OBJECTIVE Telemedicine encounters are expanding in utility for outpatient care and evaluation, partially as a necessity during the COVID-19 pandemic. It is unclear if telemedicine evaluation is comparable to in-person assessment of patients with spinal pathology undergoing surgical consultation. The objective of this study was to determine if treatment plans change for spine patients evaluated in person following an initial telemedicine consultation. METHODS Patients referred to the authors’ comprehensive spine center were evaluated first via telemedicine and then in clinic. Telemedicine evaluations were conducted via video evaluation with an attending surgeon. Demographic data including age, gender, and distance traveled from the clinic were retrospectively recorded. A chart review retrieved symptoms, radiographic details, and past medical history. The primary outcome was if the treatment plan changed (plan change [PC]) after seeing the patient in the clinic. Chi-square tests and binary logistical regression produced uni- and multivariate analyses. RESULTS There were 152 new patients seen via telemedicine and in person. Pathology was present in the cervical (28.3%), thoracic (9.9%), and lumbar (61.8%) spine. The most common symptom was pain (72.4%), followed by radiculopathy (66.4%), weakness (26.3%), myelopathy (15.1%), and claudication (12.5%). There were 37 patients (24.3%) for whom there was a PC after clinic evaluation, and of those, only 5 (3.3%) were due to physical examination (PCPE) findings. On univariate analysis, a longer duration between telemedicine and clinic visit (odds ratio [OR] 1.094 per 7 days, p = 0.003), having pathology in the thoracic spine (OR 3.963, p = 0.018) and lack of sufficient imaging (OR 25.455, p < 0.0001) were predictive of a PC. Having pathology in the cervical spine (OR 9.538, p = 0.047) and adjacent-segment disease (OR 11.471, p = 0.010) were predictive of a PCPE. CONCLUSIONS This study demonstrates that telemedicine may be an effective modality for the initial evaluation of spine surgical patients, without compromising decision-making in the absence of an in-person physical examination.
Background Most of the countries in the world adopted isolation measures during the COVID-19 pandemic. According to Kola L. et. al (2021), “in most settings in low and middle-income countries (LMICs), ongoing in-person mental health services have been disrupted and patients with severe mental conditions and substance abuse disorders are often unable to obtain medications, attend to treatment centres, or receive social services”. The aim of this paper is to describe the effects of the COVID-19 pandemic on the demand for attention in a mental health service as reported by healthcare workers. Methods A quantitative cross-sectional descriptive study was conducted and a survey designed by the Secretaría de Políticas Integrales sobre Drogas de la Nación Argentina was applied to a total of 29 healthcare workers of a mental health centre in the Province of Córdoba, Argentina, during the month of November, 2020. Results The perception of healthcare workers towards the demand for attention shows that the 3 main reasons for consultation during the first three months of isolation measures were drug abuse (50%), request for treatment (10.3%), and order for medication (10.3%). During the three subsequent months, the reasons for consultation were drug abuse (62.1%), request for treatment (44.8%) and remote treatment modality (24.1%). Healthcare workers state that drug abuse consultations increased 65.5% and the self-inflicted violence consultations increased 44.8%. Conclusions The isolation measures generate a change in the demand for attention. There are differences between various phases of the isolation measures, where an increase in the drug abuse consultations and remote treatment modality could be observed. Key messages To develop predictability according to the variations in the demand for attention produced during public health crisis. To train healthcare workers in order to make interventions in public health crisis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.