Seizure control, stress, and access to care during the COVID-19 pandemic in New York City: The patient perspective.
Adult
Aged
Aged, 80 and over
Anticonvulsants
/ therapeutic use
Attitude to Health
COVID-19
/ complications
Cross-Sectional Studies
Epilepsy
/ complications
Female
Health Services Accessibility
Humans
Male
Middle Aged
New York City
Patient Satisfaction
Remote Consultation
Stress, Psychological
/ complications
Surveys and Questionnaires
Treatment Outcome
Urban Population
Young Adult
COVID-19
access to care
epilepsy
pandemic
stress
teleneurology
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
18
08
2020
revised:
20
10
2020
accepted:
09
11
2020
pubmed:
2
12
2020
medline:
15
1
2021
entrez:
1
12
2020
Statut:
ppublish
Résumé
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. 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). 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. 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.
Identifiants
pubmed: 33258109
doi: 10.1111/epi.16779
pmc: PMC7753328
mid: NIHMS1646541
doi:
Substances chimiques
Anticonvulsants
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
41-50Subventions
Organisme : US Department of Defense
ID : W81XWH-18-1-0612
Pays : International
Organisme : Heffer Family and Segal Family Foundations
Pays : International
Organisme : NINDS NIH HHS
ID : U54 NS100064
Pays : United States
Organisme : American Epilepsy Society
Pays : International
Organisme : NINDS NIH HHS
ID : R37 NS043209
Pays : United States
Organisme : NICHD NIH HHS
ID : U54 HD090260
Pays : United States
Organisme : Dan Levitz
Pays : International
Organisme : Abbe Goldstein
Pays : International
Organisme : Joshua Lurie
Pays : International
Organisme : NINDS NIH HHS
ID : R01 NS091170
Pays : United States
Organisme : Laurie Marsh
Pays : International
Organisme : NINDS NIH HHS
ID : R01 NS043209
Pays : United States
Informations de copyright
© 2020 International League Against Epilepsy.
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