Virtual consultations have become common place since the pandemic in 2020 with pros and cons of this approach to care. Learn more about this approach to delivery of nutritional advice.
Remote or virtual consultations are not a one-size-fits-all solution to deliver care for COVID-19 recovery (Lee, Koo and Panter, 2021).
Benefits of remote or virtual consultations include:
- Reduced travel time and costs for patients
- Reduced pressure on parking or clinical space in care settings
- This approach to delivery of care is encouraged particularly during times of 'lockdown' or restricted access to attending in person (Cawood et al., 2020; Iannaccone et al., 2020)
Challenges of virtual consultations include:
- Digital poverty and inequitable access to phones or the internet (NHS, 2020)
- No engagement with digital technologies (NHS, 2020)
- Loss of patients’ cues during remote consultation
- Virtual consultations may not be viable when the best care is face-to-face
Providing virtual nutritional assessment, advice and treatment
Community patients
- Providing personnel healthcare as part of a 'hospital-at-home' or similar homecare service required performing regular (e.g. daily) follow-up (face-to-face visits or phone interviews for symptoms) throughout this period of care. Nutritional treatment might be part of this
- Directing community-based patients to relevant websites that give advice on general health and symptoms – see our Understanding symptoms during your COVID-19 recovery patients page
- Identifying nutritional needs early can help to support healthcare staff. Multidisciplinary teams should be using self-screening nutrition tools for patients who can use these and be asking questions to patients using systematic and consistent approaches
- Essential nutritional advice for people living at home should be given through consistent written or online information (Barazzoni et al., 2020; Brugliera et al., 2020)
Hospital patients
- Nursing staff should be alerted when dietitians are not allowed to enter wards
- Dietetic teams should look to use virtual meetings or consultations and access electronic patient information to help assess nutritional needs and provide nutritional advice and treatment
- Relevant nutritional information should be disseminated at multidisciplinary team meetings in order to reinforce the importance of screening and addressing nutritional needs (Lawrence et al., 2021)
For those without COVID-19 but indirectly affected, consider nutrition-related risks such as:
- poor food availability and accessibility for those who struggle to go to the shops
- interruption in nutrition support services
- lack of visits from family or friends to provide food, company and feeding assistance
- cancellation of social lunch clubs
- increased unemployment with limited financial resources
- sedentary lifestyles and higher consumption of unhealthy foods
- deconditioning in older adults (Public Health England, 2021). See more about underlying mechanisms for further information
Patients with dyshagia
There is a list of procedures utilised in by multidisciplinary teams to assess dysphagia, which have been categorised according to their risk of COVID-19 transmission (Miles et al., 2020).
Other considerations for the use of telehealth when assessing and monitoring dysphagia have been proposed. Authors have also suggested screening procedures for dysphagia in the context of the COVID-19 pandemic.