Unescorted clinic visits: Practical consequences of a stressor imposed by the COVID-19 pandemic

Background: One of the restrictive measures of COVID-19 (Coronavirus Disease 2019) pandemic control is the prohibition of escorted clinic visits. Ophthalmological patients’ specific features imply different degrees of dependency, directly affecting their response to such quarantine impositions. This study aims to assess the effects of unaccompanied medical appointments in outpatients’ stress level and absorption of medical advice.

Methods: A questionnaire-based survey was conducted in a large ophthalmic service in Northern Greece during September 2020. Suitable subjects were requested to self-administer a 7-item questionnaire addressing subjective perception of stress and their ability to fully understand and recall doctor’s instructions, considering eye examination in the absence of an escort.

Results: Analysis was based on two hundred consecutive patients who completed the survey. Sixty-three patients (31.5%) reported unescorted clinic visits increasing stress, with a median value of 7.5 (mean 6.77 ± 2.7) in a scale from 1 to 10. A large proportion of patients (30%) claimed difficulty recalling doctor’s comments or instructions and 24.6% anticipated not fully understanding them, should they attend the clinic unaccompanied. Patients living in smaller towns report the highest stress levels (p=0.002) when attending the clinic alone. A marked impact on women and the elderly above 70 years (up to threefold) was identified.

Conclusion: This is the first study specifically addressing practical repercussions of unescorted clinic visits during COVID-19 pandemic. A negative effect on patients’ emotional status and counseling effectiveness was demonstrated. Female gender and advanced age were found as determinants of the highest vulnerability.