Abstract
Background: In the first wave of the COVID-19 pandemic in 2020, many countries made changes to the routine management of patients with non-communicable diseases, including neurocognitive disorders. Therefore, many “so-called” non-urgent elective procedures and outpatient appointments have been canceled or postponed, possibly impacting negatively on health and well-being of patients in the short- and long-term.Aim: Here, we aimed at describing numbers and types of outpatient appointments canceled as a result of government's restrictive measures in our memory clinic.Methods: The scheduled appointments at the memory clinic of the Santa Lucia Foundation IRCCS, Rome, Italy, are recorded in a comprehensive dataset under strict administrative control. Here, we compared appointments (first-time and follow-up) that were canceled from January to April 2020 with those of the corresponding months in 2019.Results: We observed a substantial decrease in appointments during 2020. The majority of scheduled appointments were follow-up, and about a quarter were first-time appointments. We estimated that 66.7% and 77.4% of patients missed out respectively their first and follow-up appointments in our memory clinic due to government's restrictive measures in March–April 2020.Conclusions: A large number of patients with neurocognitive disorders missed crucial appointments due to government's restrictive measures, and many experienced a delay in initial diagnosis and initiation of treatment. This has relevant impact on their treatment and consequently has (is still having and potentially will have) an increase on the healthcare service burden of clinics. Furthermore, as a second wave of COVID-19 affects Europe, and with winter approaching, it is a compelling priority to ensure easy and rapid access to appropriate assessment, care and treatment in the event of a new outbreak and potential subsequent lockdowns, with particular attention to the development of specific healthcare technologies customized to older persons with cognitive impairment.
Highlights
Since the first case of Severe Acute Respiratory Syndrome— Coronavirus-2 (SARS-Cov-2) was reported and confirmed in Wuhan in December 2019 [1] there have been a series of governments’ restrictive measures worldwide to reduce the spread of the pandemic
Until the pandemic is under regulation control, we will be unable to establish the extent that the postponement of routine clinical care has on persons with mild and major neurocognitive disorders (NCD)
In the present study we focused on patients with NCD whose neuropsychiatric care changed due to the first COVID-19 outbreak
Summary
Since the first case of Severe Acute Respiratory Syndrome— Coronavirus-2 (SARS-Cov-2) was reported and confirmed in Wuhan in December 2019 [1] there have been a series of governments’ restrictive measures worldwide to reduce the spread of the pandemic. The focus on procedures to urgently slow SARS-CoV-2 infection rates and minimize the number of infected individuals has extreme importance, it has short- and long-term negative consequences on health and well-being of patients with non-communicable diseases, including neurocognitive disorders (NCD) [6,7,8,9,10]. This may affect the diagnosis of newonset mild and major NCD and have a potential negative effect on neuropsychiatric symptoms, medication adherence, and disease progression [11]. Many “so-called” non-urgent elective procedures and outpatient appointments have been canceled or postponed, possibly impacting negatively on health and well-being of patients in the short- and long-term
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