scholarly journals Using telemedicine and wearable technology to establish a virtual clinic for people with Parkinson’s disease

2020 ◽  
Vol 9 (3) ◽  
pp. e001000
Author(s):  
Lauren Evans ◽  
Biju Mohamed ◽  
Edward Christopher Thomas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Value Added ◽  
Treatment Decision ◽  
Wearable Technology ◽  
Time Saving ◽  
Face To Face ◽  
Administration Time ◽  
Set Up ◽  
Virtual Clinic

BackgroundTo develop an effective, patient-centred and sustainable service, we set up a virtual clinic (VC) for patients with Parkinson’s disease, combining phone consultations and reports from wearable technology. The Parkinson’s Kinetigraph (PKG) is a wrist-worn device providing objective motor assessment, generating a report used by clinicians to optimise medication regimens.InterventionsA pilot study of VC was designed using quality improvement methodology. For a VC appointment, patients were phoned by a clinician. After discussing symptoms and reviewing the PKG report, the clinician could decide on any medication changes or other interventions and relay this to the patient’s general practitioner in a clinic letter. Patient feedback was gathered via questionnaires and data collected on the outcomes and timings of the consultations.ResultsOver 12 clinics, 61 patients had VC appointments. Of questionnaire respondents, 89% were satisfied with VC (n=41). At VC, the clinician was able to make a treatment decision comparable to a face-to-face clinic in 79% of cases (n=48). Reasons appointments were deemed unsuccessful included issues with the PKG, speech or hearing problems and complex phase of disease. VC appointments, including administration time, last on average 22 min. This compares to 20 min face-to-face appointments but these do not include administration time.ConclusionsWe have demonstrated a safe and effective VC template. Most VC appointments are equivalent to face-to-face clinic in terms of treatment outcome. Success could be further improved by appropriate patient selection. Using VC is time saving and can result in releasing face-to-face appointment slots for those in urgent need or newly referred patients. Further cost analysis is required; the cost of the PKG alone is more expensive than a face-to-face appointment, but this does not take into account other value added, such as patient convenience and satisfaction, and reduced need for ambulance transport.

scholarly journals 923 Accuracy of Assessment in Hand Trauma; Pre COVID-19 Face to Face Assessment Compared to Virtual Assessment During COVID-19 Lockdown

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Westley ◽  
H Creasy ◽  
R Mistry
Keyword(s):  
Telephone Call ◽  
Initial Assessment ◽  
Accurate Assessment ◽  
Hand Trauma ◽  
Face To Face ◽  
Queen Victoria ◽  
Set Up ◽  
Operation Note ◽  
Similar Accuracy ◽  
Virtual Clinic

Abstract Introduction The Queen Victoria Hospital (QVH) was designated a cancer and trauma hub during the COVID-19 pandemic. With this, a new virtual hand trauma clinic was set up. We assess accuracy of assessment within this virtual set-up with comparison to pre COVID-19 face-to-face assessment. Method Two weeks of clinic sessions during and pre lockdown were analysed. Initial assessment was compared with the patient's operation note. Results In the pre COVID-19 two-week period 129 face-to-face appointments were analysed. Of 99 patients that required surgery 77 (78%) had an accurate assessment. 6 were overestimated, 12 were underestimated. 189 patients were seen over two weeks during lockdown via telephone or video call. Accuracy of assessment increased with seniority of the clinician. Of 126 patients that required an operation 109 (87%) had an accurate assessment; all structures injured were correctly predicted. 12 were overestimated, 5 had their injury underestimated. Conclusions The new virtual clinic allowed patients to be remotely assessed during lockdown, reducing footfall and unnecessary journeys. We found that virtual clinic assessments are accurate, and no patient underwent an unnecessary procedure. Using a telephone call plus photo gave similar accuracy as a video call. Virtual assessment was more accurate than face-to-face assessment.

scholarly journals Chemical and Biological Molecules Involved in Differentiation, Maturation, and Survival of Dopaminergic Neurons in Health and Parkinson’s Disease: Physiological Aspects and Clinical Implications

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 754
Author(s):  
Giulia Gaggi ◽  
Andrea Di Credico ◽  
Pascal Izzicupo ◽  
Giovanni Iannetti ◽  
Angela Di Baldassarre ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopaminergic Neurons ◽  
Potential Role ◽  
High Efficiency ◽  
Biological Molecules ◽  
Alternative Approach ◽  
Non Coding Rnas ◽  
Set Up

Parkinson’s disease (PD) is one of the most common neurodegenerative disease characterized by a specific and progressive loss of dopaminergic (DA) neurons and dopamine, causing motor dysfunctions and impaired movements. Unfortunately, available therapies can partially treat the motor symptoms, but they have no effect on non-motor features. In addition, the therapeutic effect reduces gradually, and the prolonged use of drugs leads to a significative increase in the number of adverse events. For these reasons, an alternative approach that allows the replacement or the improved survival of DA neurons is very appealing for the treatment of PD patients and recently the first human clinical trials for DA neurons replacement have been set up. Here, we review the role of chemical and biological molecules that are involved in the development, survival and differentiation of DA neurons. In particular, we review the chemical small molecules used to differentiate different type of stem cells into DA neurons with high efficiency; the role of microRNAs and long non-coding RNAs both in DA neurons development/survival as far as in the pathogenesis of PD; and, finally, we dissect the potential role of exosomes carrying biological molecules as treatment of PD.

