Allison Gandey

June 17, 2009

June 17, 2009 — A new telemedicine program is showing promise for patients living far from research centers, experiencing travel difficulties, or feeling too sick to commute. Presenting at the 13th International Congress of Parkinson's Disease and Movement Disorders, in Paris, France, investigators showed that the Web-based program is effective in assessing Parkinson's disease.

"This helps patients receive specialty care regardless of where they live," presenter Kevin Biglan, MD, from the University of Rochester, in New York, said during an interview. "Patients receive high-quality care and report that they are satisfied with this care."

In a news release about the study, Christopher Goetz, MD, from Rush University Medical Center, in Chicago, Illinois, adds, "There is an implicit advantage to techniques that allow at-home evaluations. Given that the days of doctors making house calls are largely over, telemedical techniques offer the infrastructure for physician experts at a central location to receive clinical information on patients who cannot travel."

Dr. Goetz points out that this information could be used for patient-care decisions or medication adjustments that depend on examination findings. "For research purposes, this technique could be advantageous and obviate the need for required visits to a medical center during a clinical trial."

Web-Based Program Improving Access to Care

Researchers studied 10 participants in the new telemedicine program. Patients received an in-person evaluation at baseline followed by telemedicine visits at 1, 3, 6, and 6.5 months. A nurse trained to perform the motor Unified Parkinson Disease Rating Scale completed the rigidity and retropulsion items.

Patients had a mean age of 72 years, a mean Hoehn and Yahr of 2.7, and a mean motor score of 34.7. A total of 3 participants experienced motor fluctuations.

Investigators found that all items of the motor scale could be completed at each telemedicine visit. Test-retest reliability of the motor score was excellent, with an intraclass correlation coefficient of 0.82.

The researchers assessed the validity of the long-distance approach by comparing the motor scores and individual motor items completed in person and at 1 month during the telemedicine visit. They found this was excellent, with an intraclass correlation coefficient of 0.78.

More Study Needed

Dr. Biglan told Medscape Neurology that other groups, including some nursing homes, experimenting with telemedical approaches were very interested to learn more at the meeting about his team's experience.

He pointed out that this was a small study and patients self-selected the option, so their positive feedback about the long-distance approach was anticipated.

His group is working on a new 20-patient study and plans to continue expanding and testing the program.

The researchers have disclosed no relevant financial relationships.

13th International Congress of Parkinson's Disease and Movement Disorders: Abstract Mo-273. Presented June 11, 2009.

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