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Marin CE, Pinto PDO, Dos Passos GR, Cuervo DL, Wagner MB, Becker J, Sato DK. Reliability of telemedicine evaluation for EDSS functional systems in multiple sclerosis. J Telemed Telecare 2025; 31:673-679. [PMID: 37904499 DOI: 10.1177/1357633x231207903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Introduction: There was an increase in telemedicine during the COVID-19 pandemic to follow patients with multiple sclerosis (MS). However, there is scarce data if online evaluations can cover important information assessed during in-clinic appointments, especially the Expanded Disability Status Score (EDSS). This study aims to develop a remote evaluation tool for EDSS functional systems and compare the performance with face-to-face evaluations. Methods: This was a single-center study that included all MS patients followed up at outpatient clinics of Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul, between April and August 2022. Initially, patients were routinely in-clinic evaluated by one trained neurologist for EDSS. After, patients were evaluated remotely without any information about the in-clinic EDSS results. We used a standardized interview with an interactive video platform to evaluate EDSS functional systems by telemedicine. Results: Forty-nine participants completed the two steps. Intra-class coefficient was 0.97 (95% CI: 0.95-0.98), concordance for EDSS below 4.0 was 0.87 (95% CI: 0.77-0.93) and ≥4.0 was 0.97 (95% CI: 0.89-0.99). There was perfect agreement in the final EDSS in 71.4% of the online and in-clinic evaluations. In the multivariate analysis, the visual (beta = 0.453; p = 0.003) and pyramidal (beta = 0.403; p = 0.009) systems contributed significantly to the difference in the final EDSS. Conclusion: The telemedicine tool created in this study can detect changes in functional systems with reliable results compared to in-clinic EDSS assessment. Telemedicine evaluations may reduce the number of in-clinic visits and the disease burden for patients with MS.
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Affiliation(s)
- Cássia E Marin
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Paula de O Pinto
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Giordani R Dos Passos
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Daissy Lm Cuervo
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Mario B Wagner
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Jefferson Becker
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
| | - Douglas K Sato
- Neurology Department, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Neurology Department, Instituto do Cérebro do Rio Grande do Sul (INSCER), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil
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Önal B, Eldemir S, Ceren AN, Eldemir K. Experiences of physical therapists applying telerehabilitation to neurological patients: A qualitative study. Braz J Phys Ther 2025; 29:101195. [PMID: 40121906 PMCID: PMC11979916 DOI: 10.1016/j.bjpt.2025.101195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 01/07/2025] [Accepted: 02/18/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Telerehabilitation has been widely used in neurological diseases in recent years. The experiences of physical therapists and the difficulties they face are critical to the effectiveness of telerehabilitation. OBJECTIVE To examine in depth the technical challenges, patient interaction strategies, and session management processes faced by physical therapists who use telerehabilitation for patients with neurological conditions and to assess the opinions of physical therapists about the advantages, disadvantages, technological infrastructure needs, and support strategies of telerehabilitation. METHODS In this study, phenomenological qualitative research method was used. In-depth interviews were conducted with eight physical therapists who treated patients with neurological disorders with telerehabilitation in our country. Interview data were analyzed using content analysis. RESULTS The analysis revealed seven key themes and 26 sub-themes, which were categorized into two main areas: telerehabilitation session management and perceptions of telerehabilitation sessions. In the area of session management, physical therapists reported challenges related to the adaptation of traditional rehabilitation techniques to the online environment, including difficulties with assessing patients' physical conditions remotely, ensuring patient engagement, and managing technical issues such as internet connectivity and software limitations. They also highlighted the importance of clear communication, structured session planning, and the need for additional training to effectively conduct telerehabilitation sessions. CONCLUSIONS Considering the advantages and disadvantages stated by physical therapists using telerehabilitation with patients with neurological conditions, solutions should be developed to increase the efficiency of telerehabilitation. Applications with simple interfaces, a home environment suitable for exercise sessions, and strategies to support technology adaptation can significantly improve the efficiency of telerehabilitation.
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Affiliation(s)
- Birol Önal
- Atatürk University, Department of Physical Therapy and Rehabilitation, Erzurum, Turkey.
| | - Sefa Eldemir
- Sivas Cumhuriyet University, Department of Physical Therapy and Rehabilitation, Sivas, Turkey
| | - Ali Naim Ceren
- Hacattepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Kader Eldemir
- Sivas Cumhuriyet University, Department of Physical Therapy and Rehabilitation, Sivas, Turkey
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Totala P, Janu V, Sharma RK, Agrawal M, Garg M, Gosal JS, Bhaskar S, Jha DK. Telemedicine in Follow-up after Spine Surgery: Need of the Hour. Asian J Neurosurg 2024; 19:263-269. [PMID: 38974439 PMCID: PMC11226264 DOI: 10.1055/s-0044-1787082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Purpose There is an acute shortage of neurosurgeons and spine surgeons especially in rural areas of low- and middle-income countries including India. Patients of spine surgery need to travel long distances for follow-up at tertiary care hospitals. This study was done to evaluate role and success rate of telemedicine in follow-up after spine surgery based on patients' diagnosis and demographic features and to identify barriers to successful telemedicine consultations. Materials and Methods All patients undergoing spine surgeries including craniovertebral junction (CVJ) surgeries from January 2021 to June 2022 were included in the study. Success rate of telemedicine was calculated using a simple formula: Success rate of telemedicine = successful telemedicine consultations / total number of telemedicine consultation × 100. Success rate was evaluated with respect to demographic features and underlying disease-related factors. Results Eighty-four patients formed the study group in which a total of 181 video teleconsultations were done. Overall success rate of telemedicine was 82.87%. Higher socioeconomic and educational statuses were related to higher success rates of tele-consultations ( p < 0.05). Difficulty in assessing neurological condition using video call in follow-up cases of CVJ and issues related to Internet communication network leading to inability to video call and share image/videos were major causes of failures. Conclusion Telemedicine may prove an effective option for following up patients undergoing spine surgeries except CVJ, which is likely to improve further with improvements in Internet connectivity.
