Objective: To demonstrate the feasibility of telemedicine for treatment of psychiatric co-morbidities in Parkinson’s disease and evaluate patient satisfaction with telepsychiatry.

Background: Parkinson’s disease (PD) is frequently accompanied by psychiatric co-morbidities, including anxiety and depression. There are barriers to treatment of these co-morbidities, including under-recognition and access to mental health resources. In addition, motor and non-motor fluctuations make participation in psychiatric interviews challenging. Telemedicine is a potential alternative to in-person encounters and has previously been effective in remote treatment of both PD and mood disorders. As of yet, however, it has not been evaluated in managing psychiatric co-morbidities in PD.

Methods: Participants were recruited from the University of California San Francisco’s Movement Disorders and Neuromodulation Center (MDNC). All patients seen by the MDNC’s psychiatrist in 2017 were invited to participate. Visits were conducted using a web-based, encrypted telemedicine application. Participants received an initial demographic survey after the first telemedicine visit and satisfaction surveys after each visit. The surveys were modified with permission from a previous telemedicine study for patients with PD.

Results: 30 patients (26 with PD) received 107 telepsychiatry visits. 21 participants completed initial surveys, 20 completed at least 1 satisfaction survey. Mean age was 60.5 years (SD 10.4). 67% were males. Mean distance from UCSF was 78.8 miles( SD 83.3). 50% had previous exposure to telemedicine. 80% had a diagnosis of depression (major depressive disorder or depressive disorder NOS) and 70% had an anxiety disorder (generalized anxiety disorder, panic disorder or anxiety disorder NOS). 93% of participants were very satisfied with telepsychiatry visits, 7% were satisfied. 100% would recommend telemedicine. Perceived advantages of telemedicine were: no need to drive/park (most important in 71%), saves time (19%) and more comfortable (14%). Perceived disadvantages were: loss of privacy (15%); prefer in-person visit (50%) and technical difficulties (35%).

Conclusions: Telemedicine for treatment of common psychiatric co-morbidities in PD was technically feasible, convenient and satisfactory to patients. It can be used as an adjunct to in-person psychiatric care for patients with PD. Results were presented as a poster in March 2018 at the AAGP Annual Meeting in Honolulu, HI.

References: 1. Dobkin RD, Rubino JT, Friedman J, Allen LA, Gara MA, Menza M. Barriers to mental health care utilization in Parkinson’s disease. J Geriatr Psychiatry Neurol. 2013 Jun; 26(2):105-16. 2. Dorsey ER, Venkataraman V, Grana MJ, Bull MT, George BP, Boyd CM, Beck CA, Rajan B, Seidmann A, Biglan KM. Randomized controlled clinical trial of “virtual house calls” for Parkinson disease. JAMA Neurol. 2013 May; 70(5):565-70. 3. Langarizadeh M, Tabatabaei MS, Tavakol K, Naghipour M, Rostami A, Moghbeli F. Telemental Health Care, an Effective Alternative to Conventional Mental Care: a Systematic Review. Acta Inform Med. 2017 Dec; 25(4):240-246. 4. Schneider RB, Biglan KM. The promise of telemedicine for chronic neurological disorders: the example of Parkinson’s disease. Lancet Neurol. 2017 Jul; 16(7):541-551.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/telepsychiatry-for-patients-with-parkinsons-disease/