Evaluation of a telemedical care programme for patients with Parkinson's disease.

We reviewed a telemedicine-based care model for drug optimization in Parkinson's disease. In this model patients send video recordings made in the home to the treating team via the Internet. These serve as the basis for making therapeutic decisions, in particular drug adjustments. Data from 78 patients were analysed with respect to outcome, method acceptance and management of the procedure. During the 30-day telemedicine programme, the patients recorded an average of 3.2 videos per day. The patients' motor score on the Unified Parkinson's Disease Rating Scale (UPDRS) was 31 points at enrolment and three months after ICP termination it was significantly lower at 24 points (P < 0.01), i.e. there was less impairment. The patients rated their condition better at the end than at the beginning of the programme: on a 6-point scale, the mean rating at the beginning was 3.2 and the mean rating at the end was 2.8 (P < 0.001). A blinded investigator rated the patients' videos on the same scale: at the beginning the mean score was 3.0 and at the end it was 2.8 (P < 0.05). The information from the questionnaire showed overall acceptance and practicability of the method. Both patients' and neurologists' use of the method was high. The method seems to be feasible for therapy optimization in Parkinson's disease, and of particular interest for patients with complex conditions who do not necessarily have to undergo hospital treatment.