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The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular
Hillary Brenda Nguyen1,2, Neha Mulpuri3, Danielle Cook2
1Harvard Medical School, Boston, MA 02115, USA.
Insights
The COVID-19 pandemic disrupted care for children with cerebral palsy (CP) and neuromuscular complex chronic conditions (NCCCs), significantly reducing in-person visits and procedures. Telemedicine use surged, becoming crucial for managing these patients.
Area of Science:
- Pediatric Healthcare
- Neurology
- Public Health
Background:
- The COVID-19 pandemic presented significant challenges to healthcare systems globally.
- Children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs) require specialized, ongoing care.
- Disruptions in care can negatively impact patient outcomes.
Purpose of the Study:
- To investigate the direct impact of the COVID-19 pandemic on healthcare delivery for children with CP and NCCCs.
- To compare healthcare practices for these patients before and during the pandemic.
- To identify challenges and adaptations in managing NCCC patients during a public health crisis.
Main Methods:
- A cross-sectional survey was administered to medical professionals caring for CP and NCCC patients.
- The survey collected data from May to August 2020 across multiple countries and disciplines.
- Participants compared healthcare delivery practices before and during the COVID-19 pandemic.
Main Results:
- Most healthcare workers (79 from 8 countries) reported difficulties in caring for NCCC patients during the pandemic.
- Significant decreases were observed in in-person NCCC clinic volume, multidisciplinary appointments, surgical cases, and injections (p < 0.001).
- Telemedicine usage for NCCC patient visits increased significantly (p < 0.001), with modified institutional guidelines for procedures and settings.
Conclusions:
- The COVID-19 pandemic led to a loss of routine, multidisciplinary care access for many children with NCCCs.
- Telemedicine emerged as an integral tool for communication and management.
- These findings provide a basis for understanding evolving healthcare delivery and developing best practices for future disruptions.
Abstract:
The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from eight countries who participated-predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)-most of them felt that caring for NCCC patients during the pandemic presented unique difficulties, and they reported a significant decrease in the in-person NCCC clinic volume (p < 0.001), multidisciplinary appointments (p < 0.001), surgical cases (p = 0.008), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. The usage of telemedicine significantly increased for NCCC patient visits (p < 0.001). During the COVID-19 pandemic, many children with NCCCs lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and with the threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCCs.
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