Telemedicine in The Care of Epileptic Children During The COVID-19 Pandemic
Keywords:
remote consultation, epilepsy, coronavirus infections, neurology, telemedicineAbstract
Introduction: Epilepsy is one of the most common chronic neurological diseases in pediatrics with variable clinical behavior and response to treatment, which requires frequent monitoring of the evolution. The pandemic caused by COVID-19 and social confinement limited in-person follow-up of in outpatient patients, which forced the use of alternatives; telemedicine was one of them.
Objective: To present the benefits of telemedicine modalities for the follow-up of pediatric epileptic patients.
Methods: A descriptive and prospective observational case series study was carried out with 52 epileptic patients between 0 and 18 years of age, from March 2020 to January 2022. Telemedicine modalities were used (conventional and mobile telephone, messaging SMS and voice, email, teleconsultations, home videos of the crises). A survey was also carried out on parents or guardians to find out their opinion on the usefulness of this method and the possibility of maintaining their use during the new normal.
Results: The age group of 5-14 years (44.23%), male sex (57.69%), rural origin (57.69%) and focal onset seizures (51.92%) predominated. Only 13.46% of patients required admission. A hundred percent of parents considered the remote care modality useful during the pandemic and 73.07% considered that it could be maintained in the new normal.
Conclusions: In the new normal, telemedicine could be an effective tool in combination with in-person consultations, especially for those patients with favorable clinical evolution, and also contribute to reducing costs for patients and families.
Downloads
References
1. Garófalo Gómez N, Gómez García AM, González García S. Epilepsia pediátrica y Telemedicina, una alternativa en tiempos de la COVID-19. Rev Cubana Pediatr. 2020 [acceso 14/09/2022];92:e1186. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/1186
2. Sánchez Zapata P, Zapata JF. Telesalud y Telemedicina para el manejo de la epilepsia. Rev Ecuat Neurol. 2019 [acceso 14/09/2022];28(1):63-9. Disponible en: https://revecuatneurol.com/magazine_issue_article/telesalud-telemedicina-manejo-epilepsia-telehealth-telemedicine-management-epilepsy/
3. WHO Global Observatory for eHealth series. Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth. Geneva: World Health Organization; 2010. Vol. 2. 96 pp. Disponible en: https://apps.who.int/iris/handle/10665/44497
4. Saavedra Milán B, Hernández Rodríguez HG, Medina González MC, Garía Ramírez JL, Bravo Oro A. Eficacia del programa de Telemedicina en el tratamiento de epilepsia pediátrica. Neurology Perspectives. 2021;1(4):213-9. DOI: 10.1016/j.neurop.2021.08.004
5. Hernando Requejoa V, Huertas González N, Lapeña Motilvaa J, Ogando Durán G. Consulta de epilepsia durante la pandemia de COVID-19: papel de la Telemedicina y efectos del confinamiento en pacientes epilépticos. Neurología. 2020;35(4):274-6. DOI: 10.1016/j.nrl.2020.04.014
6. Hatcher Martin JM, Adams JL, Anderson ER, Bove R, Burrus TM, Chehrenama M. et al. Telemedicine in neurology. Telemedicine Work Group of the American Academy of Neurology update. Neurology. 2019;94(1): 30-8. DOI: 10.1212/WNL.0000000000008708
7. Gulati S, Shruthi NM, Panda PK, Sharawat IK, Josey M, Pandey RM. Telephone-based follow-up of children with epilepsy: Comparison of accuracy between a specialty nurse and a pediatric neurology fellow. Seizure. 2020;83:98-103. DOI: 10.1016/j.seizure.2020.10.002
