Telemedicine for Delivery of Care in Frontotemporal Lobar Degeneration During COVID-19 Pandemic: Results from Southern Italy
Telemedicine for Delivery of Care in Frontotemporal Lobar Degeneration During COVID-19 Pandemic: Results from Southern Italy
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DOI：
10.3233/jad-200589
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发表时间：
2020-01-01
影响因子：
4
通讯作者：
Logroscino, Giancarlo
中科院分区：
文献类型：
--
作者：
Capozzo, Rosa;Zoccolella, Stefano;Logroscino, Giancarlo
背景：在许多国家政府决定实行社交距离和中断医疗非紧急服务后，COVID-19 大流行正在改变神经病学的临床实践。远程神经学是对患者进行远程评估的有效工具，但其在额颞叶痴呆 (FTD) 中的应用尚处于初步阶段。 目的：我们在 COVID-19 大流行期间使用远程医疗对 FTD 患者进行多学科评估。方法：根据国际标准，所有患者在 2018-2019 年期间均接受了 FTD 诊断。神经科医生与患者和/或护理人员一起使用结构化问卷和临床痴呆评定量表 (CDR)-FTD。搜索了 COVID-19 感染的指标症状。结果：与护理人员完成了 28 次临床访谈，其中 4 次与患者/护理人员双方进行了临床访谈。大多数患者和护理人员对神经学访谈感到满意，并表示愿意继续参与远程评估计划（90%）。自社交距离开始以来，百分之五十的患者的临床表现和生活质量显着恶化。与中心最后一次现场评估相比，CDR-FTD 量表显示行为 (p = 0.01) 和语言功能 (p = 0.009) 显着恶化。一名患者出现了 COVID-19 感染的指标症状，并经咽拭子证实为 COVID-19 阳性。结论：该研究是在意大利进行的，意大利是受 COVID-19 大流行影响特别严重的国家之一，所有非紧急医疗服务均已中断。我们的研究表明，远程医疗是对 FTD 患者进行分类的有效工具，可提高实践范围和效率。
Background: The COVID-19 pandemic is changing clinical practice in neurology, after the governments decided the introduc-tion of social distancing and interruption of medical non-emergency services in many countries. Teleneurology is an effective tool for the remote evaluation of patients but its adoption for frontotemporal lobar dementia (FTD) is in a preliminary stage.Objective: We evaluated multidisciplinary assessment of patients with FTD using telehealth during the COVID-19 pandemic.Methods: All patients received a diagnosis of FTD during 2018-2019 according to international criteria. A structured questionnaire and Clinical Dementia Rating Scale (CDR)-FTD were used by the neurologist with patients and/or caregivers. Index symptoms of COVID-19 infection were searched.Results: Twenty-eight clinical interviews were completed with caregivers and four with both patients/caregivers. Most patients and caregivers were satisfied with the neurological interview and expressed their willingness to continue to be included in remote evaluation programs (90%). Fifty percent of patients experienced significant worsening of clinical picture and quality of life since the start of social distancing. The CDR-FTD scale revealed a significant worsening of behavior (p = 0.01) and language functions (p = 0.009), compared to the last in-person evaluation at the center. One patient presented index symptoms of COVID-19 infection and was confirmed to be positive for COVID-19 with pharyngeal swab.Conclusion: The study was conducted in Italy, one of the countries hit particularly hard by the COVID-19 pandemic, with interruption of all non-emergency medical services. Our study indicates that telemedicine is a valid tool to triage patients with FTD to increase practice outreach and efficiency.