Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurology, University Hospitals of Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA; Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA.
Epilepsy Behav. 2022 Jan;126:108487. doi: 10.1016/j.yebeh.2021.108487. Epub 2021 Dec 3.
This study aimed to investigate the factors affecting the unwillingness of physicians involved in epilepsy care to continue telemedicine during the coronavirus disease 2019 (COVID-19) pandemic in Japan.
This was a national-level cross-sectional survey initiated by Japan Young Epilepsy Section (YES-Japan) which is a national chapter of The Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES). We asked physicians who conducted telemedicine in patients with epilepsy (PWE) during the COVID-19 pandemic at four clinics and 21 hospitals specializing in epilepsy care in Japan from March 1 to April 30, 2021. The following data were collected: (1) participant profile, (2) characteristics of PWE treated by telemedicine, and (3) contents and environmental factors of telemedicine. Statistically significant variables (p < 0.05) in the univariate analysis were analyzed in a multivariate binary logistic regression model to detect the independently associated factors with the unwillingness to continue telemedicine.
Among the 115 respondents (response rate: 64%), 89 were included in the final analysis. Of them, 60 (67.4%) were willing to continue telemedicine, and 29 (32.6%) were unwilling. In the univariate binary logistic regression analysis, age (Odds ratio [OR] = 1.84, 95% confidence interval [CI] 1.10-3.09, p = 0.02), psychiatrist (OR = 5.88, 95% CI 2.15-16.08, p = 0.001), hospital (OR = 0.10, 95% CI 0.01-0.94, p = 0.04), the number of COVID-19 risk factors in the participant (OR = 2.88, 95% CI 1.46-5.69, p = 0.002), the number of COVID-19 risk factors in the cohabitants (OR = 2.52, 95% CI 1.05-6.01, p = 0.04), COVID-19 epidemic area (OR = 4.37, 95% CI 1.18-16.20, p = 0.03), consultation time during telemedicine (OR = 2.51, 95% CI 1.32-4.76, p = 0.005), workload due to telemedicine (OR = 4.17, 95% CI 2.11-8.24, p < 0.001) were statistically significant. In the multivariate binary logistic regression analysis, workload due to telemedicine (OR = 4.93, 95% CI 1.96-12.35) was independently associated with the unwillingness to continue telemedicine.
This national-level cross-sectional survey found that workload due to telemedicine among physicians involved in epilepsy care was independently associated with the unwillingness to continue telemedicine.
本研究旨在探讨日本参与癫痫护理的医生在新冠疫情期间不愿意继续远程医疗的影响因素。
这是一项由日本青年癫痫分会（YES-Japan）发起的全国性横断面调查，该分会是国际抗癫痫联盟青年癫痫分会（ILAE-YES）的一个国家级分会。我们调查了在 2021 年 3 月 1 日至 4 月 30 日期间，在日本四家诊所和 21 家专门从事癫痫护理的医院为癫痫患者（PWE）进行远程医疗的医生。收集了以下数据：（1）参与者特征，（2）接受远程医疗的 PWE 的特征，和（3）远程医疗的内容和环境因素。对单因素分析中具有统计学意义的变量（p<0.05）进行多变量二元逻辑回归模型分析，以检测与不愿意继续远程医疗相关的独立因素。
在 115 名应答者中（应答率：64%），有 89 名被纳入最终分析。其中，60 名（67.4%）愿意继续远程医疗，29 名（32.6%）不愿意。在单因素二元逻辑回归分析中，年龄（比值比[OR] = 1.84，95%置信区间[CI] 1.10-3.09，p=0.02）、精神科医生（OR = 5.88，95%CI 2.15-16.08，p=0.001）、医院（OR = 0.10，95%CI 0.01-0.94，p=0.04）、参与者的 COVID-19 风险因素数量（OR = 2.88，95%CI 1.46-5.69，p=0.002）、共同居住者的 COVID-19 风险因素数量（OR = 2.52，95%CI 1.05-6.01，p=0.04）、COVID-19 流行地区（OR = 4.37，95%CI 1.18-16.20，p=0.03）、远程医疗期间的咨询时间（OR = 2.51，95%CI 1.32-4.76，p=0.005）、远程医疗工作量（OR = 4.17，95%CI 2.11-8.24，p<0.001）有统计学意义。在多因素二元逻辑回归分析中，远程医疗工作量（OR = 4.93，95%CI 1.96-12.35）与不愿意继续远程医疗独立相关。
这项全国性横断面调查发现，参与癫痫护理的医生的远程医疗工作量与不愿意继续远程医疗有关。
