[TELENEUROLOGY CLINIC - HIGH COMPLIANCE AND ADHERENCE].

BACKGROUND: Telemedicine carries the potential of providing healthcare for individuals with limited access to clinics. While in some subspecialties telemedicine has been proved to be effective, its efficacy for replacing standard visits in complex subspecialties, such as pediatric neurology, has not been studied. OBJECTIVES: To determine compliance and adherence to follow-up and medication prescription for online pediatric neurology clinics. METHODS: We reviewed clinical records for follow-up and prescription requests of medication prescribed for children visiting the Maccabi Online Neuropediatric clinic in Ariel. RESULTS: A total of 78 children (aged 10.9±3.2 years; 40 girls, 38 boys) visited the online neuropediatric clinic between October 2015 and November 2017; 78 first visits, 44 follow-up visits. The first visit lasted 50 minutes including technical time. The main diagnoses were ADD/ADHD (41/78, 53%), followed by behavioral/emotional issues (11/78, 14%), headaches/migraines (9/78, 12%), learning disabilities (8/78, 10%) epilepsy (4/78, 5%) and others (5/78, 6%). Follow-up was recommended in most cases (48/78, 62%) mainly for ADD/ADHD and headaches/migraines. Most patients complied with follow-up (55%) with better rates among ADD/ADHD (19/29, 66%). Only a few patients (3/78,4%) continued follow-up in a regular clinic. Medication was recommended for 29/41 (71%) children with ADD/ADHD; all of whom requested medication prescription from the pediatrician (as it could not be prescribed digitally). Adherence was high as most patients (24/29, 83%) continued to request medication prescription. CONCLUSIONS: While adherence and compliance rates are high in tele-neurology clinics, especially for ADHD, further controlled studies are needed to compare services to regular visits and to assess the additional benefits of specialists healthcare delivery to underserved populations.

Survey of family doctors' attitudes towards statin treatment in patients with type 2 diabetes.

AIMS: Clinical guidelines advocate that cardiovascular benefits of statin treatment overweigh the risk of impairment of glucose metabolism. The aim of the study was to examine the attitudes of family doctors towards statin treatment in patients with type 2 diabetes. METHODS: We disseminated a questionnaire examining doctors' attitudes to existing clinical guidelines and the factors leading to a doctor's decision to prescribe statins to diabetic patients. RESULTS: Clinical policy and guidelines were defined by doctors as having the greatest influence on the decision to prescribe statins for diabetic patients particularly by salaried doctors in comparison to self-employed doctors (χ2 = 9.138, df = 3, p ≤ 0.01). When considering the ways healthcare services can assist cholesterol control, monetary compensation yielded higher importance by young doctors compared to mature doctors (χ2 = 8.15, df = 2, p ≤ 0.01), while nursing services in the clinic yielded higher importance by mature doctors in comparison to younger doctors(χ2 = 13.7, df = 2, p ≤ 0.01). CONCLUSIONS: Doctors defined a list of priorities for organizational support mechanisms that are likely to lead to the formation of an intervention plan for increasing the percentage of balanced cholesterol levels in patients with diabetes.