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Affiliation(s)
- Pankaj Totala
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vikas Janu
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Raghavendra K. Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mohit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mayank Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jaskaran S. Gosal
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Suryanarayanan Bhaskar
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak K. Jha
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Pravallika R, Suthar R, Patil A, Malviya M, Saxena S, Saini L, Bansal A. Efficacy of Teleconsultation-Based Rehabilitation in Children with Landry-Guillain-Barré Syndrome: An Open Label Randomized Controlled Trial (Tele Rehab-LGBS Trial). Indian J Pediatr 2024; 91:455-462. [PMID: 37889455 DOI: 10.1007/s12098-023-04882-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES To evaluate the feasibility and efficacy of teleconsultation-based rehabilitation in children with Landry-Guillain-Barré syndrome (LGBS), measured with Medical Research Council (MRC) sum score and Hughes score. METHODS A pragmatic, prospective, parallel open label randomized controlled trial was conducted among a total of 50 children with LGBS. The children were randomized using computer generated block randomization into 2 groups (25 in each group): Standard of care (Group A) and teleconsultation-based rehabilitation (Group B). Primary and secondary outcomes were measured with MRC sum score and Hughes score at 12- and 24-wk follow-up. RESULTS The mean age was 6.4 ± 3.3 y; 29 (58%) were boys. Baseline MRC sum score (median, IQR), and Hughes score (median, IQR) in group A was 24 (7-31) and 5 (4-5) respectively; and in group B was 18 (9-24) and 4 (4-5) respectively. At discharge, median (IQR) MRC sum score in group A and B was 34 (28-41), and 30 (25-43) (p value = 0.31) respectively. Tele-rehabilitation was provided to group B for 24 wk with 96% compliance. At 12 wk, median MRC sum score in group A and group B were similar [48 (IQR 44-54) vs. 52 (IQR 46-60), p value = 0.08]. At 12 wk and 24 wk, median Hughes score in group A and B were similar. At 24 wk, 15 out of 23 subjects of group A and 18 out of 25 subjects of group B were ambulatory (p value = 0.61). CONCLUSIONS Teleconsultation-based rehabilitation was feasible with a high compliance rate. The functional outcomes measured with MRC sum score and Hughes score were similar in both the groups at 12 and 24 wk follow-up. Teleconsultation-based rehabilitation has similar efficacy as physical rehabilitation.
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Affiliation(s)
| | - Renu Suthar
- Department of Pediatrics, PGIMER, Chandigarh, India.
| | - Amol Patil
- Department of Pharmacology, PGIMER, Chandigarh, India
| | | | - Somya Saxena
- Department of Physical Medicine and Rehabilitation, PGIMER, Chandigarh, India
| | - Lokesh Saini
- Department of Pediatrics, PGIMER, Chandigarh, India
- Department of Pediatrics, AIIMS, Jodhpur, India
| | - Arun Bansal
- Department of Pediatrics, PGIMER, Chandigarh, India
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Lebioda LA, Pedroso B, dos Santos MEC, Pinto GMC, Welling LC. Neurological telerehabilitation in the COVID-19 era - current perspectives through a bibliometric analysis. Front Neurol 2023; 14:1227846. [PMID: 37794878 PMCID: PMC10546771 DOI: 10.3389/fneur.2023.1227846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
Objective To identify bibliometric parameters and research trends regarding to telerehabilitation of patients with stroke in the COVID-19 era. Methodology This is an integrative review carried out in the Scopus database, from June to July 2021, through the Biblioshiny graphical interface, provided by the Bibliometrix program. The search terms used were "Stroke," "COVID-19" and "Telerehabilitation." Results were filtered by publication date from 2019 onwards. No language restrictions were imposed. Results Twenty two articles were included in the study and the results were presented in the form of figures demonstrating that the journal Frontiers in Neurology was the one with the most relevant studies and the author with the highest number of citations. The Brazilian Academy of Neurology was the institution with the greatest number of studies and China ranked first as the country with the greatest scientific production. The authors used recent references in their work. A thematic map showed the centrality and density of the words presented and, finally, a three-field graph showed a strong intimacy between countries, keywords and authors. Conclusion A greater interest in the subject was observed in China with greater relevance of journals and institutions focused on neurology. However, despite telerehabilitation being an effective alternative in the context of the pandemic, few studies have explored this modality.
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Ruksakulpiwat S, Zhou W, Niyomyart A, Wang T, Kudlowitz A. How does the COVID-19 pandemic impact medication adherence of patients with chronic disease?: A systematic review. Chronic Illn 2023; 19:495-513. [PMID: 35971949 PMCID: PMC9382573 DOI: 10.1177/17423953221110151] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence. METHODS Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis. RESULTS Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth. DISCUSSION Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Atsadaporn Niyomyart
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tongyao Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Aaron Kudlowitz
- The College of Arts and Sciences, Case Western Reserve University, Cleveland, USA
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Al Kuwaiti A, Nazer K, Al-Reedy A, Al-Shehri S, Al-Muhanna A, Subbarayalu AV, Al Muhanna D, Al-Muhanna FA. A Review of the Role of Artificial Intelligence in Healthcare. J Pers Med 2023; 13:951. [PMID: 37373940 PMCID: PMC10301994 DOI: 10.3390/jpm13060951] [Citation(s) in RCA: 131] [Impact Index Per Article: 65.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/29/2023] Open
Abstract
Artificial intelligence (AI) applications have transformed healthcare. This study is based on a general literature review uncovering the role of AI in healthcare and focuses on the following key aspects: (i) medical imaging and diagnostics, (ii) virtual patient care, (iii) medical research and drug discovery, (iv) patient engagement and compliance, (v) rehabilitation, and (vi) other administrative applications. The impact of AI is observed in detecting clinical conditions in medical imaging and diagnostic services, controlling the outbreak of coronavirus disease 2019 (COVID-19) with early diagnosis, providing virtual patient care using AI-powered tools, managing electronic health records, augmenting patient engagement and compliance with the treatment plan, reducing the administrative workload of healthcare professionals (HCPs), discovering new drugs and vaccines, spotting medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. Nevertheless, this science pitch meets several technical, ethical, and social challenges, including privacy, safety, the right to decide and try, costs, information and consent, access, and efficacy, while integrating AI into healthcare. The governance of AI applications is crucial for patient safety and accountability and for raising HCPs' belief in enhancing acceptance and boosting significant health consequences. Effective governance is a prerequisite to precisely address regulatory, ethical, and trust issues while advancing the acceptance and implementation of AI. Since COVID-19 hit the global health system, the concept of AI has created a revolution in healthcare, and such an uprising could be another step forward to meet future healthcare needs.
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Affiliation(s)
- Ahmed Al Kuwaiti
- Department of Dental Education, College of Dentistry, Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Khalid Nazer
- Department of Information and Technology, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
- Health Information Department, King Fahad hospital of the University, Al-Khobar 31952, Saudi Arabia
| | - Abdullah Al-Reedy
- Department of Information and Technology, Family and Community Medicine Department, Family and Community Medicine Centre, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Shaher Al-Shehri
- Faculty of Medicine, Family and Community Medicine Department, Family and Community Medicine Centre, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Afnan Al-Muhanna
- Breast Imaging Division, Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
- Radiology Department, King Fahad hospital of the University, Al-Khobar 31952, Saudi Arabia
| | - Arun Vijay Subbarayalu
- Quality Studies and Research Unit, Vice Deanship of Quality, Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Dhoha Al Muhanna
- NDirectorate of Quality and Patient Safety, Family and Community Medicine Center, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Fahad A. Al-Muhanna
- Nephrology Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
- Medicine Department, King Fahad hospital of the University, Al-Khobar 31952, Saudi Arabia
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Kozel OA, Baskaran AB, Manjunath A, Goel C, Jones MR, Gibson W, Jahromi BS, Tate MC, Dahdaleh NS, Rosenow JM. Initial Patient Satisfaction With Telemedicine in Neurosurgery Outpatient Clinic During the Early COVID-19 Pandemic. NEUROSURGERY PRACTICE 2023; 4:e00039. [PMID: 39958369 PMCID: PMC11810008 DOI: 10.1227/neuprac.0000000000000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2025]
Abstract
BACKGROUND Throughout the COVID-19 pandemic, the medical community has been saturated by the necessity for telemedicine, or "telehealth", appointments. With limited prior exposure, the many challenges that accompany telehealth visits have affected how physicians conduct daily tasks and how patients perceive healthcare experiences. In the early stages of the COVID-19 pandemic, telemedicine was new to most neurosurgical patients. This study seeks to evaluate the overall neurosurgical patient experience with telemedicine. OBJECTIVE To assess overall neurosurgical patient satisfaction with telemedicine to build an understanding of the effectiveness of these encounters for future planning. METHODS After a telemedicine appointment, patients received an electronic survey. Survey questions focused on demographic information, encounter type, medical history questions, and overall satisfaction with telemedicine. Responses for the survey questions were formulated using a 5-point Likert scale. RESULTS Two hundred seventy patients were seen via telemedicine by 1 of 4 providers included in this study. 43 patients returned the surveys, with a completion rate of 16%. Patients indicated higher scores for overall satisfaction and quality of appointment. Of note, 23% of participants responded that they would be willing to pay out of pocket for a telemedicine appointment, while 77% responded they would not be willing to pay out of pocket. CONCLUSION Our survey results show patients felt comfortable discussing healthcare issues using telehealth, that appropriate levels of care were received, and they would be willing to use telehealth again. Future efforts will be necessary to educate providers and patients about the utilization of technological devices, ensure patient access to telehealth, and standardize ethical guidelines.
