Abstract Details

Title TeleSCOPE 2.0: A Follow-up Real-world Study of Telehealth for the Detection and Treatment of Drug-induced Movement Disorders (DIMD)

Topic Movement Disorders

Presentation(s) S35 - Movement Disorders: Hyperkinetic Movement Disorders (4:54 PM-5:06 PM)

Poster/Presentation
Number 008

Background Since COVID-19, mental healthcare telehealth has increased. A 2021 online survey (TeleSCOPE 1.0 [T1]) identified challenges assessing DIMDs with telehealth. TeleSCOPE 2.0 [T2] was a follow-up study.

Objective To understand telehealth’s impact on assessment of DMIDs post-COVID restrictions.

Design/Methods T2 was fielded (5/18-6/9/2023) to clinicians affiliated with neurology/psychiatry practices who prescribed VMAT2 inhibitors or benztropine for DIMDs in the past 6 months and saw ≥15% of patients via telehealth at peak and post-COVID.

Results 100 neurologists, 100 psychiatrists, and 105 NP/PAs responded. More patients were seen in-person post-COVID (12-27% vs 31-53%), but video percentage remained consistent (54-62% vs 37-53%). T2 appointment setting was influenced by access to care, technology, and digital literacy; less patients had video connection issues. Common T2 DIMD telehealth evaluation methods included personal phone videos (48-66%), telemedicine applications (36-45%), and health/fitness trackers (6-13%). Common T2 diagnostic telehealth issues included determining signs of difficulty with gait/falls/walking/standing; difficulty writing/using phone/computer; and painful movements. More patients evaluated for DIMDs received an eventual diagnosis in T2 vs T1 in-person (34-53% vs 26-46%) and video (32-51% vs 29-44%) but, on average, neurologists/psychiatrists required 1 more telehealth visit to confirm DIMD diagnosis vs in-person. On average, >50% clinicians recommended patients come in-person to confirm DIMD diagnosis. Most clinicians reported ongoing difficultly diagnosing patients via phone. In T2, less clinicians found it difficult to manage DIMDs by video (T1 52-54%; T2 28-36%). Half of clinicians reported the non-presence of a caregiver as a significant barrier to diagnosis and treatment via telehealth. Clear guidelines and provider education were the most feasible strategies to implement to improve telehealth quality of care.

Conclusions Clinicians see value in telehealth, but it’s still not as effective as in-person – requiring 1 additional telehealth visit for DIMD diagnosis; >50% of clinicians recommend patients come in-person to confirm DIMD diagnosis. Significant barriers to telehealth remain.

Authors/Disclosures
Rimal Bera (University of California, Irvine School of Medicine) PRESENTER	No disclosure on file
Ezra Blaustein (IQVIA)	No disclosure on file
Shilpi Singh (IQVIA Inc.)	No disclosure on file
Morgan Bron	Morgan Bron has received personal compensation for serving as an employee of Neurocrine Biosciences, Inc.. Morgan Bron has stock in Neurocrine.
Heintje A. Calara (Neurocrine Biosciences)	Dr. Calara has nothing to disclose.
Samantha Cicero, PhD (Neurocrine Biosciences)	No disclosure on file
Kendra Martello (Neurocrine Biosciences)	No disclosure on file
Rif S. El-Mallakh	No disclosure on file