Teleneurology Visits Had Similar to Lower Odds of Completion of AAN Multiple Sclerosis Quality Measures Compared to In-person Visits
Samantha Tidd1, Mengke Du2, Sarita Walvekar1, Kelly Bowen1, Saswat Sahoo1, Elizabeth Mearns4, Nikki Win4, Marisa McGinley3
1Cleveland Clinic Lerner College of Medicine, 2Dept. of Quantitative Health Sciences, 3Mellen Center, Cleveland Clinic, 4Genentech Inc.
Objective:
To investigate the relationship between visit type and the completion of AAN Multiple Sclerosis Quality Measures (MSQMs).
Background:
The use of teleneurology in multiple sclerosis (MS) care has increased and may be beneficial in terms of access, but the quality of the care given compared to in-person visits is uncertain.
Design/Methods:
In this retrospective cohort study, a random sample of 217 adult MS patients who completed two MS office visits at least 2 years +/- 6 months apart from 1/2019-7/2021 at a single MS center were included. Generalized linear mixed effects models were created to assess the association between visit type and the completion of each MSQM. Each model controlled for patient-level variables (race/ethnicity, gender, rural/urban status, area deprivation index, insurance, MS type, and patient determined disease steps).
Results:
217 patients were included (median age 52, 80% white, 76% female, 66% relapsing remitting MS). MRI and DMT MSQMs had high completion rates regardless of visit type and were therefore not modeled (97% and 100% completion respectively). The odds of completion of the screening MSQM for bowel, bladder, and sexual dysfunction did not differ significantly for in-person or virtual visits (OR 0.74, p=0.17). The odds of completion of the screening MSQMs of cognitive, fatigue, and exercise were significantly lower for virtual visits than for in-person visits (OR 0.32, p<0.001; OR 0.33, p=0.002; OR 0.36, p<0.001 respectively). Irrespective of visit type, the odds of completion of screening MSQMs did not differ significantly by age, race, ethnicity, ADI, or rural/urban status (p>0.05).
Conclusions:
Teleneurology visits had similar odds of completion for some MSQMs, but lower for others. Although teleneurology has potential benefits, efforts are needed to ensure high-quality care is maintained. Health disparities were not observed for MSQM completion, but as QMs evolve, health equity should be a priority for all patients.