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Affiliation(s)
- Olivia A. Kozel
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Archit B. Baskaran
- Department of Neurology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Anusha Manjunath
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Chirag Goel
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael R. Jones
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - William Gibson
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Babak S. Jahromi
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Matthew C. Tate
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nader S. Dahdaleh
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joshua M. Rosenow
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Liu XQ, Guo YX, Xu Y. Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives. World J Clin Cases 2023; 11:1442-1457. [PMID: 36926387 PMCID: PMC10011984 DOI: 10.12998/wjcc.v11.i7.1442] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/06/2023] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
The worldwide prevalence of anxiety disorders among college students is high, which negatively affects countries, schools, families, and individual students to varying degrees. This paper reviews the relevant literature regarding risk factors and digital interventions for anxiety disorders among college students from the perspectives of different stakeholders. Risk factors at the national and societal levels include class differences and the coronavirus disease 2019 pandemic. College-level risk factors include the indoor environment design of the college environment, peer relationships, student satisfaction with college culture, and school functional levels. Family-level risk factors include parenting style, family relationship, and parental level of education. Individual-level risk factors include biological factors, lifestyle, and personality. Among the intervention options for college students' anxiety disorders, in addition to traditional cognitive behavioral therapy, mindfulness-based interventions, psychological counseling, and group counseling, digital mental health interventions are increasingly popular due to their low cost, positive effect, and convenient diagnostics and treatment. To better apply digital intervention to the prevention and treatment of college students' anxiety, this paper suggests that the different stakeholders form a synergy among themselves. The nation and society should provide necessary policy guarantees, financial support, and moral and ethical supervision for the prevention and treatment of college students' anxiety disorders. Colleges should actively participate in the screening and intervention of college students' anxiety disorders. Families should increase their awareness of college students' anxiety disorders and take the initiative to study and understand various digital intervention methods. College students with anxiety disorders should actively seek psychological assistance and actively accept and participate in digital intervention projects and services. We believe that in the future, the application of methods such as big data and artificial intelligence to improve digital interventions and provide individualized treatment plans will become the primary means of preventing and treating anxiety disorders among college students.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yu-Xin Guo
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yi Xu
- School of Education, Tianjin University, Tianjin 300350, China
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Tu CC, Weng SY, Hsieh NC, Cheng WC, Alizargar J, Chang KS. Increasing Use of Telemedicine for Neurological Disorders During the COVID-19 Pandemic: A Mini-Review. J Multidiscip Healthc 2023; 16:411-418. [PMID: 36820220 PMCID: PMC9938664 DOI: 10.2147/jmdh.s390013] [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: 09/20/2022] [Accepted: 12/02/2022] [Indexed: 02/17/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly contagious viral infection. In addition to its association with common pulmonary and gastrointestinal complications, COVID-19 is also associated with numerous neurological and neuropsychiatric conditions. This minireview aims to cover current literature addressing the application of telemedicine in neurological disorders and neuropsychiatric conditions, especially in response to the COVID-19 pandemic. This article revealed that quarantine, masking, and social distancing policies practiced during the COVID-19 pandemic involved restrictions and challenges to providing medical services, especially for patients with neurological disorders with or without COVID-19 infection. During the pandemic, both healthcare administrators and clinicians, including neurologists, have rapidly adapted or introduced telemedicine technologies for delivering specialty care. In some areas in the world, telemedicine has been successfully applied to reduce the impact imposed by COVID-19. Conclusively, this article supports the idea that telemedicine is an effective tool for providing specialized healthcare for patients with neurological conditions while adhering to social distancing or lockdown policies instituted during the COVID-19 pandemic. Government and medical/healthcare authorities, physicians and healthcare providers need to work together to expand the adoption of telemedicine applications, even after the COVID-19 crisis.
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Affiliation(s)
- Chuan-Chou Tu
- Department of Internal Medicine, Yuan Rung Hospital, Changhua, 510, Taiwan, Republic of China
| | - Shih-Yen Weng
- College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China,Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China,Smart Healthcare Interdisciplinary College, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China
| | - Nan-Chen Hsieh
- College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China,Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China
| | - Wen-Chang Cheng
- Hyperbaric Oxygen Therapy and Wound Treatment Centre, Yuan Rung Hospital, Changhua, 510, Taiwan, Republic of China
| | - Javad Alizargar
- Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, Taipei City, 112, Taiwan, Republic of China,College of Nursing, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan, Republic of China
| | - Ko-Shih Chang
- Department of Cardiology, Yuan Rung Hospital, Changhua, 510, Taiwan, Republic of China,Correspondence: Ko-Shih Chang, Department of Cardiology, Yuan Rung Hospital, No. 201, Zhongzheng Road, Yuanlin, Changhua, 510, Taiwan, Republic of China, Tel +886 4 8326161 ext 2702, Fax +886 4 8317776, Email
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Shen J, Ghatti S, Levkov NR, Shen H, Sen T, Rheuban K, Enfield K, Facteau NR, Engel G, Dowdell K. A survey of COVID-19 detection and prediction approaches using mobile devices, AI, and telemedicine. Front Artif Intell 2022; 5:1034732. [PMID: 36530356 PMCID: PMC9755752 DOI: 10.3389/frai.2022.1034732] [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: 09/02/2022] [Accepted: 11/02/2022] [Indexed: 09/19/2023] Open
Abstract
Since 2019, the COVID-19 pandemic has had an extremely high impact on all facets of the society and will potentially have an everlasting impact for years to come. In response to this, over the past years, there have been a significant number of research efforts on exploring approaches to combat COVID-19. In this paper, we present a survey of the current research efforts on using mobile Internet of Thing (IoT) devices, Artificial Intelligence (AI), and telemedicine for COVID-19 detection and prediction. We first present the background and then present current research in this field. Specifically, we present the research on COVID-19 monitoring and detection, contact tracing, machine learning based approaches, telemedicine, and security. We finally discuss the challenges and the future work that lay ahead in this field before concluding this paper.
