Takafumi Kubota1, Naoto Kuroda2, Toru Horinouchi3, Naoki Ikegaya4, Yu Kitazawa5, Satoshi Kodama6, Izumi Kuramochi7, Teppei Matsubara8, Naoto Nagino9, Shuichiro Neshige10, Temma Soga11, Yutaro Takayama12, Daichi Sone13. 1. 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. Electronic address: takafumi.kubota.c7@tohoku.ac.jp. 2. 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. 3. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. 4. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan. Electronic address: nikegaya@yokohama-cu.ac.jp. 5. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurology and Stroke Medicine, Yokohama City University, Yokohama, Kanagawa, Japan. 6. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 7. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan. 8. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA. 9. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Epilepsy Center, TMG Asaka Medical Center, Asaka, Saitama, Japan. 10. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Hiroshima, Japan. 11. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. 12. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. 13. Japan Young Epilepsy Section, Kodaira, Tokyo, Japan; Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.
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.
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.