Impact of covid-19 pandemic on identified psychosocial needs of specialty social worker embedded in pulmonary practice

SESSION TITLE: Education, Research, and Quality Improvement Posters 7 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Embedding social work into outpatient pulmonary practice is a valuable way to address psychosocial challenges facing patients with lung disease. The COVID-19 pandemic raised awareness around mental health and other psychosocial issues impacting patient care. We studied the impact of the COVID-19 pandemic on the psychosocial needs of patients seen in an adult outpatient pulmonary practice. METHODS: A Licensed Clinical Social Worker was embedded in a specialty pulmonary adult outpatient practice at a single institution. We evaluated changes in the population referred to this social worker over a 32 month period pre-pandemic (May 2017-Dec 2019) compared to post-pandemic (July 2020-Feb 2023). Patients were referred to social work for mental health (including addiction, bereavement, anxiety/depression, eating disorder, and domestic violence), barriers to care (including concrete needs such as transportation, insurance, home care, coordination of care, or medications), psychosocial support (including coping with chronic illness, adjustment to diagnosis, support group, or complete psychosocial assessment),or advanced care plan (including health care proxy, palliative care, goals of care, and hospice). In addition to the reason patients were referred to social work, data on primary pulmonary diagnosis, age, and gender were also tracked. RESULTS: In the pre-pandemic cohort, a total of 415 new patient referrals were made. Of these patients, 65% were female and the average age at referral was 68 years old. Pulmonary diagnoses of the patients referred included COPD (21%), asthma (20%), interstitial lung disease (20%), bronchiectasis (8%), pulmonary hypertension (7%), or other pulmonary diagnoses including but not limited to lung cancer, pleural effusion, chronic cough, or dyspnea on exertion (23%). In the post-pandemic cohort, a total of 383 new patients were referred. 71% of the post-pandemic cohort was female and the average age at referral was 65 years old. Pulmonary diagnoses of the patients referred were similar to the pre-pandemic cohort, with the addition of COVID/Long COVID (9%). Conversely mental health referrals showed a pronounced increase and nearly doubled post-pandemic (24 % of referrals vs 42%). All other reasons for referral, as previously defined, decreased or stayed the same relative to the pre-pandemic cohort. CONCLUSIONS: There was a dramatic increase in the number of mental health referrals post-pandemic across all pulmonary diagnoses. This may suggest social isolation and fears related to the COVID-19 pandemic increased mental health symptoms. However, further work is needed to determine the etiology of this change. It is possible that the COVID-19 pandemic increased mental health symptoms experienced by pulmonary patients or that medical providers gained an increased awareness of mental health issues as a result of the pandemic. CLINICAL IMPLICATIONS: Mental health has been linked to poorer prognosis and reduced health-related quality of life in individuals with pulmonary disease. Chronic respiratory disease was also associated with higher incidence of mental health symptoms during the COVID-19 pandemic. The increase in mental health referrals to an embedded social worker demonstrates this increase continued post-pandemic and indicates the need to further study the impact of embedding social work on clinical outcomes on patient’s with mental health symptoms. DISCLOSURES: No relevant relationships by Sonali Bose No relevant relationships by Elliot Eisenberg No relevant relationships by Victoria Mock No relevant relationships by Rachel Potter