Objective: To clinically assess and evaluate the impact of automated telehealth diagnostics on patients with Parkinson’s disease (PD).

Background: A single evaluation in a clinical setting may not accurately reflect motor symptom fluctuations experienced over the course of a day, week, or month. Additionally, there is limited access to movement disorder specialist centers for a significant portion of the PD population.

Methods: Twenty-one adults (Age 45-80) with PD were randomized to the control or experimental group. All subjects were instructed to use an objective motion sensor-based monitoring system at home six times per day, one day per week, for seven months. The system includes a finger-worn motion sensor and tablet interface that guides patients through standardized tasks to quantify tremor, bradykinesia, and dyskinesia. Data is transmitted over mobile broadband for processing into reports for clinician review. All subjects used the system to avoid placebo effects; however, the clinician viewed motor symptom severity reports to adjust medications solely for the experimental group. Control group subjects returned to the clinic after 3 months and again after 6 months for a routine appointment. Instead of visiting the clinic, experimental group subjects teleconferenced with the clinician after 3 and 6 months. Outcome measures included compliance, motor scores, dyskinesias, fluctuations, quality of life, patient assessment of care, patient activation measure, and number and type of medication changes.

Results: Participants completed 87.3% of requested home based assessments, with no significant differences in compliance between groups. Clinicians successfully used information in telehealth reports that was not otherwise observed (e.g., levodopa responsiveness, symptoms worsening over time) to make therapy adjustments. Changes in clinical characteristics and participant survey data from study start to end were not significantly different between groups. Likewise, there were no differences in number of medication changes recommended between groups. 92% of subjects indicated the system as a whole was easy to use and 83% of subjects said they would be willing to use the system in the future if asked by their doctor.

Conclusions: Patient management aided by telehealth diagnostics provides comparable outcomes to current standard of care. These technologies have the potential to improve care for disparate PD populations or those unable to travel.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/automated-telehealth-diagnostics-for-remote-parkinson-monitoring/