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Stoke Mandeville Hospital
Clinical Characteristics of Medical Teleconsultation for Individuals with Chronic
Spinal Cord Injury (SCI)
Chinnaya A
1
Thiyagarajan ,
Murli
2
Thiyagarajan
, Maurizeo
1
Belci
1. National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust
2. St Georges Medical School, London
Study Design:
Retrospective Analysis
Aims:
To analyse the indications for teleconsultation by
rehabilitation physician and raise the awareness of
physicians to adopt teleconsultation to their clinical tools
in assessing and following up individuals with chronic
SCI.
Settings:
Telemedicine Clinic run by a senior rehabilitation
physician in a national spinal injuries centre.
Methods:
47 adults with chronic SCI who were referred by a consultant in spinal injuries during Dec 2013 to Dec 2014 were studied. Data
was collected from electronic patients’ records.
Results:
All were at least 2 years after injury. Sex: 32 males (68%) and 15 females (32%); Mean (SD) Age: 43 (+/-15) years; Duration of
paralysis: 14(+/-12) years; Neurological level : Cervical: 29, thoracic: 18. 36 (77%) were above T6; AIS: A-14; B-7; C-10; D-16. 33
(70%) were incomplete lesions; Reasons for referrals: Neurogenic pain- 24 (51%); Severe spasticity- 9 (19%) and Pain and
spasticity- 14 (30%). Simplified Goal Attainment Scale (GAS)- 100% and Visual Analogue Scale (VAS)- 81% were used before and
during teleconsultation as outcome measurements to assess the response to added or reduced medications with or without
interventional procedures performed in the spinal outpatient clinic. Mean (SD) travel distance from home to our centre: 42 +/28 miles.
Conclusion:
Earlier study from this cohort on individuals with chronic SCI revealed that majority of them highly valued teleconsultation. This
study showed that main indications for referral were neurogenic pain and/or spasticity with polypharmacy. The most frequently
referred individuals were with incomplete lesions at T6 and above.
Reference:
Yuen J, CA Thiyagarajan and Belci M (2015) “Patient experience survey in telemedicine for spinal cord injury patients”,
Spinal Cord advance online publication, 27 January 2015; doi:10.1038/sc.2014.247 1-4.