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Affiliation(s)
- John Shen
- Department of Computer Science, University of Virginia, Charlottesville, VA, United States
| | - Siddharth Ghatti
- Department of Computer Science, University of Virginia, Charlottesville, VA, United States
| | - Nate Ryan Levkov
- Department of Computer Science, University of Virginia, Charlottesville, VA, United States
| | - Haiying Shen
- Department of Computer Science, University of Virginia, Charlottesville, VA, United States
| | - Tanmoy Sen
- Department of Computer Science, University of Virginia, Charlottesville, VA, United States
| | - Karen Rheuban
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Kyle Enfield
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Nikki Reyer Facteau
- University of Virginia (UVA) Health System, University of Virginia, Charlottesville, VA, United States
| | - Gina Engel
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Kim Dowdell
- School of Medicine, University of Virginia, Charlottesville, VA, United States
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12
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Ramachandran D, George GB, Panicker P, Aravind R, Suresh MK, Iype T. COVID-19 and Stroke Trends in A Tertiary Care Center from South India -Our Monsoon Experience. Neurol India 2022; 70:1942-1946. [PMID: 36352591 DOI: 10.4103/0028-3886.359188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The unprecedented challenges during the COVID pandemic and the subsequent lockdown had resulted in a delay in treatment metrics for acute stroke. There is a rising concern that COVID-19 co-infection can adversely affect stroke outcome. We aim to investigate the impact of COVID-19 in the management of stroke patients. We also compared the differences in stroke manifestations, etiological pattern, treatment course, and outcome of acute stroke patients in COVID-19 confirmed cases. METHODOLOGY A single-center retrospective study was done at the Stroke Unit, Government Medical College, Thiruvananthapuram. Consecutive patients of acute stroke confirmed by imaging, presenting within 24 hours of the onset of symptoms in May to July 2020 and May to July 2019, were included. The primary data variables included baseline demographics, risk factors, admission NIHSS, stroke timings, thrombolysis rate, TOAST etiology, mRS at discharge, and in-hospital mortality. RESULTS Strokes with higher NIHSS, arrival blood sugar and blood pressure, and delays in door-to-CT and door-to-needle time were more during the pandemic. Intravenous thrombolysis was less and mortality was higher in COVID-19 strokes during the pandemic. COVID-19-positive stroke patients had more hemorrhagic strokes, more severe strokes with low CT ASPECTS, more hemorrhagic transformation, high in-hospital mortality, and poor functional outcome at discharge and 3 months. CONCLUSION Our study was a hypothesis-generating study with a limited number of patients. This study has reconfirmed the higher severity of the stroke, with a higher mRS score and mortality during the pandemic, especially among COVID-19-positive stroke patients.
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Affiliation(s)
- Dileep Ramachandran
- Departments of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Githin Benoy George
- Departments of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Praveen Panicker
- Departments of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - R Aravind
- Department of Infectious Disease, Government Medical College, Thiruvananthapuram, Kerala, India
| | - M K Suresh
- Department of General Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Thomas Iype
- Departments of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
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13
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Kim H, Kim GJ. Attitudes and use patterns for mobile technology and upper extremity home exercises in stroke survivors in the United States. Br J Occup Ther 2022; 85:677-684. [PMID: 40336648 PMCID: PMC12033836 DOI: 10.1177/03080226211070564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/30/2021] [Indexed: 05/09/2025]
Abstract
Introduction The use of mobile technology (MT) in home-based occupational therapy is expected to continue growing. This study describes daily use patterns for MT and upper extremity (UE) home exercise programs (HEPs) for community-dwelling stroke survivors in the United States. Method Cross-sectional survey. Data were analyzed using descriptive statistics and bivariate comparisons. Results N = 61 (30 stroke and 31 controls). Individuals with stroke had similar levels of knowledge, skill, and use of MT compared with non-disabled age-matched adults. Stroke participants used MT more frequently for information searching, social media, and reminders compared to control participants. Stroke participants were motivated to improve UE function (93.3%) and reported a need for additional HEP training (56.7%). Perceived facilitators to improve UE use included talking to peers (73.3%), getting more information (73.3%), and talking to a therapist (63.3%). Conclusions MT may have multiple potential benefits when integrated into occupational therapy practice including supporting instrumental ADLs, facilitating social connection, and increasing adherence to UE HEPs. Future work should focus on maximizing adherence and providing performance feedback through the use of social media to promote peer support and consistent remote communication using text messaging, phone calls, or video calls to deliver information and reminders on exercises.
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Affiliation(s)
- Hayejin Kim
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Grace J Kim
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
- Department of Rehabilitation Medicine, NYU Langone Health, New York, New York, USA
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14
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Lampickienė I, Davoody N. Healthcare Professionals' Experience of Performing Digital Care Visits-A Scoping Review. Life (Basel) 2022; 12:913. [PMID: 35743944 PMCID: PMC9225275 DOI: 10.3390/life12060913] [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: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023] Open
Abstract
The use of digital care visits has been increasing during the COVID-19 pandemic. Learning more about healthcare professionals' technology experiences provides valuable insight and a basis for improving digital visits. This study aimed to explore the existing literature on healthcare professionals' experience performing digital care visits. A scoping review was performed following Arksey & O'Malley's proposed framework using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The collected data were analyzed using thematic content analysis. Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, barriers, and suggestions for improvement. Healthcare professionals mostly reported having an overall positive experience with digital visits and discovered benefits for themselves and the patients. However, opinions were mixed or negative regarding the complexity of decision making, workload and workflow, suitability of this type of care, and other challenges. The suggestions for improvement included training and education, improvements within the system and tools, along with support for professionals. Despite overall positive experiences and benefits for both professionals and patients, clinicians reported challenges such as physical barriers, technical issues, suitability concerns, and others. Digital care visits could not fully replace face-to-face visits.
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Affiliation(s)
| | - Nadia Davoody
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Tomtebodavägen 18A, 171 77 Solna, Sweden;
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15
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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16
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Aquino ERDS, Suffert SCI. Telemedicine in neurology: advances and possibilities. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:336-341. [PMID: 35976317 PMCID: PMC9491412 DOI: 10.1590/0004-282x-anp-2022-s127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Telemedicine develops from technology that offers opportunities for knowledge transfer and information sharing and allows the provision of health services at a distance. OBJECTIVE To evaluate the number of publications on teleneurology in the last two decades in PubMed and the available evidence on the use of this technology in neurological clinical conditions. METHODS A quantitative assessment of publications related to telemedicine and neurology in the last two decades. A search was performed on the PubMed database for the descriptors ("Telemedicine"[Mesh]) AND "Neurology"[Mesh]). A review of the articles retrieved on the topic was carried out to evaluate the innovation processes used and applications in various clinical conditions involving teleneurology. RESULTS The search performed on March 14th 2022 resulted in 229 publications involving the topic of telemedicine and neurology between 1999 and 2022. Since 2000, there has been an increase in publications related to this topic, with a peak of 71 articles published in 2020, the year in which the World Health Organization defined the COVID-19 pandemic status. CONCLUSION In the last two decades, teleneurology has been developing through the expansion of technological resources and the COVID-19 pandemic intensified this process. Different modalities of teleneurology are studied in several neurology subfields and include teleconsultation (between healthcare professionals or between healthcare professionals and patients), telerehabilitation, telemonitoring and tele-education. The advances achieved by teleneurology in this period encouraged technological innovations and health processes that developed opportunities to improve the care provided in a mechanism of constant evolution.
