TY - JOUR
T1 - Disruptions of neurological services, its causes and mitigation strategies during COVID-19
T2 - a global review
AU - García-Azorín, David
AU - Seeher, Katrin M.
AU - Newton, Charles R.
AU - Okubadejo, Njideka U.
AU - Pilotto, Andrea
AU - Saylor, Deanna
AU - Winkler, Andrea Sylvia
AU - Charfi Triki, Chahnez
AU - Leonardi, Matilde
N1 - Funding Information:
DGA declares grants from the Regional Health Administration and International Headache Society; honoraria for reviewing manuscripts for the review from the World Health Organization; travel support from Teva, Lilly, Novartis and Allergan; participation in advisory board from Allergan; membership of the Spanish Society of Neurology executive board. Only the WHO payment is related with the present work. NO declares grants from Michael J Fox Foundation for Parkinson’s disease research and Tertiary Education Trust Fund (National Research Fund); payment or honoraria from International Parkinson and Movement Disorders Society Speaker Honorarium; support from International Parkinson and Movement Disorder Society support for attending meetings; leadership as Chairperson of Africa Section of Steering Committee, International Parkinson and Movement Disorder Society. DS declares grants or contracts from National Institutes of Neurological Disorders and Stroke; national Multiple Sclerosis Society, National Institutes of Mental Health, and American Academy of Neurology, not related with this work; payment honoraria for lectures for Medlink Neurology and member as Multiple Sclerosis International Federation Global Access Working Group. AP declares payment for lectures honoraria from Abbvie, Biomarin, Chiesi, Nutricia, UCB, Zambon pharmaceuticals.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Background: The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods: Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings: The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation: The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.
AB - Background: The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods: Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings: The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation: The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.
KW - COVID-19
KW - Health services administration
KW - Nervous system diseases
KW - Neurology
KW - Telemedicine
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U2 - 10.1007/s00415-021-10588-5
DO - 10.1007/s00415-021-10588-5
M3 - Review article
C2 - 34021772
AN - SCOPUS:85106427239
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
SN - 0340-5354
ER -