title: Telemedicine in Parkinson's disease: A patient perspective at a tertiary care centre.
abstract: BACKGROUND
  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.
authors: Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada. Electronic address: j.qiang@mail.utoronto.ca.
authors: Judy K
authors: JK
authors: Qiang
authors: Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Research, Division of Neurology, University of Toronto, 399 Bathurst St., Toronto, ON M5T 2S8, Canada. Electronic address: connie.marras@uhnresearch.ca.
authors: Connie
authors: C
authors: Marras
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods* / Q000639:trends; D062606:Tertiary Care Centers / Q000639:trends
keywords: Healthcare practice; Parkinson's disease; Patient perspectives; Telemedicine