Audiovisual Teleconsultation For Patients With Epilepsy In Primary Care In Rural Germany: A Pilot Study On Feasibility And Acceptance

Background: In rural areas, epilepsy patients have limited access to specialised care. They usually have to put up with travel and waiting times of several hours. In addition, often the communication between general practitioners (GP) and specialized epileptologists about diagnosis and treatment is complicated by the high workload on both sides and the different prioritization of treatment goals. Therefore, the aim of this study was to investigate the feasibility of an interprofessional audio-visual patient-doctor teleconsultation and its acceptance in clinical practice in patients with epilepsy in a rural region in Germany.Method: Ten patients participated in telemedicine consultations in their GP practice. The practice was located in a sparsely populated region of Mecklenburg- Western Pomerania and equipped with technical equipment specifically procured for project-related purposes. An explorative qualitative interview was conducted with all participants. We based this paper on the consolidated criteria for reporting qualitative research (COREQ). Results: Despite initial uncertainties on the part of the patients regarding the consultation setting, all participants found the teleconsultation helpful. Some patients were initially intimidated and felt slightly overwhelmed by the attention provided and the technology used (multiple HD cameras, large high-resolution screens). However, during the consultation they felt supported by their GP and were satisfied that their needs were addressed in a satisfactory and timely manner. The hardware used was not felt to be a nuisance or to interfere with the conversation between doctor and patient. Patients also appreciated the time saved and the organisational convenience compared to a visit to a university outpatient clinic. Most consultations led to therapeutic consequences. Some patients seemed to benefit particularly, e.g. those who needed a change in their medication. Conclusion: This pilot study provides first evidence that teleconsultations between patients, specialists and GPs are possible in rural areas. Interprofessional collaboration between GPs and epileptologists can improve the care of patients with epilepsy. Further research should investigate the effectiveness and efficiency of interprofessional telemedicine consultations for epilepsy and other conditions.