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Dubenko A, Morelli R, Cross JH, Hall J, Kharytonov V, Michaelis R, Wiebe S. Mental health and quality of life of individuals with epilepsy during the war in Ukraine. Epilepsia 2024. [PMID: 38943522 DOI: 10.1111/epi.18052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE To investigate the repercussions of the war in Ukraine on people with epilepsy (PWE), focusing on access to health care, seizure control, quality of life (QoL), psychological distress, anxiety, and depression; and to identify the key factors influencing these measures. METHODS Consecutive PWE, ≥18 years of age, presenting to one of seven health centers across Ukraine were invited to complete a self-administered survey in 2023. The survey gathered information on clinical and demographic aspects, geographic displacement, and access to care and medications. It also contained five valid questionnaires exploring psychological distress (Kessler-10), QoL with the EuroQOL-5D-5L (EQ-5D-5L), depression with the Neurological Disorders in Epilepsy scale (NDDIE), anxiety with the Hospital Anxiety and Depression Scalae-Anxiety (HADS-A), and epilepsy severity with the Global Assessment of the Severity of Epilepsy scale (GASE). Multivariate linear regression models assessed the relationship between measures of mental health and QoL and their potential predictors. Ethical approval was obtained from the Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Ukraine. RESULTS Among 305 participants (mean age 38 years), 40% were female and 44% had to change residence because of the war. Seizures worsened during the war in 52% of those with active epilepsy and 42% of those with well-controlled epilepsy. Difficulties accessing health care and anti-seizure medications occurred in 25% and 34% of PWE, respectively, and was worse among those who were displaced. According to the mental health instruments, 46% suffered psychological distress, 62% experienced anxiety, 50% were depressed, and 59% rated their epilepsy as somewhat severe or worse. Statistically significant predictors of psychological distress, anxiety, and depression included female gender, more severe epilepsy, increased seizures during the war, and requiring mental health support. SIGNIFICANCE The war significantly disrupted access to health care and availability of medication in PWE, who suffer from significant anxiety, depression, and psychological distress. We identify high-risk factors that can guide resource allocation for prevention and treatment.
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Affiliation(s)
- Andriy Dubenko
- Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Kharkov, Ukraine
| | | | - J Helen Cross
- UCL NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Julie Hall
- International League Against Epilepsy, Washington, DC, USA
| | | | - Rosa Michaelis
- Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Samuel Wiebe
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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Vargas ME, Gershon AS, Pugliese M, Gotfrit RJ, Manuel D, Sadatsafavi M, Stukel TA, To T, Kendall CE, Thavorn K, Robillard R, Kendzerska T. Pandemic Effect on Healthcare Use and Death in Adults with Epilepsy: A Population Study. Can J Neurol Sci 2023:1-11. [PMID: 38115804 DOI: 10.1017/cjn.2023.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVES We conducted a population-based study using Ontario health administrative data to describe trends in healthcare utilization and mortality in adults with epilepsy during the first pandemic year (March 2020-March 2021) compared to historical data (2016-2019). We also investigated if changes in outpatient visits and diagnostic testing during the first pandemic year were associated with increased risk for hospitalizations, emergency department (ED) visits, or death. METHODS Projected monthly visit rates (per 100,000 people) for outpatient visits, electroencephalography, magnetic resonance, computed tomography, all-cause ED visits, hospitalizations, and mortality were calculated based on historical data by fitting monthly time series autoregressive integrated moving-average models. Two-way interactions were calculated using Quasi-Poisson models. RESULTS In adults with epilepsy during the first quarter of the pandemic, we demonstrated a reduction in all-cause outpatient visits, diagnostic testing, ED visits and hospitalizations, and a temporary increase in mortality (observed rates of 355.8 vs projected 308.8, 95% CI: 276.3-345.1). By the end of the year, outpatient visits increased (85,535.4 vs 76,620.6, 95% CI: 71,546.9-82,059.4), and most of the diagnostic test rates returned to the projected. The increase in the rate of all-cause mortality during the pandemic, compared to pre-pandemic, was greater during months with the lower frequency of diagnostic tests than months with higher frequency (interaction p-values <.0001). CONCLUSION We described the impact of the pandemic on healthcare utilization and mortality in adults with epilepsy during the first year. We demonstrated that access to relevant diagnostic testing is likely important for this population while planning restrictions on non-urgent health services.
