Dataset Information

SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience.

ABSTRACT:

Introduction

When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal appointments to telemedicine services.

Methods

Documentations of telephone contacts and telemedicine consultations at the Epilepsy Center Frankfurt Rhine-Main were recorded in detail between March and May 2020 and analyzed for acceptance, feasibility, and satisfaction of the conversion from personal to telemedicine appointments from both patients' and medical professionals' perspectives.

Results

Telephone contacts for 272 patients (mean age: 38.7?years, range: 17-79?years, 55.5% female) were analyzed. Patient-rated medical needs were either very urgent (6.6%, n?=?18), urgent (23.5%, n?=?64), less urgent (29.8%, n?=?81), or nonurgent (39.3%, n?=?107). Outpatient service cancelations resulted in a lack of understanding (9.6%, n?=?26) or anger and aggression (2.9%, n?=?8) in a minority of patients, while 88.6% (n?=?241) reacted with understanding, or relief (3.3%, n?=?9). Telemedicine consultations rather than a postponed face-to-face visit were requested by 109 patients (40.1%), and these requests were significantly associated with subjective threat by SARS-CoV-2 (p?=?0.004), urgent or very urgent medical needs (p?=?0.004), and female gender (p?=?0.024). Telemedicine satisfaction by patients and physicians was high. Overall, 9.2% (n?=?10) of patients reported general supply problems due to SARS-CoV-2, and 28.4% (n?=?31) reported epilepsy-specific problems, most frequently related to prescriptions, or supply problems for antiseizure drugs (ASDs; 22.9%, n?=?25).

Conclusion

Understanding and acceptance of elective ambulatory visit cancelations and the conversion to telemedicine consultations was high during the coronavirus disease 2019 (COVID-19) lockdown. Patients who engaged in telemedicine consultations were highly satisfied, supporting the feasibility and potential of telemedicine during the COVID-19 pandemic and beyond.

SUBMITTER: Willems LM

PROVIDER: S-EPMC7537633 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience.

Willems Laurent M LM Balcik Yunus Y Noda Anna H AH Siebenbrodt Kai K Leimeister Sina S McCoy Jeannie J Kienitz Ricardo R Kiyose Makoto M Reinecke Raphael R Schäfer Jan-Hendrik JH Zöllner Johann Philipp JP Bauer Sebastian S Rosenow Felix F Strzelczyk Adam A

Epilepsy & behavior : E&B 20201006

<h4>Introduction</h4>When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal appointments to telemedicine services.<h4>Methods</h4>Documentations of telephone contacts and telemedicine consultations at the Epilepsy Center Frankfurt Rhine-Main were recorded ...[more]

PMID: 33181898

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Project description:BackgroundRegular visit to psychiatric clinic is essential for successful treatment of any psychiatric condition including attention-deficit/hyperactivity disorder (AD/HD). However, cancellation of outpatient appointments in patients with AD/HD, which represents a significant medical loss, has not been systematically investigated to our knowledge.MethodsA systematic chart review was conducted for patients visiting the Shimada Ryoiku medical Center for Challenged Children in Japan at the age of ≤15 years from January to December 2013. The primary outcome measure was the cancellation rate, defined as the number of missed visits divided by the number of scheduled visits. The cancellation rates during 24 months after the first visit were compared between outpatients with AD/HD and other psychiatric disorders, including pervasive developmental disorders (PDD), and developmental coordination disorders and/or communication disorders (DCD-CD). A generalized linear model with binomial distribution was used to examine factors associated with cancellation rates exclusively in the AD/HD group.ResultsWe included 589 patients (mean ± SD age, 5.6 ± 3.4 years; 432 males) in the analysis. The cancellation rate in patients with AD/HD was 12.3% (95% confidence interval [CI]: 10.0-15.1), which was significantly higher than in those with PDD (5.6%, 95% CI: 3.8-8.3) and DCD-CD (5.3%, 95% CI: 3.6-7.8). Prescriptions of osmotic-release oral system-methylphenidate (OROS-MPH) and antipsychotics were associated with fewer cancellations in AD/HD patients (odds ratios: 0.61, 95% CI: 0.39-0.95 and 0.49, 95% CI: 0.25-0.95, respectively), although these significances did not find in the subgroup analysis including only patients with ≥ 6 years old.ConclusionsPatients with AD/HD were more likely to miss appointments compared to those with other psychiatric disorders. The impact of AD/HD medications as well as potential psychiatric symptoms of their parents or caregivers on appointment cancellations needs to be evaluated in more detail in future investigations.

Project description:Background and objectiveThe Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic.MethodThis retrospective study used appointment-level data from 55 Federally Qualified Health Centre clinics in Texas between March and November 2020. To account for the nested data structure of repeated appointments within each patient, a mixed-effects multivariable logistic regression model was used to examine associations between telemedicine use and missed appointments, adjusting for patient sociodemographic characteristics, geographic classification, past medical history, and clinic characteristics. The independent variable was having a telemedicine appointment, defined as an audiovisual consultation started and finalized via a telemedicine platform. The outcome of interest was having a missed appointment (yes/no) after a scheduled and confirmed medical appointment. Results from this initial model were stratified by appointment type (in-person vs. telemedicine).ResultsThe analytic sample included 278,171 appointments for 85,413 unique patients. The overall missed appointment rate was 18%, and 25% of all appointments were telemedicine appointments. Compared to in-person visits, telemedicine visits were less likely to result in a missed appointment (OR = 0.87, p < .001). Compared to Whites, Asians were less likely to have a missed appointment (OR = 0.82, p < .001) while African Americans, Hispanics, and American Indians were all significantly more likely to have missed appointments (OR = 1.61, p < .001; OR = 1.19, p = .01; OR = 1.22, p < .01, respectively). Those accessing mental health services (OR = 1.57 for in-person and 0.78 for telemedicine) and living in metropolitan areas (OR = 1.15 for in-person and 0.82 for telemedicine) were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Patients with frequent medical visits or those living with chronic diseases were more likely to miss in-person appointments but less likely to miss telemedicine appointments.ConclusionsTelemedicine is strongly associated with fewer missed appointments. Although our findings suggest a residual lag in minority populations, specific patient populations, including those with frequent prior visits or chronic conditions, those seeking mental health services, and those living in metropolitan areas were less likely to miss telemedicine appointments than in-person visits. These findings highlight how telemedicine can enable effective and accessible care by reducing missed healthcare appointments.KEY MESSAGESTelemedicine was associated with 13% lower odds of missed appointments.Patients with frequent medical visits or those living with chronic diseases were less likely to miss telemedicine appointments but more likely to miss in-person appointments.Patients seeking mental health services were less likely to miss telemedicine appointments but more likely to miss in-person appointments.Similarly, those living in metropolitan areas were less likely to miss telemedicine appointments but more likely to miss in-person appointments.

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Dataset Information

SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience.

Introduction

Methods

Results

Conclusion

Publications

SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience.

Similar Datasets

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