Real-World Evaluation of the Feasibility, Acceptability and Safety of a Remote, Self-Management Parkinson's Disease Care Pathway: A Healthcare Improvement Initiative

Angie A. Kehagia, Sarah Chowienczyk, Michelle Helena Van Velthoven, Emma King, Tracie North, Deb Shenton, Jane Abraham, Joseph Langley, Rebecca Partridge, Ursula Ankeny, Terry Gorst, Emma Edwards, Sue Whipps, Martha Batup, Jane Rideout, Mat Swabey, Jemma Inches, Sue Bentley, Georgina Gilbert, Camille Carroll*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Downloads (Pure)

Abstract

Background: There is significant unmet need for effective and efficiently delivered care for people with Parkinson's disease (PwP). We undertook a service improvement initiative to co-develop and implement a new care pathway, Home Based Care (HBC), based on supported self-management, remote monitoring and the ability to trigger a healthcare contact when needed. Objective: To evaluate feasibility, acceptability and safety of Home Based Care. Methods: We evaluated data from the first 100 patients on HBC for 6 months. Patient monitoring, performed at baseline and 6-monthly, comprised motor (MDS-UPDRS II and accelerometer), non-motor (NMSQ, PDSS-2, HADS) and quality of life (PDQ) measures. Care quality was audited against Parkinson's UK national audit standards. Process measures captured feasibility. Acceptability was assessed using a mixed-methods approach comprising questionnaires and semi-structured interviews. Results: Between October 2019 and January 2021, 108 PwP were enrolled onto HBC, with data from 100 being available at 6 months. Over 90% of all questionnaires were returned, 97% were complete or had < 3 missing items. Reporting and communications occurred within agreed timeframes. Compared with baseline, after 6m on HBC, PD symptoms were stable; more PwP felt listened to (90% vs. 79%) and able to seek help (79% vs. 68%). HBC met 93% of national audit criteria. Key themes from the interviews included autonomy and empowerment. Conclusions: We have demonstrated acceptability, feasibility and safety of our novel remotely delivered Parkinson's care pathway. Ensuring scalability will widen its reach and realize its benefits for underserved communities, enabling formal comparisons with standard care and cost-effectiveness evaluation.

Original languageEnglish
Pages (from-to)197-208
Number of pages12
JournalJournal of Parkinson's Disease
Volume14
Issue number1
DOIs
Publication statusPublished - 23 Jan 2024

ASJC Scopus subject areas

  • Neurology (clinical)
  • Cellular and Molecular Neuroscience

Keywords

  • digital health technology
  • Parkinson's disease
  • remote management
  • Self-management
  • sensor

Fingerprint

Dive into the research topics of 'Real-World Evaluation of the Feasibility, Acceptability and Safety of a Remote, Self-Management Parkinson's Disease Care Pathway: A Healthcare Improvement Initiative'. Together they form a unique fingerprint.

Cite this