TeleSCOPE 2.0: Clinicians’ Perspectives on the Assessment of Possible Drug-Induced Movement Disorders (DIMDs) via Telehealth After the Peak of the COVID-19 Pandemic

This work was sponsored by Neurocrine Biosciences Inc. Introduction: Since COVID-19, mental healthcare telehealth use has increased. A 2021 survey (TeleSCOPE 1.0) identified challenges assessing DIMDs with telehealth (ie, video or phone visits). TeleSCOPE 2.0 was conducted to understand the telehealth impact on detection, identification, and management of DIMDs post-COVID restrictions. Methods: An online survey was fielded 5/18/2023-6/9/2023 to neurologists, psychiatrists, nurse practitioners (NPs) and physician assistants (PAs) affiliated with neurology/psychiatry practices who prescribed vesicular monoamine transporter 2 inhibitors or benztropine for DIMDs in the past 6 months and saw ≥15% of patients via telehealth at peak and post-COVID. Neurologists’ and psychiatrists’ results are reported. Results: 100 psychiatrists and 100 neurologists responded. Post-COVID, neurologists conducted less telehealth visits than psychiatrists (phone/video: 10%/37% vs 18%/51%) and saw more patients in-person (53% vs 31%). Checking medications and changes in movement-related symptoms were the most common pre-visit methods to indicate potential DIMDs; 74% psychiatrists and 30% neurologists utilized the validated Abnormal Involuntary Movement Scale. Clinicians reported less difficulty evaluating patients remotely for DIMDs with caregivers present. While nearly 70% psychiatrists diagnosed DIMDs over videoconference vs ~50% neurologists, both required 1 additional telehealth vs in-person visit to diagnose DIMDs. Many psychiatrists (57%) and neurologists (65%) have received no training on diagnosing DIMDs via telehealth. Conclusions: While psychiatrists/neurologists view telehealth as valuable, most haven’t received training on diagnosing DIMDs and report telehealth is less effective than in-person - requiring 1 additional telehealth visit for DIMD diagnosis. Increased implementation of guidelines and provider education for telehealth visits are feasible strategies to improve telehealth quality.