Nie Pan, Zhang Jibo, Yang Xin, Shao Yuyang, Zhang Xiuming, Liu Wen, Fu Kai, Chen Jincao, Zhang Jie
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Center for Functional Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Neurol. 2022 May 3;13:879250. doi: 10.3389/fneur.2022.879250. eCollection 2022.
The purpose of this study was to evaluate the safety, efficiency, and cost expenditure of remote programming in patients with Parkinson's disease (PD) after deep brain stimulation (DBS).
A total of 74 patients who underwent DBS at the Department of Neurosurgery, Zhongnan Hospital of Wuhan University between June 2018 and June 2020 were enrolled in this study. There were 27 patients in the remote programming group and 47 patients in the outpatient programming group. Clinical data, programming efficiency, adverse events, expenditure, and satisfaction were compared between the two groups.
A total of 36 times of remote programming were performed on the 27 patients in the remote programming group, and four had mild adverse events during programming, and the adverse events disappeared within 1 week. The satisfaction questionnaire showed that 97.3% of the patients were satisfied with the surgical effect. The patients in the remote programming group (88.9%) were more likely to receive long-term programming after DBS than the patients in the outpatient programming group (74.5%). The Parkinsonism symptoms improved in both programming groups. The majority (18/27) of patients in the remote programming group lived away from the programming center, while the majority (27/47) of patients in the outpatient programming group lived in Wuhan, where the programming center was located ( = 0.046). The cost per patient per programming was US$ 43.5 in the remote programming group and $59.5 (56-82.7) in the outpatient programming group ( < 0.001). The median time cost for each visit was 30 min (25-30) in the remote programming group and 150 min (135-270.0) in the outpatient programming group ( < 0.001).
Remote programming is safe and effective after DBS in patients with Parkinson's disease. Moreover, it reduces expenditure and time costs for patients and achieves high satisfaction, particularly for patients living far from programming centers.
本研究旨在评估帕金森病（PD）患者在接受脑深部电刺激（DBS）后进行远程程控的安全性、有效性和成本支出。
本研究纳入了2018年6月至2020年6月期间在武汉大学中南医院神经外科接受DBS治疗的74例患者。其中远程程控组27例，门诊程控组47例。比较两组患者的临床资料、程控效率、不良事件、费用支出及满意度。
远程程控组27例患者共进行了36次远程程控，4例患者在程控过程中出现轻度不良事件，不良事件在1周内消失。满意度调查问卷显示，97.3%的患者对手术效果满意。远程程控组患者（88.9%）在DBS后比门诊程控组患者（74.5%）更有可能接受长期程控。两组程控后帕金森症状均有改善。远程程控组大多数患者（18/27）居住在远离程控中心的地方，而门诊程控组大多数患者（27/47）居住在程控中心所在的武汉（P = 0.046）。远程程控组每次程控的人均费用为43.5美元，门诊程控组为59.5美元（56 - 82.7美元）（P < 0.001）。远程程控组每次就诊的中位时间成本为30分钟（25 - 30分钟），门诊程控组为150分钟（135 - 270.0分钟）（P < 0.001）。
帕金森病患者DBS后进行远程程控是安全有效的。此外，它降低了患者的费用和时间成本，并获得了较高的满意度，尤其是对于居住在远离程控中心的患者。
