Multiple Sclerosis Patient Management During the COVID-19 Pandemic: Practical Recommendations From the Portuguese Multiple Sclerosis Study Group (GEEM)

Abstract

The spread of the COVID-19 pandemic has imposed significant challenges on healthcare provision, requiring changes in the conventional patient management, particularly in chronic diseases like multiple sclerosis (MS). To increase patient safety and reduce the risk of infection, while ensuring an appropriate and regular follow-up, tele-medicine gained prominence as a valid alternative to face-to-face appointments. However, the urgency of the implementation and the lack of experience in most MS centers led to “ad hoc” and extremely diverse approaches, which now merit to be standardized and refined. Indeed, while tele-consultation cannot fully replace face-to-face visits, it certainly can, and will, be incorporated as part of the routine care of MS patients in the near future. Bearing this in mind, the Portuguese Multiple Sclerosis Study Group (GEEM) has developed a set of recommendations for the usage of tele-medicine in the management of MS patients, both during the pandemic and in the future. The consensus was obtained through a two-step modified Delphi methodology, resulting in 15 recommendations, which are detailed in the manuscript.

Healthcare Disruptions and Use of Telehealth Services Among People With Multiple Sclerosis During the COVID-19 Pandemic

“…Therefore, clinicians must exercise their clinical judgment and follow the guidelines established by consensus expert panels. 27,28 Contrary to our hypotheses, most social determinants of health did not predict healthcare disruptions or telehealth use. This may be partly due to the homogeneity of our sample (e.g., 74% identified as white) and definitions of certain categorical variables (e.g., annual household income had only four levels with $75,000 or higher as the highest level which consisted of 41% of the sample; Table 1).…”

The effect of telenursing education of self-care on health-promoting behaviors in patients with multiple sclerosis during the COVID-19 pandemic: A clinical trial study

“…Another strength of this study is implementation of telenursing during the COVID-19 pandemic, which can eliminate meetings and face-to-face sessions so that patients can receive necessary education electronically and remotely. In the COVID-19 epidemic, a change in the conventional management of patients, particularly those with chronic diseases such as MS, is considered necessary, and telemedicine is introduced as a valid alternative to face-to-face appointments; recommendations are available for using telemedicine in the management of MS patients ( Cerqueira et al, 2021 ). Telenursing increases immunity and reduces the risk of infection in patients with chronic diseases, particularly MS patients, who have underlying diseases and are at high risk for COVID-19, thereby preventing infection and the spread and transmission of the virus ( Kord et al, 2021 ).…”

The Effect of Self-Care Education With The Telenursing Approach On Health-Promoting Behaviors In Multiple Sclerosis Patients During The COVID-19 Pandemic: A Clinical Trial Study

“…Another strong point of this study is the implementation of telenursing during the COVID-19 pandemic, which can eliminate meetings and face-to-face sessions so that patients can receive necessary education electronically and remotely. In the COVID-19 epidemic, a change in the conventional management of patients, particularly those with chronic diseases such as MS, is considered necessary, and telemedicine is introduced as a valid alternative to face-to-face appointments; recommendations are available for using telemedicine in the management of MS patients (44). Telenursing increases immunity and reduces the risk of infection in patients with chronic diseases, particularly MS patients, who have underlying diseases and are at high risk for COVID-19, thereby preventing infection and the spread and transmission of the virus (45).…”