Seigel Courtney R, Martin Holly, Bastin Grace, Myers Laura J, Taylor Stan, Pike Francis, Wilkinson Jayne, Williams Linda S
Indiana University School of Medicine, Indianapolis, IN, USA.
Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, USA.
J Neurol. 2024 May;271(5):2850-2858. doi: 10.1007/s00415-024-12200-y. Epub 2024 Feb 23.
Patient acceptability with outpatient teleneurology has been reported within specific conditions, but less is known about acceptability across neurologic conditions. The study objective was to compare the acceptability of teleneurology between patients with various neurological conditions and determine what other factors influence acceptability.
This was a prospective study of Veterans who completed new outpatient teleneurology visits with the Department of Veterans Affairs National Teleneurology Program. Visits were conducted via video to home or video to the outpatient clinic. Patient acceptability was assessed via telephone interview two weeks post-visit. Acceptability was a summed score (3-21) of three 7-point Likert questions (higher = more acceptable). Clinical diagnosis categories were based on the neurologists' ICD10 diagnosis code. Acceptability score was modeled using a censored Tobit model controlling for demographics, type of tele-visit, medical comorbidity, and ICD10 category.
In FY 2021, 277 of 637 (43.5%) patients completed an interview with analyzable acceptability data. Of these 277, 70 (25.3%) had codes indicating headache, 46 (16.6%) movement disorder, 45 (16.2%) general symptoms, and 116 (41.9%) for all other categories. Mean patient acceptability was 18.3 (SD 3.2). There was no significant difference in scores between these groups. The only factor independently related to acceptability was medical comorbidity, with higher comorbidity associated with higher acceptability scores.
Patients find their outpatient teleneurology experience highly acceptable independent of neurologic condition. Those with more comorbidity report higher acceptability. Use of teleneurology may be useful and acceptable across many outpatient neurologic conditions including for more medically complex patients.
在特定条件下，门诊远程神经病学的患者接受度已有报道，但对于不同神经系统疾病的接受度了解较少。本研究的目的是比较不同神经系统疾病患者对远程神经病学的接受度，并确定还有哪些其他因素会影响接受度。
这是一项针对退伍军人的前瞻性研究，这些退伍军人通过退伍军人事务部国家远程神经病学项目完成了新的门诊远程神经病学就诊。就诊通过视频家访或视频门诊进行。在就诊两周后通过电话访谈评估患者的接受度。接受度是三个7分李克特问题的总分（3 - 21分）（分数越高 = 接受度越高）。临床诊断类别基于神经科医生的ICD10诊断代码。使用删失托比特模型对接受度得分进行建模，该模型控制了人口统计学特征、远程就诊类型、合并症和ICD10类别。
在2021财年，637名患者中有277名（43.5%）完成了具有可分析接受度数据的访谈。在这277名患者中，70名（25.3%）的代码表明患有头痛，46名（16.6%）患有运动障碍，45名（16.2%）有一般症状，116名（41.9%）属于所有其他类别。患者的平均接受度为18.3（标准差3.2）。这些组之间的得分没有显著差异。与接受度独立相关的唯一因素是合并症，合并症越多，接受度得分越高。
患者发现他们的门诊远程神经病学体验非常可接受，与神经系统疾病无关。合并症较多的患者报告的接受度更高。在许多门诊神经系统疾病中，包括病情更复杂的患者，使用远程神经病学可能是有用且可接受的。
