Objective: Our goal was to evaluate the feasibility, effectiveness, and acceptability of a remote consultation with a movement disorder neurologist to patients suspected to have a drug-induced movement disorder (DIMD).

Background: DIMDs can be persistent and disabling, making prevention critical; but these disorders are often under-reported, under-recognized and inappropriately managed. Research shows that telemedicine for movement disorders (e.g. Parkinson’s disease) is feasible and may provide similar care as in-person visits; however, further validation in other movement disorders is necessary.

Method: Mental health clinicians referred patients with DIMDs to have a consultation and they were randomized to in-person or telemedicine visits. They had two visits, four to six months apart, and the neurologist provided their impression and care recommendations. We applied mixed methods to comprehensively assess factors that may impact feasibility, effectiveness, and acceptability of the program. Participants were invited to complete surveys about their well-being and experience, and mental health clinicians gave feedback using a survey and qualitative interviews.

Results: At visit 1, 79% of in-person participants completed a visit, compared to 86% of telemedicine participants. Visit 2 was successfully completed by 71% of in-person participants and 57% of telemedicine participants. One person in the telemedicine group withdrew due to technical poor video quality, and no other technical difficulties were reported. The neurologists felt confident in their ability to examine the participants remotely. Patient reported outcomes did not change between the two visits for either group, and many mental health clinicians (63%) agreed that the consultation improved care for the patient. Satisfaction scores were high among both participant groups after visit 1 (mean=29.9 in-person; 27.5 telemedicine), but the value fell for the telemedicine group following visit 2 (mean=30.7 in-person, 24.4 telemedicine). All mental health clinicians indicated that they would use a consultation service like this in the future. Main themes from their interviews related to acceptance within their practices, were resources and patient factors.

Conclusion: A consult service through telemedicine is feasible, effective, and acceptable, and can bridge the care gap between psychiatry and neurology in a rural location.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/bridging-the-care-gap-for-individuals-with-drug-induced-movement-disorders-using-telemedicine-a-randomized-pilot-study/