{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:31:22Z","timestamp":1740162682831,"version":"3.37.3"},"reference-count":34,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Chugai Pharmaceutical Co., Ltd","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the impact of the COVID-19 pandemic on outpatient care in Japanese patients with neuromuscular diseases (NMDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This retrospective cohort study included patients between January 2018 and February 2019; the follow-up period was divided into \u2018before COVID-19\u2019 (March 2019\u2013February 2020) and \u2018during COVID-19\u2019 (March 2020\u2013February 2021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>JMDC claims database study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Of the 10 655 557 patients identified, we included patients with spinal muscular atrophy (SMA; n=82), neuromyelitis optica (NMO; n=342), myasthenia gravis (MG; n=1347), Guillain-Barr\u00e9 syndrome (GBS; n=442) or autoimmune encephalitis\/encephalopathy (AIE; n=133). Patients were required to have \u22651\u2009month of data available, have a diagnosis of NMD during the enrolment period and be available for follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>We estimated the proportion of patients with &gt;30% change in outpatient consultation and rehabilitation visits before versus during the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Small reductions in the proportion of patients with outpatient consultation\/rehabilitation visits were observed before versus during the pandemic. Compared with before the pandemic, 30.4%, 27.8%, 28.7%, 49.4% and 50.0% of patients showed a &gt;30% decrease in outpatient consultation visits and 58.6%, 75.0%, 50.0%, 76.3% and 84.6% showed a &gt;30% decrease in outpatient rehabilitation visits during the pandemic for SMA, NMO, MG, GBS and AIE, respectively. The median change in the number of outpatient consultation visits per year before versus during pandemic was \u22121.0\u2009day for all NMDs, and that in outpatient rehabilitation visits per year was \u22126.0, \u20135.5, \u22121.5, \u20136.5 and \u22129.0\u2009days for SMA, NMO, MG, GBS and AIE, respectively. The reduction in outpatient rehabilitation visits was greater in the absence versus presence of a neurology specialist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Outpatient consultation and rehabilitation visits during the COVID-19 pandemic were affected in Japanese patients with NMDs. Longer-term evaluations are required to understand if these reductions in outpatient care would affect patient prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070818","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T18:16:14Z","timestamp":1687976174000},"page":"e070818","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of the COVID-19 pandemic on outpatient care and rehabilitation in neuromuscular clinical practice in Japan: a health insurance claims database analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0432-0402","authenticated-orcid":false,"given":"Toshio","family":"Saito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari","family":"Matsuo-Tezuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Sugitani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takumi","family":"Tajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Fukao-Washino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadaoki","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Iwagami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"2023062811151216000_13.6.e070818.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.04.019"},{"key":"2023062811151216000_13.6.e070818.2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1055\/s-0036-1586263","article-title":"Neuromuscular diseases","volume":"36","author":"Morrison","year":"2016","journal-title":"Semin Neurol"},{"key":"2023062811151216000_13.6.e070818.3","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00182208"},{"key":"2023062811151216000_13.6.e070818.4","first-page":"69","article-title":"Rehabilitation management in neuromuscular disease","volume":"11","author":"Carter","year":"1997","journal-title":"J Neuro Rehab"},{"key":"2023062811151216000_13.6.e070818.5","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06210"},{"key":"2023062811151216000_13.6.e070818.6","first-page":"207","article-title":"Exercise in neuromuscular disorders: a promising intervention","volume":"38","author":"Voet","year":"2019","journal-title":"Acta Myol"},{"key":"2023062811151216000_13.6.e070818.7","unstructured":"World Health Organization . 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