Motolese Francesco, Magliozzi Alessandro, Puttini Fiorella, Rossi Mariagrazia, Capone Fioravante, Karlinski Keren, Stark-Inbar Alit, Yekutieli Ziv, Di Lazzaro Vincenzo, Marano Massimo
Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy.
Montfort Brain Monitor, Binyamina, Israel.
Front Neurol. 2020 Oct 7;11:567413. doi: 10.3389/fneur.2020.567413. eCollection 2020.
To evaluate the feasibility of a smartphone remote patient monitoring approach in a real-life Parkinson's disease (PD) cohort during the Italian COVID-19 lockdown. Fifty-four non-demented PD patients who were supposed to attend the outpatient March clinic were recruited for a prospective study. All patients had a known UPDRS-III and a modified Hoehn and Yahr (H&Y) score and were provided with a smartphone application capable of providing indicators of gait, tapping, tremor, memory and executive functions. Different questionnaires exploring non-motor symptoms and quality of life were administered through phone-calls. Patients were asked to run the app at least twice per week (i.e., full compliance). Subjects were phone-checked weekly throughout a 3-week period for compliance and final satisfaction questionnaires. Forty-five patients (83.3%) ran the app at least once; Twenty-nine (53.7%) subjects were half-compliant, while 16 (29.6%) were fully compliant. Adherence was hindered by technical issues or digital illiteracy (38.7%), demotivation (24%) and health-related issues (7.4%). Ten patients (18.5%) underwent PD therapy changes. The main factors related to lack of compliance included loss of interest, sadness, anxiety, the absence of a caregiver, the presence of falls and higher H&Y. Gait, tapping, tremor and cognitive application outcomes were correlated to disease duration, UPDRS-III and H&Y. The majority of patients were compliant and satisfied by the provided monitoring program. Some of the application outcomes were statistically correlated to clinical parameters, but further validation is required. Our pilot study suggested that the available technologies could be readily implemented even with the current population's technical and intellectual resources.
为评估在意大利新冠疫情封锁期间，智能手机远程患者监测方法在现实生活中的帕金森病（PD）队列中的可行性。招募了54名本应参加3月门诊诊所的非痴呆型PD患者进行一项前瞻性研究。所有患者均有已知的统一帕金森病评定量表第三部分（UPDRS-III）评分和改良的 Hoehn 和 Yahr（H&Y）评分，并被提供了一款能够提供步态、轻敲、震颤、记忆和执行功能指标的智能手机应用程序。通过电话进行了不同的探索非运动症状和生活质量的问卷调查。要求患者每周至少运行该应用程序两次（即完全依从）。在为期3周的时间里，每周对受试者进行电话检查，以了解其依从情况并填写最终满意度问卷。45名患者（83.3%）至少运行过一次该应用程序；29名（53.7%）受试者部分依从，而16名（29.6%）完全依从。技术问题或数字文盲（38.7%）、缺乏动力（24%）和健康相关问题（7.4%）阻碍了依从性。10名患者（18.5%）接受了帕金森病治疗方案的调整。与缺乏依从性相关的主要因素包括兴趣丧失、悲伤、焦虑、没有照顾者、跌倒以及较高的H&Y评分。步态、轻敲、震颤和认知应用结果与疾病持续时间、UPDRS-III评分和H&Y评分相关。大多数患者对所提供的监测方案依从且满意。一些应用结果与临床参数在统计学上相关，但需要进一步验证。我们的初步研究表明，即使利用当前人群的技术和智力资源，现有技术也可以很容易地实施。