scholarly journals Knowledge, Attitudes, Practices, and Burden During the COVID-19 Pandemic in People with Parkinson’s Disease in Germany

2020 ◽  
Vol 9 (6) ◽  
pp. 1643 ◽  
Author(s):  
Hannah M. Zipprich ◽  
Ulrike Teschner ◽  
Otto W. Witte ◽  
Aline Schönenberg ◽  
Tino Prell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Educational Level ◽  
Preventive Measures ◽  
Cognitive Disorders ◽  
Preventive Behavior ◽  
Social Contacts ◽  
Face To Face ◽  
Telephone Interviews ◽  
Level Of Knowledge

Background: Adherence to measures that have been adopted during the COVID-19 pandemic is crucial to control the spread of the coronavirus. Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson’s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and burden in order to elucidate nonadherence to preventive measures. Results: The majority of patients understood the preventive measures and felt sufficiently informed. Analysis of qualitative answers, however, showed that about 30% of patients had an insufficient level of knowledge, which was not associated with educational level, cognitive disorders, or depression. Changes in behaviour were reported by 73 patients (99% performed at least one specific preventive behavior, and 86.9% have reduced social contacts and stayed home). A closer analysis of qualitative answers showed that 27.3% of patients continued to meet relatives face-to-face almost daily. Anxiety and worries about the current situation were reported by 58.6% of patients; 31.3% complained about a decrease in their mobility since the beginning of the restrictions, mainly because of worsening of PD and because regular therapies (e.g., physiotherapy) were canceled. Conclusions: About 30% of PD patients are nonadherent to preventive measures. Use of simple dichotomous questions overestimates adherence to preventive measures in patients with PD.

scholarly journals Discriminating progressive supranuclear palsy from Parkinson's disease using wearable technology and machine learning

2020 ◽  
Vol 77 ◽  
pp. 257-263 ◽  
Author(s):  
Maarten De Vos ◽  
John Prince ◽  
Tim Buchanan ◽  
James J. FitzGerald ◽  
Chrystalina A. Antoniades
Keyword(s):  
Machine Learning ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Progressive Supranuclear Palsy ◽  
Wearable Technology

Parkinson's disease and the COVID-19 pandemic: responding to patient need with nurse-led telemedicine

2020 ◽  
Vol 16 (3) ◽  
pp. 131-133 ◽  
Author(s):  
Sue Thomas ◽  
Francesca Mancini ◽  
Louise Ebenezer ◽  
Jane Price ◽  
Tania Carta ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Patient Engagement ◽  
Face To Face ◽  
The Uk ◽  
Alternative Solutions ◽  
Treatment And Diagnosis

With the COVID-19 pandemic limiting face-to-face interaction, the drive for innovation and the need to develop alternative solutions to patient engagement, treatment and diagnosis has been suddenly accelerated. Sue Thomas and national and international colleagues outline a novel technological initiative launched in Italy to cope with the pressures of the pandemic, providing inspiration for similar future projects in the UK

Remote delivery of psychological interventions for Parkinson's disease

2018 ◽  
Vol 30 (12) ◽  
pp. 1783-1795 ◽  
Author(s):  
Caitlin Swalwell ◽  
Nancy A. Pachana ◽  
Nadeeka N. Dissanayaka
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Neuropsychiatric Symptoms ◽  
Psychological Interventions ◽  
Mobility Limitations ◽  
Face To Face ◽  
Acceptance And Commitment ◽  
Patients Experience

ABSTRACTObjective:Over two-thirds of Parkinson's disease (PD) patients experience comorbid neuropsychiatric symptoms, which adversely impact their quality of life and often require intervention. There is a preference for non-pharmacological, psychological approaches in addressing these symptoms. Given mobility limitations, travel burden, and cost, accessibility to psychological treatment can be problematic in this population. There has been a recent shift toward delivering care via telehealth in PD. Accordingly, this review aimed to examine remotely delivered psychological interventions for PD patients.Results:Most of the telehealth studies for PD involved Cognitive Behavioral Therapy (CBT) based anxiety and depression telephone interventions with relatively short (one month) follow-up periods.Conclusion:Although a preliminary work indicates efficacy, future studies should demonstrate the non-inferiority of these telehealth programs compared to face-to-face delivery, and examine the long-term outcomes of remotely delivered therapy. Video-conferencing (VC) appears to be a promising modality to overcome noted limitations of telephone delivery, and has demonstrated efficacy for PD speech programs. Further research should be conducted evaluating telehealth VC modalities for delivery of psychotherapy including CBT, as well as mindfulness-based therapy and acceptance and commitment therapy for remote treatment of depression and anxiety in PD.

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