Expediting telehealth use in clinical research studies: recommendations for overcoming barriers in North America

Naito, Anna; Wills, Anne‐Marie; Tropea, Thomas F; Ramirez‐Zamora, Adolfo; Hauser, Robert A.; Martino, Davide; Turner, Travis H.; Rafferty, Miriam; Afshari, Mitra; Williams, Karen; Vaou, Okeanis; McKeown, Martin J.; Ginsburg, Letty; Ezra, Adi; Iansek, Robert; Wallock, Kristin; Evers, Christiana; Schroeder, Karlin; DeLeon, Rebeca; Yarab, Nicole; Alcalay, Roy N.; Beck, James C.

doi:10.1038/s41531-021-00177-8

Cited by 20 publications

(21 citation statements)

References 9 publications

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“…Telemedicine could facilitate time-efficient multidisciplinary care, as it has the ability to connect multiple health care professionals simultaneously [ 21 ]. Furthermore, telemedicine has the potential to facilitate cancer survivorship care, pain and symptom management in the palliative care setting, and participation in clinical trials for rural patients [ 22 , 23 , 24 ]. Due to the large rural population in Saskatchewan, telemedicine was incorporated into patients’ care by various disciplines several years prior to the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study

et al. 2022

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Background: Telemedicine is a useful tool that connects patients to their care team remotely and improves access to medical care for rural residents. This study aimed to determine the telemedicine experience of both rural patients with cancer and their physicians, and to explore factors associated with a positive patient experience. Methods: In this cross-sectional study, cancer patients and physicians in Saskatchewan completed a paper-based survey composed of 32 items or an electronic survey of 18 items, respectively. Logistic regression analysis was performed to assess patient satisfaction in relation to various sociodemographic and cancer-related factors. Results: Overall, 25 physicians and 165 patients participated in the study. Among the physicians, 94% were confident in their telemedicine assessment, 58% agreed that telemedicine improved clinical efficiency, and 73% agreed that doctor–patient rapport was unimpaired with telemedicine. Of 165 patients, 61% had used telemedicine for the first time, 81% felt that their needs were met, 83% were satisfied with the quality of their care, and 88% had a positive experience. Overall, 83% patients vs. 45% physicians preferred telemedicine to a face-to-face clinic visit (p = 0.005). On univariate analysis, patients ≥ 65 years old had a greater positive telemedicine experience compared to patients < 65 years old (odds ratio 4.1 [1.2–13.8], p = 0.02). Conclusion: Both patients and physicians have a high rate of positive experiences with telemedicine. However, patients have a higher preference for telemedicine over face-to-face visits compared to physicians. In addition, elderly patients have more positive telemedicine experiences compared to younger patients.

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Section: Discussionmentioning

confidence: 99%

Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study

et al. 2022

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“…North American clinicians reported patient resistance to videoconferencing in the early COVID-19 crisis as the second barrier to its implementation, after the lack of access to technology [ 40 ]. It will therefore be critical to ensure that deploying video-based consultations does not create disparities between patients from different socioeconomic backgrounds, not only for their medical care but also for their inclusion into research studies [ 41 ]. Lastly, clinical studies have suggested that telemedicine for PD patients is as effective as in-person care [ [42] , [43] , [44] ].…”

Section: Discussionmentioning

confidence: 99%

Clinical perception and management of Parkinson's disease during the COVID-19 pandemic: A Canadian experience

Jacquet¹,

Bogard²,

Normandeau³

et al. 2021

Parkinsonism & Related Disorders

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Background The COVID-19 pandemic has necessitated the social isolation of the population and the rapid implementation of remote care for patients with neurodegenerative diseases. The objective of this study was to explore the perceived impact of confinement in patients with Parkinson’s disease and document the effects of gender and living environment. Methods We recruited two cohorts from the Canadian provinces of Québec and Alberta, which differed in the dynamics of COVID-19 spreading at the time of the study, and administered a questionnaire on the perceived effects of confinement on daily living and disease management. Results The data reveals that approximately half of the patients experienced a change in one or more clinical symptoms, with differences observed between gender (e.g. day-to-day changes in slowness in men, aggravated headaches in women) and geographic location (e.g. increased depression in Alberta but reduced sleep quality in Québec). Furthermore, participants identifying as women or living in Alberta implemented more frequently home or online exercise. Lastly, high levels of satisfaction with phone or video consultations did not translate into a sustained interest to pursue this mode of healthcare. Conclusions This study suggests that COVID-19-related confinement affected Parkinson’s disease manifestation and management. Patients also reported varying levels of interest to continue remote care. A number of differences reported in our study were seemingly related to gender and living environment.

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“…27,28 Similarly, for research, valid tools that can be applied through telehealth could improve recruitment and retention, reduce costs, and ensure single rater consistency for clinical endpoints. 3 As our screening data suggests, there is also increasing evidence for the ubiquity of home internet and smartphones among the aging population. [29][30][31] There is a growing body of literature supporting the feasibility, validity, and reliability of conducting motor assessments remotely in PD, but the objective assessment of rigidity, postural stability, and overall fall-risk have been considered problematic on standard rating scales without in-person assessment.…”

Section: Discussionmentioning

confidence: 89%

Are Virtual Objective Assessments of Fall‐Risk Feasible and Safe for People with Parkinson's Disease?

Afshari

Hernandez

Nonnekes

et al. 2022

Movement Disord Clin Pract

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Background Falls are inherent to Parkinson's disease (PD) progression, and risk assessment is mandatory for optimal long term management. Objective To determine if the telehealth application of two observer‐based, objective measures of fall‐risk in PD—Five‐Times‐Sit‐To‐Stand (FTSTS) and 360° Rapid‐Turns‐Test (RTT)—is feasible and safe. Methods Following in‐clinic training, 15 people with Hoehn and Yahr Stage 2 (n = 8) and 3 (n = 7) PD, median MoCA score 25 (range 14–29), and subjective freezing‐of‐gait (n = 13), participated in four televisits with care partners biweekly for 10 weeks where virtual FTSTS/RTT assessments were performed. Results Participants completed all protocol‐driven 120 virtual FTSTS and 60 RTT assessments with effective ratability (feasibility) and zero adverse events (safety). 22% virtual FTSTS and 55% RTT met criteria for high fall‐risk designation. Conclusions Objective fall‐risk assessment with virtual FTSTS and RTT through telehealth among HY2‐3 PD patients, with varying motor and cognitive function, is feasible and safe following introductory in‐clinic training.

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Expediting telehealth use in clinical research studies: recommendations for overcoming barriers in North America

Cited by 20 publications

References 9 publications

Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study

Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study

Clinical perception and management of Parkinson's disease during the COVID-19 pandemic: A Canadian experience

Are Virtual Objective Assessments of Fall‐Risk Feasible and Safe for People with Parkinson's Disease?

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