A doctor's appointment via video consultation – for many people, this idea is still unfamiliar. However, the field of telemedicine is continuously expanding and is also being strengthened by the new Digital Healthcare Act (DVG). US researchers have investigated the role of telemedicine in neurological diseases, including dementia.
The background and benefits of telemedicine are obvious: The research group around Jaime M. Hatcher-Martin assumes that demographic change will lead to an increasing need for neurological treatments for older people. Telemedicine could close gaps in care here by, for example, enabling examinations of patients who would otherwise be unable to see a specialist due to long distances or physical or cognitive limitations. Furthermore, according to the authors, telemedicine can offer earlier specialized care, reduce the burden on patients and nursing staff, and improve patient satisfaction.
Positive Experiences with Telemedicine in Stroke Care
„Pioneers“ in neurological telemedicine are stroke treatments („telestroke“). Since the first approaches around 20 years ago, access has been continuously expanded and quality improved. Despite these advances in stroke care, however, there has been little data on the role of telemedicine in other neurological diseases. To what extent can telemedicine improve access to care? How accurate is the diagnostics? What is the acceptance rate among patients and doctors? To provide an overview of these points, the researchers evaluated 753 studies on telemedicine. They related to different neurological diseases, such as epilepsy, headaches, multiple sclerosis, or dementia.
Regarding dementia telemedicine, the authors„ assessment is positive. The studies indicate that this type of treatment improves access to care, has high diagnostic accuracy, ensures satisfaction among patients and caregivers, and saves costs. For example, one analysis found that nearly two-thirds of the (telemedicine) sessions described would likely not have occurred if the doctor had to travel long distances to conduct them. Several studies investigated the diagnostic accuracy and reliability of using standard screening tests – with comparable results between teleneurology and in-person examinations. Only one study specifically asked about patients“ satisfaction with teleneurology compared to in-person examinations. All participants had experienced both "versions" and, according to the results, were equally satisfied.
Longer treatment duration for telemedicine patients
Even the results of the Mini-Mental State Examination over the course of a year showed no differences between the two forms of therapy. The authors see this as an indication that teleneurology is at least as effective as in-person visits in terms of treatment outcome. In addition, it was shown that teleneurology patients had a significantly longer treatment duration. This suggests that they made use of treatments more frequently in comparison.
The researchers cautiously point out that only 7 of the 20 evaluated teleneurology/dementia studies were randomized clinical trials. They recommend further and more precise studies to determine how teleneurology compares to in-person dementia care.
The full study can be found here:
Telemedicine in neurology (January 2020)
