consultations via e-mail: 6.37% (198). Consultations by phone: 0.13% (3). Classification: Patient Follow-up 45.4% (219). Therapeutic drug confirmation: 13.7% (66). Dose adjustment / change of medication: 6.8% (33). Consultations related to COVID-19: 6.2% (30). Pharmaceutical consultations: 2.5% (12). Patients admitted to the Argentine Healthcare State Program (PNSP): 2.1% (10). Miscellaneous consultations: 23.3% (112). Satisfaction survey: In relation to drug delivery service quality, 98.1% (157) of respondents stated that they received the medicines at home correctly, rating home delivery system with 8/10 or higher. As to the ease of communication with pharmacists, 94.4% (152) of respondents stated that they found it easy to communicate with pharmacists over the quarantine. In terms of problem solving, 91.8% (146) of respondents stated that they could solve their problems. As to the attention received, 99.4% (157) rated it as good and very good. Psychosocial Area: Virtual meetings:340; calls:3970; attention to families:1710; psychoprophylactic monitoring of emergency on-duty staff: 345; and individual attention of transplant patients and transplant waiting list patients: 710 over the same period. The degree of satisfaction was of 97.4% among patients and of 99.7% among accompanied isolation groups.
Findings: Within a context in which a sense of fear, anguish, and uncertainty prevailed, the rapid response from the EAIT -through the implementation of proper strategies- succeeded in keeping the negative impact of confinement on this vulnerable group and the institutional healthcare team to the minimum, besides having a very high degree of satisfaction.
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