Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
Telemed J E Health. 2012 Nov;18(9):684-7. doi: 10.1089/tmj.2011.0276. Epub 2012 Sep 6.
Motor impairment and travel time have been shown to be important barriers to recruitment for Parkinson's disease (PD) clinical trials. This study determined whether use of Internet-based video communication for study visits would improve likelihood of participating in PD clinical trials.
University of Utah PD clinic patients were invited to complete a survey asking if they would be willing to participate in a hypothetical research study under four different scenarios. McNemar's test was used to test the hypothesis that remote assessments would improve willingness to participate.
Willingness to participate was 101/113 (87%) in the standard scenario. Willingness to participate was highest (93%; p=0.046) with most visits occurring via telemedicine at a local clinic, followed by some visits occurring via telemedicine at a local clinic (91%; p=0.157). Willingness to participate was lower with some (80%; p=0.008) or most (82%; p=0.071) visits occurring by home telemonitoring.
Use of telemedicine may be an acceptable means to improve participation in clinical trials. This would need to be confirmed with the use of a larger-scale inquiry involving rural populations. Future research should assess subject or caregiver comfort and trainability with respect to computer-based technology in the home and systems barriers for wider implementation of telemedicine in neurology.
运动障碍和出行时间已被证明是招募帕金森病（PD）临床试验患者的重要障碍。本研究旨在确定使用基于互联网的视频通信进行研究访视是否会提高参与 PD 临床试验的可能性。
犹他大学 PD 诊所的患者被邀请完成一项调查，询问他们是否愿意在四种不同情况下参与假设的研究。使用 McNemar 检验来检验远程评估是否会提高参与意愿的假设。
在标准情况下，113 名患者中有 101 名（87%）愿意参与。在最常通过远程医疗在当地诊所进行大部分访视的情况下（93%；p=0.046），参与意愿最高，其次是在当地诊所进行一些远程医疗访视的情况下（91%；p=0.157）。在通过家庭远程监测进行一些（80%；p=0.008）或大部分（82%；p=0.071）访视的情况下，参与意愿较低。
使用远程医疗可能是提高临床试验参与度的一种可接受的手段。这需要通过涉及农村人口的更大规模调查来证实。未来的研究应评估患者或照顾者在家庭中使用基于计算机的技术的舒适度和可培训性，以及在神经病学中更广泛实施远程医疗的系统障碍。
