{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:53:49Z","timestamp":1792065229745,"version":"4.4.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S031716712610691X_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Virtual care services increased during the COVID-19 pandemic, enabling access to physician consultations. Most studies on virtual care in Parkinson\u2019s disease (PD) have focused on tertiary centers, limiting generalizability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S031716712610691X_as2\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe trends in virtual care use over time in people living with PD in Ontario, Canada, by rural and urban region of residence using health administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S031716712610691X_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a population-based repeated cross-sectional study between March 2020 and August 2023, among community-dwelling people living with PD aged \u226566 years in Ontario, Canada. We used Poisson regression models with generalized estimating equations to estimate rate ratios (RR) with 95% confidence intervals (CIs) comparing virtual visit rates in urban versus rural areas across physician specialties (family physicians, neurologists and psychiatrists\/geriatricians).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S031716712610691X_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 24,736 people living with PD in March 2020, 58.6% were male (mean age 77.6 [SD = 7.0] years), and most resided in urban areas (89.9%). Compared to urban residents, rural residents had significantly lower rates of virtual visits to neurologists (adjusted RR = 0.93; 95% CI: 0.90\u20130.96), family physicians (aRR = 0.73; 95% CI: 0.70\u20130.77) and geriatricians\/psychiatrists (aRR = 0.67; 95% CI: 0.65\u20130.77). Over 3.5 years, virtual visits declined compared to the first 6 months for neurologists (aRR = 0.23; 95% CI: 0.22\u20130.25), family physicians (aRR = 0.39; 95% CI: 0.38\u20130.41) and geriatricians\/psychiatrists (aRR = 0.45; 95% CI: 0.40\u20130.51).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S031716712610691X_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>People living with PD in urban centers accessed virtual care more frequently than those living rurally. Virtual care utilization decreased over time. The sustainability of virtual care and its impact on health equity among people living with PD requires further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2026.10691","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:10:41Z","timestamp":1792062641000},"page":"1-10","source":"Crossref","is-referenced-by-count":0,"title":["Virtual Care Trends in Older Adults with Parkinson\u2019s Disease in Urban and Rural Ontario, Canada, During COVID-19"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8250-5915","authenticated-orcid":false,"given":"Priti","family":"Gros","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"},{"name":"University of Toronto"},{"name":"Toronto Western Hospital"},{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomi","family":"Odugbemi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Maclagan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyin","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Guan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Marras","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"},{"name":"University of Toronto"},{"name":"Toronto Western Hospital"},{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Lang","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Toronto Western Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Kalia","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Toronto Western Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6571-5531","authenticated-orcid":false,"given":"Richard H.","family":"Swartz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"},{"name":"University of Toronto"},{"name":"Sunnybrook Health Sciences Centre"},{"id":[{"id":"https:\/\/ror.org\/05n0tzs53","id-type":"ROR","asserted-by":"publisher"}],"name":"Sunnybrook Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7341-0655","authenticated-orcid":false,"given":"Susan E.","family":"Bronskill","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05p6rhy72","id-type":"ROR","asserted-by":"publisher"}],"name":"ICES"},{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"},{"id":[{"id":"https:\/\/ror.org\/05n0tzs53","id-type":"ROR","asserted-by":"publisher"}],"name":"Sunnybrook Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"S031716712610691X_ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0305062"},{"key":"S031716712610691X_ref26","unstructured":"26. 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Participants with early Parkinson disease seen in teaching hospitals: are they representative of the overall Parkinson disease population? 2024."},{"key":"S031716712610691X_ref35","doi-asserted-by":"publisher","DOI":"10.23970\/AHRQEPCSRCOVIDTELEHEALTH"},{"key":"S031716712610691X_ref39","doi-asserted-by":"publisher","DOI":"10.1177\/0891988713481269"},{"key":"S031716712610691X_ref6","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2024.1498756"},{"key":"S031716712610691X_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-024-02807-w"},{"key":"S031716712610691X_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28990"},{"key":"S031716712610691X_ref38","unstructured":"38. Negotiations Branch PaPSD. Introduction of the new virtual care model in the Ontario health care system. 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