US CARDIOLOGIST AND PATIENT PERSPECTIVES ON COVID-19 TELEHEALTH PRACTICES FOR PATIENTS WITH TRANSTHYRETIN AMYLOID CARDIOMYOPATHY (ATTR-CM)

Background

Telemedicine has become increasingly important due to COVID-19. Frequency of practice and strengths/limitations for ATTR-CM are unknown. Cardiologist and patient surveys were conducted to understand telehealth-use in identification, referral and management of patients with heart failure (HF) and ATTR-CM.

Methods

Quantitative and qualitative surveys were conducted (May-July 2020) of 11 HF patients (of which n=8 ATTR-CM), 50 US cardiologists who diagnosed and/or treated patients with HF and/or ATTR-CM; experience with telehealth, and familiarity with ATTR-CM.

Results

Before COVID-19, cardiologists reported ~7% patient visits occurred via telehealth; during COVID-19, use increased ~85%. Diagnostic delays were reported for patients with suspected ATTR-CM. Imaging delays and preference for in-person visits reduced suspicion/diagnosis (Table). Telehealth's greatest value was for treatment monitoring and used most efficiently in amyloid specialty/academic settings. Physicians reported telehealth would become a permanent part of clinical-care and anticipated 25% of future use. While patient barriers existed, hybrid in-person/telehealth model allowed specialist care while effectively receiving tests locally.

Conclusion

Telehealth was rapidly adopted due to COVID-19. This research suggests reliance on virtual visits can delay diagnosis of ATTR-CM, but useful for treatment initiation/follow-up and presents opportunities to avoid patient-care disruptions.