{"id":1823,"date":"2022-10-04T00:00:00","date_gmt":"2022-10-04T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/telemedicine-use-and-outcomes-after-transient-ischemic-attack-and-minor-stroke-during-the-covid-19-pandemic-a-population-based-cohort-study\/"},"modified":"2023-06-14T20:02:17","modified_gmt":"2023-06-15T00:02:17","slug":"telemedicine-use-and-outcomes-after-transient-ischemic-attack-and-minor-stroke-during-the-covid-19-pandemic-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/telemedicine-use-and-outcomes-after-transient-ischemic-attack-and-minor-stroke-during-the-covid-19-pandemic-a-population-based-cohort-study\/","title":{"rendered":"Telemedicine use and outcomes after transient ischemic attack and minor stroke during the COVID-19 pandemic: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; The COVID-19 pandemic has led to an increase in telemedicine use. We compared care and outcomes in patients with transient ischemic attack (TIA) or minor ischemic stroke before and after the widespread adoption of telemedicine in Ontario, Canada, in 2020.<\/p>\n<p><strong>Methods<\/strong> &#x2014; In a population-based cohort study using linked administrative data, we identified patients with TIA or ischemic stroke discharged from any emergency department in Ontario before the widespread use of telemedicine (Apr. 1, 2015, to Mar. 31, 2020) and after (Apr. 1, 2020, to Mar. 31, 2021). We measured care, including visits with a physician, investigations and medication renewal. We compared 90-day death before and after 2020 using Cox proportional hazards models, and we compared 90-day admission using cause-specific hazard models.<\/p>\n<p><strong>Results<\/strong> &#x2014; We identified 47 601 patients (49.3% female; median age 73, interquartile range 62&#x2013;82, yr) with TIA (n = 35 695, 75.0%) or ischemic stroke (n = 11 906, 25.0%). After 2020, 83.1% of patients had 1 or more telemedicine visit within 90 days of emergency department discharge, compared with 3.8% before. The overall access to outpatient visits within 90 days remained unchanged (92.9% before v. 94.0% after; risk difference 1.1, 95% confidence interval [CI] &#x2013;1.3 to 3.5). Investigations and medication renewals were unchanged. Clinical outcomes were also similar before and after 2020; the adjusted hazard ratio was 0.97 (95% CI 0.91 to 1.04) for 90-day all-cause admission, 1.06 (95% CI 0.94 to 1.20) for stroke admission and 1.07 (95% CI 0.93 to 1.24) for death.<\/p>\n<p><strong>Interpretation<\/strong> &#x2014; Care and short-term outcomes after TIA or minor stroke remained stable after the widespread implementation of telemedicine during the COVID-19 pandemic. Our findings suggest that telemedicine is an effective method of healthcare delivery that can be complementary to in-person care for minor ischemic cerebrovascular events.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; The COVID-19 pandemic has led to an increase in telemedicine use. We compared care and outcomes in patients with transient ischemic attack (TIA) or minor ischemic stroke before and after the widespread adoption of telemedicine in Ontario, Canada, in 2020. Methods &#x2014; In a population-based cohort study using linked administrative data, we identified [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1823","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Yu AYX, Penn J, Austin PC, Lee DS, Porter J, Fang J, Redelmeier DA, Kapral MK. <em>CMAJ Open<\/em>. 2022; 10(4):E865-71. Epub 2022 Oct 4.","source_url":"https:\/\/www.cmajopen.ca\/content\/10\/4\/E865","ices_scientist":[1150,1385,1290,1337,1298],"site":[6733],"research_program":[6742],"news_release":[7392],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9271],"video":[],"downloads":null,"links":null,"sitecore_item_id":"22D7E8E9-AFB9-42C4-BC6A-C8B151BCD113","sitecore_item_name":"Telemedicine-use-and-outcomes-after-transient-ischemic-attack-and-minor-stroke","sitecore_field_values":"{\n  \"Title\": \"Telemedicine use and outcomes after transient ischemic attack and minor stroke during the COVID-19 pandemic: a population-based cohort study\",\n  \"Short title\": \"Telemedicine use and outcomes after\",\n  \"Summary\": \"This study compared care and outcomes in patients with transient ischemic attack or minor ischemic stroke before and after the widespread adoption of telemedicine in Ontario, Canada, in 2020.\",\n  \"Citation\": \"<p>Yu AYX, Penn J, Austin PC, Lee DS, Porter J, Fang J, Redelmeier DA, Kapral MK. <em>CMAJ Open<\/em>. 2022; 10(4):E865-71. Epub 2022 Oct 4. DOI: <a href=\"https:\/\/doi.org\/10.9778\/cmajo.20220027\" title=\"opens external link\">https:\/\/doi.org\/10.9778\/cmajo.20220027<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; The COVID-19 pandemic has led to an increase in telemedicine use. We compared care and outcomes in patients with transient ischemic attack (TIA) or minor ischemic stroke before and after the widespread adoption of telemedicine in Ontario, Canada, in 2020.<\/p>n<p><strong>Methods<\/strong> &mdash; In a population-based cohort study using linked administrative data, we identified patients with TIA or ischemic stroke discharged from any emergency department in Ontario before the widespread use of telemedicine (Apr. 1, 2015, to Mar. 31, 2020) and after (Apr. 1, 2020, to Mar. 31, 2021). We measured care, including visits with a physician, investigations and medication renewal. We compared 90-day death before and after 2020 using Cox proportional hazards models, and we compared 90-day admission using cause-specific hazard models.<\/p>n<p><strong>Results<\/strong> &mdash; We identified 47 601 patients (49.3% female; median age 73, interquartile range 62&ndash;82, yr) with TIA (n = 35 695, 75.0%) or ischemic stroke (n = 11 906, 25.0%). After 2020, 83.1% of patients had 1 or more telemedicine visit within 90 days of emergency department discharge, compared with 3.8% before. The overall access to outpatient visits within 90 days remained unchanged (92.9% before v. 94.0% after; risk difference 1.1, 95% confidence interval [CI] &ndash;1.3 to 3.5). Investigations and medication renewals were unchanged. Clinical outcomes were also similar before and after 2020; the adjusted hazard ratio was 0.97 (95% CI 0.91 to 1.04) for 90-day all-cause admission, 1.06 (95% CI 0.94 to 1.20) for stroke admission and 1.07 (95% CI 0.93 to 1.24) for death.<\/p>n<p><strong>Interpretation<\/strong> &mdash; Care and short-term outcomes after TIA or minor stroke remained stable after the widespread implementation of telemedicine during the COVID-19 pandemic. Our findings suggest that telemedicine is an effective method of healthcare delivery that can be complementary to in-person care for minor ischemic cerebrovascular events.<\/p>n<p><a href=\"https:\/\/www.cmajopen.ca\/content\/10\/4\/E865\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{85A20A85-A5DB-4EC9-A9C2-DDBB2DEDBF72}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{CEEE13AD-C7DE-455F-ACF8-AAD7D27BB178}|{31BBD6A4-EF6F-4859-AEFA-1FDFA8BF8BB5}|{57AF234D-1D94-4F54-9C03-2816CC1CF638}\",\n  \"Posted Date\": \"20221004T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/October\/Telemedicine-use-and-outcomes-after-transient-ischemic-attack-and-minor-stroke"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Telemedicine use and outcomes after transient ischemic attack and minor stroke during the COVID-19 pandemic: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; The COVID-19 pandemic has led to an increase in telemedicine use. 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