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. 2022 Jan;81(1):6-12.

Early Impact of the COVID-19 Pandemic on Outpatient Neurologic Care in Hawai'i

Julie Crocker  1 , Keke Liu  1 , Maiya Smith  1 , Max Nakamoto  1 , Catherine Mitchell  2 , Ena Zhu  2 , Enze Ma  1 , Frances Tiffany Morden  1 , Ariel Chong  3 , Nicholas Van  3 , Nong Dang  1 , Pat Borman  1   2 , Enrique Carrazana  2 , Jason Viereck  1   2   4 , Kore Kai Liow  1   2   4
Affiliations

Early Impact of the COVID-19 Pandemic on Outpatient Neurologic Care in Hawai'i

Julie Crocker et al. Hawaii J Health Soc Welf. 2022 Jan.

Abstract

In March 2020, Hawai'i instituted public health measures to prevent the spread of Coronavirus disease 2019 (COVID-19), including stay-at-home orders, closure of non-essential businesses and parks, use of facial coverings, social distancing, and a mandatory 14-day quarantine for travelers. In response to these measures, Hawai'i Pacific Neuroscience (HPN) modified practice processes to ensure continuity of neurological treatment. A survey of patients was performed to assess the impact of the COVID-19 pandemic and pandemic-related practice processes for quality improvement. Overall, 367 patients seen at HPN between April 22, 2020, and May 18, 2020, were surveyed via telephone. Almost half (49.6%) participated in a telemedicine appointment, with the majority finding it easy to use (87.4%) and as valuable as face-to-face appointments (68.7%). Many (44.5%) patients said they would have missed a health care appointment without the availability of telemedicine, and 47.3% indicated they might prefer to use telemedicine over in-person appointments in the future. Many reported new or worsening mental health problems, including depression (27.6%), anxiety (38.3%), or sleep disturbances (37.4%). A significant number reported worsening of their condition, with 33.1% of patients who experience migraines reporting increased symptom severity or frequency, 45.8% patients with Alzheimer's disease reporting worsened symptoms, 38.5% of patients with Parkinson's disease who had a recent fall, and 50.0% of patients with multiple sclerosis experiencing new or worsened symptoms. Insights from this survey applied to the practice's pandemic-related processes include emphasizing lifestyle modification, screening for changes in mental health, optimizing treatment plans, and continuing the option of telemedicine.

Keywords: COVID-19, pandemic; outpatient care; survey; telemedicine.

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