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Affiliation(s)
| | - Andrea S Gershon
- ICES, Ottawa, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Research Institute, The Hospital of Sick Children, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael Pugliese
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- ICES, Ottawa, Toronto, ON, Canada
| | - Ryan Jason Gotfrit
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Douglas Manuel
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- ICES, Ottawa, Toronto, ON, Canada
| | - Mohsen Sadatsafavi
- Faculty of Pharmaceutical Sciences, Respiratory Evaluation Sciences Program, The University of British Columbia, Vancouver, BC, Canada
| | - Therese A Stukel
- ICES, Ottawa, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Teresa To
- ICES, Ottawa, Toronto, ON, Canada
- Research Institute, The Hospital of Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Claire E Kendall
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- ICES, Ottawa, Toronto, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Kednapa Thavorn
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- ICES, Ottawa, Toronto, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Tetyana Kendzerska
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- ICES, Ottawa, Toronto, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Lu M, Crooks RE, Pricop DF, Cox E, Anghelescu B, Hamilton M, Martino D, Bruno V, Josephson CB, Patten S, Smith EE, Roach P. Patient experiences of virtual care across specialist neuroscience and psychiatry clinics related to the second wave of the COVID-19 pandemic in Calgary, Alberta. HEALTH AND TECHNOLOGY 2023; 13:523-533. [PMID: 37303978 PMCID: PMC10152010 DOI: 10.1007/s12553-023-00754-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/25/2023] [Indexed: 06/13/2023]
Abstract
Purpose The emergence of the COVID-19 (SARS-CoV-2) pandemic has led to public health restrictions and a shift towards virtual care and telehealth. The aim of this study was to explore barriers and facilitators of virtual care from the perspective of neurological and psychiatric patients. Methods One-on-one interviews were conducted remotely using telephone and online video teleconferencing. There was a total of 57 participants, and a thematic content analysis was conducted using NVivo software. Results The two main themes were (1) virtual health service delivery and (2) virtual physician/patient interaction, with subthemes around how virtual care improved accessibility of care for patients and improved patient-centered care; how privacy and technical issues impact patients using virtual care; and the need for relationality and connection between health care providers and patients while using virtual care. Conclusions This study showed that virtual care can increase accessibility and efficiency for patients and providers, indicating its potential for ongoing use in the delivery of clinical care. Virtual care was found to be an acceptable mode of healthcare delivery from the perspective of patients; however, there is a continued need for relationship-building between care providers and patients.
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Affiliation(s)
- Michelle Lu
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, T2N 4N1 AB Canada
| | - Rachel E. Crooks
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, T2N 4N1 AB Canada
| | - Diana F. Pricop
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403 - 29 Street NW, Calgary, T2N 2T9 AB Canada
| | - Emily Cox
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
| | - Beatrice Anghelescu
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
| | - Mark Hamilton
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Veronica Bruno
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Colin B. Josephson
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB 3D10, T2N 4Z6 Canada
| | - Scott Patten
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403 - 29 Street NW, Calgary, T2N 2T9 AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB 3D10, T2N 4Z6 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Eric E. Smith
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Pamela Roach
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, T2N 4N1 AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, Health Research Innovation Centre, University of Calgary, Room 1A10, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB 3D10, T2N 4Z6 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
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Slonkova J, Chudy M, Togtokhjargal A, Tomaskova H, Vacovska H, Rytirova G, Dolezalova I. The effects of COVID-19 on sleep and general health of Czech patients with epilepsy. Heliyon 2023; 9:e13413. [PMID: 36816256 PMCID: PMC9918435 DOI: 10.1016/j.heliyon.2023.e13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