8. Martínez Juárez IE, Santos Peyret A, Hernández Vanegas LE, Breda Yepes M, Durón RM. Proyecto colaborativo inicial con Honduras para el centro de atención integral de epilepsia del programa prioritario de epilepsia en México con un enfoque de Telemedicina. Innovare: Revista de ciencia y tecnología. 2019;8(1):38-45. DOI: 10.5377/INNOVARE.V8I1.8106
9. Santos Peyret AS, Crail Meléndez D, Sebastián Díaz MA, Velasco Vázquez C, Del Río Quiñones MA, Gómez Figueroa E, et al. Descripción de los centros de referencia de pacientes con epilepsia para la implementación del Proyecto TeleECHO en un instituto nacional de salud. Arch Neurocien. 2022;27(1):23-8. DOI: 10.31157/an.v27i1.306
10. Castellón Rodríguez I. Propuesta de arquitectura de redes para telemedicina [tesis de pregrado]. Santa Clara, Cuba: Universidad Central Marta Abreu de Las Villas; 2016 [acceso 14/09/2022]. Disponible en: https://dspace.uclv.edu.cu/bitstreams/8dd8a618-68e0-4b49-b397-1bba2b6205cf/download
11. González Fernández RI, Rodríguez Díaz A. La telemedicina en Cuba: antecedentes, estado actual y proyectos en desarrollo. I Congreso Iberoamericano de Telesalud y Telemedicina y VII Reunión Regional de ATALACC; 16-18 octubre de 2014; Lima, Perú. 2014 [acceso 14/09/2022]:2 pp. Disponible en: https://revista.teleiberoamerica.com/numero-2/minisimposios/11m.GonzalezTelemedicinaCuba.pdf
12. Stolik Lipszyc O, Jáuregui Izquierdo C, Galeano Zaldivar L. Telemedicina: Servicios de salud y TIC. Revista Cubana de Economía Internacional. 2019 [acceso 14/09/2022];6(2):60-81. Disponible en: https://revistas.uh.cu/rcei/article/view/3223
13. Linares Cánovas LP, Linares Cánovas LB, Herrera Forcelledo A. Telemedicina, impacto y perspectivas para la sociedad actual. Universidad Médica Pinareña. 2018 [acceso 18/09/2022];14(3):14 pp. Disponible en: https://revgaleno.sld.cu/index.php/ump/article/view/299/html
14. Domínguez Moreno R, García Grimshaw M, Chávez Martínez OA, Rebolledo García D, Diestel-Bautista JC, Michel Chávez A, et al. Global & community health: implementation of and patient satisfaction with the first Neurologic Telemedicine Program in Mexico during COVID-19. Neurology. 2021;97(6):293-6. DOI: 10.1212/WNL.0000000000012291
15. Marcen GC, López Pisón J, Samper Villagrasa P, Molina Herranz D, Moreno Sánchez A, Salinas Salvador B. Valoración de la atención telemática en una consulta de neuropediatría durante el estado de alarma por COVID-19. Estudio transversal y encuesta de satisfacción. Journal of Healthcare Quality Research. 2023;38(1):43-9. DOI: 10.1016/j.jhqr.2022.05.004
16. Niemann MH, Alvarado MC, Camayd Muñoz C, Jonas RR, Wenger JK, Douglass LM. A multimodal telehealth strategy to improve pediatric epilepsy care. Pediatr Clin North Am. 2020;67(4):629-34. DOI: 10.1016/j.pcl.2020.04.004
17. Bahrani K, Singh MB, Bhatia R, Prasad K, Vibha D, Shukla G, et al. Telephonic review for outpatients with epilepsy-A prospective randomized, parallel group study. Seizure. 2017;53:55-61. DOI: 10.1016/j.seizure.2017.11.003
18. Rodríguez N, Palacios E, Vergara JP, Salgado SA, Gaona I. Satisfacción del neurólogo y de los pacientes con diagnóstico de epilepsia en una consulta de seguimiento a través de telemedicina sincrónica en el Hospital San José de Arjona (Bolívar), 2014-2015. Acta Neurológica Colomb. 2015;31(3):253-60.DOI: 10.22379/2422402238
