Different scientific associations have elaborated recommendations about MS and/or NMOSD patients care and management during COVID-19 pandemic. They advised to take extra care to minimize their exposure to the virus and use alternatives to face-to-face medical appointments. This has prompted a transition of conventional care to telemedicine (TM) as quickly as possible. There is no data regarding current patient’s follow-up neither TM usage among MS and/or NMOSD Latin American experts.
To investigate experiences from Latin American MS and/or NMOSD experts on follow-up of their patients focusing on TM management.
A cross-sectional study was performed. 141 MS and/or NMOSD experts from Argentina (AR), Chile (CH), Colombia (CO) and Brazil (BR) were invited to answer an anonymous, voluntary web-based survey. The survey was sent via email (3 July 2020) to potential respondents and was available online for only one week to avoid bias regarding epidemic change in our region.
A total of 129 (91.48 %) experts completed the survey (56 from AR, 33 BR, 30 CH, and 10 CO), age 41.23 ±10.20, 43.4% works at public hospital. Regarding medical appointments (virtual or face-to-face), it decreased on a 50% during the pandemic era (14.78 ±16.71 and 7.43 ±9.68 patients/week before and during the COVID-19 pandemic respectively). Only 19.4% had experience in TM previous COVID-19 pandemic (26.8% AR, 0% BR, 23.3% CH, and 30% CO), while 79.8% are currently using TM (89.3% AR, 75.8% BR, 60% CH, and 100% CO). Most of them using video call (52.3%). Using TM, 44.1% of the experts were able to carry out neurological examination, 85.6% believe be able to identify a relapse, 48.6% use Patient Determined Disease Steps (PDDS) and 38.7% continue using the conventional Expanded Disability Status Scale (EDSS). On the other hand, 83.7% continue face-to-face medical appointment, the most frequent causes were: first time appointment (91.8%), therapeutic failure (94.%) and management of a relapse (97.3%) and only 20% for the routine appointment. To decrease virus exposure, only 40% perform a complete and thorough neurological evaluation, most of them avoid funduscopy.
Considering the vertiginous speed of the spread of COVID-19 in Latin American, results from our survey demonstrate preparedness and responsiveness among Latin American MS and/or NMOSD experts. Despite scarce prior TM experience, most experts were able to use TM as a new tool for monitoring their patients.