Objectives To assess the impact of COVID-19 illness and pandemic era on sleep, general health, health care, and social status in patients with epilepsy in the Czech Republic. Methods Our designed and approved questionnaire consisted of 23 questions. We focused on (1) patients' demographic and epidemiological data regarding COVID-19, (2) subjective assessment of sleep; (3) epilepsy, and (4) perception of general health during the first year of the COVID-19 pandemic in the Czech Republic from March 2020 to May 2021. We administered the questionnaires during outpatient visits or by phone calls in three major university Czech epilepsy centers (Ostrava, Brno, Pilsen). Results We enrolled 227 (100%) patients. The mean age (±SD) was 41.2 ± 14.82 years (min 18, max 86 years), and 138 (61%) were women. COVID-19 was confirmed using the PCR test method in 57 (25.1%) patients. In the pre-pandemic era, 62 (27.3%) patients reported sleep disturbances. Insomnia in 46 (74.2%) and excessive daytime sleepiness in 6 (9.7%) were the most mentioned sleep abnormalities. Nocturnal seizures predispose to sleep impairment (p = 0.014) and vivid dreams and nightmares (p = 0.033). COVID-19 infection significantly increased the risk of vivid dreams and nightmares in patients with diurnal seizures (p = 0.006). Sleep quality impairment and seizure frequency worsening [(p < 0.001) and (p = 0.001), respectively] were the most significant risk factors to perform general health deterioration regardless of having COVID-19 (p = 0.559). The most affected age group was 51+ years (p = 0.033). The three centers provided adequate outpatient care during the first year of the pandemic. The employment and social status of the patients remained unchanged (p = 0.074). Conclusions COVID- 19 infection significantly increased the occurrence of vivid dreams and nightmares in patients with diurnal seizures. Sleep quality deterioration and seizure frequency worsening significantly negatively impacted general health performance.
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Affiliation(s)
- Jana Slonkova
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Corresponding author. Department of Neurology, University Hospital Ostrava, 17 listopadu 1790, 70852, Ostrava- Poruba, Czech Republic, ,
| | - Milos Chudy
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Ariunjargal Togtokhjargal
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Hana Tomaskova
- Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Hana Vacovska
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Gisela Rytirova
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Irena Dolezalova
- First Department of Neurology, St. Anne′s University Hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic,Faculty of Medicine Masaryk University Brno, Kamenice 5, 625 00 Bohunice, Czech Republic
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5
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Jiang SX, Schwab K, Enns R, Ko HH. Survey of the Impact of COVID-19 on Chronic Liver Disease Patient Care Experiences and Outcomes. J Can Assoc Gastroenterol 2022; 6:8-16. [PMID: 36785575 PMCID: PMC9384520 DOI: 10.1093/jcag/gwac022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has a secondary impact on the health of patients with chronic liver disease (CLD). Our objective was to study this impact on care provision, telemedicine, and health behaviours in CLD patients. Methods CLD patients of an urban gastroenterology clinic who attended a telemedicine appointment between March 17, 2020 and September 17, 2020, completed an online survey on care delays, health behaviours, and experience with telemedicine. Chart review was conducted in 400 randomly selected patients: 200 charts from during the pandemic were compared to 200 charts the previous year. Data were extracted for clinicodemographic variables, laboratory investigations, and clinical outcomes. Results Of 399 patients invited to participate, 135 (34%) completed the online survey. Fifty (39%) patients reported 83 care delays due to the COVID-19 pandemic, with the majority (71%) of delays persisting beyond 2 months. Ninety-five (75%) patients were satisfied with telemedicine appointments. There was a longer delay between lab work and appointments in patients seen during the pandemic compared to 2019 (P = 0.01). Compared to the year prior, during the COVID pandemic, there was a similar number of cases of cirrhosis decompensation (n = 26, 13% versus n = 22, 11%) and hospitalization (n = 12, 6% versus n = 5, 3%). Conclusion The COVID-19 pandemic has led to care delays for CLD outpatients, with most delays on the scale of months. These patient-reported experiences and clinical observations can direct optimization of CLD care as effects from the pandemic evolve.
