Describe telehealth utilization and metrics of patient care in a comprehensive multiple sclerosis (MS) Clinic during three distinct phases of the COVID-19 Pandemic.

Routine clinical evaluations are vital for effective disease and symptom management in MS. In March 2020, Covid-19 pandemic policy required rapid implementation of a remote telehealth model, which has since become an integrated part of many clinics. Published studies on the impact of telehealth implementation in MS patient care largely focus on patient satisfaction and feasibility rather than objective metrics of patient care and disease progression.

A retrospective chart analysis was conducted at the University of Utah from March 2019 to February 2022. Data was divided into three commensurate study periods: pre-pandemic (MAR2019-FEB2020), height of the pandemic (MAR2020-FEB2021), and stable pandemic (MAR2021-FEB2022). Basic demographics, timed-25-foot-walk (T25FW), mobility status, clinical relapses, and disease-modifying therapies (DMTs) and steroids were included in the analysis. 

Total number of neurology visits did not significantly differ between the three study periods. Of the 100 MS patients included in the study: 73 were female, with mean age 53 (23-81) years with an average BMI of 29.5 Kg/m². 65 patients performed walking tests unassisted, 26 with assistance (cane/walker), and 9 were wheelchair-bound. The average T25FW measured pre-pandemic was 7.1 s (n=94) and 7.2 s (n=80) measured during the stable pandemic period. 24 MS relapses in 19 patients treated with IV steroids were identified during the study. 43 instances of DMT change in 40 patients were recorded: 19 changes during the pre-pandemic period, 14 during the height of the pandemic period, and 10 during the stable pandemic period. 21 patients were not on DMT.