[TELENEUROLOGY CLINIC - HIGH COMPLIANCE AND ADHERENCE].

ABSTRACT

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.