Stroke and digital technology: a wake-up call from COVID-19 pandemic

Iodice, Francesco; Romoli, Michele; Giometto, Bruno; Clerico, Marinella; Tedeschi, Gioacchino; Bonavita, Simona; Leocani, Letizia; Lavorgna, Luigi

doi:10.1007/s10072-020-04993-3

Cited by 35 publications

(28 citation statements)

References 41 publications

(44 reference statements)

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“…COVID-19 pandemic and restriction to people mobility for safety reasons has boosted telemedicine in medical clinical practice. Telemedicine has been used in neurology mainly as telestroke [1,2] to bring thrombolysis in rural and underserved areas. Experiences in the management of chronic neurological disorders, before pandemic, were limited and scattered [3], and even during COVID-19 pandemic, very few studies have been conducted [4,5] with different modalities or on single disorder [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Virtual visits for chronic neurologic disorders during COVID-19 pandemic

et al. 2021

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Background COVID-19 pandemic has boosted telemedicine in medical clinical practice. Experiences in the management of chronic neurological disorders are limited and scattered. The aim of the study was to evaluate feasibility and efficacy of virtual visit for chronic neurological disorders during COVID-19 pandemic. Methods All patients scheduled for a visit during the lockdown period were contacted. The patients fell into four categories: (1) long-term follow-up, the patient was re-scheduled; (2) visit was necessary, teleconsultation was accepted; (3) problem was solved by phone call; and (4) visit was necessary and teleconsultation was not feasible, then visit was maintained. Google Meet was used. During the virtual visit, neurological examination was performed, and demographic and clinical characteristics were recorded. Results At the end of May 2020, 184 virtual visits for 178 patients were performed for the following diseases: myasthenia gravis (47 patients), multiple sclerosis (79), epilepsy (12), headache (6), and parkinsonism (34). The patients were 70 males and 108 females with a mean age of 53.5 years (range 13–90). During virtual visit, we were able to obtain a satisfactory neurological examination. Conclusions We demonstrated feasibility and effectiveness of virtual visit in the management of a large group of patients with common chronic neurological disorders.

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Section: Introductionmentioning

confidence: 99%

Virtual visits for chronic neurologic disorders during COVID-19 pandemic

et al. 2021

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“…In this frame, during 2020 and the beginning of 2021, telemedicine (TM) has experienced a huge development to maintain the provision of routine care in neurological and, more specifically, neuromuscular patients. Various approaches have been proposed for different diseases [ 2 – 7 ], but more in general, in the pandemic era, telemedicine provided the opportunity to maintain the patient-clinician alliance, reducing risks of outpatient evaluation for both patients and medical staff and becoming crucial in the management of neurological diseases resetting distances and pandemic obstacles.…”

Section: Introductionmentioning

confidence: 99%

How to manage with telemedicine people with neuromuscular diseases?

et al. 2021

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Introduction COVID-19 pandemic radically transformed our daily clinical practice, raising the need not to lose close contact with patients without being able to see them face-to-face. These issues are even more felt and evident in fragile patients, as those affected by neuromuscular disease. An important help came from new digital technologies that allow clinicians to remotely monitor health status and any deterioration of chronically ill patients. Methods In this mini-review, an initiative of the “Digital Technologies, Web and Social Media Study Group” of the Italian Society of Neurology, we propose to analyze the approach to neuromuscular patients by looking over raising evidence on the main cornerstones of Telemedicine (TM): clinician-patient interaction, remote clinical assessment, remote monitoring, and digital therapeutics. In particular, we explored the strategies developed by researchers and their impact on the physical and emotional status of the patients, with particular focusing on their adherence to the program of virtual monitoring. Results TM plays an important role in each of four stages of approach to neuromuscular disease, having demonstrated validity in keep close clinical patient interaction, clinical assessment, remote monitoring, and telerehabilitation. Nevertheless, there is no remote alternative to electrophysiological testing neither validate tools to assess disability. Conclusion The role of TM in neuromuscular care is yet underestimated but is crucial, beyond the pandemic era. Further development of TM is advisable, through making specific apps, remotely controlled by clinicians, and making more engaging clinicians-patients interaction. Last, it is necessary to ensure adequate internet access to everyone.

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“…Telehealth in Italy had limited application in neurological practice until the COVID-19 pandemic mainly because of lack of formal regulations and of recognition as a reimbursable medical service in the National Health System. The pandemic has greatly accelerated the Telehealth development in several countries [19][20][21][22][23][24]: in Italy, over a 10-week period progresses occurred which would have otherwise required possibly 10 years [9,[25][26][27][28][29]. Telehealth allowed us to provide medical services to >1600 patients with chronic neurological diseases who suddenly found themselves with limited medical reference points.…”

Section: Discussionmentioning

confidence: 99%