Feasibility of real-time internet-based teleconsultation in patients with multiple sclerosis: interventional pilot study.

BACKGROUND: Telemedicine (TM) is currently flourishing in rural and emergency settings but its implementation in routine management of chronic neurological disorders develops more hesitatingly. Limited access to specialized care facilities and expanding patient populations are currently, combined with unprecedented mobility restrictions imposed by the 'coronavirus disease of 2019' pandemic, stressing the need for remote solutions in this field. Studies in subjects with multiple sclerosis (MS) have been heterogeneous in objectives and methodology, but generally support the concept that TM interventions produce clinical benefit, cost-effectiveness and user satisfaction. Nonetheless, data on live interaction between patients and health-care providers for MS teleconsultation purposes remain scarce. OBJECTIVE: To demonstrate the feasibility of planned real-time audiovisual teleconsultation over the internet in patients with MS. METHODS: Twenty subjects with MS presenting at a specialized MS center in Belgium were recruited for this study. One teleconsultation was scheduled in each participant. Patients were provided a unique hyperlink by mail in advance, leading them automatically and directly to the virtual waiting room, where they could accept or decline our incoming call. All teleconsultations were performed by a trained medical student with the intention to keep the conversation similar to what is usually discussed during a classic face-to-face MS consultation; no remote physical exams were performed. The approach was considered feasible if at least 80% of the planned TM visits could be successfully completed at the foreseen moment. Patient satisfaction (technical quality, convenience and overall quality of care) was evaluated at the end of each teleconsultation by means of 5-point Likert scales containing the categories very unsatisfied, unsatisfied, neutral, satisfied and highly satisfied. RESULTS: Seventeen out of twenty teleconsultations were successfully completed (85%). Failures were due to patients not responding (2/20) and technical issues (1/20). Rates of patients declaring themselves satisfied or highy satisfied were 17/17 for technical quality, 15/17 for convenience and 16/17 for overall quality of care. CONCLUSIONS: Planned real-time audiovisual teleconsultation over the internet is feasibile and highly appreciated in patients with MS. Incorporation of such services in routine clinical MS practice is expected to improve access to specialized care facilities for affected subjects.