Objective: To compare telephone and in-person visits in the clinical care of Parkinson’s disease (PD) patients.

Background: There has been growing interest in using telemedicine to expand accessibility of patients with PD to clinical care. During the COVID-19 pandemic, there was an abrupt transition from in-person to remote visits; in our center, due to regulatory and practical barriers, this was conducted by telephone. This abrupt externally-induced and near-complete transition provided an opportunity to directly compare both methods and to explored whether the absence of face-to-face interactions would alter the frequency of changes in medical therapy.

Method: We reviewed medical records of 100 PD patients followed at McGill Movement disorders clinic who had a telephone visit March-May 2020 (convenience sample) plus at least one prior in-person visit within 12 months. The primary outcome was the proportion of visits which ended in a change of therapy. We used the chi-square test and logistic regression for comparison of categorical variables.

Results: The population was 40% female, age=72±10.1 years. We observed fewer medication changes during telephone visits; a change was made in 44% of telemedicine visits compared to 59% of the preceding in-person visit [OR 1.83, 95%CI: 1.05-3.21]. This reduction was particularly evident for starting a new medication (new motor medication=OR 3.27[95%CI: 1.02-10.52], new non-motor medication=OR 3.62[95%CI: 1.27-10.3]). Patients in telemedicine visits were less often referred for outside consultation (0% telemedicine vs. 5% in-person, p=0.024). There was a modest nonsignificant reduction dose changes of existing treatments in telemedicine visits (motor [OR 1.28, 95%CI: 0.73-2.24], non-motor OR 1.83, 95%CI: 0.84-3.99]).

Conclusion: The results showed a reduction of medication changes in PD during telephone visits, which was particularly evident for starting new medications. Whereas our study may point to limitations of telephone consultations, the relatively modest difference between visit types (44% vs 59%), can also suggest that telephone visits were conducted with rigor and may be a reasonable option in certain situations. However, healthcare providers should be aware of potential differences in treatment decisions according to visit type.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/telephone-visit-efficacy-for-parkinsons-disease-during-the-covid-19-pandemic/