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      Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

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          Abstract

          Background

          Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change.

          Summary

          The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine.

          Key Messages

          With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

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          Most cited references 76

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          Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline

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            Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

            These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.
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              Validity of self-assessment of pubertal maturation.

              Studies of adolescents often use self-assessment of pubertal maturation, the reliability of which has shown conflicting results. We aimed to examine the reliability of child and parent assessments of healthy boys and girls.
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                Author and article information

                Journal
                Horm Res Paediatr
                Horm Res Paediatr
                HRP
                Hormone Research in Pædiatrics
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                1663-2818
                1663-2826
                February 2021
                22 January 2021
                : 93
                : 6
                : 343-350
                Affiliations
                aDivision of Pediatric Endocrinology and Diabetes, Children's Hospital at Montefiore, Albert Einstein School of Medicine, Bronx, New York, USA
                bDivision of Pediatric Endocrinology, Baystate Children's Hospital, Springfield, Massachusetts, USA
                cDivision of Pediatric Endocrinology, Georgetown University, Washington, District of Columbia, USA
                dDivision of Pediatric Endocrinology, Diabetes and Metabolism, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA
                eDivision of Pediatric Endocrinology, Department of Pediatrics, OHSU (Oregon Health and Science University), Portland, Oregon, USA
                fCenter for Diabetes and Endocrinology, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA
                gDivision of Pediatric Endocrinology, Nationwide Children's Hospital at The Ohio State University, Columbus, Ohio, USA
                hDivision of Pediatric Diabetes and Endocrinology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
                iDivision of Endocrinology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
                jDivision of Pediatric Endocrinology, Medical University of South Carolina, Charleston, South Carolina, USA
                Author notes
                *Molly O. Regelmann, Division of Pediatric Endocrinology, Children's Hospital at Montefiore, 3415 Bainbridge Ave., Bronx NY 10467 (USA), moregelm@ 123456montefiore.org
                Article
                hrp-0093-0343
                10.1159/000513060
                7900478
                33486483
                Copyright © 2021 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                Page count
                Tables: 3, References: 45, Pages: 8
                Categories
                Clinical Practice Committee Publication

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