Elsevier

Epilepsy & Behavior

Volume 126, January 2022, 108487
Epilepsy & Behavior

Barriers to telemedicine among physicians in epilepsy care during the COVID-19 pandemic: A national-level cross-sectional survey in Japan

https://doi.org/10.1016/j.yebeh.2021.108487Get rights and content

Highlights

  • We studied the factors affecting physician’s unwillingness to provide care via telemedicine.

  • During the coronavirus-2019 pandemic, telemedicine was used for healthcare delivery.

  • Our nation-wide cross-sectional survey focused on epilepsy care provided via telemedicine.

  • Workload due to telemedicine caused the physicians’ unwillingness to continue it.

Abstract

Objective

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.

Method

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.

Result

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.

Conclusion

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.

Keywords

Telemedicine
Telehealth
Epilepsy
Seizure
Barrier
COVID-19

Cited by (0)

1

Equally contribution.

View Abstract