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Affiliation(s)
- Shirley X Jiang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katerina Schwab
- Undergraduate Medical Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Enns
- Division of Gastroenterology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hin Hin Ko
- Correspondence: Hin Hin Ko, BSc (Pharm), MD, FRCPC, Division of Gastroenterology, Faculty of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada, e-mail:
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Song Y, Cui C, Jia Y, Zhang W, Meng L, Sznajder KK, Xu Y, Yang X. Family Functioning and Optimism as Protective Factors of Life Satisfaction Among Stroke Patients During the COVID-19 Epidemic in Shenyang, China. Front Public Health 2022; 10:738634. [PMID: 35558534 PMCID: PMC9087178 DOI: 10.3389/fpubh.2022.738634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease-19 (COVID-19) pandemic may result in detrimental consequences for stroke patient's wellbeing. Family functioning and optimism could help stroke patients cope with crises leading to possible improvements in life satisfaction. This study aims to explore the protective effects of family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic in China. This study was designed as a cross-sectional survey. A total of 207 stroke inpatients who were receiving pharmacotherapy and rehabilitation in general public hospital of Liaoning province during the COVID-19 pandemic in China were consecutive selected and interviewed by online questionnaires via the WeChat platform effectively from April 8 to 30, 2020. The scales included: Satisfaction with Life Scale (SWLS), Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Scale and Revised Life Orientation Test (LOT-R). Hierarchical multiple regression (HMR) analysis was conducted to test the associated factors of life satisfaction. Stroke patient's life satisfaction was at a high level (Mean = 26.46, SD = 6.23) during the pandemic. Stroke patient's residence, duration of stroke, stroke type, and community shut down measures were the strong predictors of life satisfaction. Family functioning and optimism increased life satisfaction among stroke patients. This study contributes to the research on the association between family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic. Interventions that improve family functioning and enhance optimism should be provided in order to elevate life satisfaction for stroke patients.
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Affiliation(s)
- Yuequn Song
- Department of Neurosurgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Can Cui
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Yajing Jia
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Weiyu Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Lifang Meng
- Department of Scientific Research Management, China Medical University, Shenyang, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Yuanyuan Xu
- Group of Chronic Disease and Environmental Genomics, China Medical University School of Public Health, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
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Pricop DF, Subotic A, Anghelescu BA, Eagles M, Hamilton M, Roach P. Impacts of the COVID-19 Pandemic on the Healthcare Provision and Lived Experiences of Patients with Hydrocephalus. J Patient Exp 2022; 9:23743735221092555. [PMID: 35434294 PMCID: PMC9006093 DOI: 10.1177/23743735221092555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The emergence of COVID-19 (SARS-CoV-2) led to distancing measures which acutely affected healthcare infrastructure, leading to limited in-person clinical visits and an increased number of virtual appointments. This study aimed to examine the effects this had on adults with hydrocephalus by describing the lived experiences of a cohort of patients at an outpatient hydrocephalus clinic. Between early May and early July of 2020, remote structured interviews were conducted with participants. Interviews were in-depth and open-ended, allowing participants to reflect and expand on the effects of the social distancing mandate on their well-being and quality of care. Three themes emerged: (1) impacts of changes in treatment provision, (2) impacts of changes in mitigating activities, and (3) impacts of changes on personal well-being. The comprehensive understanding of lived experiences may inform the future provision of healthcare services and social policy. Improved approaches to remote care telemedicine have the potential to facilitate high-quality care.
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Affiliation(s)
- Diana F. Pricop
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Arsenije Subotic
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Matthew Eagles
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mark Hamilton
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Pamela Roach
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Li P, Lin J, Wu C, Huang S, Zhu S. The impact of social factors, especially psychological worries on anxiety and depression in patients with epilepsy. Epilepsy Behav 2021; 125:108376. [PMID: 34775247 DOI: 10.1016/j.yebeh.2021.108376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Social factors are believed to affect mental health in patients with epilepsy (PWE). However, there is still a lack of sufficient manifest proof, given the difficulty of exposing PWE to relatively consistent natural social environments with a low or high level of social interaction to study their significant role. METHODS This single-center, longitudinal study was conducted via online questionnaires during the coronavirus disease 2019. PWE were recruited from downtown Wuhan and surrounding areas. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used to assess psychological status. RESULTS We analyzed 588 questionnaires completed by 294 PWE who participated in the dual survey. Under lockdown and reopening, the prevalence of anxiety was 13.6%/22.5%, and the prevalence of depression was 19.4%/34.0%. Raising children and seizure-related characteristics, including uncontrolled seizures, seizure exacerbation, seizure frequency ≥ 2/m, and changes in drug regimen, were risk factors in the first and second surveys. A high education level (OR = 1.946, 95% CI = 1.191-3.182), low life satisfaction (OR = 1.940, 95% CI = 1.007-3.737), worry about unanticipated seizures (OR = 2.147, 95% CI = 1.049-4.309), and worry about purchasing medication outside (OR = 2.063, 95% CI = 1.060-4.016) were risk factors for higher scores after reopening. Worry about unanticipated seizures (OR = 3.012, 95% CI = 1.302-6.965) and in-person medical consultation (OR = 2.319, 95% CI = 1.262-4.261) were related to newly diagnosed patients with psychological disorder after reopening. CONCLUSIONS We identified an association between social variables and epileptic psychiatric comorbidities.
