Telemedicine in Neurological Disorders: Opportunities and Challenges

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Abstract

Introduction: Telemedicine represents an emerging model for the assessment and management of various neurological disorders. Methods: We sought to discuss opportunities and challenges for the integration of telemedicine in the management of common and uncommon neurological disorders by reviewing and appraising studies that evaluate telemedicine as a means to facilitate the access to care, deliver highly specialized visits, diagnostic consultations, rehabilitation, and remote monitoring of neurological disorders. Results: Opportunities for telemedicine in neurological disorders include the replacement of or complement to in-office evaluations, decreased time between follow-up visits, reduction in disparities in access to healthcare, and promotion of education and training through interactions between primary care physicians and tertiary referral centers. Critical challenges include the integration of the systems for data monitoring with an easy-to-use, secure, and cost-effective platform that is both widely adopted by patients and healthcare systems and embraced by international scientific societies. Conclusions: Multiple applications may spawn from a model based on digitalized healthcare services. Integrated efforts from multiple stakeholders will be required to develop an interoperable software platform capable of providing not only a holistic approach to care but also one that reduces disparities in the access to care.

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Most cited references 71

Record: found
Abstract: found
Article: not found

The global decrease in cancer mortality: trends and disparities.

D Hashim, P Boffetta, C. La Vecchia … (2016)

A decrease in cancer mortality has been reported in the United States, Europe, and other high-income regions during the last two decades. Whether similar trends apply to low-to-middle income countries-and globally-is unclear.

0 comments Cited 133 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Blood pressure control by home monitoring: meta-analysis of randomised trials.

Francesco Cappuccio, Sally M. Kerry, Lindsay K. Forbes … (2004)

To determine the effect of home blood pressure monitoring on blood pressure levels and proportion of people with essential hypertension achieving targets. Meta-analysis of 18 randomised controlled trials. 1359 people with essential hypertension allocated to home blood pressure monitoring and 1355 allocated to the "control" group seen in the healthcare system for 2-36 months. Differences in systolic (13 studies), diastolic (16 studies), or mean (3 studies) blood pressures, and proportion of patients achieving targets (6 studies), between intervention and control groups. Systolic blood pressure was lower in people with hypertension who had home blood pressure monitoring than in those who had standard blood pressure monitoring in the healthcare system (standardised mean difference 4.2 (95% confidence interval 1.5 to 6.9) mm Hg), diastolic blood pressure was lower by 2.4 (1.2 to 3.5) mm Hg, and mean blood pressure was lower by 4.4 (2.0 to 6.8) mm Hg. The relative risk of blood pressure above predetermined targets was lower in people with home blood pressure monitoring (risk ratio 0.90, 0.80 to 1.00). When publication bias was allowed for, the differences were attenuated: 2.2 (-0.9 to 5.3) mm Hg for systolic blood pressure and 1.9 (0.6 to 3.2) mm Hg for diastolic blood pressure. Blood pressure control in people with hypertension (assessed in the clinic) and the proportion achieving targets are increased when home blood pressure monitoring is used rather than standard blood pressure monitoring in the healthcare system. The reasons for this are not clear. The difference in blood pressure control between the two methods is small but likely to contribute to an important reduction in vascular complications in the hypertensive population.

0 comments Cited 107 times – based on 0 reviews      Review now

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Record: found
Abstract: found
Article: not found

Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

Wayne D. Rosamond, Mathew Reeves, Karin V Nyström … (2017)

Telestroke is one of the most frequently used and rapidly expanding applications of telemedicine, delivering much-needed stroke expertise to hospitals and patients. This document reviews the current status of telestroke and suggests measures for ongoing quality and outcome monitoring to improve performance and to enhance delivery of care.

0 comments Cited 86 times – based on 0 reviews      Review now

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Author and article information

Journal

Title: Telemedicine and e-Health

Abbreviated Title: Telemedicine and e-Health

Publisher: Mary Ann Liebert Inc

ISSN (Print): 1530-5627

ISSN (Electronic): 1556-3669

Publication date Created: July 2019

Publication date (Print): July 2019

Volume: 25

Issue: 7

Pages: 541-550

Affiliations

[1 ]Division of Hematology-Oncology, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio.

[2 ]Department of Oncology, Medical Oncology Unit, University of Siena, Siena, Italy.

[3 ]Department of Neurology and Rehabilitation Medicine, Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio.

[4 ]College of Medicine, University of Cincinnati, Cincinnati, Ohio.

[5 ]Autonomic Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy.

[6 ]Department of Neuroscience Rita Levi Montalcini, University of Turin, Torin, Italy.

[7 ]Department of Neurology and Rehabilitation Medicine, The Waddell Center for Multiple Sclerosis, University of Cincinnati, Cincinnati, Ohio.