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Telehealth Management in Movement Disorder: A Retrospective Study

Published online by Cambridge University Press:  23 September 2014

Angela Roberts-South ,
Linda Hall  and
Mandar S. Jog
Angela Roberts-South*
Affiliation:
University of Western Ontario, London, Ontario, Canada National Parkinson Foundation Centre of Excellence, London, Ontario, Canada
Linda Hall
Affiliation:
London Health Sciences Centre, London, Ontario, Canada National Parkinson Foundation Centre of Excellence, London, Ontario, Canada
Mandar S. Jog
Affiliation:
University of Western Ontario, London, Ontario, Canada London Health Sciences Centre, London, Ontario, Canada National Parkinson Foundation Centre of Excellence, London, Ontario, Canada
*
339 Windermere Road, A10-026, London, Ontario, N6A 5A5, Canada. Email: asouth4@uwo.ca
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Abstract

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Background:

Management of chronic diseases such as movement disorders can be challenging. Nurse-administered telephone follow-up programs have demonstrated clinical and cost efficacy in a variety of health care models. However, their efficacy in movement disorders has not been sufficiently addressed. This observational study fills a knowledge gap by reporting the nature of individuals utilizing a nurse-administered telephone service and the reasons for and the outcomes of calls.

Method:

Consecutive calls received by the clinic for a 12-month duration were recorded. A sample of 312 calls from 132 patient charts was analyzed. Variables for analysis and coding schema were determined a-priori and included demographic information as well as information around the reasons for and outcomes of calls. The narratives of documented calls were reviewed retrospectively and responses coded for analysis by a separate researcher. Data was analyzed using descriptive statistical methods.

Result:

Patients made the majority of calls (49%). 27% of calls related to worsening symptoms and another 35% of calls related to medication issues or renewals. The mean call duration was 15.93 minutes. The majority of calls were received mid-way between clinic visits (M = 89.24 days). The nurse resolved 84% of calls independently. The mean number of calls per patient was 2.93. Issues reported by patients were resolved (approximately 90%) without need for follow-up emergency, family, or subspecialty clinic visits.

Conclusion:

The results underscore the complexity of medical issues in a movement disorders population. The current study provides support for a nurse-administered telephone follow-up program in movement disorders.

Résumé:

Résumé:Contexte:

Le traitement des maladies chroniques telles les troubles du mouvement sont un défi. Les programmes de suivi téléphonique assurés par des infirmières ont démontré leur efficacité au point de vue clinique et financier dans différents modèles de soins de santé. Cependant leur efficacité dans les troubles du mouvement n'a pas été étudiée suffisamment. Cette étude d'observation a pour objectif de remédier à cette situation en rapportant les caractéristiques des individus qui ont recours au service téléphonique assuré par des infirmières et les raisons et les résultats des appels.

Méthode:

Les appels consécutifs reçus à la clinique au cours d'une période de 12 mois ont été enregistrés. Un échantillon de 312 appels consignés aux dossiers de 132 patients ont été analysés. Les variables choisies pour l'analyse et le mode de codage ont été déterminés a priori et incluaient de l'information démographique ainsi que de l'information concernant les raisons des appels et les résultats. Le compte rendu des appels documentés a été révisé rétrospectivement et les réponses ont été codées pour fin d'analyse par un autre chercheur. Les données ont été analysées au moyen de méthodes statistiques descriptives.

Résultats:

La majorité des appels provenait de patients (49%). Une aggravation des symptômes était le motif de 27% des appels et 35% des appels concernaient la médication ou son renouvellement. La durée moyenne des appels était de 15,93 minutes. La majorité des appels a eu lieu à mi-chemin entre les visites à la clinique (M = 89,24 jours). L'infirmière a résolu de façon indépendante le motif de 84% des appels. Le nombre moyen d'appels par patient était de 2,93. Les questions rapportées par les patients ont été résolues (environ 90%) sans nécessiter de visite de suivi d'urgence, de visite de la famille à la clinique ou de référence en sous-spécialité.

Conclusion:

Les résultats soulignent la complexité des questions médicales chez une population de patients atteints de troubles du mouvement. Cette étude démontre l'utilité d'un programme de suivi téléphonique assuré par une infirmière dans les troubles du mouvement.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 2 , March 2013 , pp. 230 - 234
Copyright
Copyright © The Canadian Journal of Neurological 2013

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