MPR et Covid 2

Le 15/10/2021 de 16:00 à 18:00

Retour Session


Interruption of disabled outpatients’ follow-up in Physical and Rehabilitation Medicine: an observational cross-sectional study of deleterious consequences of the first COVID-19 outbreak

Isabelle Laffont (Montpellier, France), Anthony Gelis (Montpellier, France), Carole Balva (Montpellier, France), Isabelle Tavares (Montpellier, France), Marc Julia (Montpellier, France), Fanny Pradalier (Montpellier, France), François Feuvrier (Montpellier, France), Sylvain Fazilleau (Montpellier, France), Claire Jourdan (Montpellier, France), Arnaud Dupeyron (Nimes, France), Claire Duflos (Montpellier, France)

Objective : This prospective monocenter observational cross-sectional study aims at reporting the impact of the COVID-19 pandemic on outpatients with chronic disabling conditions followed in Physical and Rehabilitation Medicine (PRM).

Material / Patients and Methods : The study ran at a French University Hospital where 832 outpatients whose PRM medical consultation (MC) had been cancelled during the first COVID-19 lockdown (March 17 - May 11, 2020) were contacted by phone by residents fulfilling a structured questionnaire.
The necessity to perform a rapid MC within the next 3 weeks constituted the main judgment criterion. The reason for this urgent need of a MC, the access to other medical services during the period and the interruption of home-based rehabilitation services were also recorded.

Results : We contacted 455/832 patients [mean age 50.0+/-17.5], 239 with neurological (N) and 209 with musculoskeletal (MS) diseases :  211 (46,4%) required a rapid MC, mainly for decrease in functioning (48 %), pain (22 %) or both (22%), not significantly different between MS and N patients (p=0.1).
Home/community-based rehabilitation was interrupted in 87% of the  319/455 patients who received physical therapy. The occurrence of a MC with a general practitioner (29.0%) had no link with the need for rapid PRM consultation, suggesting the specificity of PRM.
Considering the 93 patients receiving botulinum toxin injections, 44,1% needed rapid rescheduling, mainly for decrease of function (47,8%).

Discussion - Conclusion : Our results show that 46% of disabled patients whose PRM MC has been cancelled during the COVID-19 lockdown experienced medical deterioration, quantifying a form of  “loss of chance” due to the discontinuation of PRM follow-up.

Discussion : excellent

Keywords : COVID, care organizations, loss of chance

Disclosure of interest : aucun