Abstract
Telemedicine provides a possibility to deal with the scarcity of resources and money in the health care system. Palliative care has been suggested to be appropriate for an increasing number of patients with neurodegenerative disorders, but these patients often lack care from either palliative care or neurology. Since palliative care means a multidisciplinary approach it is meaningful to use palliative care structures as a basis. There exists no systematic access to neurological expertise in an outpatient setting. A successful link of two existing resources is shown in this project connecting the Department of Neurology of an University Hospital with specialized outpatient palliative care (SPC) teams. A videocounselling system is used to provide expert care for neurological outpatients in a palliative setting.Methods: A prospective explorative single arm pilot trial was implemented to provide a mobile telesystem for 5 SPC teams. The opportunity was given to consult an expert in neuropalliative care at the specialized center in the hospital (24/7). Semistructured interviews were conducted with the physicians of the SPC teams after a trial duration of 9 months.Results: Our data provides strong evidence that the technical structure applied in this project allows a reasonable neurological examination at distance. Qualitative interviews indicate a major impact on the quality of work for the SPC teams and on the quality of care for neurological patients.Conclusion: The system proves to be useful and is well accepted by the SPC teams. It supplies a structure that can be transported to other disciplines.
Highlights
A multidisciplinary palliative care approach improves patient’s quality of life and symptoms in advanced neurological diseases (1)
Either the palliative care expertise might be lacking in neurologists or the neurological expertise be missing in palliative care experts (3)
A specialized outpatient palliative care (SPC) support which enables patients to stay at home is currently seen as the most appropriate form of palliative care
Summary
A multidisciplinary palliative care approach improves patient’s quality of life and symptoms in advanced neurological diseases (1). End of life care in neurological diseases is often challenging since disease trajectories are less predictable compared to cancer patients (2). Either the palliative care expertise might be lacking in neurologists or the neurological expertise be missing in palliative care experts (3). Outpatient Palliative Care services are a multidisciplinary approach with a network around the core team. A specialized outpatient palliative care (SPC) support which enables patients to stay at home is currently seen as the most appropriate form of palliative care. The neurological expertise is lacking in SPC teams which makes it difficult to handle patients with either neurological diseases or neurological symptoms. In most countries no regulated approach to a neurological consultant in an outpatient setting is established
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