ABSTRACT
Background: The COVID-19 pandemic has created social and medical disruptions to the Australian community. The introduction of telehealth Medicare Benefits Schedule (MBS) item numbers in early March 2020 has shifted mental health consultations from face-to-face to telehealth. There is a literature gap pertaining to the ongoing trends that extend past the initial 'first wave' of the pandemic in the context of an Australian landscape. Aim/Objective: To describe the pattern of mental health care consultations in a university-based general practice in Sydney, specifically, the distribution of face-to-face, telephone and tele-video consultations, according to the change in socio-political landscape and lockdowns. The secondary aim is to explore the effect of age, ethnicity, birth sex and student status, and the severity of patient symptoms via K10/DASS21 scores. Method(s): Retrospective data will be obtained from records of 456 patients attending a university-based general practice in Sydney, Australia between four different 35-day time periods: baseline pre- COVID-19 (1st February 2019 to 8th March 2019);first COVID-19 lockdown (31st March 2020 to 5th May 2020);second COVID-19 lockdown (20th August 2021 to 24th September 2021);post COVID-19 lockdown (1st February 2022 to 8th March 2022). Attendances will be defined by mental health MBS codes that correspond to mental health consultations, mental health care plans, and mental health care plan reviews, for face-to-face, telephone and tele-video consultations. K10/DASS21 scores will also be obtained. Statistical analysis will be performed using the two-sample t-test on SPSS. Finding(s): Data analysis is currently in progress. Results will be available by July 2022. Implications: Given the recent temporary telehealth extension announced by the Australian Government on 16th January 2022, the findings of our study will illustrate the impact of the COVID-19 pandemic on mental health consultations in various subgroups and provide additional data for policymakers to facilitate further examination in continuing MBS subsidisation.
ABSTRACT
Objective: The objective of this study is to investigate the utility of the virtual neurological examination (VNE) in arriving at an accurate localization and diagnosis, in comparison with the traditional in-person neurological examination (IPNE). Background: The Coronavirus disease 2019 (COVID-19) pandemic forced a shift to virtual care within many neurological care settings. Little is known about the validity of the VNE for clinical decision-making compared to the IPNE. This study will provide further insight into the value of the VNE in the outpatient setting. Design/Methods: A retrospective chart review is being conducted of patients who were evaluated and examined virtually and in-person within 4 months in the outpatient general neurology, cognitive neurology, neuromuscular, and stroke clinics at two tertiary care centers at the University of Toronto during the COVID-19 pandemic. Descriptive statistical methods are used to compare virtual and in-person assessment results, accuracy, localization, diagnosis, investigations and management approaches. Results: Preliminary comparison of 10 patients from the neuromuscular clinic at St. Michael's Hospital, showed only 2 cases where the localization changed after the IPNE. Interestingly, in both cases, the additional findings on the IPNE, not documented on the VNE, were unrelated to the reason for referral. In 4 cases, the IPNE provided increased diagnostic certainty, but did not change the leading differential diagnosis after the virtual assessment. In the remaining 6 cases, the diagnosis made after both virtual and in-person assessments were unchanged. Conclusions: The study is ongoing, and full results will be presented (N=∼60). Preliminary results show that conclusions drawn from a VNE appear comparable to those from an INPE in diagnosis and localization of neurological complaints. The IPNE may provide a more detailed assessment to detect subtle abnormalities unrelated to the reason for referral. This study's outcomes will inform the use of virtual care across a variety of neurological presentations.
ABSTRACT
Background: The outbreak of the COVID-19 pandemic has led to unprecedented disruptions to global cancer care delivery. We conducted this multidisciplinary survey to gain insights into the real-life impact of the pandemic as perceived by cancer patients. Methods: Cancer patients at various stages of their cancer journeys were surveyed with a questionnaire constructed by a multidisciplinary panel of oncologists, clinical psychologists, occupational therapists, physiotherapists and dieticians. The 64-question survey covered patient's concerns on cancer care resources, treatment provision and quality, changes in health-seeking behaviour;the impact of social isolation on physical wellbeing and psychological repercussions. Results: 600 cancer patients in Hong Kong were surveyed in May 2020. Preliminary results showed that 70% of respondents related a COVID-19 diagnosis to compromised cancer treatment and outcome. Although only 45% considered hospital attendance as safe, 80% indicated their willingness to attend oncology appointments remained unaffected. 91% of patients stated their decision to receive chemotherapy was not changed;however, 40% would be willing to trade off the efficacy/side-effect profile for an outpatient regimen. Patients also reported compromised physical wellbeing due to social isolation, in particular, deterioration in exercise tolerance & limb power (44%), reduced appetite (29%), worse sleep quality (35%). Interestingly, 59% of pts reported better care support as a result of family spending more time together. Anxiety and depression were reported in 70% and 54% of patients, respectively. In addition, 20 oncologists provided their predictions on changes in pt's health-seeking behaviours under the pandemic. Results showed that they significantly underestimated patients' willingness and preference to keep their scheduled oncology appointments and treatments despite the risk involved. Conclusions: This original survey revealed the breadth and profoundness of the impact of the COVID-19 pandemic as perceived by cancer patients, headlining patients’ care priorities and showing their unmet needs. It should be taken into consideration as we modify the way cancer care is provided during this unsettling period and beyond. Legal entity responsible for the study: The authors. Funding: The Kowloon Central Cluster Research Committee KCC Research Grant 2020/21, Hong Kong (KCC/RC/G/2021-B01). Disclosure: All authors have declared no conflicts of interest.