COVID-19’s Impact on Clinical Care Strategies: Adopting New Methods

Author(s):

NeurologyLive compiled a number of interviews and conversations with leaders within the neurology community to discuss how they adopted new methods of care throughout the COVID-19 pandemic.

As the calendar year concludes, NeurologyLive took the time to look back and reflect on how COVID-19, and the pandemic itself, has impacted clinical care across a range of different conditions and treatment strategies in 2020. This second segment of “Reflections on the Impact of COVID-19: A Short Expert Series,” covers how clinicians made adjustments, including which new strategies they adopted for their clinical care.

click here to check out the rest of the series!

As the pandemic continued to protrude on the normal ways of clinical care, physicians across the world remained quick on their feet, and adapted new styles ranging from treatment regimens, to emergency protocols, and increased use of telemedicine.

A multitude of recommendations were published throughout the year, each in effort to minimize the risk of infectious exposure to COVID-19. For patients with epilepsy, an important factor was to limit the risk of seizure exacerbation through treatment adherence and ensure a regular supply of medication. In May, recommendations were created by an international group to seek optimized care, and were led by Jacqueline French, MD, professor of neurology at NYU Grossman School of Medicine, director of epilepsy research and epilepsy clinical trials, NYU Langone Health’s Comprehensive Epilepsy Center.

To ensure minimize the risk of exposure for emergency medical services (EMS) providers when transferring patients with stroke, recommendations were created by an international group of stroke specialists, on behalf of the American Heart Association (AHA) and American Stroke Association (ASA) Stroke Council Science Subcommittees. They called for need for additional screening and enhanced communication between EMS and hospitals in the triage phase were among the proposed challenges and resolutions included.

In mid-March, a group of headache specialists, including Robert E. Shapiro, MD, PhD, professor of neurology, University of Vermont Larner College of Medicine, and founding president, Alliance for Headache Disorders Advocacy, brought up a number of issues that were plaguing their ability to conduct their medical practices amid the pandemic. In an effort raise awareness of these problems, Shapiro and his colleagues published a paper that detailed a number of clinical strategies for the treatment of migraine that can be done without in-person visits. In April, we gathered his thoughts on the paper and migraine care during the era of COVID-19.

Throughout the pandemic, a number of clinicians were forced to take on new roles that they had never attempted before, including those in residency programs who were still in schooling while working on the front lines. Matthew Robbins, MD, director, Neurology Residency Program, Weill Cornell Medicine, provided his thoughts on how the residency program grew from their experiences on the front line.

Like most of the country, adapting to technology was an adjustment. For Jessica Zwerling, MD, MS, she helped her patients with Alzheimer disease (AD) and cognitive decline navigate the video visit functionalities by creating an easy-to-follow how-to guide for patients and caregivers. Zwerling, who serves as the associate director of the Center for the Aging Brain at Montefiore Medical Center, broke down how the center continued to adapt during the pandemic, and what motivates her to provide for not only the patient, but the caregiver as well.