Objective: To evaluate the clinical utility of the Parkinson’s Kinetigraph (PKG™) in the remote management of Parkinson’s disease (PD) in terms of assistance with therapeutic decision-making, cost, and patient acceptability.

Background: In order to improve PD care, patients need to be better equipped to self- manage their condition remotely [1]. Wearable devices allow for the continual monitoring of symptoms within the home setting, and have potential to provide high levels of personalised care. The PKG™ is a wrist-worn device developed for remote monitoring in PD [2]. Since 2015, the PKG™ has been implemented as part of our routine PD service. We evaluated the clinical utility of the PKG™ in terms of assisting therapeutic decision making, cost, and patient acceptability.

Methods: PKG data were collated in real time in three PD management pathways; new patients, complex care and follow up. Data included demographics, report findings and clinical outcome. Patient acceptability data were collated via a patient questionnaire (n=61). Costs and potential savings associated with the PKG were calculated by the NHS business advisory service.

Results: Between July 2015 and January 2018, 216 PKGs were performed, 104 in New Patients (NP), 107 in Follow Up (FU) and 5 in Complex Care (CC). The most frequent purpose of the PKG was to investigate medication response (55%). In each of the PD pathways, the most frequently reported findings were sleep fragmentation (NP 31%, FU 31% and CC 60%) and high bradykinesia scores (NP 43%, FU 45% and CC 40%). There were remotely-implemented treatment changes made in 93% of cases. Patient acceptability of the PKG was high, with 61% of patients reporting they found the PKG very or extremely valuable in providing data to their clinician they otherwise could not have provided. 81% of patients were satisfied with not having to travel to see the consultant, and 96% of patients were willing to continue using the PKG as part of their routine care. Implementation of the PKG in routine PD care has the potential to reduce routine consultant follow-up appointments by 50%, leading to an estimated saving of £104,000pa per 250 patients.

Conclusions: The PKG can be used to assist in remote therapeutic decision making, and is feasible in terms of cost and patient acceptability. This evaluation demonstrates potential use of the PKG in remote management pathways for PD.

References: 1. Dorsey, E. R. et al. Moving Parkinson care to the home. Mov. Disord. (2016). 2. Griffiths, R. I. et al. Automated Assessment of Bradykinesia and Dyskinesia in Parkinson’s Disease. J. Parkinsons. Dis. 2, 47–55 (2012).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-the-clinical-utility-of-the-parkinsons-kinetigraph-pkg-in-the-remote-management-of-parkinsons-disease/