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Effects of Telemedicine on Dysphagia Rehabilitation in Patients Requiring Home Care: A Retrospective Study
Rieko Moritoyo1, Kazuharu Nakagawa1, Kanako Yoshimi2
1Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo (Formerly Tokyo Medical and Dental University), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Abstract:
This study investigated telemedicine as an alternative to home-visit medical care (HMC) when HMC for patients with dysphagia was suspended. This retrospective study assessed whether telemedicine reduced adverse events compared to suspending care during the initial 3 months of the coronavirus pandemic. Seventy-six HMC patients were enrolled. Those who received telemedicine formed the telemedicine group (TG), and those who declined comprised the suspended group (SG). Baseline data and adverse events, including whole-body and dysphagia-related adverse events, were analyzed using the Mann-Whitney U-test, Fisher's exact test, and binomial logistic regression. Of the 76 patients, 20 were in TG and 56 in SG. Telemedicine consultations' frequency was 1-3. Significant baseline differences occurred in the Charlson Comorbidity Index (CCI) and caregiver type. In the TG and SG, 0% and 12.5% of patients experienced whole-body adverse events and 10.0% and 33.9% had dysphagia-related adverse events, respectively. Dysphagia-related adverse events were significantly lower in TG (p = 0.046). Telemedicine was significantly associated with fewer dysphagia-related adverse events after adjusting for age, CCI, and Dysphagia Severity Scale (p = 0.040). Telemedicine effectively supplemented in-person dysphagia rehabilitation, enabling continued monitoring and reducing complications, although patient self-selection and caregiver support may have influenced outcomes.
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