High acceptability, convenience and reduced carbon emissions of tele-neurology outpatient services at a regional referral centre in Kenya

Authors

Fazal Yakub, Aga Khan UniversityFollow
Jasmit Shah, Aga Khan UniversityFollow
Dilraj Sokhi, Aga Khan UniversityFollow

Document Type

Article

Department

Internal Medicine (East Africa); Brain and Mind Institute

Abstract

Background: There is severe shortage of neurologists in sub-Saharan Africa. Tele-neurology consultations (TNC) can bridge this service gap, but there is very little published evidence on TNC in our setting, which we addressed through our study.

Methods: We prospectively enrolled patients at our neurology outpatients from October 2020 to October 2021. We administered a post-TNC questionnaire which captured satisfaction/acceptability using Likert scales. A sub-group of participants who also did in-person consultations (IPC) were additionally administered post-IPC questionnaires. Statistical comparisons were made using the paired student t-test, and descriptive data expressed as median (inter-quartile range).

Results: From 219 enrolled patients, 66.7% participants responded: 74.0% had both IPC and TNC; 63.0% were female; age was 40.9 (30.6–55.2) years; and 2.7% were from neighbouring countries. The commonest presentations were headache (30.8%), seizures (26.0%) and neurodegenerative disorders (15.1%). For TNC, >90% found it: (i) as comfortable as IPC (p = 0.35); (ii) didn't violate their privacy; (iii) saved time [3.0 (2.0–4.0) hours], travel [11.0 (7.2–21.1) km] and cost [$9.09 (4.55–18.18)]; and (iv) addressed their concerns satisfactorily such that they would use TNC again. Conversely, 15.1% didn't agree with TNC being as effective as IPC, and felt the neurologist did not satisfactorily identify all of their health problems (p = 0.03). In total, our TNC service saved our patients $6167, 1143 h, and 25,506 km of travel, translating to 3.5 t (equivalent to 21 newly-planted trees) of carbon dioxide emissions.

Conclusions: Our study demonstrates that TNC is an acceptable, efficient, effective, and environmentally-sustainable care delivery model.

Publication (Name of Journal)

eNeurologicalSci

DOI

https://doi.org/10.1016/j.ensci.2023.100484

Recommended Citation

Yakub, F., Shah, J., Sokhi, D. (2023). High acceptability, convenience and reduced carbon emissions of tele-neurology outpatient services at a regional referral centre in Kenya. eNeurologicalSci, 33, 1-6.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/357

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.