Objective: To evaluate rapid remote deployment of the Self-Administered Screening Questionnaire for Parkinson’s Disease-Associated Psychosis (SASPAP) and assess whether screening identifies unmet need for clinician discussion of psychosis symptoms.

Background: Psychosis affects up to 60% of individuals with Parkinson’s disease and is associated with falls, caregiver burden, nursing home placement, and increased mortality. Symptoms are underreported because of embarrassment, limited insight, and lack of routine clinic discussion. In 2023, the SASPAP was validated against the Parkinson’s Disease Psychosis Scale and physician interview, with 87.8% sensitivity and 92.3% specificity. Digital screening may help address this gap when embedded in a mobile application already used by many individuals with Parkinson’s disease to track symptoms and support communication with clinicians. We evaluated the SASPAP entirely remotely through a Parkinson’s digital health platform and mobile application with thousands of users, enabling broad, scalable access to screening between clinic visits.

Method: The 4-item SASPAP, completable in a few minutes, was deployed remotely through a digital Parkinson’s disease mobile application in a large, predominantly US-based, geographically diverse population. A follow-up questionnaire assessed prior symptom discussion and whether clinicians routinely asked about hallucinations or delusions.

Results:

A total of 702 screeners were submitted in 26 days, demonstrating rapid large-scale remote screening outside traditional clinic encounters. Overall, 33.1% of submitted screeners were positive for psychosis-related symptoms, closely matching the 33.6% positivity reported in the original validation cohort. Among respondents to the follow-up questionnaire after a positive screen, 51.1% had not discussed these symptoms with a clinician before screening, and 44.4% reported that their clinician did not routinely ask about hallucinations or delusions.

Conclusion:

Rapid remote digital implementation of the SASPAP was feasible at scale in a real-world Parkinson’s disease population and yielded results consistent with prior validation data. The brief digital screener identified substantial unmet need for proactive psychosis inquiry and may support faster identification, clinical routing, and longitudinal monitoring of symptoms that might otherwise go unrecognized.

References: Koneru V, Espay AJ, Cole AJ, Weintraub D, Crist K, Pascual MB, Ondo WG. The Self-Administered Screening Questionnaire for Parkinson’s Disease-Associated Psychosis (SASPAP). Mov Disord. 2023;38(11):1982-1987. doi:10.1002/mds.29627

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remote-digital-deployment-of-a-validated-psychosis-screener-in-parkinsons-disease-real-world-feasibility-and-screening-yield/