Clinical outcomes and economic impact of a digital telemedicine intervention in patients with functional motor disorders: a single-blind, randomised controlled trial

Abstract

Background Functional motor disorders (FMD) cause long-term disability and economic burden. There is a need for multidisciplinary interventions to manage both motor and non-motor symptoms. We aim to evaluate the clinical and economic effects of integrating digital telemedicine into multidisciplinary FMD management. Methods This single-blind, randomised controlled trial involved patients with FMD. They were randomly assigned to receive 5-day multidisciplinary rehabilitation with either a digital telemedicine or a standard care programme. The digital telemedicine group received remote management and wearable sensors. A blinded evaluator assessed primary and secondary outcomes at baseline, post-treatment, 12-week and 24-week follow-ups. The primary outcomes were changes in motor symptoms. The secondary outcomes were changes in non-motor symptoms, quality of life (QoL) and mobility in unsupervised settings. The incremental cost-effectiveness ratio (ICER) and quality-adjusted life years (QALYs) were calculated at 24 weeks. Results Of the total of 62 patients, half made up the digital telemedicine group (n=31, 40.82% female, mean age 42.55±12.65 years) and half the standard care group (n=31, 59.18% female, mean age 43.77±14.44 years). The mental QoL score for the standard care group was lower (p=0.045) and declined compared with the digital telemedicine group (p=0.034), with lower scores at follow-up (p=0.03). At 24 weeks, the ICER (€5503/ QALY) showed that digital telemedicine, despite higher initial costs, yielded 0.037 additional QALYs and reduced healthcare use during follow-up. Conclusions Despite similar improvements in motor symptoms in both groups, digital telemedicine offers an effective adjunct to maintain mental health QoL and reduces healthcare costs in the long-term management of FMD.