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Affiliation(s)
- Emanuelle Roberta da Silva Aquino
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil
- Hospital Sírio-Libanês, São Paulo, SP, Brazil
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17
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Amin CA, Mayela RV, Yamil M, Yazmín RS, Arturo AC, Daniel MR, Lorena ZV, Karla SB, Manuel DR. Satisfaction With Telemedicine Consultation as Follow-Up Visit in Patients with Parkinsonism and Essential Tremor in during the Covid-19 Pandemic. Neurol India 2022; 70:2003-2008. [DOI: 10.4103/0028-3886.359193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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James-Palmer AM, Daneault JF. Tele-yoga for the management of Parkinson disease: A safety and feasibility trial. Digit Health 2022; 8:20552076221119327. [PMID: 35990111 PMCID: PMC9386843 DOI: 10.1177/20552076221119327] [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] [Received: 06/29/2022] [Accepted: 05/30/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Despite current standard treatments, persons with Parkinson disease (PD) still experience motor and non-motor symptoms that impact daily function and quality of life, warranting the investigation of additional interventions. Holistic complementary interventions such as yoga have been shown to be beneficial for persons with PD. However, there are multiple barriers to in-person interventions such as transportation difficulties and disease-related mobility impairments which may be mitigated by digital health applications. Therefore, this study’s purpose was to assess the safety and feasibility of a synchronous tele-yoga intervention for persons with PD. Methods Sixteen participants were enrolled in a single group safety and feasibility trial. The entire study was conducted remotely and consisted of a baseline assessment followed by a six-week waiting period, then a second assessment, a six-week tele-yoga intervention period, a post-intervention assessment, a six-week follow-up period, and lastly a follow-up assessment. During the tele-yoga period, participants completed two one-on-one 30-minute tele-yoga sessions weekly for a total of 12 sessions. Primary outcomes included adverse events, adherence, technological challenges, and usability. Secondary outcomes included enjoyment and clinically relevant outcome measures assessing both motor and non-motor symptoms. Results No severe adverse events were attributed to the intervention. Retention was 87.5%, assessment session adherence was 100%, and intervention session adherence was 97%. Technological challenges did not impact feasibility. The intervention was usable and enjoyable. While this study was not powered or designed to assess the efficacy of the intervention, preliminary improvements were shown for some of the clinically relevant outcome measures. Conclusions Overall, this study showed that the implementation of a synchronous one-on-one tele-yoga intervention was safe, feasible, usable, and enjoyable for persons with PD. Randomized control trials investigating its efficacy should be initiated. The study was registered with ClinicalTrials.gov (NCT04240899, https://clinicaltrials.gov/ct2/show/NCT04240899).
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Affiliation(s)
- Aurora M James-Palmer
- Department of Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, USA
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19
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Kalal N, Vel NS, Mundel S, Daiyya S, Dhayal S, Bishnoi S, Asiwal S, Jhajhariya S. Effectiveness and barriers of telehealth services during COVID-19 pandemic: A narrative review. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2022. [DOI: 10.4103/injms.injms_62_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ganapathy K. The business of telehealth. APOLLO MEDICINE 2022. [DOI: 10.4103/am.am_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Srivastava A, Swaminathan A, Chockalingam M, Srinivasan MK, Surya N, Ray P, Hegde PS, Akkunje PS, Kamble S, Chitnis S, Kamalakannan S, Ganvir S, Shah U. Tele-Neurorehabilitation During the COVID-19 Pandemic: Implications for Practice in Low- and Middle-Income Countries. Front Neurol 2021; 12:667925. [PMID: 34690907 PMCID: PMC8529345 DOI: 10.3389/fneur.2021.667925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.
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Affiliation(s)
- Abhishek Srivastava
- Centre for Physical Medicine and Rehabilitation, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | | | | | - Murali K Srinivasan
- Faculty of Occupational Therapy, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Nirmal Surya
- Chairman Surya Neuro Centre Mumbai, President Indian Federation of Neurorehabilitation (IFNR), Mumbai, India
| | - Partha Ray
- National Health Services England, The Walton Centre Liverpool & National Professor of Neurology, Liverpool, United Kingdom
| | - Prasanna S Hegde
- Deglutology and Speech-Language Pathology, HCG Hospital, Bangalore, India
| | - Preetie Shetty Akkunje
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjivani Kamble
- Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Sonal Chitnis
- Bharati Vidyapeeth (Deemed to be) University, School of Audiology Speech Language Pathology, Pune, India
| | - Sureshkumar Kamalakannan
- South Asia Centre for Disability Inclusive Development and Research (SACDIR), Public Health Foundation of India, The Indian Institute of Public Health Hyderabad, Hyderabad, India
| | - Suvarna Ganvir
- Department of Neuro Physiotherapy, Dr. Vitalrao Vikhe Patil Foundation's College of Physiotherapy, Ahmednagar, India
| | - Urvashi Shah
- Department of Neurology, King Edward Memorial and Global Hospitals Mumbai, Mumbai, India
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22
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Calandri IL, Hawkes MA, Marrodan M, Ameriso SF, Correale J, Allegri RF. Changes in the Care of Neurological Diseases During the First Wave of the COVID-19 Pandemic: A Single Private Center Study in Argentina. Front Neurol 2021; 12:613838. [PMID: 34539536 PMCID: PMC8446505 DOI: 10.3389/fneur.2021.613838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Healthcare systems are struggling to cope with the rapid evolution of the COVID-19 pandemic. In Argentina, the pandemic is advancing despite prolonged lockdown measures. We aim to analyze the impact of the easing of lockdown measures in the number of visits to the emergency department (ED), and outpatient consultations (OC) to a tertiary neurological center. Methods: We compared the number of ED visits with the social mobility overtime. We also compared the number of OC, and the geographic distribution of patients' addresses between 2019 and 2020. Results: ED visits decreased 48.33% (n = 14,697 in 2019 vs. n = 7,595 in 2020). At the beginning of the lockdown, the social mobility decreased in pharmacies/groceries, and workplaces, along with a reduction in the number of ED visits. With the easing of lockdown restrictions, the social mobility decreased in residential places, slightly increased in workplaces and almost return to normal in pharmacies/groceries. Variations in ED visits correlate better with social mobility in workplaces (coef. =0.75, p < 0.001) than in groceries/pharmacies (coef. =0.68, p < 0.001). OC decreased 43%. Fourteen percent of OC were tele consults. This was associated with an increase of the geographical area of influence of our center (standard distance of 109 km in 2019 and 127 km in 2020). Conclusions: Despite an increase in social mobility, the number of ED visits and OC to an Argentinian tertiary neurological center remain worrisomely low. The pandemic catalyzed the introduction of telemedicine in our country. This has also allowed patients from distant zones to gain access to specialized neurological care.
