Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond

Appireddy, Ramana; Jalini, Shirin; Shukla, Garima; Lomax, Lysa Boissé

doi:10.1017/cjn.2020.92

Cited by 19 publications

(27 citation statements)

References 10 publications

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“…5 As accessibility, cost, and availability are considered to be ongoing concerns to Canada's senior population, particularly for those with complicated health conditions, virtual care solutions may serve to alleviate problems to healthcare access. 6,7 On the flip side, as health literacy and technological familiarity are varied amongst the senior population, virtual care may exacerbate problems to health access.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Determinants and Experiences of Senior Stroke Patients with Virtual Care

Chan

O’Riordan

Appireddy

2020

Can. J. Neurol. Sci.

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Objective: The study sought to explore the experiences of participants affected by stroke with home video visit (HVV) for follow-up visits in order to understand the determinants, barriers, and benefits associated with HVVs. Methods: Semi-structured interviews were conducted with (n = 23) participants to gather insight and descriptive information about patients’ experiences with HVV. Specifically, we sought to collect descriptions about the (1) costs and time associated with in-person visits, (2) facilitators and barriers to in-person and virtual visits, and (3) their values attached to traditional and virtual forms of patient care. Results: HVVs were perceived to be a mode of healthcare that is time-saving and convenient for both participants and physicians. However, our study also found some participants felt uncomfortable using technology to conduct medical visits while others still supported a positive view of traditional forms of in-person visits because they valued the in-person interactions and safe environment of the hospital. Conclusion: While HVVs were considered to be useful in addressing geographical barriers to health care, technological and digital health literacy may serve to impede seniors from using the service, with some of them opting to go to the hospital despite geographical barriers. Resultantly, HVVs may serve both to alleviate and exacerbate certain determinants to health care.

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Section: Introductionmentioning

confidence: 99%

Exploring the Determinants and Experiences of Senior Stroke Patients with Virtual Care

Chan

O’Riordan

Appireddy

2020

Can. J. Neurol. Sci.

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“…Due to the COVID-19 pandemic there has been an expedited move towards telemedicine and remotely delivered rehabilitation [ 40 , 41 ]. This trend looks set to continue and we are likely to see many changes in the delivery of rehabilitation moving forward [ 42 , 43 ].…”

Section: Discussion: Efficiencies and Challengesmentioning

confidence: 99%

Lifestyle, Exercise and Activity Package for People living with Progressive Multiple Sclerosis (LEAP-MS): adaptions during the COVID-19 pandemic and remote delivery for improved efficiency

Lowe

Barlow

Lloyd

et al. 2021

Trials

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The LEAP-MS (Lifestyle, Exercise and Activity Package for People living with Progressive Multiple Sclerosis) study has developed an individualised supported self-management approach for physical activity for people with progressive multiple sclerosis (MS) and severe disability. The intervention has been evaluated in a single-arm feasibility study with embedded process evaluation. The feasibility study was due to open to recruitment during the COVID-19 2020–2021 pandemic, 1 month into the first UK-wide lockdown. We worked rapidly to implement adaptions to the trial procedures and intervention delivery that we believe are applicable to randomised controlled trials. Recruitment became predominantly via self-referral. Electronic consent was employed, with consent discussions occurring over the telephone. Registration, consent, eligibility assessment and data collection as well as the intervention (online physical activity tool) were via a secure, encrypted multi-user web-based platform for participants, physiotherapists and researchers accessible via various hardware. Physiotherapy consultations, as well as the process evaluation, were conducted remotely using video conferencing software or the telephone. A remote training package for physiotherapists and site initiations was also developed and electronic site files employed. Our adaptions are extremely topical given the COVID-19 situation, and whilst not what we had originally planned, have enabled successful delivery of the feasibility study and are relevant to conducting randomised controlled trials and meeting the needs of people with MS who are far more isolated than ever before. Trial registration ClinicalTrials.govNCT03951181. Registered on 15 May 2019.

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“…Unprecedented restrictions enforced by the COVID‐19 pandemic have induced adaptations in health‐care delivery systems, which have led to expansion of virtual care. Telephone consultations are well‐known modalities in virtual care and are promising platforms through which continued medical care can be provided, especially to patients with chronic neurological conditions 1,2 . However, without the physical examination, physicians have to base their decision‐making exclusively on patient‐reported symptoms.…”

Section: Introductionmentioning

confidence: 99%

Telephone consultation for myasthenia gravis care during the COVID‐19 pandemic: Assessment of a novel virtual myasthenia gravis index

et al. 2021

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Introduction/Aims: The aim of the study was to determine the association between the virtual Myasthenia Gravis Impairment Index (vMGII) with other patient-reported outcomes (PROs) of myasthenia gravis (MG) and its usefulness in telephone consultations with MG patients.Methods: This was a retrospective case series in which vMGII score along with virtual Single Simple Question (vSSQ), virtual Patient-Acceptable Symptom State PASS (vPASS) response, and patient disease status based on Myathenia Gravis Foundation of America postintervention status were collected during telephone consultation along with the MGII, SSQ, and PASS responses during the preceding in-person clinic visits.Results: In 214 patients, the mean difference of vMGII between the vPASS "Yes" and "No" groups was −14.2 ± 1.4 (95% confidence interval, −16.9 to −11.3; P < .001) with mean vMGII for vPASS "Yes" group being 6.4 ± 7.7 and vPASS "No" being 20.5 ± 11.5. A vMGII of 11.5 or higher predicted vPASS "yes" response with a sensitivity of 78.7% and specificity of 81.4%. A strong negative correlation was found between the vMGII and vSSQ (r = −.667; P < .001). The mean vMGII was 0.48 ± 1.42 for patients in remission, and 9.31 ± 10.93 for improved, 9.32 ± 8.79 for stable, and 22.58 ± 14.04 for worsened groups (P < .001). These associations were the same as those obtained during the preceding in-person clinic visit and the direction of change in MGII scores also indicated change in disease status. Discussion: vMGII is an effective measure to assess an MG patient's disease status in telephone consultations and relates well with other PRO measures. The vMGII remains reliable for assessing MG disease status even with removal of the physical examination component.

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Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond

Abstract: RA-Conception, first draft and approval. SJ-Conception and critical review of the manuscript. GS-Conception and critical review of the manuscript. LBL-Conception and critical review of the manuscript.

Cited by 19 publications

References 10 publications

Exploring the Determinants and Experiences of Senior Stroke Patients with Virtual Care

Exploring the Determinants and Experiences of Senior Stroke Patients with Virtual Care

Lifestyle, Exercise and Activity Package for People living with Progressive Multiple Sclerosis (LEAP-MS): adaptions during the COVID-19 pandemic and remote delivery for improved efficiency

Telephone consultation for myasthenia gravis care during the COVID‐19 pandemic: Assessment of a novel virtual myasthenia gravis index

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