ABSTRACT
Objective: To evaluate feasibility of remote visits in people with MS (pwMS). Background: Disease monitoring in multiple sclerosis (MS) includes periodic visits to treating neurologists (MSologists) for a clinical and paraclinical examinations. In light of the recent Coronavirus pandemic, there is an urgent need to develop and implement strategies for remote patient monitoring using telemedicine. Design/Methods: We randomized 45 pwMS into three groups that determined the modality of their next scheduled visit: (i) regular outpatient visit, (ii) a visit over the phone or (iii) a visit by means of video chat. Baseline disease characteristics included clinical information (EDSS, treatment, disease duration) and patient reported outcomes (Multiple Sclerosis Impact Scale, MSIS). As the primary endpoint, non-inferiority of telemedical visits (groups ii and iii) was determined based on mean scores on the TMPQ (Telemedicine Physician Satisfaction Questionnaire: min: 17 and max: 85 points) at follow up compared to regular visits (group i). The secondary endpoint consisted of physician satisfaction with the single visits based on the PPSM (Patient and Physician Satisfaction) score (min: 6 and max: 36 points). Results: 42 pwMS completed this study. The mean (SD) age was 34 (8) years, median EDSS was 0 (range: 0-6). The mean (SD) disease duration was 6 (2.4) years. Satisfaction with the telemedical visits (groups ii and iii) was non-inferior compared to regular visits (group i). Mean (SD) TMPQ scores were 73 (4.3) in the regular visit group, 79 (3.9) in the telephone visit group, and 76 (3.7) in the video chat group. Physician satisfaction was similar for all three groups. PPSM scores were 32 (3.3) in the regular visit group, 32 (2.7) in the telephone visit group, and 34 (1.8) in the video chat group. Conclusions: In this randomized controlled trial, single tele-visits for pwMS were not inferior to regular visit determined by patient and physician satisfaction.
ABSTRACT
The COVID-19 pandemic has meant a major crisis for Ecuador. It seriously affected the population's economic situation and involved immediate decisions in educational issues, as well as uncertainty and negative expectations in labor issues. As an involuntary social experiment, it showed three types of knowledge breakdown: the population's practical and everyday knowledge, scientific knowledge and knowledge about science, and emotional knowledge. Building these knowledge types makes things easier to spread false information, misunderstanding of science, and emotional confusion. To do this, the article is based on a nation-wide survey with over 2,000 households in Ecuador, carried out between May and July 2020. These data enable a review of the pandemic's social impacts, including the pre-existing structures that made them possible. © 2021 Universidade Federal de Goias. All rights reserved.