المؤلفون: Asukile M; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Chishimba L; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Chomba M; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Mataa M; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Mutete F; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Mwendaweli N; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Yumbe K; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Zimba S; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Habanyama G; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia., Shampile S; Zamba Ministry of Health, Lusaka, Zambia., Makupe A; Zamba Ministry of Health, Lusaka, Zambia., Saylor D; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.

المصدر: Annals of neurology [Ann Neurol] 2022 Apr; Vol. 91 (4), pp. 445-454. Date of Electronic Publication: 2022 Feb 28.

نوع المنشور: Journal Article; Observational Study

بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 7707449 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-8249 (Electronic) Linking ISSN: 03645134 NLM ISO Abbreviation: Ann Neurol Subsets: MEDLINE

مواضيع طبية MeSH: COVID-19* , Pandemics*, Neurology/*organization & administration , Telemedicine/*organization & administration, Adult ; Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Cross-Sectional Studies ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Neurologists ; Patient Acceptance of Health Care ; Patient Satisfaction ; Prospective Studies ; Smartphone ; Surveys and Questionnaires ; Videoconferencing ; Zambia

مستخلص: Objective: The objective of this study was to assess the feasibility, acceptability, and benefits of a teleneurology clinic serving adults usually attending a neurology outpatient clinic in Lusaka, Zambia during the coronavirus disease 2019 (COVID-19) pandemic.
Methods: Televisits were offered to patients scheduled for neurology appointments between March and July 2020 using the telephone, WhatsApp video, or Zoom calls based on patient accessibility. Visit outcomes were documented, and patient and neurologist satisfaction surveys were completed.
Results: Of 323 patients, 195 (60%) were reachable by telephone, 179 of these were alive, and 74% (133/179) of those alive agreed to a televisit. Stroke (30%), seizures (20%), and headache (16%) were the most common diagnoses seen via televisit. Most televisits (80%) were by telephone call, 14% by WhatsApp video call, and 6% by Zoom. Nearly one-third (30%) of the patients were stable and discharged from the clinic, 32% only required medication refills, and 19% required an in-person visit. Sixty patients (out of 85 reachable and 71% response rate) and 7 of 9 neurologists (78% response rate) completed satisfaction surveys. Neurologists reported greater assessment confidence with Zoom, but confidence was high for all modalities. Patients preferring televisits (75%, 45/60) noted reduced expense and time requirements, whereas those preferring in-person visits (22%, 13/60) cited the desire for physical examinations. Overall, 98% of patients and 100% of neurologists were satisfied with televisits.
Interpretation: Teleneurology visits were acceptable and feasible for adults attending an outpatient neurology clinic in Zambia and their neurologists. They offer a promising supplement to in-person visits in resource-limited settings, even when video-conference capabilities and electronic medical records are absent. ANN NEUROL 2022;91:445-454.
(© 2022 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)