Randomized controlled clinical trial of "virtual house calls" for Parkinson disease.
Randomized controlled clinical trial of "virtual house calls" for Parkinson disease.
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DOI：
10.1001/jamaneurol.2013.123
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发表时间：
2013-05
期刊：
影响因子：
29
通讯作者：
Biglan, Kevin M.
中科院分区：
文献类型：
--
作者：
Dorsey, E. Ray;Venkataraman, Vinayak;Grana, Matthew J.;Bull, Michael T.;George, Benjamin P.;Boyd, Cynthia M.;Beck, Christopher A.;Rajan, Balaraman;Seidmann, Abraham;Biglan, Kevin M.
神经疾病的负担正在增加，但获得护理的机会有限。通过远程医疗为患者提供特殊护理可以帮助缓解这一日益严重的问题。评估使用基于网络的视频会议(远程医疗)在家中为帕金森病患者提供特殊护理的可行性、有效性和经济效益。为期7个月的双中心随机对照临床试验。两个学术医疗中心的患者之家和门诊，20名帕金森病患者在家中可以上网。由专家在家中远程提供或在诊所面对面提供的护理。主要结果变量是可行性，以如期完成的远程医疗访问的百分比来衡量。次要结果测量包括帕金森病问卷-39(PDQ-39)测量的临床收益和时间和旅行测量的经济价值。20名参与者参加了这项研究，他们被随机分为远程医疗组(n=9)或面对面护理组(n=11)。在安排的27次远程医疗访问中，完成了93%(n=25)，而在33次计划的面对面访问(p=1.0)中，完成了91%(n=30)。在这项小型研究中，与亲身护理相比，随机接受远程医疗的患者的生活质量变化没有差异(4.0分改善vs.6.4分改善；p=0.61)。与面对面访问相比，每次远程医疗访问平均为参与者节省了100英里的旅行和3个小时的时间。使用基于网络的视频会议在家中提供专业护理是可行的，可以为患者提供价值，并可能提供与面对面护理类似的临床好处。需要进行更大规模的研究，以确定临床益处是否确实可与亲身护理相媲美，以及观察到的结果是否具有推广性。“通过基于网络的视频会议直接在家中为帕金森患者提供专科护理--一项比较有效性研究(TELIME-PD)”：ClinicalTrials.gov标识：NCT01476306
The burden of neurological disorders is increasing, but access to care is limited. Providing specialty care to patients via telemedicine could help alleviate this growing problem. To evaluate the feasibility, effectiveness, and economic benefits of using web-based videoconferencing (telemedicine) to provide specialty care to patients with Parkinson disease in their homes. Seven-month, two-center, randomized controlled clinical trial. Patients’ homes and outpatient clinics at two academic medical centers 20 patients with Parkinson disease with internet access at home. Care from a specialist delivered remotely at home or in-person in clinic. The primary outcome variable was feasibility, as measured by the percentage of telemedicine visits completed as scheduled. Secondary outcome measures included clinical benefit as measured by the Parkinson Disease Questionnaire-39 (PDQ-39) and economic value as measured by time and travel. Twenty participants enrolled in the study and were randomized to telemedicine (n=9) or in-person care (n=11). Ninety-three percent (n=25) of 27 scheduled telemedicine visits were completed compared to 91% (n=30) of 33 scheduled in-person visits (p=1.0). In this small study, the change in quality of life did not differ for those randomized to telemedicine compared to in-person care (4.0 point improvement v. 6.4 point improvement; p = 0.61). Compared to in-person visits, each telemedicine visit saved participants on average 100 miles of travel and three hours of time. Using web-based video conferencing to provide specialty care at home is feasible, provides patients value, and may offer similar clinical benefit to in-person care. Larger studies are needed to determine whether the clinical benefits are indeed comparable to in-person care and whether the results observed are generalizable. “Providing Specialty Care to Individuals with Parkinsonism Directly in Their Homes Via Web-based Video Conferencing — A Comparative Effectiveness Study (TELEMED-PD)”: clinicaltrials.gov Identifier: NCT01476306
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影响因子：
158.5
作者：
Follett, Kenneth A.;Weaver, Frances M.;Reda, Domenic J.
通讯作者：
Reda, Domenic J.
影响因子：
11.2
作者：
Dahodwala, Nabila;Xie, Ming;Mandell, David S.
通讯作者：
Mandell, David S.
影响因子：
3
作者：
Glasgow, RE;Wagner, EH;Greene, SA
通讯作者：
Greene, SA
影响因子：
8.6
作者：
Dorsey, E. Ray;Voss, Tiffini S.;Biglan, Kevin M.
通讯作者：
Biglan, Kevin M.
影响因子：
8.6
作者：
Dorsey, E. Ray;Deuel, Lisa M.;Biglan, Kevin M.
通讯作者：
Biglan, Kevin M.