MS Patients Voice Satisfaction With Telehealth Use During COVID-19

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by Lindsey Shapiro, PhD |

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Telehealth services for physical and mental healthcare were used often by people with multiple sclerosis (MS) during the COVID-19 pandemic and most were satisfied or highly satisfied with such care, according to a study based on survey results.

“The findings suggest that telehealth services were well liked during the pandemic,” Michelle Chen, PhD, the study’s lead author and a core member of Rutgers Institute for Health, Health Care Policy and Aging Research, in New Jersey, said in a press release.

“Because many individuals with MS have physical disability that may make travel more difficult, temporary expansions of telehealth coverage should be made permanent after the pandemic in order to expand access and reduce health care disparities,” Chen added.

The study, “Healthcare disruptions and use of telehealth services among persons with multiple sclerosis during the COVID-19 pandemic,” was published in the Archives of Physical Medicine and Rehabilitation

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To help slow transmission of the SARS-CoV-2 virus that causes COVID-19, many public spaces, including doctor’s offices and clinics, were significantly less accessible throughout the pandemic.

As people with MS and other chronic conditions require frequent care, telehealth — virtual doctor’s appointments — emerged as an alternative to compensate for limited in-person care during the pandemic.

A team of researchers with the Kessler Foundation examined healthcare disruptions and telehealth use among 70 adults with MS and 93 others without any neurological disorder (a control group) using online patient surveys collected between September and October 2020. Findings are part of a larger investigation into the pandemic’s effects on people with MS, traumatic brain injuries, and strokes.

Most of the patients were white (74.3%), lived in the U.S. (88%), and held at least one university degree. A majority had relapsing-remitting MS (RRMS; 68.6%), while 12.9% each had primary-progressive MS (PPMS) or secondary-progressive disease (PPMS). Their mean age was 47.7, and their mean disease duration was 12.8 years.

Results showed that more control participants reported known COVID-19 exposures (23%) and being tested for the virus (41%) than those in the MS group, where 7% had a known exposure and 26% were tested. No participant was diagnosed with COVID-19 during the study period.

MS patients experienced significantly fewer healthcare disruptions, such as missed or cancelled appointments, due to the pandemic than did controls. Specifically, 38–50% of MS patients reported interruptions in their MS and non-MS medical care, compared with 66% of the control group.

Interruptions in mental healthcare were similar in both groups, occurring in 20–33% of MS patients and 26% of healthy participants.

More MS patients utilized telehealth for physical and mental healthcare than in-person appointments, showing a significant rise from pre-pandemic levels.

Nearly twice as many MS patients used telehealth for their medical care (61–62%) than those who received in-person care (39%). Patients who needed assistive devices for walking, had more debilitating symptoms, or were unemployed due to disability were also more likely to utilize telehealth for medical care unrelated to their MS.

In contrast, control participants did not show a significant rise in the use of telehealth for medical appointments during the pandemic.

“Given that [people with MS] are immunocompromised and therefore may be more vulnerable to SARS-CoV-2 infections and complications, it is possible that more [MS patients] are choosing telehealth over in-person services in order to minimize risk of infections and mortality,” the researchers wrote.

In both groups, telehealth was highly utilized for mental healthcare, with 90% of MS patients and 79% of controls turning to it. Among those with MS, this amounted to a five times greater use of telehealth than in-person appointments (17%).

Greater psychological distress due to the pandemic was associated with more mental healthcare disruptions and more frequent use of telehealth services in both groups.

“Anxiety about being infected with or dying from COVID-19 may underlie the high degree of healthcare disruptions observed and more frequent use of telehealth compared to in-person services in our sample,” the team noted.

Overall, 77% of MS patients reported they were very satisfied or somewhat satisfied with their MS telehealth care, 74–84% were satisfied with their non-MS medical care, and 93% were satisfied with their mental telehealth care.

Among controls, similarly, 71–80% were satisfied with their medical telehealth care and 80% with their mental telehealth care.

“The current study significantly contributes to our understanding of health care utilization during the COVID-19 pandemic,” said Helen Genova, PhD, the study’s principal investigator and associate director of the Center for Autism Research at the Kessler Foundation.

Researchers noted that the study is limited by its small size and by largely consisting of white participants with a high socioeconomic status, as income could influence patient access to the technology required for telehealth care.

Still, as many MS patients are physically limited and have difficulties traveling to MS clinics, telehealth should be adopted and continue after the pandemic, the researchers suggested.

“While the current public health crisis has highlighted the need for telehealth services at a population-wide scale, certain groups of individuals have always had difficulty accessing in-person healthcare, such as individuals with significant physical limitations or lower socioeconomic status as well as rural residents,” they wrote.

“That being said, there are limitations to telehealth, such as the inability to perform physical examinations as well as imaging and laboratory tests,” the team concluded. “Therefore, clinicians must exercise their clinical judgment and follow the guidelines established by consensus expert panels.”

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