Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

Landi, Doriana; Ponzano, Marta; Nicoletti, Carolina Gabri; Cola, Gaia; Cecchi, Gianluca; Grimaldi, Alfonso; Mataluni, Giorgia; Mercuri, Nicola Biagio; Sormani, Maria Pia; Pacileo, Guglielmo; Marfia, Girolama Alessandra

doi:10.1007/s10072-021-05398-6

Cited by 17 publications

(19 citation statements)

References 21 publications

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“…A survey conducted at an MS Center in Italy found that only higher levels of education and income were associated with interest in telemedicine, but not characteristics of MS such as mobility. 18 These findings are similar to those in the general population. Of 148,402 patients attending primary care or specialty ambulatory care visits, only 54.4% completed a telehealth visit, of which 45.6% were video visits.…”

Section: Discussionsupporting

confidence: 84%

Disparities in Telehealth Care in Multiple Sclerosis

et al. 2022

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Background and Objectives:The COVID-19 pandemic has dramatically increased telehealth use. We assessed access to and use of telehealth care including videoconferencing, and usability of videoconferencing among persons with multiple sclerosis (MS).Methods:In Fall 2020, we surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants reported availability and receipt of MS care or education through telehealth. Participants who completed ≥1 live videoconferencing visit completed the Telehealth Usability Questionnaire (TUQ). We tested factors associated with access to and receipt of telehealth care using logistic regression. We tested factors associated with TUQ scores using quantile regression.Results:Of the 8434 participants to whom the survey was distributed, 6043 responded (71.6%); 5403 were eligible for analysis. Of the respondents, 4337 (80.6%) were women, and they had a mean (SD) age of 63.2 (10.0) years. Overall, 2889 (53.5%) reported access to MS care via telehealth, 2110 (39.1%) reported receipt of MS care via telehealth including 1523 (28%) via videoconference. Among participants who reported telehealth was available, older age was associated with decreased odds of having a telehealth video visit; higher income and being physically active were associated with increased odds. Older age and moderate to very severe visual symptoms were associated with lower perceived usability of telehealth.Conclusion:Older age, lower socioeconomic status and disease-related impairments are associated with less access to and use of telehealth services in people with MS. Barriers to telehealth should be addressed to avoid aggravating health care disparities when using digital medicine.

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Section: Discussionsupporting

confidence: 84%

Disparities in Telehealth Care in Multiple Sclerosis

et al. 2022

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“…The use of telemedicine appointments and digital tools in clinical settings has increased in recent years, mainly due to the coronavirus disease (COVID-19) pandemic [ 58 , 59 ]. In a recent survey of 613 patients with MS, 54% stated that they would be open to telemedicine appointments with neurologists and an unmet need for digital tools tailored to patients with MS was highlighted [ 60 ]. As MSProDiscuss is web-based, it was tested during the COVID-19 pandemic and showed promise in assisting with remote visits in which lack of face-to-face interaction can be a barrier to HCP–patient communication [ 40 ].…”

Section: Future Applications Of New Technologies In Msmentioning

confidence: 99%

MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

Ziemssen

Vandercappellen

Mondragon

et al. 2022

JCM

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This article describes the rationale for the development of the MSProDiscuss™ clinical decision support (CDS) tool, its development, and insights into how it can help neurologists improve care for patients with multiple sclerosis (MS). MS is a progressive disease characterized by heterogeneous symptoms and variable disease course. There is growing consensus that MS exists on a continuum, with overlap between relapsing–remitting and secondary progressive phenotypes. Evidence demonstrates that neuroaxonal loss occurs from the outset, that progression can occur independent of relapse activity, and that continuous underlying pathological processes may not be reflected by inflammatory activity indicative of the patient’s immune response. Early intervention can benefit patients, and there is a need for a tool that assists physicians in rapidly identifying subtle signs of MS progression. MSProDiscuss, developed with physicians and patients, facilitates a structured approach to patient consultations. It analyzes multidimensional data via an algorithm to estimate the likelihood of progression (the MSProDiscuss score), the contribution of various symptoms, and the impact of symptoms on daily living, enabling a more personalized approach to treatment and disease management. Data from CDS tools such as MSProDiscuss offer new insights into disease course and facilitate informed decision-making and a holistic approach to MS patient care.

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“…6,9 For example, telemedicine can decrease the time before people with MS can access specialized heath care services (eg, neurologic rehabilitation experts) compared with standard in-person care. 10,11 Televideo-enabled neurologic care for patients with MS decreases travel time, 12,13 limits time off work, 12,14 reduces caregiver burden, 4,12 Once published in an issue, the paper will be removed from the Online First section and appear in that issue's table of contents. Meanwhile, the manuscript is citable using the DOI, which appears on the first page.…”

Section: Introductionmentioning

confidence: 99%

Accessibility to Telerehabilitation Services for People With Multiple Sclerosis: Analysis of Barriers and Limitations

Gopal

Bonanno

Block

et al. 2022

International Journal of MS Care

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Background: In multiple sclerosis (MS), telemedicine improves access to specialized medical care; however, barriers remain, including universal access and effective implementation. Focusing on telerehabilitation, ie, remotely delivered physical therapy, our goal was to identify barriers to telerehabilitation implementation and factors associated with patients completing telerehabilitation physical therapy treatment. Methods: Quantitative data included a review of electronic health records of patients with MS treated at the University of California San Francisco Physical Therapy Faculty Practice. We extracted demographic, clinical, and transit-related factors. For patients who scheduled an initial evaluation, we recorded the number of follow-ups, cancellations, completed physical therapy goals, and discharges. Qualitative data included interviews with 3 board-certified neurologic physical therapists and patients’ perspectives recorded in the subjective portion of physical therapy notes. Results: We identified 111 patients with at least 1 visit (in-person or telerehabilitation) to physical therapy (82 women; mean ± SD age, 54.2 ± 12.7 years). Patients with no disability (Expanded Disability Status Scale [EDSS] score, 0) were 73% less likely to schedule a follow-up appointment (in-person or telerehabilitation) than those with some disability (EDSS score, >0) (odds ratio, 0.27; 95% CI, 0.09–0.75; P = .012). Neurologic physical therapists identified reduced travel burden and scheduling flexibility as benefits of telerehabilitation vs in-person visits. Barriers to telerehabilitation included low technological literacy, cognitive impairment, and fall risk. Patients described scheduling conflicts and pain/illness as barriers to telerehabilitation. Conclusions: Patients with no disability were least likely to complete physical therapy treatment via telerehabilitation. Although both benefits and barriers to completing physical therapy via telerehabilitation are present, the neurologic physical therapists were supportive of a hybrid model for physical therapy.

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Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

Cited by 17 publications

References 21 publications

Disparities in Telehealth Care in Multiple Sclerosis

Disparities in Telehealth Care in Multiple Sclerosis

MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

Accessibility to Telerehabilitation Services for People With Multiple Sclerosis: Analysis of Barriers and Limitations

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