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Early-stage innovation report
Use of telemedicine in managing deep brain stimulation for movement disorders
  1. Menaka Pasangy Paranathala,
  2. Una Brechany,
  3. Russell Mills,
  4. Claire Nicholson,
  5. Alistair Jenkins,
  6. Mohammed Akbar Hussain
  1. Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Mohammed Akbar Hussain, Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK; mohammed.hussain56{at}nhs.net

https://doi.org/10.1136/bmjinnov-2021-000735

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    Summary box

    What are the new findings?

    • Telemedicine is a viable and effective method of remote patient monitoring, even in patients with movement disorders.

    • It was well received by patients, and increased their confidence in managing their condition.

    How might it impact on healthcare in the future?

    • Telemedicine reduces the burden on healthcare staff, resources and infrastructure by reducing need for direct contact. This is particularly valuable in the recent advent of remote programming.

    • It enables patients to be planned for surgeries in a timely way, so reducing emergency presentations and clinical crises.

    • This technology can be used for other conditions where close monitoring is required.

    Introduction

    During the global COVID-19 pandemic, there has been a move towards ‘remote’ healthcare and minimising non-essential traffic through primary and secondary care to minimise the spread of the virus. Studies have shown that patients with deep brain stimulators (DBSs) have a high requirement for input regarding programming and maintenance of their systems.1 2 Patients with neuromodulators for movement disorders are usually seen by specialist nurses for follow-up. One component of assessment is checking the implantable pulse generators (IPGs) which are the batteries for the stimulation, and planning surgery for replacement in a timely manner. If this is not done, it can lead to clinical crises for the patient, emergency admission and longer stays in hospital while they wait for emergency surgery and recover from the episode3 leading to significant mental and physical impact. Monitoring of recharging patterns, where the IPG is rechargeable, is valuable in highlighting any problems.

    To maintain clinical care during the pandemic, there was a move towards video and audio conferencing of outpatient appointments for new and follow-up patients within neurosurgery.3 4 Studies suggest that this method of clinical follow-up is acceptable to patients with DBS.1 5 Other options for telemedicine are secure interactive software for communication with the patient via their own …

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    Footnotes

    • Twitter @menakapara

    • Contributors MPP and MAH devised the project. All authors were involved in implementation of the project and critique of it. MPP, RM and UB collated the data and prepared the graphs for publication. MPP did the initial draft of the manuscript with MAH. All authors were involved in manuscript review and critique.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.