Using telemedicine to evaluate patients with Parkinson's disease is reliable and feasible, according to data from a small, randomized, controlled pilot study of nursing home and community-dwelling patients.
Patients in the study with Parkinson's disease (PD) who received telemedicine care over the course of 6 months showed improvements in quality of life, mood, satisfaction with care, cognition, and motor function, compared with those who received standard care, Dr. Kevin M. Biglan and Dr. Ray Dorsey of the University of Rochester (N.Y.) and their colleagues reported at the International Congress of Parkinson's Disease and Movement Disorders in Paris.
They also reported that televideo assessments of the motor Unified Parkinson's Disease Rating Scale (UPDRS) were reliable and valid, compared with the standard in-person assessment of these patients.
The researchers enrolled 14 patients who lived 150 miles from the university (4 in a nursing home and 10 who lived in the community nearby). By providing the patients with Web-based telemedicine, they sought to improve their access to specialized care. They also hoped to be able to use telemedicine to expand the pool of Parkinson's patients who could participate in clinical trials if the logistics and difficulties relating to travel and costs were eliminated.
At baseline, the participants were a mean age of 71 years, and half were women. They had a mean Hoehn & Yahr stage of 2.7 (range, 1-5) and a mean motor UPDRS of 34.7 (range, 1-108, with higher scores indicating greater disability).
The community participants were randomized to telemedicine care (six) or standard care (four). All four nursing home patients received telemedicine care. Those in the telemedicine group received three one-on-one visits over 6 months (month 1, 2, and 3) from one of two investigators who were movement disorder specialists. There was a fourth visit, at 6.5 months, to allow for the test-retest reliability comparison of the 6- and 6.5-month motor scores.
The Web-based televideo assessments were conducted at the nursing home. They mirrored an inperson evaluation, during which patients were asked about their PD, medications, function, and complications of therapy. The investigator performed a motor UPDRS examination at each visit, with a nurse available to assist in performing rigidity testing and pull testing.