Telehealth and chronic pain management from rapid adaptation to long-term implementation in pain medicine: A narrative review

Pérez, Jordi; Niburski, Kacper; Stoopler, Michelle; Ingelmo, Pablo

doi:10.1097/pr9.0000000000000912

Cited by 47 publications

(53 citation statements)

References 34 publications

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“…They felt that they needed to adapt their practices for tele-assessments, including less reliance on their own observations and heavier reliance on supplementary sources of information and parents for child assessments. Research has consistently shown that adaptations of clinical practices are required to support clients or patients via telehealth ( Malandraki, Arkenberg, Mitchell, & Malandraki, 2021 ; Waller et al, 2021 ), and assessments for some conditions such as chronic pain require additional involvement from the clients or patients (e.g., Perez, Niburski, Stoopler, & Ingelmo, 2021 ). A number of specific challenges related to telehealth delivery for autism assessments were identified by clinicians, including administration difficulties with eye contact being most challenging to assess.…”

Section: Discussionmentioning

confidence: 99%

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians

Gibbs

Cai

Aldridge

et al. 2021

Research in Autism Spectrum Disorders

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Background The COVID-19 pandemic has seen a rapid increase in the use of telehealth to deliver services to autistic individuals and their families. Research into the provision of autism assessments via telehealth is limited and few studies have explored clinician perspectives of conducting diagnostic assessments for autism in this way. The objective of this study was to examine the acceptability of a new telehealth model from the perspective of key stakeholder groups in an Australian community-based sample i.e. clients undergoing assessment, parent/carers and expert clinicians. Methods Sixteen adult clients ( M age = 39.00, SD age = 14.39) and fifty-six parent/carers of children and adults ( M age = 44.09, SD age = 9.87) undergoing autism assessments completed an online survey about their experiences of assessments via telehealth. Of these, six clients and twelve parent/carers agreed to participate in follow up interviews. Seven clinicians were also interviewed. Results In this study, the majority of adults and parent/carers reported that they, or the person they cared for, felt comfortable interacting with the clinician, would be willing to undergo future assessments via telehealth and were not concerned that important information had been missed during the assessment. Although the clinicians were slightly less satisfied with tele-assessment process compared to face-to-face and relied on external sources of information more than they would during a face-to-face assessment, their overall confidence in their diagnostic decision making remained high. Conclusion Autism assessment via telehealth may be an acceptable alternative in some circumstances. However, a telehealth service should consider screening clients for suitability and adequately preparing clients for tele-assessments.

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Section: Discussionmentioning

confidence: 99%

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians

Gibbs

Cai

Aldridge

et al. 2021

Research in Autism Spectrum Disorders

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“…It has been also debated, that with the development of the technologies, the pain management, diagnosis and therapy can be virtually implemented with use of high definition 3D, 3D holograms which can be touched, felt and behave, augmented reality options etc. [35] Study by Bikson et al discussed the advancements in tele-neuromodulation following the pandemic. Tele-neuromodulation has been considered as a promising course of novel therapeutic solutions for patients with limited accessibility to the services based on mobility, location, financial issues etc.…”

Section: Disease-specific Telemedicine Research and Considerationsmentioning

confidence: 99%

Pediatric neurology and telehealth before and during SARS-CoV-2 pandemic

Gołębiowska

2021

J Educ Health Sport

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Telehealth has been known in medicine for over 70 years. Until the year 2020 it has been utilized in a limited setting to provide long-distance care for individuals residing in areas lacking health facilities. SARS-CoV-2 pandemic shifted the priorities of healthcare system towards COVID-19 infections, which resulted in the transition of non-emergency consultations to telemedicine in many countries. Since pediatric neurology requires frequent follow-up and multidisciplinary care, the purpose of our work is to determine the spectrum of use of telehealth in pediatric neurology before and during the pandemic. Secondly, we would like to discuss the differences of focus in tele-neurology for children patients between the pre-pandemic and during pandemic timeframes.Within 171 articles of PubMED database, 36 substantial articles on the introduction of telehealth to pediatric neurology were included in the review. 30.5% of the articles have included the implementation of telemedicine before the pandemic, 69.5% of the articles discussed improvements made after the pandemic started. The spectrum of disorders and interventions considered for telehealth included epilepsy, cerebral palsy, rare diseases, teleneuropsychology and teleneurorehabilitation. Among major differences between pre-pandemic and pandemic research, increase in international cooperation and discussion of not only medical, but also scientific and academic impact of the pandemic could be noted.Telehealth offers sustainable alternatives to many interventions which cannot be performed in-person during public health emergency such as SARS-CoV-2 pandemic. Despite high satisfaction of caregivers and healthcare professionals from the virtual visits, solutions are still far from perfection and need improvements to provide more support for the patients with various disorders, cover the concerns of privacy and confidentiality, as well as support patients from low-income and lack of electronic techology backgrounds.

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“…The rapid adaptation of telemedicine in child neurology care due to the COVID-19 pandemic has been assessed in several studies, 13,15,[20][21][22][23][24][25] but beyond the initial implementation, the impact on care had not been fully assessed. Analyzing trends of telemedicine, a heterogeneous picture emerges with regards to patients suitable for telemedicine care and the effects of health disparities.…”

Section: Discussionmentioning

confidence: 99%

One year of child neurology telemedicine: a data-driven analysis of 14,820 encounters

Kaufman

Xian

Galer

et al. 2021

Preprint

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IntroductionDetermining the long-term impact of telemedicine in care across the diagnostic and age spectrum of child neurology during the COVID-19 pandemic and with the re-opening of outpatient clinics.MethodsAn observational cohort study of 34,837 in-person visits and 14,820 telemedicine outpatient pediatric neurology visits between October 1, 2019 and April 9, 2021. We assessed differences in care across visit types, time-period observed, time between follow-ups, patient portal activation rates and demographic factors.Results26,399 patients were observed in this study (median age 11.4 years [interquartile range, 5.5-15.9]; 13,209 male). We observed a higher proportion of telemedicine for epilepsy (ICD10 G40: OR 1.4, 95% CI 1.3-1.5) and a lower proportion for movement disorders (ICD10 G25: OR 0.7, 95% CI 0.6-0.8; ICD10 R25: OR 0.7, 95% CI 0.6-0.9). Infants were more likely to be seen in-person after re-opening clinics than by telemedicine (OR 1.6, 95% CI 1.5-1.8) as were individuals with neuromuscular disorders (OR 0.6, 95% CI 0.6-0.7). Racial and ethnic minority populations and those with highest social vulnerability had lower rates of telemedicine participation throughout the pandemic (OR 0.8, 95% CI 0.8-0.8; OR 0.7, 95% CI 0.7-0.8).DiscussionTelemedicine implementation was followed by continued use even once in-person clinics were available. Pediatric epilepsy care can often be performed using telemedicine while young children and patients with neuromuscular disorders often require in-person assessment. Prominent barriers for socially vulnerable families and racial and ethnic minorities persist.

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Telehealth and chronic pain management from rapid adaptation to long-term implementation in pain medicine: A narrative review

Abstract: Telehealth services for chronic pain management are a vast new field with many potential applications for providing high quality, patient-centered care.

Cited by 47 publications

References 34 publications

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians

Pediatric neurology and telehealth before and during SARS-CoV-2 pandemic

One year of child neurology telemedicine: a data-driven analysis of 14,820 encounters

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