Telehealth in the wake of COVID19

The COVID19 pandemic has forced health care professionals in fertility to look carefully at how they interact with patients. In particular, healthcare professionals have to consider how, wherever possible, to replace face-to-face consultations with video communications, known as telehealth.

Obviously, it is not possible to replace all consultations with video communications. For instance, physical examinations, diagnostic procedures and treatments will still bring healthcare professional and patients together. But what about other types of consultations?

Counselling

This is important for women being treated for infertility. Studies show that counselling decreases anxiety and stress and leads to higher rates of pregnancy.

The good news is that counselling seems to transfer well into the telehealth setting. This has been demonstrated by researchers at the University of Vermont, USA. They demonstrated that online counselling achieved similar results results to face-to-face consultations, reducing distress and promoting pregnancy.

Women experiencing infertility issues took the online programme, the Mind/Body Program for Fertility. They experienced medium to large decreases in anxiety and stress. This compared to a control group and the online group were two-and-a-half times more likely to become pregnant.

Results were similar to face-to-face

The results were similar to those of the face-to-face version of the Mind/Body Program.

Dr. Jessica Clifton, Lead Researcher said, “Offering this highly effective program online removes the barriers to counselling. These barriers prevent so many women undergoing fertility treatment from getting the help they need. This enables women no matter where they live or their circumstances to reduce stress and increase their chances of conceiving.”

Dr. Clifton and her colleagues at the University of Vermont in collaboration with Harvard Medical School, developed the online program over three years. It mirrors the in-person version, offering 10 hour-long modules of instruction that include video, audio and text.

Materials in the programme cover:

  • The relationship between stress, lifestyle and fertility
  • Relaxation techniques, including diaphragmatic breathing and Hatha Yoga
  • Mindfulness and cognitive/behavioural therapy
  • Stress reduction strategies
  • Listening and communication skills
  • Strategies for emotional expression and effective coping with anger
  • Assertiveness training and goal-setting skills.

The online version of the programme also offers feedback from a trained therapist to participants’ homework assignments. A therapist is available remotely as needed throughout the duration of the study.

Infertility patients were willing to take an online program

The study also demonstrated that women experiencing infertility were willing to take an online program. They were largely satisfied with it according to assessments.

Dr. Clifton said, “The results suggest we could change the way reproductive medicine is provided. Medical practices could implement quick and easy screening to identify distressed patients. We could then offer a convenient, effective and affordable internet-based intervention for these patients. That would measurably reduce their distress and help them achieve their dream of conceiving a child.”

This demonstrates that telehealth is a feasible means of delivering counselling programmes in infertility. It also means that counselling and psychosocial programmes associated with infertility need not be cancelled because of COVID19.  A means to deliver them quickly via telehealth should now be adopted.

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