Patients Prefer Telehealth Over Visits in Person for Certain Services

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by Steve Bryson PhD |

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Telehealth services during the COVID-19 pandemic was perceived to be a good alternative to in-person healthcare appointments among people with Parkinson’s disease, according to an anonymous survey.

Respondents said telehealth reduced travel, was more convenient, was suitable for follow-up appointments, and was preferred for speech-language pathology and mental health sessions.

In comparison, in-person visits were favored by patients for physical examinations because providers may notice symptoms better than through telehealth, and assessments and communication were more thorough.

The survey, “Attitudes Toward Telehealth Services Among People Living With Parkinson’s Disease: A Survey Study,” was published in the journal Movement Disorders.

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The COVID-19 pandemic moved many visits to the doctor from in-person appointments to telehealth services. Surveys showed that telehealth use by people with Parkinson’s increased from 10% before the pandemic to 64% during the pandemic.

However, the details of telehealth service use and attitudes toward telehealth among those who live with Parkinson’s are unknown.

To learn more, the Parkinson’s Foundation and the Columbia University Parkinson’s Disease Center of Excellence distributed an anonymous survey to 16,026 email addresses on mailing lists from the two organizations.

Among the 944 respondents included in this analysis, the mean age was 71.5 years and the mean disease duration was 7.0 years.

According to the survey findings, 90.2% of respondents were aware of telehealth services, and 82.8% used telehealth.

In the previous year, in-person visits were the most commonly used medical service, including for primary care, movement disorder services, neurology, physical and occupational therapy, speech-language pathology (SLP), and mental health. The use of in-person appointments was followed by telehealth appointments such as video and phone.

More than 40% of respondents reported that video or phone telehealth services were equally or more satisfying than in-person visits across all service types.

Telehealth satisfaction — equally or more satisfied than in-person — was highest for speech-language pathology (78.8%), followed by mental health services (69.2%).

There was no difference in most aspects of the perceived quality of care received in person or via video. However, phone appointments had the lowest performance in relation to communication and time spent during the visits. In-person visit performance between different healthcare facilities diverged significantly, but not for video and phone visit performance.

The reasons for telehealth satisfaction included shorter travel times (46.0%), followed by ease and convenience (21.6%), then the option for follow-up appointments (18.7%).

“I don’t have to drive in traffic and find parking. I prefer not going to a hospital where there are a lot of people,” said a respondent, while another wrote, “to be at an appointment I need a wheelchair, a walker, and the assistance of my wife/caregiver and sometimes paid home care worker.”

Participants also suggested limiting telehealth services to less clinically complicated visits or speech-language pathology.

“When I am just checking in on how I am doing,” one respondent said, while another noted, “speech therapy over virtual is easier when we do it daily.”

Among participants who preferred in-person visits, 42.8% felt that their healthcare provider was able to notice symptoms better in-person than by telehealth, while 20% responded that in-person visits were more thorough, and 19.6% indicated the importance of sight and touch in a physical examination.

“It is difficult for my doctor to really see my gait, movements responses, etc., when I am not there in person,” responded one individual.

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Another said, “I see my neurologist 1–2 times a year. It’s not possible to check the progression of [Parkinson’s disease] over the phone.”

Two participants mentioned that they preferred in-person appointments to see movement disorders specialists, but telehealth was helpful for mental health discussions.

“In summary, telehealth was effective, widely used, and reported as satisfying by [people with Parkinson’s] in the past year,” the researchers wrote. “Although telehealth may not be appropriate for every clinical service, the use of telehealth for [Parkinson’s disease] appointments within a hybrid model of patient care should remain an option for [people with Parkinson’s], especially for SLP and mental health, and legislation should ensure the accessibility of this option in the future.”