Opportunities and barriers in care for patients with post COVID-19 condition: a Delphi study among healthcare workers.

BACKGROUND

Post COVID-19 condition (PCC) presents complex, long-term health challenges, yet evidence-based treatments and well-organized care pathways remain limited, creating uncertainty for healthcare professionals. This study aimed to identify healthcare workers’ (HCWs) perspectives on prerequisites, barriers and strategies for improving care for patients with PCC in the Netherlands.

METHODS

An online Delphi study was conducted between October 2023 and June 2024, comprising two questionnaire rounds among Dutch HCWs directly or indirectly involved in PCC care. Questionnaire themes were informed by prior research and expert input. Responses were analyzed descriptively, and feasibility ratings were assessed on a 10-point scale.

RESULTS

A total of 270 HCWs participated in round one, of whom 169 (63%) completed round two. Most participants worked in primary care and were directly involved in PCC care. One-third of HCWs reported insufficient treatment options and 25% indicated that PCC care is poorly organized. Key prerequisites included evidence-based treatment options (57%), interprofessional collaboration (34%) and scientific research (31%). Major barriers were lack of specialized PCC treatment centers (38%), limited recognition of PCC (27%) and absence of medication and treatments (25%). Broadening the professional knowledgebase and establishing specialized PCC treatment centers were ranked as top strategies to improve PCC care and were considered feasible. HCWs rated their own PCC knowledge higher than PCC knowledge of their peers (7.8 versus 5.8/10) but acknowledged gaps, particularly in treatment options and biomedical aspects. High workload and lack of capacity and time (49%), and lack of reimbursement for interprofessional consultations (43%) were major barriers for multidisciplinary collaboration.

CONCLUSIONS

PCC care in the Netherlands faces significant organizational and knowledge-related challenges. Strengthening collaboration across care domains and levels, alongside targeted long-term investments in research, education, and specialized care pathways are essential to improve care quality and address identified prerequisites and barriers.