Table 1.
Overview of the Main Evidences Supporting the “Opportunities” for Telemedicine
| FIELD OF APPLICATION | EVIDENCE |
|---|---|
| Parkinson disease | Videoconferencing may provide access to multidisciplinary medical care, reducing travel time, distance, and wait time in patients with PD living in unserved areas4 |
| Feasibility, acceptance, and effectiveness of a virtual exercise coach to promote daily walking in community-dwelling persons with PD91 | |
| Feasibility of remote physical assessment of PD patients undergoing rehabilitation92 | |
| Feasibility of remote evaluation and treatment of speech disorders in patients with PD88–90 | |
| Chronic diseases and depression | Telehealth nursing conducted by daily telemonitoring and remote sessions of problem-solving treatment for depression improve symptoms and reduce the number of emergency department visits compared to in-home nursing in elderly with chronic diseases and depression5 |
| Prevention of cerebrovascular diseases | Home blood pressure monitoring in patients with hypertension is associated with better morbidity and mortality when compared to standard office visits,8–13 although significantly more expensive.14 |
| Telemedicine may improve glycemic control and promote a healthy lifestyle in patients with types I and II diabetes mellitus15–17 | |
| Pediatric neuro-oncology | Videoconferencing and e-mail communications are available twinning tools between institutions in industrialized and developing countries. Twinning facilitates the implementation of multidisciplinary neuro-oncology programs in low-income countries35–38 |
| Multiple sclerosis | Telephone counseling and web-based home telehealth monitoring improves DMT adherence in patients living with MS39 |
| Telephone-based, teleconference or web-based interventions are effective means to increase physical activity and improve fatigue in MS41–44 | |
| Remote diagnosis and management of cognitive difficulties and depression in patients with MS45,47,48 | |
| Smartphone-based telerehabilitation has favorable effects on fatigue in MS40 | |
| The use of virtual reality to effectively administer physiotherapy and rehabilitation to individuals living with MS50,51 | |
| Advanced therapies (Deep brain stimulation, infusion systems, and transcranial direct current stimulation) | Feasibility of using telemedicine for DBS in patients with PD living in unserved areas55,56 |
| Feasibility of using telemedicine for LCIG initiation in patients with PD living in unserved areas57 | |
| Feasibility of remotely supervised tDCS in the treatment of MS-associated depression58 | |
| Stroke | Combination of video consultation, teleradiology, and high stroke tele-expertise on a on a 365/24/7 basis67,68 |
| Standard of care therapies for acute stroke are facilitated by telestroke, not only by increasing intravenous thrombolysis rates and prompt decisions on endovascular therapy but also with early triage and management of transient ischemic attacks and minor strokes68,69 | |
| Epilepsy | Tele-EEG (remote EEG consultation) allows for better access to specialized medical care, reduces the costs and the total time associated with testing70 |
| Feasibility of tele-EEG for obtaining clinician second opinions and off-line reviews of prerecorded data.72 | |
| Tele-EEG is an achievable, safe, timely and effective method of providing EEG services to hospitals in which neurophysiological services are not available.70,73 |
PD, Parkinson Disease; DMT, disease-modifying therapies; MS, multiple sclerosis; DBS, deep brain stimulation; LCIG, levodopa–carbidopa intestinal gel; tDCS, transcranial direct current stimulation; EEG, electroencephalogram.