Wijers Anke, Hochstenbach Laura, Tissingh Gerrit
Department of Neurology Zuyderland Medical Centre Heerlen The Netherlands.
Department of Remote Care Zuyd University of Applied Sciences Heerlen The Netherlands.
Mov Disord Clin Pract. 2021 Jul 19;8(7):1075-1082. doi: 10.1002/mdc3.13280. eCollection 2021 Oct.
Parkinson's disease (PD) is best managed by neurologists, traditionally including frequent doctor-patient contact. Because of a rise in PD prevalence and associated healthcare costs, this personnel-intensive care may not be future proof. Telemedicine tools for home monitoring have shown to reduce healthcare consumption in several chronic diseases and also seem promising for PD.
To explore whether telemonitoring can reduce outpatient healthcare consumption in PD.
We conducted a cohort study with 116 outpatients with PD who used the telemedicine tool "myParkinsoncoach." The tool involved periodic monitoring, feedback, knowledge modules, and text message functionality. Retrospective data about PD-related healthcare consumption in the year before and after introduction of the tool were retrieved from the hospital information system. Additional data about tool-related activities performed by nursing staff were logged prospectively for 3 months.
There was a 29% reduction in the number of outpatient visits ( < 0.001) in the year after introduction of the tool compared with the year before. A 39% reduction was seen in overall PD-related healthcare costs ( = 0.001). Similar results were found for patients ≥70 years old. Nursing staff spent on average 15.5 minutes per patient a month on monitoring the tool and follow-up activities.
Study results demonstrate a significant reduction in PD-related healthcare consumption using telemonitoring. Notably, these results were also found in elderly patients. Further research is needed to confirm these findings, preferably taking a broader perspective on healthcare consumption and within a larger, multicenter and prospective setup.
帕金森病(PD)最好由神经科医生管理,传统上这包括频繁的医患接触。由于帕金森病患病率上升以及相关医疗成本增加,这种人员密集型护理可能无法适应未来需求。用于家庭监测的远程医疗工具已显示可减少几种慢性病的医疗消耗,对帕金森病似乎也很有前景。
探讨远程监测是否能减少帕金森病患者的门诊医疗消耗。
我们对116名使用远程医疗工具“myParkinsoncoach”的帕金森病门诊患者进行了一项队列研究。该工具包括定期监测、反馈、知识模块和短信功能。从医院信息系统中检索该工具引入前后一年中与帕金森病相关的医疗消耗的回顾性数据。前瞻性记录护理人员在3个月内执行的与工具相关活动的其他数据。
与引入该工具前一年相比,引入该工具后一年门诊就诊次数减少了29%(<0.001)。帕金森病相关的总体医疗成本降低了39%(=0.001)。70岁及以上患者也有类似结果。护理人员平均每月为每位患者花费15.5分钟监测该工具及进行后续活动。
研究结果表明,使用远程监测可显著降低帕金森病相关的医疗消耗。值得注意的是,老年患者也有这些结果。需要进一步研究以证实这些发现,最好从更广泛的医疗消耗角度以及在更大规模、多中心和前瞻性的研究中进行。