Impact of COVID-19 Pandemic on Epilepsy Practice in Japan: A National-Level Multicenter Survey Initiated by Young Epilepsy Section
Abstract number :
3.361
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2021
Submission ID :
1826320
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Naoto Kuroda, MD - Wayne State University; Toru Horinouchi – Department of Psychiatry and Neurology – Hokkaido University Graduate School of Medicine; Naoki Ikegaya – Department of Neurosurgery – Graduate School of Medicine, Yokohama City University; Yu Kitazawa – Department of Pediatrics – Wayne State University; Satoshi Kodama – Department of Neurology – The University of Tokyo; Takafumi Kubota – Department of Neurology – University Hospitals of Cleveland Medical Center / Case Western Reserve University; Izumi Kuramochi – Department of Psychiatry – Saitama Medical University; Teppei Matsubara – Athinoula A. Martinos Center for Biomedical Imaging – Massachusetts General Hospital; Naoto Nagino – Epilepsy Center – TMG Asaka Medical Center; Shuichiro Neshige – Department of Clinical Neuroscience and Therapeutics – Hiroshima University; Temma Soga – Department of Epileptology – Tohoku University Graduate School of Medicine; Daichi Sone – Department of Clinical and Experimental Epilepsy – UCL Institute of Neurology; Yutaro Takayama – Department of Neurosurgery – National Center Hospital, National Center of Neurology and Psychiatry
Rationale: Epilepsy practice has been greatly affected worldwide by the coronavirus disease (COVID-19) pandemic. We investigated the impact of COVID-19 on epilepsy practice by conducting a national-level survey among leading hospitals and clinics in Japanese epilepsy practice.
Methods: We surveyed four clinics specializing in epilepsy care and 20 hospitals accredited as (quasi-)epilepsy centers or epilepsy training facilities. We collected monthly data on the number of visits by outpatients with epilepsy, outpatient electroencephalography (EEG) results, and telemedicine in epilepsy in each facility between January 2019 and December 2020. We collected data on the number of admissions for epilepsy, EEG monitoring, and epilepsy surgery from the 20 aforementioned hospitals. We compared these outcome measurements for each month at each facility between 2019 and 2020 using the Wilcoxon signed-rank test. We also performed linear mixed-model analysis to determine the factors associated with these outcomes. Fixed effects incorporated the number of populations in each prefecture, physicians with epilepsy board certificates in each facility, COVID-19 cases in each prefecture in the previous month, and whether a state of emergency was declared (April–May 2020, in Japan). For the outcomes of the number of visits by outpatients with epilepsy, outpatient EEG results, and telemedicine in epilepsy, the fixed effects also included the type of facility (hospital/clinic). The random effects included the facilities.
Results: Figure 1 shows the monthly transition for each outcome. The Wilcoxon signed-rank test showed a significantly lower number of visits by outpatients with epilepsy (p < 0.001), outpatient EEG results (p < 0.001), number of admissions for epilepsy (p < 0.001), and EEG monitoring (p = 0.016) and a significantly greater number of cases of telemedicine in epilepsy (p < 0.001) in 2020 than in 2019. The linear mixed model demonstrated that the declaration of a state of emergency was an independent predictor associated with the number of visits by outpatients with epilepsy (estimate = -77.5: p < 0.001), outpatient EEG results (estimate = -35.5: p < 0.001), telemedicine in epilepsy (estimate = 106.1: p < 0.001), admissions for epilepsy (estimate = -9.1: p = 0.001), EEG monitoring (estimate = -3.3: p = 0.01), and epilepsy surgery (estimate = -0.89: p = 0.004). Meanwhile, the number of COVID-19 cases in each prefecture was an independent predictor associated with the number of outpatient EEGs (estimate = -0.002: p < 0.001), telemedicine in epilepsy (estimate = 0.023: p < 0.001), and epilepsy admissions (estimate = -0.0005: p = 0.009).
Conclusions: Our national-level survey demonstrated that the emergency declaration due to the COVID-19 pandemic, as well as the number of COVID-19 cases in each prefecture, had tremendous effects on Japanese epilepsy practice.
Funding: Please list any funding that was received in support of this abstract.: None.
Health Services (Delivery of Care, Access to Care, Health Care Models)