Objective: This work presents an analysis of real-world, device-reported outcomes from patients in Greece, following a 6-month, continuous telemonitoring paradigm for Parkinson’s disease. Results show there are potential benefits of integrating this paradigm into medical practice.

Background: During the last decade, technological advancements have made continuous telemonitoring, both for Parkinson’s disease (PD), and for other disorders [2, 3] possible. Telemonitoring and telemedicine promote a patient-centric approach, and it is proven to be reliable, with comparable results to standard medical practice [4, 5]. In this work, the benefits of telemonitoring were evaluated in patients from Greece using real-world data, and a separate analysis was done for 2 subgroups, based on the level of physicians’ adoption of telemonitoring in their practice.

Method: The data were collected from 267 patients in Greece, attended by 77 physicians with a private practice (distributed as seen in Figure 1). For the analysis, 2 groups of physicians were created, based on their different experience in telemonitoring. Those were, physicians with (a) ≤3 patients (Group A) and (b) ≥4 patients (Group B).

Symptom progression was evaluated based on the average device-reported [6] OFF time (DR-OFF), within 3 time periods of (a) 1 month (M0), (b) 2-4 months (M3) and (c) 5-7 months (M6). Only patients with a normalized (min-max) DR-OFF time greater than 10% (211 patients) were included in the analysis.

A repeated measurement ANOVA was performed, with the physician group as a predictor of DR-OFF change. A Kruskal-Wallis test was conducted to compare the DR-OFF distribution in different periods, and the differences between the 2 physician groups.

Results: The repeated measurement ANOVA showed that time is a statistically significant factor (p<0.001) for reducing DR-OFF (Figure 2), while the physician group seems to be important (p=0.08).

In all periods, patients of Group A have a higher DR-OFF time compared to those of Group B (Table 1). However, the difference is reduced in M3 and even more in M6. For both groups, reduction in DR-OFF time is statistically significant between M0 and M6 (p=0.03).

Conclusion: This work provides evidence that introducing continuous telemonitoring in clinical practice can lead to alleviation of PD symptoms, with the patients’ monitoring duration and the physicians’ experience being important factors.

References: [1] S. Ryu, ‘History of telemedicine: evolution, context, and transformation’, Healthcare Informatics Research, vol. 16, no. 1, pp. 65–66, 2010.
[2] N. D. Shah, E. A. Krupinski, J. Bernard, and M. F. Moyer, ‘The evolution and utilization of telehealth in ambulatory nutrition practice’, Nutrition in Clinical Practice, vol. 36, no. 4, pp. 739–749, 2021.
[3] L. Pagliani, N. Elisa, R. D. Eduardo, F. Antonini-Canterin, and Others, ‘Role of New Technologies in Supporting the Treatment of Complex Patients’, Heart Failure Clinics, vol. 17, no. 2, pp. 279–287, 2021.
[4] D. Grimes et al., ‘Patient-centred management of Parkinson’s disease’, The Lancet Neurology, vol. 19, no. 11, pp. 887–888, 2020.
[5] E. R. Dorsey, B. R. Bloem, and M. S. Okun, ‘A new day: the role of telemedicine in reshaping care for persons with movement disorders’, Movement Disorders, vol. 35, no. 11, pp. 1897–1902, 2020.
[6] N. Kostikis, G. Rigas, S. Konitsiotis, and D. I. Fotiadis, “Configurable Offline Sensor Placement Identification for a Medical Device Monitoring Parkinson’s Disease,” Sensors, vol. 21, no. 23, p. 7801, Nov. 2021, doi: 10.3390/s21237801.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-continuous-monitoring-in-parkinsons-disease-through-real-world-device-reported-outcomes/