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Science News

New Findings About Telehealth for People with Parkinsonís

People with Parkinson’s disease (PD) reported positive experiences with a telehealth program that offered remote visits with neurologists, reports a study published online on December 4 in Neurology: Clinical Practice.  Using telehealth, also referred to as “virtual” office visits, means being able to see your doctor and health care professionals remotely via your computer, your tablet or even your smartphone.  

Using telehealth to deliver care remotely is increasingly being used to provide medical care to people who may find it difficult to travel to see their doctors. It may have the potential to improve care for some people with Parkinson’s disease. For example, it may benefit the more than 40 percent of Medicare recipients with PD have never seen a neurologist despite evidence that people who do experience better care and quality of life. 

Led by Ray Dorsey, M.D., M.B.A., researchers from the University of Rochester Medical Center and The Johns Hopkins School of Medicine offered people with PD or related disorders a free one-time telehealth consultation with a neurologist specializing in movement disorders. People living in five states (California, New York, Maryland, Delaware and Florida) were eligible to participate in the program, which was conducted from August 2012 to May 2013.

The program’s 55 participants ranged in age from 35 to 90 (average age 67.8); 50 were diagnosed with PD and had the disease from one to 16 years. Most of the telehealth visits (80 percent) took place at the person’s home and included a medical history, remote examination of symptoms such as gait and tremor, and a recommendations for PD management. Thirty-three of the participants responded to an online survey following the visit.

Results

  • Thirty-three people with Parkinson’s disease or a related disorder who had a telehealth consultation with a movement disorders specialist were mostly positive about the experience.
  • In rating areas such as the specialist’s ability to understand and explain the condition, provide recommendations and gather information, 90 percent of surveyed participants were very satisfied or satisfied.
  • 85 percent of participants were able to make a personal connection with the specialist that was greater than or comparable to an in-person visit.
  • All the surveyed participants would recommend telehealth to a friend.
  • The consultation resulted in new recommendations for PD patients: 86 percent of participants were advised to exercise more, 63 percent to change their current medication, and 53 percent to add a new medication.

What Does It Mean?

The use of media and teleconferencing has business in many fields, and this study shows its potential to impact PD care. 

In neurology, telehealth has been most helpful to date in the urgent diagnosis of stroke, where neurologists can diagnose and treat strokes acutely. Its use in less urgent settings has not been well-studied. Among its potential advantages, telehealth may be cheaper than seeing doctors in-person (e.g., saves money on commute) and it may provide access to specialists in areas where these are not available. Two major concerns about telehealth are that 1) the neurological examination is more limited when performed remotely (eg. muscle tone or reflexes cannot be assessed) 2) People with PD who use telehealth may find it less personable. 

The results of this study are encouraging that if done properly, the second concern may not be true. The majority of people felt comfortable discussing their health with a doctor using videoconferencing. Participants who normally had to travel significant distances to see a neurologist appreciated the convenience of an at-home visit. 

This is hopeful news for people for whom seeing the nearest Parkinson’s specialist may require several hours of driving and for those whose disability — whether due to Parkinson’s or another reason — is so advanced that leaving the home becomes difficult or even impossible.

While this study is promising, it will take time for this technology to become available to the wider community. A few institutions offer telehealth care for people with Parkinson’s. But there are challenges in regards to licensure and insurance coverage that need to be resolved before it becomes more easily available.

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Reference: Venkataraman, V, Donohue, S, Biglan, K, Wicks, P, Dorsey, ER (2013) Virtual Visits for Parkinson Disease: A Case Series. Neurology: Clinical Practice. DOI: 10.1212/01.CPJ.0000437937.63347.5a http://dx.doi.org/10.1212/01.CPJ.0000437937.63347.5a

Source Date: Dec 23 2013