Essential tremor patients managed through in-person and telemedicine have similar experiences with prescribed non-invasive neuromodulation therapy
Salima Brillman1, Toni Prince2, Apoorva Rajagopal2, Sooyoon Shin2, Kate Rosenbluth2
1Parkinson'S Disease and Movement Disorders Center of Silicon Valley, 2Cala Health
This real-world evidence study assessed the effect of prescription setting on patient experience with an at-home non-invasive neuromodulation therapy.
Telemedicine can increase accessibility to healthcare, but it is unclear how remote versus in-person patient engagement, especially during an initial visit requiring patient evaluation, affects therapeutic outcomes.
This analysis evaluated de-identified data from essential tremor patients prescribed a wrist-worn Transcutaneous Afferent Patterned Stimulation (TAPS) device (Cala Health, Burlingame, CA, USA). The device tracked therapy usage and, for a subset of sessions, measured tremor motion using an onboard accelerometer before and after a therapeutic session. Patient experience was evaluated by (i) time from prescription to shipment to the patient, (ii) at-home therapy usage, and (iii) therapy efficacy, quantified using median improvement in device-measured tremor power.
The time elapsed from prescription to when patients received the device was comparable between the cohorts (26±37 days all, 26±41 days telemedicine cohort; p=0.63). 265 patients, 13 of which were from a single telemedicine prescriber, had the device for at least 30 days and had at least 10 sessions of valid accelerometer data available for analysis. Both patient cohorts had similar device use patterns, with patients typically completing 1-2 sessions/day on 2.6 days/week (median; range 0-7 days/week). Objective motion data from 12,731 sessions (613 from telemedicine patients) showed 88% of all patients (77% telemedicine patients; across-group p=0.24) had ≥2-fold improvement in tremor power during their most severe sessions when tremor relief might be most needed, and 53% of all patients (31% telemedicine patients; across-group p=0.12) had ≥2-fold improvement in tremor power aggregated over all sessions.
No differences were observed in patient experience with Cala Trio, suggesting that patient management via telemedicine is a feasible way to evaluate and treat patients without sacrificing health outcomes.