184 Chapter 8 DISCUSSION This study shows that the use of virtual care, specifically telephone and video consultations, during the lockdown caused by the COVID-19 pandemic proved to be a good alternative to regular physical consultations for the large majority of patients with infertility and endometriosis and their healthcare providers. Both the patient groups and the healthcare providers thought that the use of telephone consultations would be a good addition to regular care in the future, but that it could not replace regular physical consultations. All groups were positive about video consultations, although video consultations had not yet been widely implemented at the time of this study. Quality of life in infertility patients appeared to be lower for all subdomains when compared with the reference population. The patient-centeredness of endometriosis care during the COVID-19 pandemic seems comparable to that of the reference population used. The first lockdown in the Netherlands came quite suddenly. One of the strengths of this study was the early distribution of questionnaires to the patients during the first lockdown of the COVID-19 pandemic, which limits the chance of recall bias from patients. The use of the validated FertiQoL and ECQ allowed for an objective and validated measurement of quality of life for infertility patients and of patient-centeredness of endometriosis care during COVID-19. The questionnaires were developed in collaboration with two patient organizations to ensure that the questions were relevant and reflected patients’ experiences during that stage of the pandemic. Due to the short time frame of this study and despite the extensive collaboration with the patient organizations and multiple reminders to complete the questionnaires, the response rate remained relatively low, and this is a potential source of response bias. The use of virtual care as an alternative for physical consultations during the pandemic was rated positively by patients; these results are in line with recently published studies during the COVID-19 pandemic (11-14). Yet the replacement of physical consultations by telephone consultations in the future was not seen as a desirable option by the majority of patients from both groups. A possible explanation is that fertility treatments are not possible without physical appointments, for instance for the monitoring of follicle growth. Endometriosis patients receive regular check-ups where their physician routinely performs a physical examination, including transvaginal ultrasonography. The desire to obtain reassurance in this way might also explain why endometriosis patients prefer physical appointments. However, the results should be interpreted with caution, as the number of respondents to these questions was low.
RkJQdWJsaXNoZXIy MTk4NDMw