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Título

Indicators of telemedicine feasibility in Parkinson's disease patients during the COVID-19 pandemic

Resumo

Introduction: During the COVID-19 pandemic, access to health services was limited by government measures to combat the spread of the virus. Consequently, care for other diseases was impaired, such as Parkinson's disease (PD). Telemedicine was adopted as a way to make health care viable in the face of the lockdown state. Objective: To assess feasibility indicators of a telehealth intervention for patients with PD, during the pandemic isolation period in 2020. Methods: The sample consisted of 107 patients from the Movement Disorders outpatient clinic of a tertiary hospital from May 1 to December 31, 2020. Eligibility criteria were: diagnosis of PD, face-to-face consultation in the previous 12 months, access to necessary communication and caregiver availability in cases of dementia. If eligible, they were invited to attend a medical appointment on WhatsApp© video calls. Recruitment, attendance, technical problems and acceptance rates were calculated as indicators of feasibility. Acceptance was assessed by a questionnaire with 10 questions about: feasibility, sense of security, satisfaction, effectiveness and future use of the intervention, with a visual analogue scale. Results: We had 61.3% recruitment and 90.7% attendance rates. Physicians perceived technical difficulties in 11.2% of consultations. The low recruitment rate was mainly due to the high proportion of patients who changed their telephone number and could not be reached. The inability of outpatient clinics to obtain registration data, the unavailability of technology and the absence of a caregiver were other problems found. Acceptance, in general, was higher than 80%, with the exception of a question about effectiveness in improving the symptoms of the disease, which had an average rate of 75%, suggesting that a single consultation is insufficient to resolve all patient complaints, especially those that require a multidisciplinary approach. Participants were referred to rehabilitation services, but in most cases there was no attendance due to the few public rehabilitation centers available. Conclusion: This is probably the first study to assess the feasibility of telemedicine on WhatsApp© in the care of patients with PD in the Brazilian public health system. The results showed good acceptance and attendance rates for the strategy, but more studies with a control group and intervention effect outcomes are needed.

Palavras Chave

Parkinson Disease; Telemedicine; COVID-19

Área

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