Understanding contextual and practical factors to inform WHO recommendations on using chest imaging to monitor COVID-19 pulmonary sequelae: a qualitative study exploring stakeholders' perspective

HONEIN-ABOUHAIDAR, Gladys, Cynthia RIZKALLAH, Imad Bou AKL, Gian Paolo MORGANO, Tereza VRBOVÁ, van Deventer EMILIE, Maria del Rosario PEREZ and Elie A AKL. Understanding contextual and practical factors to inform WHO recommendations on using chest imaging to monitor COVID-19 pulmonary sequelae: a qualitative study exploring stakeholders' perspective. HEALTH RESEARCH POLICY AND SYSTEMS. LONDON: BMC, 2024, vol. 22, No 1, p. 1-11, 13 pp. ISSN 1478-4505. Available from: https://dx.doi.org/10.1186/s12961-023-01088-1.

Basic information

• Original name: Understanding contextual and practical factors to inform WHO recommendations on using chest imaging to monitor COVID-19 pulmonary sequelae: a qualitative study exploring stakeholders' perspective
• Authors: HONEIN-ABOUHAIDAR, Gladys, Cynthia RIZKALLAH, Imad Bou AKL, Gian Paolo MORGANO, Tereza VRBOVÁ (203 Czech Republic, belonging to the institution), van Deventer EMILIE, Maria del Rosario PEREZ and Elie A AKL.
• Edition: HEALTH RESEARCH POLICY AND SYSTEMS, LONDON, BMC, 2024, 1478-4505.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30304 Public and environmental health
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 4.000 in 2022
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1186/s12961-023-01088-1
• UT WoS: 001243992400001
• Keywords in English: COVID-19; Chest imaging; Practice guidelines; Qualitative research; Long COVID
• Tags: 14119612, 14119613, rivok
• Tags: International impact, Reviewed

Abstract

Background A recommendation by the World Health Organization (WHO) was issued about the use of chest imaging to monitor pulmonary sequelae following recovery from COVID-19. This qualitative study aimed to explore the perspective of key stakeholders to understand their valuation of the outcome of the proposition, preferences for the modalities of chest imaging, acceptability, feasibility, impact on equity and practical considerations influencing the implementation of using chest imaging.Methods A qualitative descriptive design using in-depth interviews approach. Key stakeholders included adult patients who recovered from the acute illness of COVID-19, and providers caring for those patients. The Evidence to Decision (EtD) conceptual framework was used to guide data collection of contextual and practical factors related to monitoring using imaging. Data analysis was based on the framework thematic analysis approach.Results 33 respondents, including providers and patients, were recruited from 15 different countries. Participants highly valued the ability to monitor progression and resolution of long-term sequelae but recommended the avoidance of overuse of imaging. Their preferences for the imaging modalities were recorded along with pros and cons. Equity concerns were reported across countries (e.g., access to resources) and within countries (e.g., disadvantaged groups lacked access to insurance). Both providers and patients accepted the use of imaging, some patients were concerned about affordability of the test. Facilitators included post- recovery units and protocols. Barriers to feasibility included low number of specialists in some countries, access to imaging tests among elderly living in nursing homes, experience of poor coordination of care, emotional exhaustion, and transportation challenges driving to a monitoring site.Conclusion We were able to demonstrate that there is a high value and acceptability using imaging but there were factors influencing feasibility, equity and some practical considerations associated with implementation. We had a few suggestions to be considered by the expert panel in the formulation of the guideline to facilitate its implementation such as using validated risk score predictive tools for lung complications to recommend the appropriate imaging modality and complementary pulmonary function test.