Objective: To demonstrate feasibility of TM for LCIG home titration, evaluate resource use, and assess patient, neurologist and nurse satisfaction.

Background: LCIG, is used for continuous infusion in advanced Parkinson’s disease. To achieve optimal effect, LCIG dose is individually titrated, traditionally requiring hospitalization. However, dose adjustment may depend on physical activity and stress, why home titration could be beneficial. Telemedicine (TM) using Video Communication System offers alternative titration procedures, allowing LCIG initiation at home.

Methods: Four clinics enrolled 15 patients to observe the efficiency and feasibility of this new TM based monitoring.

Results: Patient’s median age was 67 (52-73) years and time since diagnosis 10 (7-23) years. Median time between LCIG initiation and end of TM assisted titration was 2.8 (2.0-13.8) days. Overall median time required for home titration by neurologists, nurses and patients’ was 74min (29-112min), 5hrs 49min (166-603min) and 8hrs 53min (251-878min), respectively. Neurologists and nurses considered this to be less time than required for hospital titration. TM allowed patients 92% free time from start to end of titration. Technical problems associated with TM contacts were rare (7%), mostly related to digital link, and quickly resolved. Patients, neurologists and nurses were satisfied using TM. No serious adverse drug reaction but one device complaint was reported (tube occlusion).

Conclusions: In this study TM assisted LCIG titration at home was resource efficient, technically feasible, safe, and satisfactory by patients, neurologists and nurses.

This abstract was presented as a poster at the WCPD, Milan, 6-9 Dec, 2015.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/telemedicine-facilitates-efficient-and-safe-home-titration-of-levodopacarbidopa-intestinal-gel-lcig-in-patients-with-advanced-parkinsons-disease/