Abstract
Objective: To evaluate the feasibility of a smartphone remote patient monitoring approach in a real-life Parkinson's disease (PD) cohort during the Italian COVID-19 lockdown.Methods: Fifty-four non-demented PD patients who were supposed to attend the outpatient March clinic were recruited for a prospective study. All patients had a known UPDRS-III and a modified Hoehn and Yahr (H&Y) score and were provided with a smartphone application capable of providing indicators of gait, tapping, tremor, memory and executive functions. Different questionnaires exploring non-motor symptoms and quality of life were administered through phone-calls. Patients were asked to run the app at least twice per week (i.e., full compliance). Subjects were phone-checked weekly throughout a 3-week period for compliance and final satisfaction questionnaires.Results: Forty-five patients (83.3%) ran the app at least once; Twenty-nine (53.7%) subjects were half-compliant, while 16 (29.6%) were fully compliant. Adherence was hindered by technical issues or digital illiteracy (38.7%), demotivation (24%) and health-related issues (7.4%). Ten patients (18.5%) underwent PD therapy changes. The main factors related to lack of compliance included loss of interest, sadness, anxiety, the absence of a caregiver, the presence of falls and higher H&Y. Gait, tapping, tremor and cognitive application outcomes were correlated to disease duration, UPDRS-III and H&Y.Discussion: The majority of patients were compliant and satisfied by the provided monitoring program. Some of the application outcomes were statistically correlated to clinical parameters, but further validation is required. Our pilot study suggested that the available technologies could be readily implemented even with the current population's technical and intellectual resources.
Highlights
On March 9th, 2020 the Italian government imposed a national lockdown, due to Coronavirus disease 2019 (COVID-19) outbreak
We present a prospective study in which we explored the feasibility of remote patient monitoring (RPM) in a real-life cohort of Parkinson’s disease (PD) patients
This was performed through a smartphone application designed for monitoring motor and cognitive performances of patients affected by neurological disorders
Summary
On March 9th, 2020 the Italian government imposed a national lockdown, due to Coronavirus disease 2019 (COVID-19) outbreak Such restriction aimed to protect fragile people with chronic diseases, a population that is at risk of SARS-CoV-2 complications. In the last few years, mobile technologies have been extensively explored in patient management. We present a prospective study in which we explored the feasibility of remote patient monitoring (RPM) in a real-life cohort of Parkinson’s disease (PD) patients. This was performed through a smartphone application designed for monitoring motor and cognitive performances of patients affected by neurological disorders
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