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Affiliation(s)
| | - Maximiliano A Hawkes
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | | | | | - Jorge Correale
- Departamento de Neurología, Fleni, Buenos Aires, Argentina
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23
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Gonzalez-Gerez JJ, Saavedra-Hernandez M, Anarte-Lazo E, Bernal-Utrera C, Perez-Ale M, Rodriguez-Blanco C. Short-Term Effects of a Respiratory Telerehabilitation Program in Confined COVID-19 Patients in the Acute Phase: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147511. [PMID: 34299962 PMCID: PMC8306449 DOI: 10.3390/ijerph18147511] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic has caused distress for healthcare providers due to the respiratory problems it causes, among others. In this situation, rehabilitation of the respiratory system has been suggested and implemented in different COVID-19 patients. This study evaluated the feasibility and effectiveness of a novel program based on breathing exercises through telerehabilitation tools in COVID-19 patients with mild to moderate symptomatology in the acute stage. Forty subjects were randomized in an experimental group, based on pulmonary rehabilitation, and in a control group, of which the subjects did not perform physical activity. Thirty-eight subjects, with nineteen in each group, completed the one-week intervention. We performed measurements using the Six-Minute Walk Test, Multidimensional Dyspnoea-12, Thirty-Second Sit-To-Stand Test, and Borg Scale. Both groups were comparable at baseline. Significant differences were found for all of the outcome measures in favour of the experimental group. Ninety percent adherence was found in our program. A one-week telerehabilitation program based on respiratory exercises is effective, safe, and feasible in COVID-19 patients with mild to moderate symptomatology in the acute stage.
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Affiliation(s)
- Juan Jose Gonzalez-Gerez
- Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, University of Almeria, 04120 Almeria, Spain; (J.J.G.-G.); (M.S.-H.)
| | - Manuel Saavedra-Hernandez
- Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, University of Almeria, 04120 Almeria, Spain; (J.J.G.-G.); (M.S.-H.)
| | - Ernesto Anarte-Lazo
- Doctoral Program in Health Sciences, University of Seville, 41009 Seville, Spain
- Correspondence:
| | - Carlos Bernal-Utrera
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (C.B.-U.); (C.R.-B.)
| | - Manuel Perez-Ale
- Spanish Army, Health Support in the Naval Base of Rota, 11520 Cadiz, Spain;
| | - Cleofas Rodriguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (C.B.-U.); (C.R.-B.)
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Aghoram R, Wadwekar V, Narayan SK, Nair PP, Ramkumar S, Jain S. Neurology Exams during the COVID-19 Pandemic. Ann Indian Acad Neurol 2021; 24:626-627. [PMID: 34728977 PMCID: PMC8513949 DOI: 10.4103/aian.aian_816_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rajeswari Aghoram
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Vaibhav Wadwekar
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Sunil K. Narayan
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Pradeep P. Nair
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - S Ramkumar
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Sourabh Jain
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Prudencio M, Erben Y, Marquez CP, Jansen-West KR, Franco-Mesa C, Heckman MG, White LJ, Dunmore JA, Cook CN, Lilley MT, Song Y, Harlow CF, Oskarsson B, Nicholson KA, Wszolek ZK, Hickson LJ, O'Horo JC, Hoyne JB, Gendron TF, Meschia JF, Petrucelli L. Serum neurofilament light protein correlates with unfavorable clinical outcomes in hospitalized patients with COVID-19. Sci Transl Med 2021; 13:scitranslmed.abi7643. [PMID: 34131052 PMCID: PMC8432951 DOI: 10.1126/scitranslmed.abi7643] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022]
Abstract
SARS-CoV-2 infection, the cause of coronavirus disease 2019 (COVID-19), causes neurological manifestations in a substantial proportion of patients. Determining the extent of neuronal injury is essential to better understand disease pathophysiology and to evaluate potential therapies. Prudencio et al. analyzed serum from 142 patients hospitalized with COVID-19 and showed that the expression of the neurofilament light protein (NFL), a marker of neuroaxonal injury, was elevated compared to healthy controls. In addition, serum NFL expression correlated with disease severity and tended to be reduced in subjects treated with remdesivir. The results suggest that serum NFL analysis should be incorporated when evaluating therapeutic trials for COVID-19. Brain imaging studies of patients with COVID-19 show evidence of macro- and microhemorrhagic lesions, multifocal white matter hyperintensities, and lesions consistent with posterior reversible leukoencephalopathy. Imaging studies, however, are subject to selection bias, and prospective studies are challenging to scale. Here, we evaluated whether serum neurofilament light chain (NFL), a neuroaxonal injury marker, could predict the extent of neuronal damage in a cohort of 142 hospitalized patients with COVID-19. NFL was elevated in the serum of patients with COVID-19 compared to healthy controls, including those without overt neurological manifestations. Higher NFL serum concentrations were associated with worse clinical outcomes. In 100 hospitalized patients with COVID-19 treated with remdesivir, a trend toward lower NFL serum concentrations was observed. These data suggest that patients with COVID-19 may experience neuroaxonal injury and may be at risk for long-term neurological sequelae. Neuroaxonal injury should be considered as an outcome in acute pharmacotherapeutic trials for COVID-19.
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Affiliation(s)
- Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Christopher P Marquez
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Camila Franco-Mesa
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Michael G Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Launia J White
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Judith A Dunmore
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Casey N Cook
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - Meredith T Lilley
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Yuping Song
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Caroline F Harlow
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Björn Oskarsson
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Katharine A Nicholson
- Sean M. Healey and AMG Center for ALS, Massachusetts General Hospital (MGH), Boston, MA 02114, USA
| | | | - LaTonya J Hickson
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USA
| | - John C O'Horo
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55905, USA.,Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Jonathan B Hoyne
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - James F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA.
