Objective: To evaluate telemedicine (TM) use and access patterns during the COVID-19 pandemic in people with Parkinson’s disease (pwPD).

Background: pwPD may experience difficulty accessing medical care due to declining motor function. TM may provide timely remote access to health services, including specialty care. During the COVID-19 pandemic, the use of TM increased; however, it is unclear how its use and accessibility varied among commercially insured pwPD.

Method: This cross-sectional study used US PharMetrics Plus administrative commercial insurance claims data (01/01/2019−12/31/2021). TM use, identified using ≥1 current procedural terminology code, was assessed in each pandemic year (2020 and 2021) in adults with ≥1 inpatient or ≥2 outpatient ICD-10-CM diagnosis codes for PD ≥30 days apart. Any TM use and PD-related visits (PD diagnosis code in TM claim) were summarized, and characteristics of TM users vs nonusers among pwPD were described.

Results: Among pwPD, 61.9% (18,399 of 29,720) in 2020 and 44.1% (15,265 of 34,598) in 2021 used TM. Of these TM users, the mean (SD) number of any claims was 3.1 (3.1) in 2020 and 2.9 (3.3) in 2021, and the majority had PD-related TM visits (71.6% in 2020, 61.0% in 2021). Among pwPD, TM visits accounted for 17.9% of all healthcare claims in 2020 and 11.5% in 2021, of which 42.3% in 2020 and 40.3% in 2021 were PD-related claims. Most TM visits among pwPD included ≥1 interactive audio or video component (80.6% in 2020, 83.5% in 2021) and involved an established patient visit (78.5% in 2020 and 81.2% in 2021). Of 106,617 total TM visits with pwPD in 2020 and 2021, only 25.7% were provided by a neurologist. Compared with nonusers, TM users with PD were more likely to be female (38.7% vs 35.0%), had a higher mean (SD) Charlson Comorbidity Index score (1 [2] vs 2 [2]), were more likely to be Medicare users (48.0% vs 36.8%) and were more likely to reside in western (15.0% vs 25.3%) or eastern (14.4 vs 18.1%) regions. TM use was highest in Hawaii (68.6%), Massachusetts (66.3%) and Vermont (64.1%).

Conclusion: Approximately half of pwPD in a commercially insured population used TM during the pandemic; its use varied most notably by region, state and insurance enrollment. A neurologist provided only one-quarter of all TM visits. Additional analyses will inform gaps in TM access and its long-term utility in pwPD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-cross-sectional-study-of-telemedicine-use-during-the-covid-19-pandemic-in-people-with-parkinsons-disease/