Virtual visits for Parkinson disease: A multicenter noncontrolled cohort

Abstract

Background: Previous small-scale studies have demonstrated the feasibility of providing remote specialty care via virtual visits. We assessed the feasibility and benefits of a one-time consultation between a remote Parkinson Disease (PD) specialist and an individual with PD at home on a larger scale.

Methods: We conducted a multicenter noncontrolled cohort of virtual visits administered over videoconferencing between remote PD specialists and individuals with PD in their home. Specialists performed a patient history and a PD-specific physical examination and provided recommendations to patients and their local physicians. The primary outcome measures were feasibility, as measured by the proportion of visits completed as scheduled, and the 6-month change in quality of life, as measured by the Parkinson's Disease Questionnaire 39. Additional outcomes included satisfaction with visits and interest in future virtual visits.

Results: A total of 277 participants from 5 states enrolled, 258 participants completed virtual visits with 14 different physicians, and 91% of visits were completed as scheduled. No improvement in quality of life was observed at 6 months (0.4-point improvement; 95% confidence interval -1.5 to 0.6; p = 0.39). Overall satisfaction with virtual visits was high among physicians (94% satisfied or very satisfied) and patients (94% satisfied or very satisfied), and 74% of participants were interested in receiving future care via virtual visits.

Conclusions: Providing specialty care remotely into the homes of individuals with PD is feasible, but a one-time visit did not improve quality of life. Satisfaction with the visits was high among physicians and patients, who were interested in receiving such care in the future.

Classification of evidence: This study provides Class IV evidence that for patients with PD, remote specialty care is feasible but does not improve quality of life.

Clinicaltrialsgov identifier: NCT02144220.

Figure 1. Flowchart of study participants

Figure 2. Geographic distribution of enrolled participants (n = 277)

Two participants traveled across state lines to receive care remotely (one from Arizona to California and one from Pennsylvania to Delaware). Map data: Google, ©2016. Accessed December 5, 2016.

Figure 3. Physician and patient satisfaction

Physician satisfaction (A) and patient satisfaction (B) with different aspects of the virtual visit (n = 257 responses).

Figure 4. Patient preference for virtual visits relative to in-person visits (n = 258 responses)