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA. .,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
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Raheja A, Manjunath N, Garg K, Tandon V, Gupta V, Mishra S, Ather S, Suri A, Chandra PS, Singh M, Shariff A, Kale SS. Turning a New Chapter in Neurosurgery Outpatient Services: Telemedicine A "Savior" in this Pandemic. Neurol India 2021; 69:344-351. [PMID: 33904449 DOI: 10.4103/0028-3886.314523] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Teleconsultation services in India, especially in neurosurgery, are relatively new. Despite its large-scale adoption during the COVID-19 pandemic, comprehensive analyses of patients' perspectives and hurdles are lacking. Materials and Methods We conducted an anonymized telephonic survey of consecutive neurosurgical patients who availed telemedicine services at our institute, using a validated, structured questionnaire. To prevent bias, interviewers were not involved in the study design/analyses. Patients' perception of usefulness and performance of teleconsultation was graded on a 5-point Likert scale. Results Of the 330 patients who availed teleconsultation services, 231 (70%) completed the survey. Even though 91% of the respondents had access to a smartphone, only 10% received a video-based teleconsult. As per respondents, the challenges included poor network (7%), suboptimal communication/discussion (5.6%), lack of physical examination (6%), and misinterpretation of prescription by pharmacists/patients (6%). The majority of the respondents (58%) either agreed/strongly agreed that teleconsultation helped them tide over the medical exigency during the lockdown; however, the clinical diagnosis did not influence this response (P = 0.21). The vast majority of the respondents felt that teleconsultation is beneficial (97%), as it minimizes their exposure to COVID-19. One-third of the patients preferred this service over physical visits and 60% agreed to its continuation till resumption of routine care. Access to video-teleconsultation was the chief suggestion in 39 of 74 suggestions received. Conclusions Telemedicine in neurosurgery offers favorable patient satisfaction during this pandemic and may be a satisfactory alternative to physical outpatient services in the future. Video-based teleconsults should be the preferred modality of communication for neurosurgery patients.
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Affiliation(s)
- Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Niveditha Manjunath
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India,, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Ather
- Department of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Manmohan Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ahamadulla Shariff
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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27
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Stipa G, Gabbrielli F, Rabbito C, Di Lazzaro V, Amantini A, Grippo A, Carrai R, Pasqui R, Barloscio D, Olivi D, Lori S. The Italian technical/administrative recommendations for telemedicine in clinical neurophysiology. Neurol Sci 2021; 42:1923-1931. [PMID: 32974797 PMCID: PMC7514225 DOI: 10.1007/s10072-020-04732-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022]
Abstract
Recent advances in technology, information technology, Internet networks, and, more recently, fiber optics in industrialized countries allow the exchange of a huge amount of data, in real time, across the globe. The acquisition of increasingly sophisticated technologies has made it possible to develop telemedicine, by which the specialist's evaluation can be carried out on the patient even remotely. In Italy, this very useful tool, although possible from a technological and information technology point of view, has not been developed because of the lack of clear and univocal rules and of major administrative obstacles related to the Italian Public Health System. To promote telemedicine implementation in Italy, the Italian Society of Clinical Neurophysiology and the Italian Society of Telemedicine together with the National Centre for Telemedicine and New Assistive Technologies of the Italian Higher Institute of Health prepared these inter-society recommendations. Because of potential forensic value of these recommendations, they were prepared considering the current regulations and the General Data Protection Regulation and will provide the basis for a Consensus Conference planned to discuss and prepare National Telemedicine Guidelines.
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Affiliation(s)
- G Stipa
- Neurophysiology Unit, Neuroscience Department, Terni Hospital - A.O. S. Maria, Terni, Italy.
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy.
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy.
| | - F Gabbrielli
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy
- National Center for Telemedicine, Italian National Institute for Health - ISS, Rome, Italy
| | - C Rabbito
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy
| | - V Di Lazzaro
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy
| | - A Amantini
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy
- Neurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy
| | - A Grippo
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy
- Neurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy
| | - R Carrai
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy
- Neurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy
| | - R Pasqui
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy
| | - D Barloscio
- Neurophysiology Unit, Neuroscience Department, Terni Hospital - A.O. S. Maria, Terni, Italy
| | - D Olivi
- Neurophysiology Unit, Neuroscience Department, Terni Hospital - A.O. S. Maria, Terni, Italy
| | - S Lori
- Italian Society of Clinical Neurophysiology - SINC, Rome, Italy
- Italian Society of Telemedicine and Healthcare - SIT, Rome, Italy
- Neurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy
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28
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Mahayosnand PP, Sabra ZM, Sabra DM. COVID-19 and Gaza: The Ideal Time to Establish a Medical Reserve Corps of Public Health Preventive Medicine Specialists. Health Secur 2021; 19:235-239. [PMID: 33784477 DOI: 10.1089/hs.2020.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ponn P Mahayosnand
- Ponn P. Mahayosnand, MPH, is a Research Scholar, Ronin Institute for Independent Scholarship, Montclair, NJ. Z. M. Sabra and D. M. Sabra are Students, Faculty of Medicine, Islamic University of Gaza, Gaza Strip. This commentary was first posted as a preprint on SocArXiv on November 1, 2020 (https://doi.org/10.31235/osf.io/hktpj)
| | - Z M Sabra
- Ponn P. Mahayosnand, MPH, is a Research Scholar, Ronin Institute for Independent Scholarship, Montclair, NJ. Z. M. Sabra and D. M. Sabra are Students, Faculty of Medicine, Islamic University of Gaza, Gaza Strip. This commentary was first posted as a preprint on SocArXiv on November 1, 2020 (https://doi.org/10.31235/osf.io/hktpj)
| | - D M Sabra
- Ponn P. Mahayosnand, MPH, is a Research Scholar, Ronin Institute for Independent Scholarship, Montclair, NJ. Z. M. Sabra and D. M. Sabra are Students, Faculty of Medicine, Islamic University of Gaza, Gaza Strip. This commentary was first posted as a preprint on SocArXiv on November 1, 2020 (https://doi.org/10.31235/osf.io/hktpj)
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29
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Agarwal M, Arushi A, Dhingra LS, Patel LJ, Agrawal S, Srivastava P, Tripathi M, Srivastava A, Bhatia R, Singh MB, Prasad K, Vibha D, Vishnu VY, Rajan R, Pandit AK, Singh RK, Gupta A, Radhakrishnan DM, Das A, Ramanujam B, Agarwal A, Elavarasi A. Patient Experience of a Neurology Tele-Follow-Up Program Initiated During the Coronavirus Disease 2019 Pandemic: A Questionnaire-Based Study. TELEMEDICINE REPORTS 2021; 2:88-96. [PMID: 35720744 PMCID: PMC8989087 DOI: 10.1089/tmr.2020.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 06/15/2023]
Abstract
Background: Teleneurology consultations can be highly advantageous since neurological diseases and disabilities often limit patient's access to health care, particularly in a setting where they need to travel long distances for specialty consults. Patient satisfaction is an important outcome assessing success of a telemedicine program. Materials and Methods: A cross-sectional study was conducted to determine satisfaction and perception of patients toward an audio call based teleneurology follow-up initiated during the coronavirus disease 2019 pandemic. Primary outcomes were satisfaction to tele-consult, and proportion of patients preferring telemedicine for future follow-up. Results: A total of 261 patients who received tele-consult were enrolled. Satisfaction was highest for domain technological quality, followed by patient-physician dialogue (PPD) and least to quality of care (QoC). Median (interquartile range) patient satisfaction on a 5-point Likert scale was 4 (3-5). Eighty-five (32.6%; 95% confidence interval 26.9-38.6%) patients preferred telemedicine for future follow-up. Higher overall satisfaction was associated with health condition being stable/better, change in treatment advised on tele-consult, diagnosis not requiring follow-up examination, higher scores on domains QoC and PPD (p < 0.05). Future preference for telemedicine was associated with patient him-/herself consulting with doctor, less duration of follow-up, higher overall satisfaction, and higher scores on domain QoC (p < 0.05). On thematic analysis, telemedicine was found convenient, reduced expenditure, and had better physician attention; in-person visits were comprehensive, had better patient-physician relationship, and better communication. Discussion: Patient satisfaction was lower in our study than what has been observed earlier, which may be explained by the primitive nature of our platform. Several variables related to the patients' disease process have an effect on patient satisfaction. Conclusion: Development of robust, structured platforms is necessary to fully utilize the potential of telemedicine in developing countries.