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Affiliation(s)
- Ping Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Jiahe Lin
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Chunmei Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China.
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China.
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Delgado-García G, Wiebe S, Josephson CB. The use of patient-reported measures in epilepsy care: the Calgary Comprehensive Epilepsy Program experience. J Patient Rep Outcomes 2021; 5:83. [PMID: 34636998 PMCID: PMC8505782 DOI: 10.1186/s41687-021-00356-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The regular use of patient-reported measures (PRMs) has been associated with greater patient satisfaction and outcomes. In this article, we will review the Calgary Comprehensive Epilepsy Program's successful experience with PRMs in both clinical and research settings, as well as our current challenges and future directions. Our experience will illustrate that is feasible and convenient to implement PRMs, and especially electronic PRMs (ePRMs), into epilepsy clinics. These PRMs have direct clinical and research applications. They inform clinical decision making through readily interpretable scales to which clinicians can expeditiously respond. Equally, they are increasingly forming an integral and central component of intervention and outcomes-based research. However, implementation studies are necessary to address knowledge gaps and facilitate adoption and dissemination of this approach. A natural symbiosis of the clinical and research realms is precision medicine. The foundations of precision-based interventions are now being set whereby we can maximize the quality of life and psychosocial functioning on an individual level. As illustrated in this article, this exciting prospect crucially depends on the routine use of ePRMs in the everyday care of people with epilepsy. Increasing ePRMs uptake will clearly be a catalyst propelling precision epilepsy from aspiration to clinical reality.
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Affiliation(s)
- Guillermo Delgado-García
- Department of Clinical Neurosciences, Cumming School of Medicine, Foothills Medical Centre, University of Calgary, 1403 - 29 St NW, Calgary, AB, Canada.,Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Samuel Wiebe
- Department of Clinical Neurosciences, Cumming School of Medicine, Foothills Medical Centre, University of Calgary, 1403 - 29 St NW, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,Clinical Research Unit, University of Calgary, Calgary, AB, Canada
| | - Colin B Josephson
- Department of Clinical Neurosciences, Cumming School of Medicine, Foothills Medical Centre, University of Calgary, 1403 - 29 St NW, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. .,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,Centre for Health Informatics, University of Calgary, Calgary, AB, Canada.
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10
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Gonzalez‐Martinez A, Planchuelo‐Gómez Á, Vieira Campos A, Martínez‐Dubarbie F, Vivancos J, De Toledo‐Heras M. Medium-term changes in patients with epilepsy during the COVID-19 pandemic. Acta Neurol Scand 2021; 144:450-459. [PMID: 34195984 DOI: 10.1111/ane.13481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The novel coronavirus disease (COVID-19) pandemic has led to social distancing measures and impaired medical care of chronic neurological diseases, including epilepsy, which may have adversely affected well-being and quality of life of patients with epilepsy (PWE). The objective of this study is to evaluate the impact of the COVID-19 pandemic in the levels of anxiety, depression, somnolence, and quality of life using validated scales in PWE in real-life clinical practice. MATERIALS & METHODS Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale; ESS), and quality of life (QOLIE-31-P) in PWE treated in a Refractory Epilepsy Unit were longitudinally analyzed. Data were collected before the beginning (December 2019 - March 2020) and during the COVID-19 pandemic (September 2020-January 2021). RESULTS 158 patients (85 from the first round and 73 from the second round) 45.0 ± 17.3 years of age, 43.2% women, epilepsy duration 23.0 ± 14.9 years, number of antiepileptic drugs 2.1 ± 1.4, completed the survey. Significant longitudinal reduction of QOLIE-31-P (from 58.9 ± 19.7 to 56.2 ± 16.2, p = .035) and GAD-7 scores (from 8.8 ± 6.2 to 8.3 ± 5.9, corrected p = .024) was identified. No statistically significant longitudinal changes in the number of seizures (from 0.9 ± 1.9 to 2.5 ± 6.2, p = .125) or NDDI-E scores (from 12.3 ± 4.3 to 13.4 ± 4.4, p = .065) were found. Significant longitudinal increase of ESS (from 4.9 ± 3.7 to 7.4 ± 4.9, p = .001) was found. CONCLUSIONS During the COVID-19 pandemic, quality of life and anxiety levels were lower in PWE, and sleepiness levels were raised, without seizure change.
