The purpose of this study was to conduct a mixed-methods community needs assessment to identify the barriers, opportunities, and equity gaps for healthcare providers diagnosing and treating Long COVID and for patients living with Long COVID.
The secondary objective of the project was to iterate OHSU's Long COVID PT Protocol to disseminate to community clinicians.
Deidentified quantitative data on referrals were gathered from the electronic medical record from January 1, 2021 to May 24, 2024. Descriptive statistics were run to understand referral patterns to the Long COVID Clinic based on geography, race, and ethnicity.
Qualitative data consisted of semi-structured interviews with 7 patients with Long COVID and 12 clinicians, representing medicine, nursing, respiratory therapy, physical therapy, social work, and mental health therapy. Interviews were conducted virtually between April - June, 2024. Transcripts, recordings, and interview notes were used to identify common themes and needs.
OHSU’s Long COVID Clinic received 3189 referrals from 16 states during the study period. 981 (31%) of these referrals completed initial virtual appointments with a Long COVID physician. Compared to the general population, Hispanic, Asian, and Black patients were under-represented. However, the proportion of patients who completed appointments was comparable across ethnicity and race.
Interviews highlighted numerous barriers in the identification, assessment, and treatment of Long COVID, including economic, geographic, social, technological, and professional, particularly in marginalized populations.
The project identified the need for improved Long COVID education to patients and clinicians, universal competence of best practices among all clinical providers, and a societal shift in perspective regarding Long COVID recovery. To this end, the OHSU Long COVID PT Protocol underwent iterations to address these needs. Additionally, educational resources for the public and for clinicians were developed to demystify the multi-systemic nature of the condition.
Next steps include vetting of the updated protocol and disseminating the developed resources. Future study into the causes of disparities in referral patterns is also necessary to ensure health equity.
Physiotherapy is a key component of long COVID care, yet conventional strategies to increase physical capacity through progressive exercise have caused more debility in patients with Long COVID than benefit. Thus, a paradigm shift in the rehabilitative approach is necessary, and dissemination of Long COVID clinical best practices is required to empower all community clinicians to effectively care for this growing patient population.
Community Needs Assessment
