Trial Report Clinical outcomes and economic impact of a digital telemedicine intervention in patients with functional motor disorders:... 2025 Gandolfi et al

[Andy]

Full title: 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.

Open access

 

[Utsikt]

Primary outcome​

No significant main effect of group or time×group interaction was observed, indicating similar changes in both groups over time

Secondary outcomes​

A significant group effect was observed for mental QoL scores, which were lower in the standard care than in the DTi group (F(1) = 4.172, p=0.045). There were no significant group differences for fatigue, pain, depression, anxiety, alexithymia or physical QoL. Patient-reported perception of change at the CGI showed no significant differences (tables 2–4).

I think this says it all. They compared what looks like two ineffective treatments.

Our findings hold two-fold importance. First, they demonstrate that multidisciplinary management, with structured diagnosis, patient education and rehabilitation, improves both motor and non-motor symptoms, such as fatigue, depression, anxiety and alexithymia, regardless of the DTi component.

No, it does not demonstrate efficacy. To do that, you’d need a proper control group.

Second, the differences in the mental QoL scores for the DTi group suggest that the intervention may have reduced feelings of abandonment and neglect commonly reported by FMD patients.37 Continuous interaction through digital platforms and wearables may have created a sense of ongoing support, counteracting the perception of being left alone after initial rehabilitation. The DTi may also have enhanced patient engagement, motivation and coping strategies, which are known to improve psychological well-being in coping with chronic conditions.38

It’s quite damning of the entire profession if simply receiving attention is enough to make patients happy.

Moreover, the use of wearable devices may have helped bridge the gap between subjective experiences and objective findings for FMD, providing the patients with tangible insights into their daily activity.

Put in other words: getting the patients to believe in some techbabble about wearable measurements keeps them off the HCPs backs.

The entire paper reads like a propaganda piece for the authors’s specific services. They are essentially saying that none of what we do matters, but we can do it cheaper than the others can, so you should pay us instead. Bread and circus to distract the masses.