{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T18:04:24Z","timestamp":1784397864550,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Telemedicine can improve access and continuity of care for people with epilepsy (PwE), but its adoption across Italian epilepsy centers remains inadequately characterized. We conducted a nationwide cross\u2010sectional survey of all 75 epilepsy centers certified by the Italian Chapter of the International League Against Epilepsy (Lega Italiana Contro l'Epilessia, LICE) as of July 1, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The survey assessed center characteristics, telemedicine implementation, services provided, digital tool use, institutional recognition, satisfaction, barriers, advantages, and changes since COVID\u201019. Associations with adoption were analyzed using chi\u2010squared or Fisher's exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Telemedicine was currently used in 34 centers (45%), more frequently in higher\u2010level centers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), with no association to patient volume (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.229) or geographic macroarea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.319). Adoption rates varied regionally: North (54.3%), Central (34.8%), South\/Islands (41.2%). Follow\u2010up visits were the most common (91.2%), while first consultations (26.5%) and teleneurophysiology (23.5%) were less frequent. Messaging apps were widely used (median 4, IQR 3\u20135 on a 0\u20135 scale), whereas certified email and medical apps were less common (median 1). Nearly half of centers reported the absence of reimbursement. Satisfaction scores among professionals (five\u2010point Likert scale) were moderate to high (3.5\u2009\u00b1\u20090.9). Barriers included technical limitations, insufficient equipment, and inability to perform exams; perceived advantages included improved continuity of care, reduced outpatient visits, and enhanced patient's quality of life. Since the COVID\u201019 pandemic, 38.2% reported reduced telemedicine use, 35.3% increased use, and 26.5% no change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Less than half of LICE\u2010certified Italian epilepsy centers currently use telemedicine. Adoption remains uneven, with benefits recognized but important technical, organizational, and reimbursement\u2010related barriers limiting widespread and sustainable integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Telemedicine could help people with epilepsy get more consistent care, but fewer than half of Italian epilepsy centers currently use it. A national survey found that use varies by region and is more common in higher\u2010level centers. Most telemedicine activity involves follow\u2010up visits, while first appointments and remote testing are rare. Many centers rely on simple messaging apps, and reimbursement is often missing. Staff generally view telemedicine positively, but technical problems, lack of equipment, and the inability to perform exams limit its usefulness. Since COVID\u201019, some centers have reduced telemedicine use, while others have increased or maintained it. Overall, adoption remains uneven and is held back by practical and organizational barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70220","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T12:11:46Z","timestamp":1769861506000},"page":"516-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Telemedicine in epilepsy care: A Nationwide survey by the Italian Chapter of the International League Against Epilepsy (\n                    <scp>LICE<\/scp>\n                    ) on adoption, barriers, and perceived value"],"prefix":"10.1002","volume":"11","author":[{"given":"Francesco","family":"Brigo","sequence":"first","affiliation":[{"name":"Innovation, Research and Teaching Service Teaching Hospital of the Paracelsus Medical Private University (PMU), Azienda Sanitaria dell'Alto Adige  Bolzano\u2010Bozen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Assenza","sequence":"additional","affiliation":[{"name":"Research Unit of Neurology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"},{"name":"Operative Research Unit of Neurology Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3575-2942","authenticated-orcid":false,"given":"Fedele","family":"Dono","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurology Institute \u201cSS Annunziata\u201d University Hospital of Chieti  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Duca","sequence":"additional","affiliation":[{"name":"U.O.C. Neuropsichiatria Infantile Ospedale Civile Di Macerata  Macerata Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Lanzone","sequence":"additional","affiliation":[{"name":"Neurophysiology Service IRCCS San Raffaele Scientific Institute  Milan Italy"},{"name":"Neurology Unit IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Lattanzi","sequence":"additional","affiliation":[{"name":"Epilepsy Center C. Poma Hospital  Mantua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Licchetta","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna (Full Member of the ERN EpiCARE)  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3103-230X","authenticated-orcid":false,"given":"Tommaso","family":"Lo Barco","sequence":"additional","affiliation":[{"name":"Epilepsy Center C. Poma Hospital  Mantua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Spagnoli","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Neuropsichiatria Infantile, Dipartimento Materno\u2010Infantile Azienda USL\u2010IRCCS di Reggio Emilia  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Tassi","sequence":"additional","affiliation":[{"name":"\u2018Claudio Munari\u2019 Epilepsy Surgery Center Niguarda Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Trivisano","sequence":"additional","affiliation":[{"name":"Neurology, Epilepsy and Movement Disorders Unit Bambino Ges\u00f9 Children's Hospital, IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies \u2010 EpiCARE  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriano","family":"Mecarelli","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University  Rome Italy"},{"name":"LICE (Italian League Against Epilepsy) Foundation  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01048-6"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00737"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107164"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00722"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107282"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107298"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2024.10.012"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17045"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2023.02.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/20406223211029616"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25849"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17793"},{"issue":"1","key":"e_1_2_10_14_1","first-page":"2","article-title":"Models of care and relevance of territorial management in assisting persons with epilepsy","volume":"11","author":"Mecarelli O","year":"2024","journal-title":"Glob Reg Health Technol Assess"},{"key":"e_1_2_10_15_1","unstructured":"Istituto Superiore di Sanit\u00e0.Documento di consensus nazionale sulla telemedicina per la neurofisiologia clinica. Rapporti ISTISAN 23\/1.2023. Available from:https:\/\/sinc\u2010italia.it\/wp\u2010content\/uploads\/2023\/05\/Consensus\u2010Nazionale\u2010Telemedicina\u2010marzo\u20102023.pdf"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010020\u201004732\u20108"},{"key":"e_1_2_10_17_1","unstructured":"Ministero [Italiano] della Salute [Italian Ministry of Health].National guidelines for the provision of specialist services via telemedicine. State\u2010Regions Conference.2020[cited 2025 Oct 7]. Available from:https:\/\/www.statoregioni.it\/media\/3221\/p\u20103\u2010csr\u2010rep\u2010n\u2010215\u201017dic2020.pdf"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053980"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2020.106520"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.108487"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200459"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107527"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107740"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.108303"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12616"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.107863"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2024.109934"}],"updated-by":[{"DOI":"10.1002\/epi4.70307","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000}}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70220","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi4.70220","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:29:40Z","timestamp":1778934580000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.70220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/epi4.70220"],"URL":"https:\/\/doi.org\/10.1002\/epi4.70220","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,31]]},"assertion":[{"value":"2025-10-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}