The goal of this study was to conduct an analysis of the differences in clinical and seizure-related outcomes between telemedicine and in-person visits and attempt to identify characteristics of patients who prefer telemedicine.
Epilepsy is a chronic neurologic disorder affecting approximately 6.38 individuals per 1000 and often requires lifelong care with frequent specialist visits. The COVID-19 public health emergency has led to the expansion of telemedicine as an alternative for ambulatory visits, benefiting patients with cognitive impairments and driving restrictions by easing access to care. However, our knowledge of the application and benefits of telemedicine is limited, as there is limited to no literature to compare benefits of in-person versus tele medicine visits.
A retrospective chart review was performed with approval from the Institutional review board. We collected social, demographic, and clinical characteristics of all adult epilepsy patients seen either as an in-person or telehealth encounter at University of Kentucky between 1st July 2021 and 30th September 2022.
600 visits were initially assessed for eligibility and 590 were included in the study. 244 (38%) patients opted for in-person appointments while 366 (62%) had virtual visits. A Pearson chi-square test showed no difference in post-visit seizure freedom, post-visit ER admissions, anti-seizure medication changes, and ability to discuss epilepsy surgery between telemedicine and in-person visits. To determine predictors of patient preference for telemedicine visits, a forward stepwise regression analysis was also conducted, and variables are analyzed using Akaike Information Criterion (AIC).
Telemedicine is a comparable alternative to in-person visits and can be used in conjunction with traditional approaches for epilepsy patients. It can be successfully offered to younger patients, individuals residing far from the hospital, minority populations, patients with significant others, and those with less severe epilepsy, thereby reducing the access gap.