Objective: To evaluate the feasibility and identify obstacles in conducting teleconsultations for patients with parkinsonism in the Brazilian public health system

Background: Patients with parkinsonism and parkinson’s disease (PD) require frequent consultations and motor revaluation,1 however, the current COVID-19 pandemic greatly reduced availability of ambulatorial consultations.2 Several studies tried to assess the feasibility tele and video consultations for patients with PD but most were performed in developed countries with selected subjects that already had the means to participate in a teleconsultation or were assisted in order to.3–6 The feasibility of tele and video consultations for patients with parkinsonism in developing countries like Brazil is unknown.

Method: We performed a cross-sectional study with patients accompanied by a parkinsonism ambulatory linked to a tertiary hospital of the Brazilian’s public health system. 106 non-first visit patients with a diagnosis of parkinsonism that would have a consultation in 2020 were tried to be contacted through telephone calls and, upon answering the call, if eligible, data regarding demographic and clinical data, opinions on teleconsultations and the feasibility of a video consultation were obtained.

Results:
Only 52 (49.1%) of patients could be contacted and met eligibility criteria. Most patients thought teleconsultations to be effective but almost half of them considered that care provided only through this method would be worsened. The most common mentioned benefit of teleconsultation was the convenience of not having to mobilize the patient for a consultation. Only two-thirds of the patients that answered the telephone call had the technological means, the knowledge to use a software for video meetings and agreed to participate in a video meeting, which would most commonly be performed using a smartphone and with the aid of a caretaker.
[table1]
Most patients were women, white and married. Family income was generally low and there was both a low and high level of education groups. Most patients had to undergo long distances to arrive at the clinic, had PD, didn’t have dementia or DBS and were at least somewhat dependent.
[table2]

Conclusion: Most patients with parkinsonism in the Brazilian public health system are unreachable through telephone calls or ineligible for tele and video consultations.

References: Little M, Wicks P, Vaughan T, Pentland A. Quantifying short-term dynamics of Parkinson’s disease using self-reported symptom data from an Internet social network. J Med Internet Res. 2013;15(1):e20. 2. Ray Moynihan, Sharon Sanders, Zoe A Michaleff, Anna Scott, Justin Clark, Emma J To, Mark Jones, Eliza Kitchener, Melissa Fox, Minna Johansson, Eddy Lang, Anne Duggan, Ian Scott, Loai Albarqouni. Pandemic impacts on healthcare utilisation: a systematic review. BMJ Open. Published online October 28, 2020. doi:10.1101/2020.10.26.20219352 3. Stillerova T, Liddle J, Gustafsson L, Lamont R, Silburn P. Remotely Assessing Symptoms of Parkinson’s Disease Using Videoconferencing: A Feasibility Study. Neurol Res Int. 2016;2016:4802570. 4. Cubo E, Gabriel-Galán JMT, Martínez JS, et al. Comparison of office-based versus home Web-based clinical assessments for Parkinson’s disease. Mov Disord. 2012;27(2):308-311. 5. Dorsey ER, Wagner JD, Bull MT, et al. Feasibility of Virtual Research Visits in Fox Trial Finder. J Parkinsons Dis. 2015;5(3):505-515. 6. Tsao JW, Demaerschalk BM. Teleneurology in Practice: A Comprehensive Clinical Guide. Springer; 2015.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/tele-and-video-consultations-of-patients-with-parkinsonism-in-the-brazilian-public-health-system-a-real-life-feasibility-study/