Patient and care partner perspectives of a teleneuropsychology intervention: a mixed-methods evaluation

While neuropsychological evaluations by telehealth are a valid alternative to face-to-face (FF) visits, teleneuropsychology has not been widely adopted. We explored patient and care partner perspectives on acceptability, appropriateness, feasibility, and use of teleneuropsychology to evaluate possible Alzheimer's disease.

Using mixed methods, we evaluated patient and care partner's quantitative surveys and qualitative interviews after two neuropsychology modalities: Teleneuropsychology or FF. Surveys included acceptability, appropriateness, and feasibility measures, and the Unified Theory of Acceptance and Use of Technology questionnaire. Median scores and interquartile ranges were compared. Interviews focused on implementation outcomes and intention to use. Qualitative analyses identified salient themes, which were integrated with quantitative findings.

Patients and care partners (94 and 93% non-Hispanic white) reported similar positive (median score = 4.0 on a 5-point scale) ratings for Teleneuropsychology and FF. Interviews found that benefits of Teleneuropsychology were support for care partner involvement, minimization of logistical demands, reduced travel burden, and increased comfort within a patient's home. Benefits of FF included increased interpersonal connection, improved communication with the provider, and less stress with technology. Some patients tended to prefer FF, while some care partners tended to prefer Teleneuropsychology.

Patients and care partners in this homogeneous sample indicated that both modalities were acceptable, appropriate, and feasible. Although quantitative ratings were similar, the "appropriate" choice for a particular patient and care partner dyad seemed to be a personalized consideration of tradeoffs that they navigated together. When Teleneuropsychology is adopted, attention to preferences and feasibility among diverse patients is needed.