Televisits for Parkinson's disease: benefits and barriers.

Abstract

Televisits are a valuable tool for Parkinson's disease (PD) follow-up; however, their implementation is hindered by a fragmented evidence base. This narrative review synthesizes 41 articles (31 observational, 10 comparative) spanning three decades, categorizing findings into three domains: feasibility, clinical outcomes, and efficiency. Results indicate high feasibility with visit completion frequently exceeding 70% and high user satisfaction primarily due to reduced travel burden and costs. Clinical outcomes appear comparable to in-person care, yet evidence on efficiency remains inconclusive. Current literature suffers from methodological limitations, including small sample sizes, U.S. geographic bias, and a lack of standardized outcome taxonomies. Notably, we identify a recurring "augmentation bias" in comparative trial designs: experimental arms frequently receive more clinical attention than controls. This suggests that reported benefits may derive from increased care frequency rather than the specific care delivery modality, questioning the cost-effectiveness of such resource-heavy models in routine practice. Furthermore, barriers regarding the digital divide and concerns about international privacy regulations (e.g., GDPR/HIPAA) remain unresolved. In conclusion, televisits should be integrated into validated hybrid frameworks rather than serving as standalone replacements. To advance the field, research must pivot from basic feasibility toward establishing standardized outcome measures and proving long-term economic sustainability in real-world clinical settings.