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Affiliation(s)
- Mudit Agarwal
- MBBS, All India Institute of Medical Sciences, New Delhi, India
| | - Arushi Arushi
- MBBS, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumar Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Animesh Das
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Bhargavi Ramanujam
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ayush Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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30
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Calabrò RS. Teleneurorehabilitation in the COVID-19 Era: What Are We Doing Now and What Will We Do Next? Med Sci (Basel) 2021; 9:medsci9010015. [PMID: 33668321 PMCID: PMC8006037 DOI: 10.3390/medsci9010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 01/20/2023] Open
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31
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Adebayo PB, Oluwole OJ, Taiwo FT. COVID-19 and Teleneurology in Sub-Saharan Africa: Leveraging the Current Exigency. Front Public Health 2021; 8:574505. [PMID: 33569366 PMCID: PMC7868436 DOI: 10.3389/fpubh.2020.574505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022] Open
Abstract
Africa has over 1.3 billion inhabitants, with over 60% of this population residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone penetration in most of the countries and virtually all of them have mobile internet services of different technologies and generations. Although the needed infrastructure is increasingly available, it should be improved upon. We have proposed the access, costs, ethics, and support (ACES) model as a bespoke, holistic strategy for the successful implementation and advancement of tele-neurology in sub-Saharan Africa.
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Affiliation(s)
- Philip Babatunde Adebayo
- Neurology Section, Department of Internal Medicine, Aga Khan University, Dar es Salaam, Tanzania
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32
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Nacoti M, Fazzi F, Biroli F, Zangari R, Barbui T, Kochanek PM. Addressing Key Clinical Care and Clinical Research Needs in Severe Pediatric Traumatic Brain Injury: Perspectives From a Focused International Conference. Front Pediatr 2021; 8:594425. [PMID: 33537259 PMCID: PMC7849211 DOI: 10.3389/fped.2020.594425] [Citation(s) in RCA: 2] [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] [Received: 08/13/2020] [Accepted: 11/06/2020] [Indexed: 12/28/2022] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children and adolescents. Survivors of severe TBI are more prone to functional deficits, resulting in poorer school performance, poor health-related quality of life (HRQoL), and increased risk of mental health problems. Critical gaps in knowledge of pathophysiological differences between children and adults concerning TBI outcomes, the paucity of pediatric trials and prognostic models and the uncertain extrapolation of adult data to pediatrics pose significant challenges and demand global efforts. Here, we explore the clinical and research unmet needs focusing on severe pediatric TBI to identify best practices in pathways of care and optimize both inpatient and outpatient management of children following TBI.
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Affiliation(s)
- Mirco Nacoti
- Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Francesco Fazzi
- Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Francesco Biroli
- Fondazione per la Ricerca dell'Ospedale di Bergamo Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Rosalia Zangari
- Fondazione per la Ricerca dell'Ospedale di Bergamo Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Tiziano Barbui
- Fondazione per la Ricerca dell'Ospedale di Bergamo Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Patrick M. Kochanek
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, John G Rangos Research Center, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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33
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Ganapathy K. Telegenomics: Relevance in India. APOLLO MEDICINE 2021. [DOI: 10.4103/am.am_26_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Luther E, Burks J, Eichberg DG, Basil G, Berry K, Lu V, Shah A, Kaur G, Ivan M, Komotar R. Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter. J Clin Neurosci 2020; 85:1-5. [PMID: 33581778 PMCID: PMC7834482 DOI: 10.1016/j.jocn.2020.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/27/2020] [Accepted: 12/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions. In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter. METHODS All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20-5/4/20), the plateau period following quarantine (5/5/20-6/27/20), and the second peak (6/28/20-7/20/20). In-person and telemedicine visits were evaluated for crossovers. Surgeries were subdivided based on lesion type and evaluated across the same time period. RESULTS From 3/23/20-7/20/20, 469 clinic visits and 196 surgeries were identified. After quarantine was lifted, face-to-face visits increased (P < 0.01) yet no change in telehealth visits occurred. Of 327 telehealth visits, only 5.8% converted to in-person during the 4-month period with the most cited reason being patient preference (68.4%). Of the 196 surgeries performed during the pandemic, 29.1% occurred during quarantine, 49.0% during the plateau, and 21.9% occurred in the second peak. No COVID negative patients developed symptoms at follow-up. 55.6% were performed on malignant tumors and 31.6% were benign with no difference in case volumes throughout the pandemic. CONCLUSIONS Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic. We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers.
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Affiliation(s)
- Evan Luther
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Joshua Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel G Eichberg
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gregory Basil
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Katherine Berry
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Victor Lu
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ashish Shah
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gurvinder Kaur
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ricardo Komotar
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Meshkat S, Salimi A, Joshaghanian A, Sedighi S, Sedighi S, Aghamollaii V. Chronic neurological diseases and COVID-19: Associations and considerations. Transl Neurosci 2020; 11:294-301. [PMID: 33335769 PMCID: PMC7712023 DOI: 10.1515/tnsci-2020-0141] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/01/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023] Open
Abstract
The 2019 novel coronavirus pandemic, severe acute respiratory syndrome CoV-2 (COVID-19), has been a worldwide urgent public health threat, resulting in six-hundred seventy thousand deaths to date. The COVID-19 pandemic has led to a series of public health challenges. One such challenge is the management of diseases such as chronic neurological diseases during an epidemic event. COVID-19 affects all kinds of people, including older people with chronic underlying diseases, who are particularly at risk of severe infection or even death. Chronic neurological diseases such as epilepsy, dementia, Parkinson's disease (PD), and multiple sclerosis (MS) are frequently associated with comorbidities; thus, these patients are in the high-risk category. Therefore, in this article, we review associations and challenges the people with epilepsy, dementia, PD, and MS faces during the COVID-19 pandemic and suggest approaches to provide consensus recommendations on how to provide the best possible care.
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Affiliation(s)
- Shakila Meshkat
- Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medicine, Shiraz University of Medical Sciences, Tehran, Iran
| | - Amir Salimi
- Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Medicine, Azad University of Medical Sciences, Tehran, Iran
| | - Asef Joshaghanian
- Department of Medicine, Hamedan University of Medical Sciences, Tehran, Iran
| | - Sogol Sedighi
- Department of Medicine, Shiraz University of Medical Sciences, Tehran, Iran
| | - Saman Sedighi
- Department of Medicine, Azad University of Medical Sciences, Tehran, Iran
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36
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Ganapathy K. Telemedicine and COVID-19. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_84_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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37
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Chandra PS. Telemedicine: The Next Important Health Vertical for Neurosciences In India. Neurol India 2020; 68:532-533. [DOI: 10.4103/0028-3886.289012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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