Telemonitoring via Questionnaires Reduces Outpatient Healthcare Consumption in Parkinson's Disease

Abstract

Background: Parkinson's disease (PD) is best managed by neurologists, traditionally including frequent doctor-patient contact. Because of a rise in PD prevalence and associated healthcare costs, this personnel-intensive care may not be future proof. Telemedicine tools for home monitoring have shown to reduce healthcare consumption in several chronic diseases and also seem promising for PD.

Objective: To explore whether telemonitoring can reduce outpatient healthcare consumption in PD.

Methods: We conducted a cohort study with 116 outpatients with PD who used the telemedicine tool "myParkinsoncoach." The tool involved periodic monitoring, feedback, knowledge modules, and text message functionality. Retrospective data about PD-related healthcare consumption in the year before and after introduction of the tool were retrieved from the hospital information system. Additional data about tool-related activities performed by nursing staff were logged prospectively for 3 months.

Results: There was a 29% reduction in the number of outpatient visits (P < 0.001) in the year after introduction of the tool compared with the year before. A 39% reduction was seen in overall PD-related healthcare costs (P = 0.001). Similar results were found for patients ≥70 years old. Nursing staff spent on average 15.5 minutes per patient a month on monitoring the tool and follow-up activities.

Conclusions: Study results demonstrate a significant reduction in PD-related healthcare consumption using telemonitoring. Notably, these results were also found in elderly patients. Further research is needed to confirm these findings, preferably taking a broader perspective on healthcare consumption and within a larger, multicenter and prospective setup.

Keywords: Parkinson's disease; healthcare consumption; home monitoring; telemedicine.

Conflict of interest statement

This study was conducted within the context of the eHealth living lab, an initiative of Zuyderland Medical Centre and healthcare insurance company CZ, in which promising eHealth solutions—screen to screen contact, telemonitoring applications and decision support tools—are implemented and evaluated. More information can be found at https://www.zuyderland.nl/nieuws/zuyderland-living-lab-voor-e-health-cz-actuele-pilots/. Neither CZ nor anyone in the hospital management staff was involved in the data collection, analysis, or writing of this article. The authors declare that there are no conflicts of interest relevant to this work.

© 2021 International Parkinson and Movement Disorder Society.

Figures

FIG. 1

Overview of patient scores converted from a questionnaire. Example of a patient's score on the 15 Parkinson's disease–related domains. A leftward shift and a green dot indicate improvement in that domain compared with the previous questionnaire, a rightward shift and a red dot indicate deterioration. ADL, activities of daily living.

FIG. 2

Patient's flow diagram. PD, Parkinson's disease.