Department of Neurology, University of Rochester Medical Center, Rochester, New York 14620, USA.
Mov Disord. 2010 Aug 15;25(11):1652-9. doi: 10.1002/mds.23145.
We conducted a randomized, controlled pilot trial to evaluate the feasibility of providing subspecialty care via telemedicine for patients with Parkinson's disease residing in a remote community located approximately 130 miles from an academic movement disorders clinic. Study participants were randomized to receive telemedicine care with a movement disorder specialist at the University of Rochester or to receive their usual care. Participants in the telemedicine group received three telemedicine visits over six months. Feasibility, as measured by the completion of telemedicine visits, was the primary outcome measure. Secondary measures were quality of life, patient satisfaction, and clinical outcomes. Ten participants residing in the community were randomized to receive telemedicine care (n = 6) or their usual care (n = 4). Four nursing home patients were assigned to telemedicine. Those receiving telemedicine completed 97% (29 of 30) of their telemedicine visits as scheduled. At the study's conclusion, 13 of 14 study participants opted to receive specialty care via telemedicine. Compared with usual care, those randomized to telemedicine had significant improvements in quality of life (3.4 point improvement vs. 10.3 point worsening on the Parkinson's Disease Questionnaire 39; P = 0.04) and motor performance (0.3 point improvement vs. 6.5 point worsening on the Unified Parkinson's Disease Rating Scale, motor subscale; P = 0.03). Relative to baseline, nursing home patients experienced trends toward improvement in quality of life and patient satisfaction. Providing subspecialty care via telemedicine for individuals with Parkinson's disease living remotely is feasible.
我们进行了一项随机对照的试点研究，以评估通过远程医疗为居住在距离学术运动障碍诊所约 130 英里的偏远社区的帕金森病患者提供专科护理的可行性。研究参与者被随机分配接受罗切斯特大学运动障碍专家的远程医疗护理或接受常规护理。远程医疗组的参与者在六个月内接受了三次远程医疗访问。以完成远程医疗访问的情况来衡量可行性是主要的结果衡量标准。次要措施是生活质量、患者满意度和临床结果。10 名居住在社区的参与者被随机分配接受远程医疗护理（n = 6）或常规护理（n = 4）。4 名疗养院患者被分配到远程医疗组。接受远程医疗的患者完成了 97%（30 次预约中的 29 次）的远程医疗访问。在研究结束时，14 名研究参与者中有 13 名选择通过远程医疗接受专科护理。与常规护理相比，随机分配到远程医疗组的患者生活质量有显著改善（帕金森病问卷 39 评分改善 3.4 分，恶化 10.3 分；P = 0.04），运动表现也有显著改善（统一帕金森病评定量表运动子量表评分改善 0.3 分，恶化 6.5 分；P = 0.03）。与基线相比，疗养院患者的生活质量和患者满意度都有改善的趋势。通过远程医疗为居住在偏远地区的帕金森病患者提供专科护理是可行的。
