Hospitals, Health IT

Telehealth shows promise for treating Parkinson’s disease

The mPower app helps Parkinson's disease patients track metrics such as dexterity, balance, gait, voice patterns and cognition, then send readings to researchers.

Preliminary results of the nation’s first randomized clinical trial of remote treatment of Parkinson’s disease are promising.

In a poster presented this week in San Diego at the International Congress of Parkinson Disease and Movement Disorders, researchers involved in the 18-state Connect.Parkinson project reported that 95 percent of Parkinson’s patients completed telehealth visits as scheduled. Virtual visits have increased the proportion of the time patients spend with a healthcare professional to 89 percent, compared to 25 percent for in-person encounters. (An abstract is available here, though the poster is more up to date.)

The only major complaint registered so far is that some clinicians have found that video quality is not always up to snuff, a problem that could dissipate as broadband networks and access improve.

“We are looking at quality of life, quality of care and reducing the burden on healthcare providers” in treating Parkinson’s patients, explained one of the study’s leaders, neurologist Dr. Ray Dorsey, co-director of the Center for Human Experimental Therapeutics at the University of Rochester (N.Y.) Medical Center.

Dorsey strongly believes that telehealth can increase access to specialists for Parkinson’s and other movement disorders. He has previously said that the U.S. has more than enough neurologists to treat these patients, but specialists are not as geographically dispersed as the patient population, so many go without necessary care because of the hassle.

Researchers did nearly all of their recruiting for Connect.Parkinson online, either through e-mail, Facebook or healthcare sites such as PatientsLikeMe. “We had immense interest in this study,” Dorsey said, with nearly 1,000 people inquiring. About 200 ended up enrolling. “We gave priority to those not seeing a neurologist,” Dorsey said.

Since coming to Rochester two years ago after directing the movement disorders division as well as neurology telemedicine at Johns Hopkins Medicine in Baltimore, Dorsey has fully embraced telemedicine. “I only see patients over the Internet now,” with the exception of the couple of weeks a year he attends in the hospital, Dorsey told MedCity News.

A pilot study he conducted while at Hopkins found that remote consultations save patients three hours of time and 100 miles of driving per visit. He and his research partners will be looking to confirm this, among other things, in the Connect.Parkinson study.

The Rochester Center for Human Experimental Therapeutics also is testing mobile apps, including one it helped develop for the iPhone called Parkinson mPower (Mobile Parkinson Observatory for Worldwide, Evidenced-based Research). In March, In March, Apple featured Dorsey and Parkinson mPower in a video introducing Research Kit.

This app helps Parkinson’s patients track metrics such as dexterity, balance, gait, voice patterns and cognition, then send readings to researchers. A six-month study funded by the Robert Wood Johnson Foundation aims to help researchers understand day-to-day struggles of those suffering from this ailment, as well as how patients respond to various medications. “People often become socially isolated,” Dorsey noted.

In just two months, mPower has enrolled 13,000 app users, Dorsey said. While only about 10 percent of them have Parkinson’s, the rest will be part of control groups.

Photos: YouTube user ParkinsonsAction, iTunes

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