Seizure control, stress, and access to care during the COVID‐19 pandemic in New York City: The patient perspective

Autor: Alexis Boro, Jad Donato, Victor Ferastraoaru, Solomon L. Moshé, Dan Zhao, Christine Hung, Elayna Rubens, Alan D. Legatt, Jillian Rosengard, Isaac Molinero, Puja Patel, Jonathan M. Gursky, Daniel J. Correa, Sheryl R. Haut, Aristea S. Galanopoulou
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Urban Population
Cross-sectional study
Health Services Accessibility
Epilepsy
stress
0302 clinical medicine
Surveys and Questionnaires
Pandemic
Health care
Aged
80 and over
access to care
education.field_of_study
Middle Aged
Treatment Outcome
Neurology
Patient Satisfaction
Full‐length Original Research
Anticonvulsants
Female
Headaches
medicine.symptom
Attitude to Health
Adult
medicine.medical_specialty
Population
Clinical Neurology
teleneurology
03 medical and health sciences
Young Adult
Patient satisfaction
COVID‐19
medicine
Humans
education
Aged
business.industry
Public health
Remote Consultation
pandemic
COVID-19
medicine.disease
030104 developmental biology
Cross-Sectional Studies
Emergency medicine
New York City
Neurology (clinical)
business
030217 neurology & neurosurgery
Stress
Psychological
Zdroj: Epilepsia
ISSN: 1528-1167
0013-9580
DOI: 10.1111/epi.16779
Popis: Objective Our epilepsy population recently experienced the acute effects of the COVID‐19 pandemic in New York City. Herein, we aimed to determine patient‐perceived seizure control during the surge, specific variables associated with worsened seizures, the prevalence of specific barriers to care, and patient‐perceived efficacy of epilepsy care delivered via telephone and live video visits during the pandemic. Methods We performed a cross‐sectional questionnaire study of adult epilepsy patients who had a scheduled appointment at a single urban Comprehensive Epilepsy Center (Montefiore Medical Center) between March 1, 2020 and May 31, 2020 during the peak of the COVID‐19 pandemic in the Bronx. Subjects able to answer the questionnaire themselves in English or Spanish were eligible to complete a one‐time survey via telephone or secure online platform (REDCap). Results Of 1212 subjects screened, 675 were eligible, and 177 adequately completed the questionnaire. During the COVID‐19 pandemic, 75.1% of patients reported no change in seizure control, whereas 17.5% reported that their seizure control had worsened, and 7.3% reported improvement. Subjects who reported worsened seizure control had more frequent seizures at baseline, were more likely to identify stress and headaches/migraines as their typical seizure precipitants, and were significantly more likely to report increased stress related to the pandemic. Subjects with confirmed or suspected COVID‐19 did not report worsened seizure control. Nearly 17% of subjects reported poorer epilepsy care, and 9.6% had difficulty obtaining their antiseizure medications; these subjects were significantly more likely to report worse seizure control. Significance Of the nearly 20% of subjects who reported worsened seizure control during the COVID‐19 pandemic, stress and barriers to care appear to have posed the greatest challenge. This unprecedented pandemic exacerbated existing and created new barriers to epilepsy care, which must be addressed.
Databáze: OpenAIRE
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