Evaluating a Telemedicine Neurological Consult Program for Drug-Induced Movement Disorders Using the RE-AIM Framework

Study Overview
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Brief Summary
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In this pilot study, the investigators will evaluate care delivery via telemedicine to individuals with drug-induced movement disorders (DIMDs). DIMDs can be disabling, and prevention is important; but these disorders are often under-reported, under-recognized and poorly managed. Interprofessional telemedicine for movement disorders is feasible and may provide similar care as in-person visits; however, the majority of studies to date have shown benefit in Parkinson's disease and further validation in other movement disorders is necessary. In this randomized controlled trial the aim is to study the acceptability, feasibility, and patient and clinician outcomes when a neurological consultation is provided for patients with DIMDs either in-person or through telemedicine. The investigators will apply the evaluation framework RE-AIM (Reach and Effectiveness, Adoption, Implementation, and Maintenance) to comprehensively assess the factors that may impact study success and program implementation. Mixed methods will be implemented to gather outcome data from mental health clinicians that refer patients and the patient participants.

Official Title
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Evaluating a Telemedicine Neurological Consult Program for Drug-Induced Movement Disorders Using the RE-AIM Framework

Conditions
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Drug-Induced Movement Disorder

Intervention / Treatment
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* Other: Telemedicine Consult
* Other: In-person Consult


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Willing and able to provide consent Willing to have their Mental Health Clinician (MHC) share sensitive clinical information with the Neurology team Able to travel to Neurology clinic Have connectivity to Zoom using wi-fi or cellular data, either at home or a comfortable and private setting (such as MHC office) Exclusion Criteria: Currently hospitalized Neurologist determines patient requires care outside of the scope of the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: In-Person<br>Control group | Other: In-person Consult<br>* Neurological consultation completed in-person<br>|
| Experimental: Telemedicine<br> | Other: Telemedicine Consult<br>* Neurological consultation completed remotely<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effectiveness; Client Satisfaction Questionnaire-8 (CSQ-8) | How satisfied are patients with the program | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effectiveness; PROMIS 29+2 V2.1 | What are the impacts on patient health status | 12 months | 
| Effectiveness; referral forms and visit notes | Was there concordance in diagnosis between the MHC and movement disorder specialist | 12 months | 
| Effectiveness; visit notes | Was there an impact on care plan | 12 months | 
| Effectiveness; MHC survey and Qualitative Interviews | Were the MHCs Satisfied with the program | 12 months |