Increasing Access to Specialty Care: A Pilot, Randomized Controlled Trial of Telemedicine for Parkinson's Disease
Increasing Access to Specialty Care: A Pilot, Randomized Controlled Trial of Telemedicine for Parkinson's Disease
复制标题
DOI：
10.1002/mds.23145
复制
发表时间：
2010-08-15
影响因子：
8.6
通讯作者：
Biglan, Kevin M.
中科院分区：
文献类型：
--
作者：
Dorsey, E. Ray;Deuel, Lisa M.;Biglan, Kevin M.
我们进行了一项随机对照试点试验，以评估通过远程医疗为居住在距离学术运动障碍诊所130英里的偏远社区的帕金森病患者提供专科护理的可行性。研究参与者被随机分配到罗切斯特大学的运动障碍专家那里接受远程医疗护理，或者接受他们通常的护理。远程医疗小组的参与者在六个月内接受了三次远程医疗访问。以远程医疗访问完成率衡量的可行性是主要成果衡量标准。次要指标是生活质量、患者满意度和临床结果。居住在社区的10名参与者随机接受远程医疗护理(n=6)或他们的日常护理(n=4)。四名疗养院患者被分配到远程医疗。接受远程医疗的人如期完成了97%(29/30)的远程医疗访问。在研究结束时，14名研究参与者中有13人选择通过远程医疗接受特殊护理。与常规护理相比，随机接受远程医疗的患者在生活质量(帕金森病问卷39中3.4分的改善与10.3分的恶化；P=0.04)和运动能力(统一帕金森病分级量表的运动子量表中0.3分的改善与6.5分的恶化；P=0.03)方面有显著改善。与基线相比，疗养院患者的生活质量和患者满意度有改善的趋势。通过远程医疗为居住在远程的帕金森氏症患者提供专科护理是可行的。(C)2010年流动无序社会
We conducted a randomized, controlled pilot trial to evaluate the feasibility of providing subspecialty care via telemedicine for patients with Parkinson's disease residing in a remote community located similar to 130 miles from an academic movement disorders clinic. Study participants were randomized to receive telemedicine care with a movement disorder specialist at the University of Rochester or to receive their usual care. Participants in the telemedicine group received three telemedicine visits over six months. Feasibility, as measured by the completion of telemedicine visits, was the primary outcome measure. Secondary measures were quality of life, patient satisfaction, and clinical outcomes. Ten participants residing in the community were randomized to receive telemedicine care (n = 6) or their usual care (n = 4). Four nursing home patients were assigned to telemedicine. Those receiving telemedicine completed 97% (29 of 30) of their telemedicine visits as scheduled. At the study's conclusion, 13 of 14 study participants opted to receive specialty care via telemedicine. Compared with usual care, those randomized to telemedicine had significant improvements in quality of life (3.4 point improvement vs. 10.3 point worsening on the Parkinson's Disease Questionnaire 39; P = 0.04) and motor performance (0.3 point improvement vs. 6.5 point worsening on the Unified Parkinson's Disease Rating Scale, motor subscale; P = 0.03). Relative to baseline, nursing home patients experienced trends toward improvement in quality of life and patient satisfaction. Providing subspecialty care via telemedicine for individuals with Parkinson's disease living remotely is feasible. (C) 2010 Movement Disorder Society