Healthcare Disruptions and Use of Telehealth Services Among People With Multiple Sclerosis During the COVID-19 Pandemic.

OBJECTIVE: The current study examined health care disruptions and use of telehealth services among people with multiple sclerosis (pwMS) during the COVID-19 pandemic. DESIGN: Cross-sectional survey. SETTING: General community. PARTICIPANTS: Participants (N=163) included 70 pwMS and 93 healthy controls (HCs). The majority of respondents were from the United States (88%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rates of health care disruptions (eg, missing/canceling appointments, experiencing delays) and telehealth use for MS and non-MS medical care and mental health care. RESULTS: In this U.S. majority, predominantly White, and high socioeconomic status sample, 38% to 50% of pwMS reported experiencing disruptions in their MS and non-MS medical care and 20% to 33% reported disruptions in their mental health care; this was significantly lower than the rates observed among HCs. Compared with HCs, pwMS were more likely to use telehealth than in-person services, especially for mental health care. The majority of pwMS and HCs reported being satisfied with telehealth services. Individuals with higher degrees of functional limitation experienced more health care disruptions and were more likely to use telehealth services than individuals with lower degrees of functional limitation. CONCLUSIONS: Despite high health care disruption rates, pwMS frequently used and were highly satisfied with telehealth services during the COVID-19 pandemic. Due to physical limitations commonly observed in the MS population that may preclude travel, telehealth services should be continued even after resolution of the pandemic to expand access and reduce health care disparities.

The impact of the COVID-19 pandemic on engagement in activities of daily living in persons with acquired brain injury.

PRIMARY OBJECTIVES: This study examined (a) the impact of coronavirus disease-2019 (COVID-19) pandemic on engagement in activity participation in persons with acquired brain injury (ABI); and (b) whether changes in activity participation during the pandemic were associated participants' health-related quality of life (HRQoL). RESEARCH DESIGN: Exploratory online survey study. METHODS: Eighty-seven respondents with ABI and 98 healthy adults (HA) participated in this study. Engagement in activity participation during COVID-19 was calculated as a percentage of the activities participants performed before the pandemic. MAIN RESULTS: Participants with ABI modified their activities less than HA in order to maintain level of engagement in activity participation. They stopped performing more activities during the pandemic compared to HA and compared to their pre-pandemic engagement. Both groups continued to do similar percentage of activities without modifications compared to before the pandemic. Better HRQoL in both groups was predicted by a larger percentage of activities continued and fewer activities stopped. CONCLUSION: Results emphasize the importance of addressing activity participation changes during situations where there are disruptions of the individual's habits and routines in order to minimize negative consequences of such changes.

Relationships between changes in daily occupations and health-related quality of life in persons with multiple sclerosis during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic provided a unique opportunity to explore the impact of the mandated lockdown and social distancing policies on engagement in daily occupations for individuals with multiple sclerosis (MS) and able bodied (i.e. healthy) adults. The study also examined whether the changes in daily occupations were associated with health-related quality of life (HrQOL). METHODS: Between the spring and early fall of 2020, 69 persons with MS and 95 healthy adults completed an online survey that included measurements of 26 activities of daily life. For each activity, participants reported whether they continued to perform the activity (with or without adjustments), whether they stopped, or started to perform the activity during the pandemic. Social support, HrQOL, and demographics, including financial distress were also obtained. RESULTS: Participants with MS and healthy adults both reduced the number of activities performed during the pandemic. Healthy adults continued to do more activities with and without adjustments compared with participants with MS. In both groups, better HrQOL was associated with the number of activities participants continued to do with and without adjustments, and worse HrQOL with the number of activities they stopped doing. CONCLUSIONS: Fewer persons with MS engaged in everyday occupations than healthy adults following the COVID-19 pandemic. The ability to maintain occupational engagement and to participate in social and daily activities is important for maintaining high HrQOL in both groups. Thus, these results call for attention in treatment and self-management of MS symptomatology.

Psychometric Properties of a COVID-19 Impact Scale Among a Sample of Individuals with Disabilities

Research Objectives To examine psychometric properties of a COVID-19 Impact Scale among individuals with disabilities. Design Cross-sectional analysis. Setting Web-based survey. Participants A sample of 418 individuals with multiple sclerosis (62.68%), traumatic brain injury (n=15.07%), and spinal cord injury (22.25%) completed a survey about experiences during the COVID-19 pandemic. The sample was 71.01% female. Ages ranged from 21-84 (M=52.00, SD=11.56). Interventions Not Applicable. Main Outcome Measures COVID-19: Impact of the Pandemic and Health Related Quality of Life (Penedo, Cohen, Bower, & Antoni, 2020). Analysis was restricted to the Psychosocial and Practical Experiences portion of the questionnaire, which yields a Total Measure Score representing overall impact of the pandemic and has three subscales (Distress, Disruption, and Resiliency). Results Principal components analysis of Rasch residuals demonstrated lack of unidimensionality for the overall Total Measure Score. Therefore, subscales were analyzed separately, each showing satisfactory internal consistency (Cronbach's alpha>0.80). The person separation index was 2.48 for Distress, 2.00 for Disruption, and 1.88 for Resiliency. Infit mean square values and corrected item-total correlations were satisfactory for all items on the Distress subscale. However, two items on Disruption and two on Resiliency had corrected item-total correlations < 0.30 and/or infit mean square values>1.30. Conclusions The three subscales on the COVID-19 impact scale had good internal consistency reliability and could differentiate the sample into at least two levels on their respective constructs. Two items referring to pandemic-related practices of health care providers showed poor fit on the Disruption subscale, and items referring to acceptance and the ability to provide others with instrumental social support showed poor fit on the Resiliency subscale. Overall, the study suggests that the instrument provides a reliable indicator of various levels of COVID impact in clinical samples with neurological disabilities. Author(s) Disclosures All authors have no conflicts of interest to declare.