Sekimoto Satoko, Oyama Genko, Hatano Taku, Sasaki Fuyuko, Nakamura Ryota, Jo Takayuki, Shimo Yasushi, Hattori Nobutaka
Department of Neurology, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Parkinsons Dis. 2019 Jan 6;2019:9403295. doi: 10.1155/2019/9403295. eCollection 2019.
We investigated the feasibility and safety of a video-based telemedicine system, delivered via a tablet, in Parkinson's disease (PD).
In a randomized, crossover, open-label pilot trial, we compared a telemedicine period (regular visits every two months with intermediate video calls via an iPad mini) with a control period (regular visits every two months), both lasting 6 months. We included 10 patients diagnosed with PD according to the British Brain Bank criteria, aged 20-75 years. The primary outcome was the PD questionnaire summary index (PDQ-39 SI). Secondary outcomes included the Hoehn and Yahr Stage and scores on the Unified PD Rating Scale (UPDRS) part I-IV, Beck Depression Inventory (BDI), and visual analog scale for satisfaction.
Both study periods were completed by 10 patients with PD. Friedman's test revealed that there were no significant differences between the two periods in primary and secondary outcomes ( > 0.05). With respect to visual analog scale scores for satisfaction, participants indicated high satisfaction with the telemedicine system. The number of extra hospital visits and phone calls did not differ between the periods. There were no adverse events or side effects.
We observed that a telemedicine system delivered via a tablet could successfully be used by patients as a part of their care. Further studies investigating the use of telemedicine to replace in-person visits are warranted. This trial is registered with UMIN000015536.
我们研究了通过平板电脑提供的基于视频的远程医疗系统在帕金森病(PD)中的可行性和安全性。
在一项随机、交叉、开放标签的试点试验中,我们比较了一个远程医疗期(每两个月定期就诊,并通过iPad mini进行中间视频通话)和一个对照期(每两个月定期就诊),两者均持续6个月。我们纳入了10名根据英国脑库标准诊断为PD的患者,年龄在20 - 75岁之间。主要结局是帕金森病问卷总结指数(PDQ - 39 SI)。次要结局包括Hoehn和Yahr分期以及统一帕金森病评定量表(UPDRS)第一至四部分的评分、贝克抑郁量表(BDI)和满意度视觉模拟量表。
10名PD患者完成了两个研究期。Friedman检验显示,两个时期在主要和次要结局方面均无显著差异(>0.05)。关于满意度视觉模拟量表评分,参与者对远程医疗系统表示高度满意。两个时期的额外医院就诊次数和电话数量没有差异。没有不良事件或副作用。
我们观察到通过平板电脑提供的远程医疗系统可以成功地被患者用作其护理的一部分。有必要进行进一步研究以调查使用远程医疗替代面对面就诊的情况。该试验已在UMIN000015536注册。