A Randomized Crossover Pilot Study of Telemedicine Delivered via iPads in Parkinson’s Disease

Abstract

Background We investigated the feasibility and safety of a video-based telemedicine system, delivered via a tablet, in Parkinson's disease (PD). Methods In a randomized, crossover, open-label pilot trial, we compared a telemedicine period (regular visits every two months with intermediate video calls via an iPad mini) with a control period (regular visits every two months), both lasting 6 months. We included 10 patients diagnosed with PD according to the British Brain Bank criteria, aged 20–75 years. The primary outcome was the PD questionnaire summary index (PDQ-39 SI). Secondary outcomes included the Hoehn and Yahr Stage and scores on the Unified PD Rating Scale (UPDRS) part I–IV, Beck Depression Inventory (BDI), and visual analog scale for satisfaction. Results Both study periods were completed by 10 patients with PD. Friedman's test revealed that there were no significant differences between the two periods in primary and secondary outcomes (p > 0.05). With respect to visual analog scale scores for satisfaction, participants indicated high satisfaction with the telemedicine system. The number of extra hospital visits and phone calls did not differ between the periods. There were no adverse events or side effects. Conclusions We observed that a telemedicine system delivered via a tablet could successfully be used by patients as a part of their care. Further studies investigating the use of telemedicine to replace in-person visits are warranted. This trial is registered with UMIN000015536.

Attitudes toward telemedicine of patients with Parkinson’s disease during the COVID‐19 pandemic

“…20,21 Patients ized study showed that a telemedicine system delivered via a tablet could successfully be used by PD patients as a part of their care. 23 Thus, it is possible to have a medical examination at home or even in a nursing home. As for PD-related symptoms, for example, facial expressions, speech, presence of tremor, and bradykinesia can be evaluated visually, and lower limb, trunk, and gait symptoms can be evaluated during the interview.…”

To assess whether a “virtual admission” can be useful for Parkinson’s disease patients with severe motor fluctuations

“…Our intention was to implement a virtual admission for patients in need of intensive monitoring and prompt adjustment of treatment. Previous studies investigating telemedicine for PD patients were focused on single interactions comparable to outpatient clinic appointments [1][2][3]. To the best of our knowledge, there are no other studies employing telemedicine as a "virtual admission.…”

Telemedicine in neurology: current evidence

“…Their results were mostly promising and well evaluated by doctors and patients 92 . In a cross-over study using a tablet for teleconsultations compared with regular consultations, PD patients had similar Unified Parkinson's Disease Scale (UPDRS) and Hoen and Yahr (H&Y) scales 93 . A small clinical trial with PD patients observed better outcomes in quality of life and UPDRS than those observed after regular consultations 94 .…”