Telehealth approach for amyotrophic lateral sclerosis patients: the experience during COVID-19 pandemic
Background and objective
Specialized multidisciplinary ALS care has been shown to extend survival and improve patient’s and caregiver’s quality of life. During the COVID-19 pandemic, the management of patients suddenly changed and telemedicine has been proven to be as effective as outpatient care. We elaborate the experience with Telemedicine of a Tertiary ALS Center from an Italian geographical area with high infectious risk during the COVID-19 pandemic.
Methods
19 patients were evaluated in telemedicine by a multidisciplinary team including a neurologist (clinical evaluation, intercurrent events, and drug prescriptions); a dietician (diet and weight monitoring); a psychologist (psychological assessment and support); and a physiotherapist (physiotherapy treatment and device prescription). Telemedicine was performed using the online platform “IoMT Connected Care Platform (Ticuro Reply).”
Results
All patients reported a positive perception of talking face to face with healthcare professionals and were satisfied with how the team understood their problems. During video televisits, there was a change in the patient’s medication regimen in 11/19; 2/19 required pneumological evaluation and started NIV; and 9/16 patients required prescription of devices. The mean monthly decline of ALSFRS-R before televisit was 0.88 (SD 1.17) and during televisit of 0.49 (SD 0.75). Bodyweight and daily caloric content remain stable. Reduction in HADS scores and stability in ALSAQ-40 were observed.
Discussion
Our study positively reproduced the multidisciplinary approach currently used with ALS patients, trying to stabilize the functional and metabolic status and improving the psychological one. Future directions include a personalized telemedicine program according to the patient’s needs.
Reference:
De Marchi F, Sarnelli MF, Serioli M, De Marchi I, Zani E, Bottone N, Ambrosini S, Garone R, Cantello R, Mazzini L; CANPALS Study Group. Telehealth approach for amyotrophic lateral sclerosis patients: the experience during COVID-19 pandemic. Acta Neurol. Scand. 2020 Nov 13. doi: 10.1111/ane.13373. Epub ahead of print. PMID: 33185886.
