Abstract
Objectives: The use of telemedicine has grown exponentially as an alternative to providing care to patients with epilepsy during the pandemic. We investigated the impact of the current pandemic among children with epilepsy from two distinct pediatric epilepsy centers. We also compared perceptions among those who received telemedicine against those who did not.Methods: We developed a questionnaire and invited families followed in Freiburg, Germany, and Calgary, Alberta, Canada, to participate during the initial 9 months of the pandemic. The survey contained 32 questions, 10 of which were stratified according to telemedicine exposure.Results: One hundred twenty-six families (80 in Freiburg, 46 in Calgary) participated, and 40.3% received telemedicine care. Most children (mean age 10.4 years, SD 5.1) had chronic epilepsy but poorly controlled seizures. Negative impacts were reported by 36 and 65% of families who had to reschedule appointments for visits and diagnostics, respectively. Nearly two-thirds of families reported no change in seizure frequency, while 18.2% reported either worsening or improvement of seizures. Although most families did not note behavioral changes, 28.2% reported behavior worsening. Families who received telemedicine care had a statistically significant reduction of parental self-reported anxiety level after virtual visits compared to those who did not experience telemedicine. Families with telemedicine consultations were more likely to consider future virtual care (84 vs. 65.2% of those without), even after the pandemic. Patient data safety, easy access to specialized services, and consistency with the same healthcare provider were graded as important in both centers, while a shorter waiting time was most relevant in Calgary.Conclusion: In our cohort, some children with epilepsy experienced increased seizures and worsening behavior during the first 9 months of the current pandemic. In addition, our data suggest that telemedicine might reduce parental anxiety symptoms, and families who experienced telehealth were more positive and open to similar appointments in the future.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has had a substantial impact on the way healthcare providers and institutions deliver care worldwide
Patients must have been diagnosed with epilepsy by a pediatric neurologist, according to the International League Against Epilepsy (ILAE) criteria [10]
The patient populations studied were similar in the two centers consisting of children with chronic epilepsy but poorly controlled seizures in the past 12 months, many of whom required recent medication changes
Summary
The coronavirus disease 2019 (COVID-19) pandemic has had a substantial impact on the way healthcare providers and institutions deliver care worldwide. Telemedicine use has grown exponentially as an option for epilepsy care and decreases the risk of COVID-19 exposure for families and healthcare providers. Even though telemedicine has been successfully used to provide epilepsy care for over a decade in some centers [2, 3], it was underutilized in epilepsy care before the pandemic [4]. With communication tools becoming accessible throughout the world, many patients and providers have expressed their willingness to incorporate both in-person and virtual appointments [7, 8]
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