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Table 3 Changes to the patient prioritization framework determining who would get access to ECT during the first wave of the COVID-19 pandemic

From: Impact of COVID-19 on electroconvulsive therapy practice across Canadian provinces during the first wave of the pandemic

 

% of ECT Centres (95% CI*)

 

Ontario

Quebec

Western Canada

Atlantic Canada

Adopted a new patient prioritization framework for offering ECT

94 (74–99)

64 (35–85)

64 (35–85)

60 (23–88)

 

Only to severely depressed, psychotic, manic, or suicidal cases

33 (16–56)

27 (10–57)

55 (28–79)

0 (0–43)

 

On a case-by-case basis†

61 (39–80)

36 (15–65)

9 (2–38)

60 (23–88)

ECT offered based on the pre-pandemic framework

6 (1–26)

36 (15–65)

36 (15–65)

40 (12–77)

Access to care was facilitated in other ways with disrupted ECT‡

58 (39–74)

62 (36–82)

45 (21–72)

60 (23–88)

 

Changing treatments (e.g., replacing ECT with rTMS)

27 (11–52)

25 (7–59)

40 (12–77)

0 (0–56)

 

Transferring patients to other facilities that provide ECT

27 (11–52)

25 (7–59)

40 (12–77)

0 (0–56)

 

Providing more frequent monitoring/follow-up

47 (25–70)

38 (14–69)

40 (12–77)

67 (21–94)

 

Collaborating with other providers to supplement treatment plan

47 (25–70)

25 (7–59)

40 (12–77)

100 (44–100)

 

Hospitalizing outpatients

13 (4–38)

50 (22–78)

0 (0–43)

0 (0–56)

  1. Values with the tenths decimal ≥ 5 were rounded up
  2. *95% CIs computed using Wilson’s method for binomial proportions [46,47,48]
  3. †Based on illness severity and other factors (e.g., age, medical history, vulnerability factors)
  4. ‡Respondents could select more than one option
  5. Abbreviations: CI = confidence interval; ECT = electroconvulsive therapy; rTMS = repetitive transcranial magnetic stimulation