Examining the impacts of the COVID-19 pandemic on the well-being and virtual care of patients with epilepsy

Subotic, Arsenije; Pricop, Diana F.; Josephson, Colin B.; Patten, Scott B.; Smith, Eric E.; Roach, Pamela

doi:10.1016/j.yebeh.2020.107599

Cited by 16 publications

(16 citation statements)

References 27 publications

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“…PWE presented no problems acquiring their medication, what has been reported in few patients due to expired prescription or unavailability 27 . Interestingly, no concerns about access to medication prescriptions have been found in remote interviews 29 …”

Section: Discussionmentioning

confidence: 78%

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

et al. 2021

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Objectives The novel coronavirus disease (COVID‐19) pandemic has led to social distancing measures and impaired medical care of chronic neurological diseases, including epilepsy, which may have adversely affected well‐being and quality of life of patients with epilepsy (PWE). The objective of this study is to evaluate the impact of the COVID‐19 pandemic in the levels of anxiety, depression, somnolence, and quality of life using validated scales in PWE in real‐life clinical practice. Materials & Methods Self‐administered scales of anxiety disorders (GAD‐7), depression (NDDI‐E), somnolence (Epworth Sleepiness Scale; ESS), and quality of life (QOLIE‐31‐P) in PWE treated in a Refractory Epilepsy Unit were longitudinally analyzed. Data were collected before the beginning (December 2019 – March 2020) and during the COVID‐19 pandemic (September 2020–January 2021). Results 158 patients (85 from the first round and 73 from the second round) 45.0 ± 17.3 years of age, 43.2% women, epilepsy duration 23.0 ± 14.9 years, number of antiepileptic drugs 2.1 ± 1.4, completed the survey. Significant longitudinal reduction of QOLIE‐31‐P (from 58.9 ± 19.7 to 56.2 ± 16.2, p = .035) and GAD‐7 scores (from 8.8 ± 6.2 to 8.3 ± 5.9, corrected p = .024) was identified. No statistically significant longitudinal changes in the number of seizures (from 0.9 ± 1.9 to 2.5 ± 6.2, p = .125) or NDDI‐E scores (from 12.3 ± 4.3 to 13.4 ± 4.4, p = .065) were found. Significant longitudinal increase of ESS (from 4.9 ± 3.7 to 7.4 ± 4.9, p = .001) was found. Conclusions During the COVID‐19 pandemic, quality of life and anxiety levels were lower in PWE, and sleepiness levels were raised, without seizure change.

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Section: Discussionmentioning

confidence: 78%

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

et al. 2021

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“…In the face of these results, healthcare assistance needs to continue during the pandemic to guarantee seizure control and mental well-being. Several studies have suggested telemedicine as one solution to maintaining contact between healthcare teams, PWE, and caregivers [7,12,[15][16][17][18]. Accessible technologies, such as WhatsApp -an online messaging platform -have had high acceptance rates for this purpose [18], and telephone calls have also been used [7,16,18].…”

Section: Discussionmentioning

confidence: 99%

Patients with epilepsy during the COVID-19 pandemic: Depressive symptoms and their association with healthcare access

Lunardi

Carvalho

Carneiro

et al. 2021

Epilepsy & Behavior

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Background: The coronavirus disease 2019 (COVID-19) outbreak impacted the lives of worldwide people with epilepsy (PWE) in various aspects, particularly in those countries most significantly affected by this pandemic, such as Brazil. We aimed to investigate the prevalence of depressive symptoms in PWE and their correlation with epilepsy features and access to treatment. Methods: PWE were invited to answer a cross-sectional online-based survey to assess and rate depressive symptoms using the NDDI-E during the first year of the COVID-19 pandemic and its relation to multiple lifestyles epilepsy clinical aspects. Results: A total of 490 PWE were recruited. The prevalence of depressive symptoms during the COVID-19 pandemic was 35.3% (cutoff score > 15 on NDDI-E). The factors associated with higher NDDI-E scores were: female sex, increased seizure frequency, barriers to access to their treating physician and antiseizure medication, and unemployment. Regarding the pandemic impact on PWE healthcare, 29.2% reported restricted access to their medication, 46.1% barriers to access their physicians, 94.2% had their consultations canceled due to the pandemic, and 28.4% had seizure worsening in this period. Conclusion:The COVID-19 pandemic affected PWE access to the healthcare system. Depressive symptoms were more severe in patients with higher seizure frequency who had difficulties obtaining proper medical care. The COVID-19 pandemic may impact the healthcare and mental wellbeing of patients with chronic diseases such as epilepsy. Nevertheless, prospective studies on epilepsy and COVID-19 are still lacking.

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“…In recent months, the COVID-19 pandemic has accelerated the uptake of virtual care ( Grossman et al, 2020 ; Kuchenbuch et al, 2020 ; Majersik and Reddy, 2020 ; OMA, 2020 ; Punia et al, 2020 ; Sattar and Kuperman, 2020 ). Emerging data shows the promise of virtual care in Epilepsy ( Banks et al, 2021 ; Lavin et al, 2020 ; Subotic et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Virtual epilepsy clinics – A Canadian Comprehensive Epilepsy Center experience pre-COVID and during the COVID-19 pandemic period

et al. 2021

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Objective The objective of this study is to assess the role of prior experience with virtual care (through e-visits) in maintaining continuity in ambulatory epilepsy care during an unprecedented pandemic situation, comparing in person versus e-visit clinic uptake. Methods This is an observational study on virtual epilepsy care (through e-visits) over two years, during a pre-COVID period (14 months) continuing into the COVID-19 pandemic period (10 months). For a small initial section of patients seen during the study period a physician survey and a patient satisfaction survey were completed (n = 53). Outcomes of eVisits were analyzed using descriptive statistics. Results Median numbers of epilepsy clinic visits conducted during the COVID-19 period (27.5 new and 113 follow up) remained similar to the median uptake during the pre-COVID period (28 new and 116 follow up). Prior experience with e-visits for epilepsy yielded smooth transition into the pandemic period, with several other advantages. The majority of eVisits were successful despite technical difficulties and major components of history and management were still easily implemented. Results from patient surveys supported that a significant amount of time and money were saved, which was in keeping with our health-economic analysis. Conclusion Our study is one of the first few reports of fully integrated virtual care in a comprehensive epilepsy clinic starting much before start of the COVID-19 pandemic. The results of our study support the feasibility of using virtual care to deliver specialized outpatient care in a comprehensive epilepsy center.

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Examining the impacts of the COVID-19 pandemic on the well-being and virtual care of patients with epilepsy

Cited by 16 publications

References 27 publications

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

Patients with epilepsy during the COVID-19 pandemic: Depressive symptoms and their association with healthcare access

Virtual epilepsy clinics – A Canadian Comprehensive Epilepsy Center experience pre-COVID and during the COVID-19 pandemic period

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