Tang Yilin, Liang Xiaoniu, Shen Bo, Wang Jiawei, Bloem Bastiaan R, Wu Jianjun, Wang Jian
Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China.
College of Arts and Science, Vanderbilt University, Nashville, TN, 37212, USA.
Commun Med (Lond). 2023 Feb 11;3(1):23. doi: 10.1038/s43856-023-00246-4.
Social distancing during the COVID-19 pandemic affected follow-up visits and medication availability for patients with Parkinson's disease (PD). As a promising strategy to deal with these challenges, the implementation of health management smartphone apps was accelerated. However, whether more intense use of such apps could improve the quality of life (QoL) for PD patients during the COVID-19 pandemic was unknown.
Using a PD management app, this observational study assessed changes in QoL, as determined by PD Questionnaire 8 (PDQ-8), among PD patients before (Jan 20, 2019 to Oct 6, 2019) and after the beginning of the COVID-19 lockdown (Jan 20, 2020 to Oct 6, 2020). According to adherence to use of the app, participants were divided into low adherence, moderate adherence, and high adherence groups. A total of 4979 PD patients registered in the app, and 226 PD patients were enrolled, including 57 patients with low adherence, 112 with moderate adherence and 57 with high adherence. A generalized linear model was used to evaluate the change of PDQ-8 scores across these three different adherence groups.
After the COVID-19 lockdown (1-year follow-up), the PDQ-8 scores are reduced by 0.8 (95% CI, 0.3-1.4) in all participants (P = 0.004). After adjustment for age, gender, education, disease duration and levodopa equivalent dose, PDQ-8 scores significantly less reduced in the high adherence group (0.3; 95% CI, 0.6-1.2) compared to the low adherence (1.9; 95% CI, 0.7-3.1) (P = 0.040) and moderate adherence groups (0.6; 95% CI, 0.2-1.3) (P = 0.012).
A health management smartphone-based app might be a way to both measure and improve QoL among PD patients, provided that sufficient adherence is achieved.
2019年冠状病毒病（COVID-19）大流行期间的社交距离措施影响了帕金森病（PD）患者的随访就诊和药物供应。作为应对这些挑战的一项有前景的策略，健康管理智能手机应用程序的实施加速。然而，在COVID-19大流行期间，更频繁地使用此类应用程序是否能改善PD患者的生活质量（QoL）尚不清楚。
本观察性研究使用一款PD管理应用程序，评估了在COVID-19封锁开始前（2019年1月20日至2019年10月6日）和开始后（2020年1月20日至2020年10月6日），通过帕金森病问卷8（PDQ-8）确定的PD患者QoL的变化。根据对应用程序的使用依从性，参与者被分为低依从性、中度依从性和高依从性组。共有4979名在该应用程序中注册的PD患者，226名PD患者被纳入研究，其中57名低依从性患者，112名中度依从性患者和57名高依从性患者。使用广义线性模型评估这三个不同依从性组中PDQ-8评分的变化。
在COVID-19封锁后（1年随访），所有参与者的PDQ-8评分降低了0.8（95%置信区间，0.3-1.4）（P = 0.004）。在调整年龄、性别、教育程度、病程和左旋多巴等效剂量后，与低依从性组（1.9；95%置信区间，0.7-3.1）（P = 0.040）和中度依从性组（0.6；95%置信区间，0.2-1.3）（P = 0.012）相比，高依从性组的PDQ-8评分降低幅度明显较小（0.3；95%置信区间，0.6-1.2）。
基于智能手机的健康管理应用程序可能是一种测量和改善PD患者QoL的方法，前提是要达到足够的依从性。
