Feasibility, Effectiveness, and Acceptability of a Telemedicine Neurological Consultation for Drug-Induced Movement Disorders; A Randomized Pilot Study

TL;DR

This study shows that telemedicine can effectively provide neurological consultations for drug-induced movement disorders in rural areas.

Contribution

The study demonstrates the feasibility and acceptability of telemedicine for neurological consultations in rural mental health settings.

Findings

Telemedicine consultations for DIMDs had low technological issues and were acceptable to participants.

Mental health clinicians found the consult service helpful and reported improved patient care.

Satisfaction scores were slightly higher for in-person consultations, but telemedicine was still well-received.

Abstract

Individuals exposed to neuroleptics are at risk of developing a drug-induced movement disorder (DIMD). Early identification and appropriate management are necessary to minimize the risk of DIMDs worsening and becoming irreversible. Movement disorder neurologists can assist other clinicians in assessing the cause of the DIMD and make care recommendations. The aim of this study was to evaluate if telemedicine can be used to provide a neurological consultation service to patients with DIMDs.

Patients referred by mental health clinicians (MHCs) in a rural state were randomized to have a neurological consult in-person or through telemedicine. Participants completed two visits with a neurologist and completed surveys about their experience and well-being. MHCs provided feedback on the service through a survey and qualitative interviews.

In the IP group, 79% or participants completed Visit 1 and 71% attended Visit 2, as compared to 86% of participants completing Visit 1 in the TM group and 57% were present for Visit 2. Satisfaction scores were slightly higher for the IP group at both visits. MHCs were satisfied with the consult, reporting that it was helpful and improved care for the patients.

Providing a consult service through telemedicine is feasible, effective, and acceptable, and can be improved further following feedback provided by the MHCs. Overall, participants and MHCs were pleased to have the opportunity to meet and collaborate with a neurologist.

The results from our study address gaps in knowledge related to providing specialist care to people with drug-induced movement disorders in a rural setting. Telemedicine consultation is feasible, with low rates of technological issues, and participants with drug-induced movement disorders were satisfied with telemedicine as a mode of care delivery.

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