Enhancing the management of Long COVID in general practice: a scoping review.

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

4D.5

Presenter:

John Broughan

Twitter:

@https://twitter.com/broughan_john

Co-authors:

Aimee Brennan (1st author), John Broughan, Geoff McCombe, John Brennan, Claire Collins, Ronan Fawsitt, Joe Gallagher, Allys Guérandel, Brendan O’Kelly, Diarmuid Quinlan, John S Lambert, Walter Cullen

Author institutions:

1. School of Medicine, University College Dublin, 2. Royal College of Physicians of Ireland, Dublin, 3. Irish College of General Practitioners, Dublin, Ireland., 4. Castle Gardens Surgery, Kilkenny., 5. Ireland East Hospital Group, Dublin., 6. Department of Psychiatry and Mental Health Research, St Vincent’s University Hospital, Dublin., 7. Mater Misericordiae University Hospital, Dublin.

Problem

Long COVID is a multifaceted condition that has impacted a considerable proportion of those with acute-COVID-19. Affected patients often have complex care needs requiring holistic and multidisciplinary care, the kind routinely provided in general practice. However, there is limited evidence regarding GP interventions. This study aimed to address this issue by conducting a scoping review of literature on GP management of Long COVID.

Approach

Arksey and O’Malley’s six-stage scoping review framework with recommendations by Levac et al. was used. PubMed, Google Scholar, the Cochrane Library, SCOPUS, and Google searches were conducted to identify relevant peer-reviewed/grey literature, and the study selection process was conducted according to the PRISMA Extension for Scoping Reviews guidelines. Braun and Clarke’s ‘Thematic Analysis’ approach was used to interpret data.

Findings

Nineteen of 972 identified papers were selected for review. These included peer-reviewed articles and grey literature spanning a wide range of countries. Six themes were identified regarding GP management of Long COVID, these being: (i) GP uncertainty, (ii) Listening and empathy, (iii) Assessment and monitoring of symptoms, (iv) Coordinating access to appropriate services, (v) Facilitating provision of continual and integrated multi-disciplinary care and (vi) Need to facilitate psychological support.

Consequences

The findings show that GPs can and have played a key role in the management of Long COVID, and that patient care can be improved through better understanding of patient experiences, standardised approaches for symptom identification/treatment, and facilitation of access to multidisciplinary specialist services when needed. Future research evaluating focused GP interventions is needed.

Submitted by:

John Broughan

Funding acknowledgement:

This study was funded by Ireland’s Health Research Board (reference number: COV19-2020-123). The study contributes to a wider body of work being produced to attenuate the adverse effects of the COVID-19 pandemic on population health in Ireland (The North-Dublin COVID-19 Cohort [‘ANTICIPATE’] Study). The study also received funding from the family of the late Dr Mary J Farrell, the Ireland East Hospital Group, and internal funding schemes at the UCD School of Medicine, and the UCD College of Health and Agricultural Sciences.