Objective: To evaluate the feasibility of telemedicine among PD patients in Nepal.

Background: Nepal is a mountainous country occupying about 85% by Himalayas and hills region. About 80 % of its population are residing in rural areas with limited health services. Further, lack of health workers hinders in the management of Parkinson’s Disease (PD) patients.

Method: PD patients who sought follow up inquiry via hotline of department of Neurology at TUTH during travel restriction covid period, between April 2021 to August 2021 were enrolled. PD Patients who inquired to hotline of Neurology Department for follow up during the allocated period (April 2020 to April 2021), with access to Viber or messenger or WhatsApp.

Results: During the study, a total of 116 phone calls were received via Department of Neurology, TUTH hotline for a myriad of neurological conditions of which 64 were PD related. After, application of inclusion and exclusion criteria, a total of 52 patients was enrolled in our study. Our telemedicine initiative enrolled 52 patients, 40 of whom were male (76.9%). Participants’ mean age was 64.02±11.94 years and around 26 patients (50%) were from outside Kathmandu. About 30% patients were residing in rural areas. They had access to internet connection in the form of Wi-Fi in 82.6% and data only in 15.3%. During the pandemic, 20% patients experienced shortage of one or more PD medications. Of 52 patients, 38 patients (73%) were using telemedicine consultation for the first time and almost all for the first time for Parkinson disease. 78% patients responded that telemedicine consultation was at par with OPD consultation and all of them were satisfied with their first telemedicine encounter. The audio and video quality were mostly average or above, connection interruptions ≥2 times occurred only in 6 patients. The average consultation time was 24.82±6.921 minutes.

Conclusion: In countries with low resource settings, telemedicine could be used as a supportive tool in better management of PD patients. Telecommunication technology, internet and mobile services has been accessible to majority of general population despite geographical barriers. Pandemic has changed the way the medicine is practiced and embracing technology seems the way moving forward.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/telemedicine-in-a-himalayan-country-unlocking-the-barrier-in-the-management-of-parkinsons-disease/