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El-Hassar L, Amara A, Sanson B, Lacatus O, Amir Belhouchet A, Kroneman M, Claeys K, Plançon JP, Rodolico C, Primiano G, Trojsi F, Filosto M, Mongini TE, Bortolani S, Monforte M, Carraro E, Maggi L, Ricci F, Silani V, Orsucci D, Créange A, Péréon Y, Stojkovic T, van der Beek NAME, Toscano A, Pareyson D, Attarian S, Van den Bergh PYK, Remiche G, Hoeijmakers JGJ, Badrising U, Voermans NC, Kaindl AM, Schara-Schmidt U, Schoser B, Gazzerro E, Haberlová J, Voháňka S, Pál E, Molnar MJ, Leonardis L, Tournev IL, Osorio AN, Olivé M, Muelas N, Alonso-Perez J, Plá F, de Visser M, Siciliano G, Sacconi S. Telemedicine in Neuromuscular Diseases During Covid-19 Pandemic: ERN-NMD European Survey. J Neuromuscul Dis 2023; 10:173-184. [PMID: 36373291 DOI: 10.3233/jnd-221525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Telemedicine (TM) contributes to bridge the gap between healthcare facilities and patients' homes with neuromuscular disease (NMD) because of mobility issues. However, its deployment is limited due to difficulties evaluating subtle neurological signs such as mild weakness or sensory deficits. The COVID-19 pandemic has disrupted healthcare delivery worldwide, necessitating rapid measures implementation by health care providers (HCPs) to protect patients from acquiring SARS-CoV-2 while maintaining the best care and treatment. OBJECTIVES Given the challenges faced by remote healthcare assistance of NMD patients, we aim to evaluate the use of TM in NMD during the COVID-19 pandemic. METHODS Based on the Model for Assessment-of-Telemedicine-Applications (MAST), we conducted a survey amongst clinicians of the ERN EURO NMD (European-Reference-Network-for-Rare-Neuromuscular-Diseases). RESULTS Based on 42 responses over 76 expected ones, our results show that the COVID-19 pandemic significantly increased the number of HCPs using TM (from 60% to 100%). The TM types most used during the COVID-19 period are teleconsultation and consultation by phone, particularly in the context of symptoms worsening in NMD patients with COVID-19 infection. Most European HCPs were satisfied when using TM but as a complementary option to physical consultations. Many responses addressed the issue of technical aspects needing improvement, particularly for elderly patients who need caregivers' assistance for accessing the TM platform. CONCLUSIONS TM has been essential during COVID-19, but its use still presents some limitations for NMD patients with cognitive deficits or for first-time diagnosis. Thus, TM should be used as complement to, rather than substitute, for face-to-face consultations.
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Affiliation(s)
- Lynda El-Hassar
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Ahmed Amara
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Benoit Sanson
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Oana Lacatus
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France.,Neurology Department, Bucharest University and Emergency Hospital, Bucharest, Romania
| | - Ahmed Amir Belhouchet
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Madelon Kroneman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Kristl Claeys
- Department of Neurology, University Hospitals Leuven, and Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jean Philippe Plançon
- European Patient Organisation for Dysimmune and Inflammatory Neuropathies (EPODIN) and EURO-NMD Educational board, Paris, France
| | - Carmelo Rodolico
- Centro di Riferimento Regionale perla Ricerca, Neurology and Neuromuscular Diseases Unit, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesca Trojsi
- First Division of Neurology, Department of Advanced Medical and Surgical Sciences, Università degli Studidella Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Massimiliano Filosto
- ASST 'Spedali Civili', Clinical Center NEMO-Brescia for neuromuscular diseases and University of Brescia, Brescia, Italy
| | - Tiziana Enrica Mongini
- Neuromuscular Center, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Sara Bortolani
- Department of Neurosciences Rita Levi Montalcini, Neuromuscular Center, University of Torino, Turin, Italy
| | - Mauro Monforte
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
| | - Elena Carraro
- Neuromuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta, Neurological Institute, Milan, Italy
| | - Federica Ricci
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Daniele Orsucci
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, Lucca, Italy
| | - Alain Créange
- Neurology Department, CHU Henri Mondor, APHP, UPEC, Créteil, France
| | - Yann Péréon
- Centre de Référence Maladies Neuromusculaires Atlantique-Occitanie-Caraïbes, Hôpital Hôtel-Dieu, Nantes, France
| | - Tanya Stojkovic
- Institut de Myologie, Centre de Référence de Pathologie Neuromusculaire Paris-Est, AP-HP, Pitié Salpêtrière University Hospital, Sorbonne University, Paris, France
| | | | - Antonio Toscano
- Department of Clinical and Experimental Medicine, Reference Centre for Rare Neuromuscular Disorders, University of Messina, Messina, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Shahram Attarian
- Centre de Référence des Maladies Neuromusculaires et de la SLA, APHM, CHU Timone, Marseille, France
| | - Peter Y K Van den Bergh
- Department of Neurology, Neuromuscular Reference Centre, University Hospital Saint-Luc, Brussels, Belgium
| | - Gauthier Remiche
- Department of Neurology, Centre de Référence Neuromusculaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Umesh Badrising
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Radboud University Medical Centre, GA Nijmegen, The Netherlands
| | - Angela M Kaindl
- Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Schara-Schmidt
- Clinic for Pediatrics I, Pediatric Neurology, University Hospital Essen, Essen, Germany
| | - Benedikt Schoser
- Department of Neurology Klinikum München, Friedrich-Baur-Institut, München, Germany
| | - Elisabetta Gazzerro
- Muscle Research Unit, Experimental and Clinical Research Center, Charit, Germany
| | - Jana Haberlová
- Department of Pediatric Neurology, Motol University Hospital, Prague, Czech Republic
| | - Stanislav Voháňka
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Endre Pál
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Lea Leonardis
- Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ivailo L Tournev
- Department of Neurology, Clinic of Nervous Diseases, University Hospital Aleksandrovska, Medical University, Sofia, Bulgaria
| | - Andrés Nascimento Osorio
- Neuromuscular Unit, Neuropaediatrics Department, Institut de Recerca Hospital Universitari Sant Joan de Déu, ISCIII, CIBERER, Barcelona, Spain
| | - Montse Olivé
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Nuria Muelas
- Department of Neurology, Neuromuscular Diseases Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jorge Alonso-Perez
- Neuromuscular Unit, Neurology Department, Hospital de Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Francesc Plá
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Marianne de Visser
- Amsterdam University Medical Centres, Academic Medical Centre, Amsterdam, The Netherlands
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
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