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Affiliation(s)
- Alicia Gonzalez‐Martinez
- Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | | | - Alba Vieira Campos
- Epilepsy Unit Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | | | - José Vivancos
- Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | - María De Toledo‐Heras
- Epilepsy Unit Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
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11
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Cross JH, Kwon C, Asadi‐Pooya AA, Balagura G, Gómez‐Iglesias P, Guekht A, Hall J, Ikeda A, Kishk NA, Murphy P, Kissani N, Naji Y, Perucca E, Pérez‐Poveda JC, Sanya EO, Trinka E, Zhou D, Wiebe S, Jette N. Epilepsy care during the COVID-19 pandemic. Epilepsia 2021; 62:2322-2332. [PMID: 34428314 PMCID: PMC8652685 DOI: 10.1111/epi.17045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 02/05/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected the care of all patients around the world. The International League Against Epilepsy (ILAE) COVID-19 and Telemedicine Task Forces examined, through surveys to people with epilepsy (PWE), caregivers, and health care professionals, how the pandemic has affected the well-being, care, and services for PWE. The ILAE included a link on their website whereby PWE and/or their caregivers could fill out a survey (in 11 languages) about the impact of the COVID-19 pandemic, including access to health services and impact on mental health, including the 6-item Kessler Psychological Distress Scale. An anonymous link was also provided whereby health care providers could report cases of new-onset seizures or an exacerbation of seizures in the context of COVID-19. Finally, a separate questionnaire aimed at exploring the utilization of telehealth by health care professionals since the pandemic began was available on the ILAE website and also disseminated to its members. Seventeen case reports were received; data were limited and therefore no firm conclusions could be drawn. Of 590 respondents to the well-being survey (422 PWE, 166 caregivers), 22.8% PWE and 27.5% caregivers reported an increase in seizure frequency, with difficulty in accessing medication and health care professionals reported as barriers to care. Of all respondents, 57.1% PWE and 21.5% caregivers had severe psychological distress (k score >13), which was significantly higher among PWE than caregivers (p<0.01). An increase in telemedicine use during the COVID-19 pandemic was reported by health care professionals, with 40% of consultations conducted by this method. Although 74.9% of health care providers thought that this impacted positively, barriers to care were also identified. As we move forward, there is a need to ensure ongoing support and care for PWE to prevent a parallel pandemic of unmet health care needs.
