SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience

When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal...

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Bibliographic Details
Published in:Epilepsy & behavior 2020-11, Vol.112, p.107483-107483, Article 107483
Main Authors: Willems, Laurent M., Balcik, Yunus, Noda, Anna H., Siebenbrodt, Kai, Leimeister, Sina, McCoy, Jeannie, Kienitz, Ricardo, Kiyose, Makoto, Reinecke, Raphael, Schäfer, Jan-Hendrik, Zöllner, Johann Philipp, Bauer, Sebastian, Rosenow, Felix, Strzelczyk, Adam
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Ambulatory Care - methods
Ambulatory Care - organization & administration
Ambulatory Care Facilities - organization & administration
Anticonvulsant
Appointments and Schedules
Betacoronavirus
Corona
Coronavirus Infections - epidemiology
Coronavirus Infections - prevention & control
COVID
COVID-19
Epilepsy - therapy
Female
Germany
Humans
Infection Control - organization & administration
Male
Middle Aged
Pandemic
Pandemics - prevention & control
Pneumonia, Viral - epidemiology
Pneumonia, Viral - prevention & control
Referral and Consultation
SARS-CoV-2
Seizure
Telemedicine - organization & administration
Telephone
Young Adult
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Summary:When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal appointments to telemedicine services. Documentations of telephone contacts and telemedicine consultations at the Epilepsy Center Frankfurt Rhine-Main were recorded in detail between March and May 2020 and analyzed for acceptance, feasibility, and satisfaction of the conversion from personal to telemedicine appointments from both patients' and medical professionals' perspectives. Telephone contacts for 272 patients (mean age: 38.7 years, range: 17–79 years, 55.5% female) were analyzed. Patient-rated medical needs were either very urgent (6.6%, n = 18), urgent (23.5%, n = 64), less urgent (29.8%, n = 81), or nonurgent (39.3%, n = 107). Outpatient service cancelations resulted in a lack of understanding (9.6%, n = 26) or anger and aggression (2.9%, n = 8) in a minority of patients, while 88.6% (n = 241) reacted with understanding, or relief (3.3%, n = 9). Telemedicine consultations rather than a postponed face-to-face visit were requested by 109 patients (40.1%), and these requests were significantly associated with subjective threat by SARS-CoV-2 (p = 0.004), urgent or very urgent medical needs (p = 0.004), and female gender (p = 0.024). Telemedicine satisfaction by patients and physicians was high. Overall, 9.2% (n = 10) of patients reported general supply problems due to SARS-CoV-2, and 28.4% (n = 31) reported epilepsy-specific problems, most frequently related to prescriptions, or supply problems for antiseizure drugs (ASDs; 22.9%, n = 25). Understanding and acceptance of elective ambulatory visit cancelations and the conversion to telemedicine consultations was high during the coronavirus disease 2019 (COVID-19) lockdown. Patients who engaged in telemedicine consultations were highly satisfied, supporting the feasibility and potential of telemedicine during the COVID-19 pandemic and beyond. •Health care systems worldwide had to face reorganization during SARS-CoV-2 pandemic•Acceptance of the SARS-CoV-2-related conversion to telemedicine services was high•Urgent concerns, perception of SARS-CoV-2-associated threats, and female gender were associated with use of telemedicine•Patient and physician satisfaction with telemedicine services was high•Supply problems
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2020.107483