Department of Neurology, University of Colorado, Aurora, CO, USA.
Department of Neurology, University of Colorado, Aurora, CO, USA.
Epilepsy Behav. 2022 Jun;131(Pt A):108707. doi: 10.1016/j.yebeh.2022.108707. Epub 2022 Apr 21.
The ILAE task force has identified a gap in treatment access for patients with nonepileptic seizures (NES) [1]. Access to multidisciplinary treatment clinics for adults with NES is limited with only 18 institutions delivering care across the United States [2]. Patient engagement has been low in the University of Colorado, NES Clinic treatment program despite our clinic's status as the only clinic of its kind in the mountain west. We analyzed patient factors of those who engaged in treatment before and after COVID-19 regulations were imposed and found a 23.6% increase in treatment engagement using telehealth. Those who engaged using telehealth were more likely to be of white race, of non-Hispanic ethnicity, publicly insured, employed, have a Charlson Comorbidity Index (CCI) of zero, a daily seizure rate of 0-1, did not have suicidal ideation or attempts, and live greater than 25 miles from the NES clinic. Delivering NES treatment via telehealth reduced the logistical and psychological barriers to initiating recovery and with a severe lack of accessible treatments for patients with NES, barrier reduction is necessary. This study describes patient factors that result in higher engagement with NES treatment using telehealth and emphasizes the importance of telehealth utilization to improve access to available treatment.
ILAE 工作组已经确定了非癫痫性发作（NES）患者治疗机会不足的问题[1]。美国只有 18 家机构提供成人 NES 的多学科治疗诊所服务，因此获得这种治疗的机会有限[2]。尽管我们的诊所是落基山以西唯一的此类诊所，但科罗拉多大学 NES 诊所的治疗计划参与度一直很低。在 COVID-19 规定实施前后，我们分析了参与治疗的患者的因素，发现使用远程医疗治疗的参与度增加了 23.6%。那些使用远程医疗进行治疗的患者更有可能是白人，非西班牙裔，有公共保险，有工作，Charlson 合并症指数（CCI）为零，每日发作率为 0-1，没有自杀意念或尝试，并且居住在距离 NES 诊所 25 英里以上。通过远程医疗提供 NES 治疗减少了启动康复的后勤和心理障碍，而对于 NES 患者来说，严重缺乏可获得的治疗方法，因此减少障碍是必要的。本研究描述了使用远程医疗进行 NES 治疗的患者参与度更高的因素，并强调了远程医疗的重要性，以提高可获得治疗的机会。
