Objective: To evaluate participant perspectives and satisfaction with a virtual home safety intervention to reduce environmental fall risks in persons with Parkinson’s disease (PwPs).

Background: While Telehealth enhances healthcare access, patient and provider perspectives are often overlooked; taking them into consideration is vital to ensure that novel Telehealth applications are pragmatic and generalizable.

Method: This is a sub-investigation of a single-site pilot study which involved 23 dyads (PwP at risk for falls and carepartners) [median PwP age: 68 years, 56.5% male, 95.7% white, 91.3% college educated, median MoCA: 27]. Dyads participated in four monthly televisits where they used a mobile platform (iPad on a wheeled stand) for virtual home tours with a physical therapist to identify and mitigate environmental fall hazards. We assessed participant satisfaction using PI-developed surveys and open feedback and platform usability with a modified System Usability Scale (SUS).

Results: 96% of dyads were extremely satisfied with the program, including its technical quality and the number of visits. 86.9% preferred televisits over in-person visits for convenience and privacy. Dyads found the virtual program content comprehensive and were satisfied with the therapist’s care. 91.3% reported gaining new awareness of home fall hazards. Difficulties maneuvering the stand, using a tablet, using the EPIC app, and connectivity issues were the common challenges noted by both dyads and the therapist. The mean score on SUS for the mobile platform was 65, indicating poor perceived usability. Most dyads (87%) felt that a smartphone would have been equally effective.  Carepartners played a crucial role with 91% of PwPs agreeing that their involvement enhanced the overall benefit of the program. Competing health and personal obligations, along with resistance to change from PwPs and/or carepartners, were primary barriers to implementing therapist’s recommendations.

Conclusion: Our virtual home safety intervention was well-received by patients and preferred over in-person visits, making it a promising tool for fall prevention in PD. Using a smartphone instead of a tablet, troubleshooting connectivity issues, and using more common videoconferencing apps might help further improve the usability and accessibility.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-reported-satisfaction-and-usability-of-a-virtual-home-based-program-for-fall-prevention-in-parkinsons-disease/