GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France.
Neurourol Urodyn. 2021 Mar;40(3):929-937. doi: 10.1002/nau.24651. Epub 2021 Mar 6.
The COVID-19 pandemic led to limit patients' visits to the neuro-urology department. Telemedicine was seen as a pragmatic solution to provide follow-up care. This study aimed to assess the efficiency and satisfaction of a telephone consultation in neuro-urology.
During the pandemic, the scheduled medical visits were converted into telephone consultation. For each teleconsultation, the physician assessed the efficiency and the patient-rated global satisfaction of the teleconsultation. The physician and the patient assessed whether this teleconsultation replaced a physical visit.
About 358 neurologic patients were included in the study. The mean efficiency of the telephone consultation was 9.3/10 (±1.5). The mean global satisfaction was 9.0/10 (±1.3). The majority of the patients (52.4%) would prefer a physical consultation. 90.2% might convert some clinic visits to teleconsultations in the future. No agreement was found between the patient and the physician when they were asked if the teleconsultation replaced the physical consultation initially scheduled (weight kappa = 0.02; 95% confidence interval = [-0.06 to 0.11]). Cognitive impairment, difficulty to obtain relevant information, and lack of physical examination were unfavorable to the efficiency of the teleconsultation. Cognitive impairment, embarrassing nature of the teleconsultation, and preference for a physical consultation were unfavorable to satisfaction of the patient.
Telemedicine in neuro-urology was associated with a high satisfaction of the patients and was described as efficient by the physicians. Despite this, the majority of the patients reported a preference for physical consultation. The COVID-19 pandemic might be an opportunity to refine our practices in neuro-urology and to develop telemedicine.
新冠疫情导致患者就诊神经泌尿科受限。远程医疗被视为提供随访的一种实用方法。本研究旨在评估神经泌尿科电话咨询的效率和满意度。
疫情期间，将预约门诊就诊转换为电话咨询。每次电话咨询后，医生评估电话咨询的效率和患者对电话咨询的总体满意度。医生和患者评估该电话咨询是否可以替代实际就诊。
本研究共纳入 358 例神经科患者。电话咨询的平均效率为 9.3/10（±1.5）。总体满意度平均为 9.0/10（±1.3）。大多数患者（52.4%）更愿意进行实际就诊。90.2%的患者将来可能会将部分就诊转为电话咨询。当被问及电话咨询是否可以替代最初预约的实际就诊时，患者和医生之间没有达成一致意见（加权 Kappa 值=0.02；95%置信区间=[-0.06 至 0.11]）。认知障碍、难以获取相关信息和缺乏体格检查不利于电话咨询的效率。认知障碍、电话咨询的尴尬性质和对实际就诊的偏好不利于患者满意度。
神经泌尿科的远程医疗得到了患者的高度认可，医生也认为其效率较高。尽管如此，大多数患者仍表示更倾向于实际就诊。新冠疫情可能是我们完善神经泌尿科实践和发展远程医疗的机会。
