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Presence of Caregivers at Telehealth Visits Significantly Improves Virtual Assessment of Drug-Induced Movement Disorders
Movement Disorders Clinical Practice ; 9(SUPPL 1):S12-S13, 2022.
Article in English | EMBASE | ID: covidwho-1925959
ABSTRACT

Objective:

To highlight the importance of caregivers based on results from TeleSCOPE, a real-world study of telehealth during COVID-19 in patients with tardive dyskinesia (TD) and other drug-induced movement disorders (DIMDs).

Background:

Given the importance of engaging caregivers (family members or other persons of support) when treating patients with TD [1], TeleSCOPE included items related to the effects of caregiver presence during virtual visits. neurology (Neuro) and psychiatry (Psych) physicians and advanced practice providers who met the following criteria ≥3 years of practice with ≥70% of time spent in clinic;prescribed a vesicular monoamine transporter two inhibitor or benztropine for DIMD at least once in the past six months;and conducted telehealth visits with ≥15% of their patients from Dec-2020 to Jan-2021. Participants responded to items regarding DIMD assessment and management, including the impact of caregivers in these areas.

Results:

277 clinicians responded (Neuro = 109, Psych = 168). For both specialties, caregiver participation was greater in video versus phone-only visits (Neuro = 51% vs 37%, Psych = 29% vs 15%). Any mention of tics/ movements by caregivers was the top prompt for further DIMD evaluation (Neuro = 82%, Psych = 89%), followed by trouble with gait/falls/walking/ standing (Neuro = 77%, Psych = 85%) and difficulty swallowing/eating (Neuro = 69%, Psych = 78%). Furthermore, patients without a participating caregiver had the highest risk of a missed DIMD diagnosis (Neuro = 89%, Psych = 83%). Other at-risk patients were lower functioning (Neuro = 86%, Psych = 80%), primarily lived in a group home (Neuro = 68%, Psych = 37%), or were new to the practice (Neuro = 28%, Psych = 51%).

Conclusion:

Although caregivers were not often present during telehealth visits (especially phone-only visits), active caregiver participation alleviated some of the challenges of virtual DIMD assessment. Caregiver mention of tics/movements or physical impact increased the likelihood of DIMD evaluation and reduced the risk of missed diagnosis. In-person visits remain the gold standard for assessing and treating DIMDs. However, when telehealth is necessary, caregivers can significantly improve the quality of virtual visits. Given this potential for improved outcomes, the role of caregivers in DIMD management merits more research and support.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Movement Disorders Clinical Practice Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Movement Disorders Clinical Practice Year: 2022 Document Type: Article