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为非典型帕金森氏症整合远程姑息治疗:从一个试点项目中吸取的经验教训。

Integrating tele-palliative care for atypical Parkinsonian disorders: Lessons learned from a pilot program.

作者信息

Afshari Mitra, Kang Kyurim, Butala Ankur A, Guenther Jana, Razzak Rab, Katz Maya, Galifianakis Nicholas B, Pantelyat Alexander

机构信息

Rush University, Department of Neurology, Chicago, IL, USA.

Johns Hopkins University, Department of Neurology, Baltimore, MD, USA.

出版信息

Clin Park Relat Disord. 2025 May 24;12:100352. doi: 10.1016/j.prdoa.2025.100352. eCollection 2025.

Abstract

INTRODUCTION

As evidence supporting palliative care (PC) via tele-medicine for neurologic patients increases, it is important to determine the best integration methods across various healthcare settings and patient populations to optimize outcomes. Given the rising demand for PC in chronic neurodegenerative diseases like Atypical Parkinsonian Disorders (APDs), it is imperative to explore different models of PC delivery for feasibility and effectiveness.

METHODS

Participants with APDs and their care partners at the University of California, San Francisco (UCSF) and Johns Hopkins University (JHU) received 2 virtual telemedicine PC sessions (at baseline and 6 months). Adherence and feasibility-related outcomes were assessed using a satisfaction survey developed by the investigators, using a five-point Likert scale, administered at baseline and 6 months. Additionally, participants' quality of life (QoL), mood, functional abilities, and care partner burden were assessed at baseline and 6-month follow-up virtual visits.

RESULTS

There was a 100 % attendance rate among participants and their care partners at both sites. Satisfaction levels regarding visit convenience were > 78 % for both visits at UCSF and reached 100 % at JHU. No significant differences were observed between baseline and 6-month assessments at both sites in QoL, mood, or caregiver burden. However, there was a significant decrease in functional abilities during the second visit (6 months) at JHU.

CONCLUSION

These results support the integration and expansion of telemedicine PC services to address the evolving needs of individuals with APDs and their care partners, offering a viable solution to enhance access to PC in diverse healthcare settings.

摘要

引言

随着支持通过远程医疗为神经系统疾病患者提供姑息治疗(PC)的证据不断增加,确定在各种医疗环境和患者群体中实现最佳整合的方法以优化治疗效果至关重要。鉴于对非典型帕金森氏症(APD)等慢性神经退行性疾病的姑息治疗需求不断上升,探索不同的姑息治疗提供模式的可行性和有效性势在必行。

方法

加利福尼亚大学旧金山分校(UCSF)和约翰·霍普金斯大学(JHU)的APD患者及其护理伙伴接受了2次虚拟远程医疗姑息治疗课程(基线时和6个月时)。使用研究人员开发的满意度调查问卷,采用五点李克特量表,在基线时和6个月时评估依从性和与可行性相关的结果。此外,在基线时和6个月随访的虚拟就诊时评估参与者的生活质量(QoL)、情绪、功能能力和护理伙伴负担。

结果

两个地点的参与者及其护理伙伴的出勤率均为100%。UCSF两次就诊的就诊便利性满意度均>78%,JHU则达到100%。两个地点在基线和6个月评估时,在生活质量、情绪或照顾者负担方面均未观察到显著差异。然而,JHU在第二次就诊(6个月时)时功能能力显著下降。

结论

这些结果支持远程医疗姑息治疗服务的整合与扩展,以满足APD患者及其护理伙伴不断变化的需求,为在不同医疗环境中增加姑息治疗的可及性提供了一个可行的解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ba1/12159488/d25edd2f9eb1/gr1.jpg

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