Erschienen in:
07.07.2020 | COVID-19 | Original Communication
Zur Zeit gratis
Impact of COVID-19 on U.S. and Canadian neurologists’ therapeutic approach to multiple sclerosis: a survey of knowledge, attitudes, and practices
verfasst von:
Farrah J. Mateen, Shawheen Rezaei, Nicholas Alakel, Brittany Gazdag, Aditya Ravi Kumar, Andre Vogel
Erschienen in:
Journal of Neurology
|
Ausgabe 12/2020
Einloggen, um Zugang zu erhalten
Abstract
Objective
To report the understanding and decision-making of neuroimmunologists and their treatment of patients with multiple sclerosis (MS) during the early stages of the SARS-CoV-2 (COVID-19) outbreak.
Methods
A survey instrument was designed and distributed online to neurologists in April 2020.
Results
There were 250 respondents (response rate 21.8%). 243 saw > = 10 MS patients in the prior 6 months (average 197 patients) and were analyzed further (92% USA, 8% Canada; average practice duration 16 years; 5% rural, 17% small city, 38% large city, 40% highly urbanized). Patient volume dropped an average of 79% (53–11 per month). 23% were aware of patients self-discontinuing a DMT due to fear of COVID-19 with 43% estimated to be doing so against medical advice. 65% of respondents reported deferring > = 1 doses of a DMT (49%), changing the dosing interval (34%), changing to home infusions (20%), switching a DMT (9%), and discontinuing DMTs altogether (8%) as a result of COVID-19. Changes in DMTs were most common with the high-efficacy therapies alemtuzumab, cladribine, ocrelizumab, rituximab, and natalizumab. 35% made no changes to DMT prescribing. 98% expressed worry about their patients contracting COVID-19 and 78% expressed the same degree of worry about themselves. > 50% believed high-efficacy DMTs prolong viral shedding of SARS-CoV-2 and that B-cell therapies might prevent protective vaccine effects. Accelerated pace of telemedicine and practice model changes were identified as major shifts in practice.
Conclusions
Reported prescribing changes and practice disruptions due to COVID-19 may be temporary but could have a lasting influence on MS care.