一种用于监测轻度至中度帕金森病患者活动能力和评估药物依从性的数字健康技术系统的可行性和可用性。

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease.

作者信息

Debelle Héloïse, Packer Emma, Beales Esther, Bailey Harry G B, Mc Ardle Ríona, Brown Philip, Hunter Heather, Ciravegna Fabio, Ireson Neil, Evers Jordi, Niessen Martijn, Shi Jian Qing, Yarnall Alison J, Rochester Lynn, Alcock Lisa, Del Din Silvia

机构信息

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.

Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

Front Neurol. 2023 Mar 15;14:1111260. doi: 10.3389/fneur.2023.1111260. eCollection 2023.

DOI:10.3389/fneur.2023.1111260

PMID:37006505

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10050691/

Abstract

INTRODUCTION

Parkinson's disease (PD) is a neurodegenerative disorder which requires complex medication regimens to mitigate motor symptoms. The use of digital health technology systems (DHTSs) to collect mobility and medication data provides an opportunity to objectively quantify the effect of medication on motor performance during day-to-day activities. This insight could inform clinical decision-making, personalise care, and aid self-management. This study investigates the feasibility and usability of a multi-component DHTS to remotely assess self-reported medication adherence and monitor mobility in people with Parkinson's (PwP).

METHODS

Thirty participants with PD [Hoehn and Yahr stage I ( = 1) and II ( = 29)] were recruited for this cross-sectional study. Participants were required to wear, and where appropriate, interact with a DHTS (smartwatch, inertial measurement unit, and smartphone) for seven consecutive days to assess medication adherence and monitor digital mobility outcomes and contextual factors. Participants reported their daily motor complications [motor fluctuations and dyskinesias (i.e., involuntary movements)] in a diary. Following the monitoring period, participants completed a questionnaire to gauge the usability of the DHTS. Feasibility was assessed through the percentage of data collected, and usability through analysis of qualitative questionnaire feedback.

RESULTS

Adherence to each device exceeded 70% and ranged from 73 to 97%. Overall, the DHTS was well tolerated with 17/30 participants giving a score > 75% [average score for these participants = 89%, from 0 (worst) to 100 (best)] for its usability. Usability of the DHTS was significantly associated with age (ρ = -0.560, BCa 95% CI [-0.791, -0.207]). This study identified means to improve usability of the DHTS by addressing technical and design issues of the smartwatch. Feasibility, usability and acceptability were identified as key themes from PwP qualitative feedback on the DHTS.

CONCLUSION

This study highlighted the feasibility and usability of our integrated DHTS to remotely assess medication adherence and monitor mobility in people with mild-to-moderate Parkinson's disease. Further work is necessary to determine whether this DHTS can be implemented for clinical decision-making to optimise management of PwP.

摘要

引言

帕金森病（PD）是一种神经退行性疾病，需要复杂的药物治疗方案来缓解运动症状。使用数字健康技术系统（DHTSs）收集活动能力和用药数据，为客观量化药物在日常活动中对运动表现的影响提供了机会。这种见解可为临床决策提供参考、实现个性化护理并有助于自我管理。本研究调查了一种多组件DHTS远程评估帕金森病患者（PwP）自我报告的用药依从性和监测活动能力的可行性和可用性。

方法

招募了30名帕金森病患者[霍恩和亚尔分级为I期（=1）和II期（=29）]参与这项横断面研究。参与者被要求连续七天佩戴DHTS（智能手表、惯性测量单元和智能手机），并在适当情况下与之交互，以评估用药依从性并监测数字活动能力结果和背景因素。参与者在日记中记录他们每天的运动并发症[运动波动和异动症（即不自主运动）]。在监测期结束后，参与者完成一份问卷以评估DHTS的可用性。通过收集到的数据百分比评估可行性，通过对定性问卷反馈的分析评估可用性。

结果

每个设备的依从率超过70%，范围在73%至97%之间。总体而言，DHTS耐受性良好，30名参与者中有17名对其可用性给出了>75%的评分[这些参与者的平均评分为89%，范围从0（最差）到100（最佳）]。DHTS的可用性与年龄显著相关（ρ = -0.560，BCa 95% CI [-0.791, -0.207]）。本研究确定了通过解决智能手表的技术和设计问题来提高DHTS可用性的方法。可行性、可用性和可接受性被确定为PwP对DHTS定性反馈的关键主题。