Telemedicine improves attendance at epilepsy appointments and has the potential to overcome socioeconomic hurdles and widen access to epilepsy care, particularly among underserved populations, new research suggests.
Researchers collected social determinants of health for all adult epilepsy patients scheduled for either an in-person or telemedicine appointment at Kentucky Neurological Institute in Lexington between July 2021 and December 2022.
The primary outcome was attendance or absence at the appointment.
Subgroup analyses were conducted to better understand the drivers of attendance at telemedicine visits and to evaluate telemedicine utilization by underserved populations.
Of 3025 individual clinic visits from 1640 unique patients (46% telehealth), the overall no-show rate was 27% and was significantly higher for in-person vs telehealth visits (32% vs 20%, respectively; P < .001).
Key drivers of no-shows included in-person visits, prior missed appointments, longer appointment lead time, having Medicaid/Medicare insurance, not having a significant other, having lower mean annual income, and being of a minority race.
In a subgroup analysis of underprivileged patients, 44% opted for telehealth visits, and they had a lower no-show rate compared with in-person visits (22% vs 33%; P < .001).
Overall, telemedicine decreased the likelihood of missing epilepsy appointments by 45%, and in a subgroup analysis of underprivileged patients, telehealth reduced the odds of no-show by 52%.
Epilepsy affects 3.4 million people in the US. Access to epilepsy specialist care is not uniform, with prominent gaps in rural areas. “This study highlights that telemedicine is effective at improving attendance, overcoming racial and socioeconomic hurdles, and widening access to epilepsy care. It stresses the need to incorporate telemedicine in epilepsy as a complementary approach to minimize health inequity,” the authors write.
The study, with first author Ruta Yardi, MD, Kentucky Neurological Institute, University of Kentucky, Lexington, was published online October 9 in Epilepsia.
This was a single-center study, which may result in selection bias. Data for the study came from electronic medical records, with the inherent disadvantage of nonuniform data entry. The researchers couldn’t distinguish between new and established epilepsy visits.
The study was supported by the Center for Clinical and Translational Science, University of Kentucky. The authors have disclosed no relevant financial relationships.
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