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Affiliation(s)
- J Helen Cross
- Programme of Developmental NeurosciencesUCL NIHR BRC Great Ormond Street Institute of Child HealthGreat Ormond Street Hospital for ChildrenLondon and Young Epilepsy LingfieldLondonUK
| | - Churl‐Su Kwon
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Ali Akbar Asadi‐Pooya
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
- Jefferson Comprehensive Epilepsy CenterDepartment of NeurologyThomas Jefferson UniversityPhiladelphiaUSA
| | - Ganna Balagura
- Department of Neurosciences, Rehabilitation, OphthalmologyGenetics, and Maternal and Child HealthPediatric Neurology and Muscular Diseases UnitIRCCS ‘G. Gaslini’ InstituteUniversity of GenoaGenoaItaly
| | - Patricia Gómez‐Iglesias
- Epilepsy Unit. Department of NeurologyHospital Clínico San CarlosHealth Research Institute “San Carlos” (IdISCC)Universidad Complutense de MadridMadridSpain
| | - Alla Guekht
- Moscow Research and Clinical Center for NeuropsychiatryMoscowRussia
- Department of Neurology, Neurosurgery and Medical GeneticsRussian National Research Medical UniversityMoscowRussia
| | - Julie Hall
- Executive DirectorInternational League Against EpilepsyFlower MoundTXUSA
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and PhysiologyKyoto University Graduate School of MedicineKyotoJapan
| | - Nirmeen A. Kishk
- Neurology DepartmentFaculty of MedicineCairo UniversityCairoEgypt
| | | | - Najib Kissani
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Yahya Naji
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Emilio Perucca
- Division of Clinical and Experimental PharmacologyDepartment of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly
- IRCCS Mondino Foundation (and member of the ERN EpiCARE)PaviaItaly
| | - Juan Carlos Pérez‐Poveda
- Neuroscience DepartmentFaculty of MedicineXavierian University, and Hospital Universitario San IgnacioBogotá D. CColombia
| | - Emmanuel O. Sanya
- Neurology division, Medicine DepartmentUniversity of Ilorin Teaching HospitalKwara StateNigeria
| | - Eugen Trinka
- Department of NeurologyCentre for Cognitive NeuroscienceChristian‐Doppler University HospitalParacelsus Medical UniversitySalzburgAustria
- Neuroscience Institute Christian‐Doppler University HospitalCentre for Cognitive NeuroscienceParacelsus Medical UniversitySalzburgAustria
- Institute of Public Health, Medical Decision‐Making and HTA, UMITMedical Informatics and TechnologyPrivate University for Health SciencesHall in TyrolAustria
| | - Dong Zhou
- Department of NeurologyWest China HospitalSichuan UniversityChengduChina
| | - Samuel Wiebe
- Departments of Clinical Neurosciences and Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Nathalie Jette
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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12
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Patients with epilepsy during the COVID-19 pandemic: Depressive symptoms and their association with healthcare access. Epilepsy Behav 2021; 122:108178. [PMID: 34252830 PMCID: PMC8412878 DOI: 10.1016/j.yebeh.2021.108178] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak impacted the lives of worldwide people with epilepsy (PWE) in various aspects, particularly in those countries most significantly affected by this pandemic, such as Brazil. We aimed to investigate the prevalence of depressive symptoms in PWE and their correlation with epilepsy features and access to treatment. METHODS PWE were invited to answer a cross-sectional online-based survey to assess and rate depressive symptoms using the NDDI-E during the first year of the COVID-19 pandemic and its relation to multiple lifestyles epilepsy clinical aspects. RESULTS A total of 490 PWE were recruited. The prevalence of depressive symptoms during the COVID-19 pandemic was 35.3% (cutoff score > 15 on NDDI-E). The factors associated with higher NDDI-E scores were: female sex, increased seizure frequency, barriers to access to their treating physician and antiseizure medication, and unemployment. Regarding the pandemic impact on PWE healthcare, 29.2% reported restricted access to their medication, 46.1% barriers to access their physicians, 94.2% had their consultations canceled due to the pandemic, and 28.4% had seizure worsening in this period. CONCLUSION The COVID-19 pandemic affected PWE access to the healthcare system. Depressive symptoms were more severe in patients with higher seizure frequency who had difficulties obtaining proper medical care. The COVID-19 pandemic may impact the healthcare and mental wellbeing of patients with chronic diseases such as epilepsy. Nevertheless, prospective studies on epilepsy and COVID-19 are still lacking.
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13
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Challenges faced by people with epilepsy on ketogenic diet therapy and their caregivers during the COVID-19 pandemic in Brazil. Epilepsy Behav 2021; 122:108193. [PMID: 34256342 PMCID: PMC9761294 DOI: 10.1016/j.yebeh.2021.108193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although ketogenic diet therapy (KDT) is a well-established, nonpharmacologic therapeutic option for patients with pharmacoresistant epilepsy, its availability is still not widespread. The COVID-19 pandemic may have further restricted the access of people with pharmacoresistant epilepsy (PWE) to KDT. Thus, we evaluated the experiences of Brazilian PWE and their caregivers during the first year of the pandemic. METHODS An online self-assessed survey containing 25 questions was distributed via social media to be answered by PWE treated with KDT or their caregivers through Google Forms from June 2020 to January 2021. Mental health was assessed using the DASS and NDDI-E scales. RESULTS Fifty adults (>18 yo), of whom 68% were caregivers, answered the survey. During the pandemic, 40% faced adversities in accessing their usual healthcare professionals and 38% in obtaining anti-seizure medication (ASM). Despite these issues, 66% of those on KDT could comply with their treatment. Those struggling to maintain KDT (34%) named these obstacles mainly: diet costs, social isolation, food availability, and carbohydrate craving due to anxiety or stress. An increase in seizure frequency was observed in 26% of participants, positively associated with difficulties in obtaining ASM [X2 (1, N = 48) = 6.55; p = 0.01], but not with KDT compliance issues. CONCLUSIONS People with pharmacoresistant epilepsy and undergoing KDT, as well as their caregivers, faced additional challenges during the COVID-19 pandemic, not only difficulties in accessing healthcare and KDT maintenance but also on seizure control and mental health.
