Abstract

BackgroundTelemedicine is a convenient health service delivery modality for patients with movement disorders, including Parkinson’s disease (PD), but is currently underutilized in the management of associated psychiatric symptoms. This study explored the feasibility of and patient satisfaction with telepsychiatry services at an academic movement disorders center.MethodsAll patients seen by telepsychiatry between January and December 2017 at the UCSF Movement Disorders and Neuromodulation Center were invited to participate. Participation was voluntary. Patients received an initial survey after the first telepsychiatry visit and satisfaction surveys after each visit. Survey responses were collected online via Research Electronic Data Capture (REDCap). Frequencies were calculated for categorical variables, and means and standard deviations were generated for continuous variables.ResultsThirty-three patients (79% with PD; 72% Medicare recipients; 64% men; mean age, 61.1 ± 10.5 years; mean distance to clinic, 79.9 ± 81.3 miles) completed a total of 119 telepsychiatry and 62 in-person visits. Twenty-two initial surveys and 50 satisfaction surveys (from 21 patients) were collected. Patients were very satisfied with the care (95%), convenience (100%), comfort (95%), and overall visit (95%). Technical quality was somewhat lower rated, with 76% patients reporting they were very satisfied, while 19% were satisfied. All patients would recommend telemedicine to friends or family members.ConclusionsTelepsychiatry is a feasible option for patients with movement disorders, leading to high patient satisfaction and improved access to care. Technical aspects still need optimization. Whenever available, telepsychiatry can be considered in addition to in-person visits. Future studies with larger samples should explore its impact on patient care outcomes and caregiver burden.

Highlights

  • Telemedicine is a convenient health service delivery modality for patients with movement disorders, including Parkinson’s disease (PD), but is currently underutilized in the management of associated psychiatric symptoms

  • The present study aimed to explore the feasibility of and patient satisfaction with telepsychiatry services offered in a busy academic movement disorders center in California

  • The follow-up duration varies depending on patient needs (DBS evaluation and perioperative care, or regular mental health care for psychiatric conditions associated with the movement disorders), and is typically six months-to-one year

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Summary

Introduction

Telemedicine is a convenient health service delivery modality for patients with movement disorders, including Parkinson’s disease (PD), but is currently underutilized in the management of associated psychiatric symptoms. Anxiety and depressive disorders are the most common psychiatric comorbidities, estimated to occur in at least half of PD patients, they may be underrecognized and not addressed effectively [1,2,3]. PD patients may experience unpredictable off-medication states that can be associated with dystonia, pain, wearing-off related anxiety, depression, or cognitive fluctuations. These symptoms, whether physical or psychological, make it challenging for patients to fully engage in psychiatric care

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