Telemedicine Found Effective During Italy’s COVID-19 Lockdown
The study, “Telemedicine during the Coronavirus Disease (COVID-19) Pandemic: A Multiple Sclerosis (MS) Outpatients Service Perspective,” was published in the journal Neurology International.
The COVID-19 pandemic made social distancing mandatory and required rapid adoption of new technologies to improve patient access to healthcare. Televisits are one type of telemedicine in which clinical visits are conducted remotely using an audio-visual connection between doctors and patients at home.
Researchers in Italy evaluated the use of telemedicine in MS patients during the COVID-19 pandemic outbreak that was declared in February 2020. Patients were recruited in an Italian general hospital between March 9 and May 18, 2020 (Italy’s lockdown period), and completed at least one televisit.
“The overall response of the community to the program was positive, and will be extended as a permanent service,” the researchers wrote, adding that “although some neurological exam modifications or substitutions were utilized, the televisits provided similar information compared with standard visits.”
For televisits, participants were required to have an internet-connected smartphone or tablet. A mobile health app called Meydoc was used to connect patients to their specialist at the scheduled time of the televisit calls.
“For some physicians, there was an extra value given by the observation of a patient’s home environment,” the researchers wrote.
The study included 46 Caucasian adults with a mean age of 42.8 years; most were women (65.2%) and had relapsing-remitting MS (86.9%). The mean disease duration of the group was 8.9 years.
Patients were treated with oral disease-modifying therapies (DMTs; 43.4%), injectables (24.7%) or medications administered into the vein (21.7%).
Most of the patients were employed college graduates (65.2%) and lived within a 60-minute drive from the hospital (86.8%).
The main reasons for all the telemedicine visits were DMT use during the pandemic and counseling on social distancing. Other frequent needs included routine MRI re-scheduling (54.3%) and advice for fevers of an unknown cause (21.7%).
COVID-19 infection was diagnosed in five patients and was the reason for a televisit in 10.8% of the cases. Other reasons for telemedicine were counseling for pregnancy, driving licence advice, and dosing of anti-epileptic medication (6.5%).
Patients who participated in more than one televisit call were those who changed DMT dosage (15 cases), had fevers of an unknown cause (10 cases) or had COVID-19 (5 cases). Notably, none of the participants completed more than two calls.
“Televisits during the COVID-19 outbreak demonstrated their utility as a care delivery method for MS,” the team concluded. “Hence, it is vital to facilitate the implementation of this technology in common practice to both face infectious threats and increase accessibility of the health care system.”