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14
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Aleboyeh S, Appireddy R, Winston GP, Boisse Lomax L, Shukla G. Virtual epilepsy clinics - A Canadian Comprehensive Epilepsy Center experience pre-COVID and during the COVID-19 pandemic period. Epilepsy Res 2021; 176:106689. [PMID: 34242903 PMCID: PMC8440323 DOI: 10.1016/j.eplepsyres.2021.106689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
Objective The objective of this study is to assess the role of prior experience with virtual care (through e-visits) in maintaining continuity in ambulatory epilepsy care during an unprecedented pandemic situation, comparing in person versus e-visit clinic uptake. Methods This is an observational study on virtual epilepsy care (through e-visits) over two years, during a pre-COVID period (14 months) continuing into the COVID-19 pandemic period (10 months). For a small initial section of patients seen during the study period a physician survey and a patient satisfaction survey were completed (n = 53). Outcomes of eVisits were analyzed using descriptive statistics. Results Median numbers of epilepsy clinic visits conducted during the COVID-19 period (27.5 new and 113 follow up) remained similar to the median uptake during the pre-COVID period (28 new and 116 follow up). Prior experience with e-visits for epilepsy yielded smooth transition into the pandemic period, with several other advantages. The majority of eVisits were successful despite technical difficulties and major components of history and management were still easily implemented. Results from patient surveys supported that a significant amount of time and money were saved, which was in keeping with our health-economic analysis. Conclusion Our study is one of the first few reports of fully integrated virtual care in a comprehensive epilepsy clinic starting much before start of the COVID-19 pandemic. The results of our study support the feasibility of using virtual care to deliver specialized outpatient care in a comprehensive epilepsy center.
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Affiliation(s)
- Sallya Aleboyeh
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ramana Appireddy
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Gavin P Winston
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Lysa Boisse Lomax
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Garima Shukla
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada.
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15
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Puteikis K, Mameniškienė R. Epilepsy care and COVID-19: A cross-sectional online survey from Lithuania. Acta Neurol Scand 2021; 143:666-672. [PMID: 33724450 PMCID: PMC8251152 DOI: 10.1111/ane.13409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
Background Changes in epilepsy care during the COVID‐19 pandemic required to reassess the patient‐specialist interaction in the context of telehealth and future vaccination campaigns. Aims of the study The aims were to outline changes in neurologists' experience when providing care for patients with epilepsy (PWE) and to investigate how neurologists perceive telehealth and vaccination. Methods We conducted an anonymous cross‐sectional online survey among members of the Lithuanian Association of Neurology. Results We received 104 completed forms by adult (74, 71.15%) and pediatric neurologists (30, 28.85%). A decrease in epilepsy consultations was noted by 76 (73.1%) specialists, and up to 26 (25.0%) could not provide diagnostic tests at a usual rate. Most respondents (99, 95.2%) would recommend the COVID‐19 vaccine for patients at risk. Telehealth was valued as a useful tool in epilepsy care, especially if combined with timely diagnostic and treatment options (Kruskal‐Wallis chi‐square = 10.392, p = .034 and F[4,99] = 3.125, p = .018, respectively). According to 85 (81.7%) respondents, video calls could substitute in‐person visits in at least half of all consultations. Conclusions Despite disrupted epilepsy care, neurologists may benefit from telehealth when providing services for PWE and become vaccination advocates to mitigate the spread of preventable infections.
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