Telemedicine in Parkinson's disease: A patient perspective at a tertiary care centre.

INTRODUCTION To overcome travel distance and lack of local expertise, telemedicine programs have been implemented and are still pilot programs in many jurisdictions. Patient perspectives remain poorly understood. In the largest study to date, we examined user satisfaction and predictors of patient choice to use telemedicine among Parkinson's Disease (PD) patients in the context of a well-developed telemedicine system. These data can help to optimize healthcare delivery by telemedicine. METHODS A patient satisfaction questionnaire was administered to current or previous users via telephone. Patients' cost savings were determined. The proportion of non-users interested in using telemedicine was quantified. Demographic and clinical characteristics of those who expressed interest in the program vs. those who did not were compared. RESULTS A total of 34 users and 103 non-users were recruited. Users reported an average cost reduction of $200 and 209 minutes of reduction in commute time (p < 0.01). While a majority (29/34 users) reported interest in continuing with telemedicine, inexperience of some telehealth nurses was a major source of patient dissatisfaction. Patients preferred a combination of telehealth and in-person visits. A majority of non-users (55/103, 53%) declared interest in telemedicine, but it had not been offered to them. A lower Hoehn and Yahr stage and a longer commute time were associated with patient interest in telemedicine. CONCLUSIONS Training of nurses is an important determinant of patient satisfaction. Clinicians should consider offering telehealth to all patients for whom it is medically appropriate, especially those who experience long travel times.