Multiple Sclerosis Care Professionals Satisfied With Clinical Video Telemedicine Visits

Peter Keszler, DO

A majority of multiple sclerosis (MS) health care professionals used clinical video telemedicine (CVT) with their patients and were satisfied with its use, according to a recent survey. The results were presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021, February 25-27, by Peter Keszler, DO, chief resident, department of neurology, George Washington University School of Medicine and Health Sciences, and colleagues.

“Many patients with MS are separated by geographic distance and disability from MS clinical centers in the US, with 30% not receiving specialty MS care. Telemedicine, defined broadly as the use of telehealth technologies to provide clinical care when distance separates patients and providers, has the potential to fill some of the gap in the provision of specialty MS services. The COVID-19 pandemic has forced providers to use telemedicine for most outpatient care to maintain social distancing,” Keszler and colleagues wrote. 

Keszler and colleagues created a 34-question survey in order to collect a representative sample of opinions on the use of telemedicine among a diverse group of health care professionals involved with MS care. They then placed the survey on the Qualtrex web-platform and distributed it to a multidisciplinary group of professionals across the US. Collected responses were analyzed with Qualtrex web-analytical software and statistical analysis system.

A total of 100 participants began the survey and 91 fully completed it. The respondents were 40.7% neurologists, 28.6% nurse practitioners and physicians' assistants, 14.3% nurses, 7.7% psychologists and neuropsychologists, 3.3% social workers, 2.2% physical therapists and occupational therapists, and 1.1% pharmacists.

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The survey collected responses from November 2019 to September 2020. Most respondents (75.8%) reported using telemedicine to care for patients with MS. Of those who used telemedicine, 97% used CVT and 71% used telephone telemedicine. Other telemedicine approaches were used less commonly, with only 10.1% of respondents using store and forward telemedicine, and 1.4% using remote patients monitoring. 

During the COVID-19 pandemic, the rate of telemedicine utilization increased from 15% of practice encounters to 72.8% of encounters. Most respondents (92.8%) were either very or somewhat satisfied with their last telemedicine visit and 94.2% of respondents reported a desire to continue using telemedicine. The most common drawback of telemedicine, as reported by 84.6% of respondents, was the inability to complete a full neurological exam.

“Telemedicine can provide a valid alternative to in person visits. Further study is needed to evaluate how opinions on telemedicine have continued to evolve as providers become more and more accustomed to its use and what barriers may exist that are limiting the utilization of store and forward and remote patient monitoring,” Keszler and colleagues concluded.

Telemedicine use has grown in the MS field, and this adaptation toward a more digital world has been an ongoing conversation for those treating this population. Leigh Charvet, PhD, clinical neuropsychologist, Division of MS, NYU Langone Health, recently came on the NeurologyLive Mind Moments podcast to discuss the work she and colleagues have done in validating and assessing digital therapeutics and telemedicine approaches in MS, and how these interventions might make an impact on the invisible symptoms of the disease. One key point Charvet made was that it can help with wider data collection on the MS population.

“There’s a segment of people living with MS who are left out of a lot of clinical trials right now, and they face even more burden to get to a clinic visit to receive some type of therapy for a trial. We’ve been encouraged by being able to reach so many more people than are typically reached in a clinical trial to evaluate these therapies,” Charvet told NeurologyLive.

The increase in telemedicine use was a somewhat broad trend across medical specialties, of course, due to the pandemic’s limiting of in-person visits. NeurologyLive spoke with physicians all over the country about the impact it had on their clinical practice in 2020, and our Year in Review series compiled those insights into one place. To check out those insights, click here.

For more coverage of ACTRIMS Forum 2021, click here.

REFERENCE

Keszler P, Maloni H, Miles Z, Jin S, Wallin M. Telemedicine utilization and perceptions of multiple sclerosis health care providers. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Abstract P172