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Parkinson's disease is the world's fastest-growing neurological condition. It is a progressive neurodegenerative disorder that causes a wide range of movement-related (motor) problems (slowness, stiffness, tremor, balance difficulties) and non-motor problems (disturbances of thinking, memory, perception, mood, bladder, bowels, blood pressure). Even before the pandemic, NHS services were struggling to meet the demand for care.
To address this need for support, the investigators have co-designed an innovative digital care pathway, Home Based Care (HBC), with people with Parkinson's (PwP) and care partners (CP) to deliver self-management support and clinical expertise to the patient's home. This pathway is supported by remote monitoring with a wrist-worn sensor and questionnaires.
In this study, the investigators will be digitising this pathway so that data from a variety of sources (including the sensor, questionnaires, and patients' health records) can be combined in one place to enable more personalised care and to provide advice to support self-management of symptoms by patients.
After the investigators have set up the digitised pathway, its implementation will be evaluated with a group of 120 people with Parkinson's and their care partners and associated healthcare providers through the Plymouth Parkinson's Service. The investigators will examine participants' adoption of and engagement with the patient-facing digital platform over the course of 3 months and gather their feedback about its usability and acceptability. A smaller group of the participants will discuss their experiences in more detail to help pinpoint aspects that work well and those needing adjustment and development.
The investigators anticipate that this system will result in improved quality of life and care and increased knowledge and confidence for self-managing symptoms. The results of the study will be used to improve the digitised Home Based Care pathway. People with Parkinson's and care partners involved in the project will help guide the sharing of these results with healthcare providers and the general public.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Digitised Home Based Care pathway | Experimental | The investigators have co-designed an innovative digital care pathway, Home Based Care (HBC), that delivers self-management support and clinical expertise to the patient's home, supported by digitally-enabled remote monitoring with a wrist-worn sensor, the Parkinson's Kinetograph, and digitally-delivered questionnaires, to replace the current pen-and-paper processes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital Home Based Care pathway | Other | The digital version of the pathway includes an integrated data platform with an automated patient flow management system, digitised patient-reported outcome on web-based patient portal, and AI-based automated reporting for clinical decision support. |
| Measure | Description | Time Frame |
|---|---|---|
| Uptake | Rates of conversion to the digital platform | 3 months |
| Degree of compliance with wearable sensor | The wearable sensors are worn on the wrist and are known as the Parkinson's Kinetograph (PKG). The PKG assess objective motor measures including bradykinesia, dyskinesia and tremor. In accordance with the HBC pathway, patients are required to wear the PKG for 6 days and nights, after which the results are analyzed by their care team. From these results, therefore, it is clear to see where the patient has complied with wearing the PKG for the allotted time frame. | 3 months |
| Proportion of digital questionnaires completed | In accordance with HBC pathway, patients are required to complete a set of questionnaires covering the same time period in which they are wearing the PKG, and are responsible for assessing subjective measures. This outcome will assess compliance by examining the patients' overall compliance with the digital monitoring questionnaires by calculating how many of the questionnaires they successfully complete over the study period. | 3 months |
| Engagement | Qualitative feedback about engagement from semi-structured interviews | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Usability scores | System Usability Scale, 5-point Likert scale with total scores ranging from 0-100 | 3 months |
| Patient perceptions of usability | Qualitative feedback about usability from semi-structured interviews |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Edward Meinert, PhD | Contact | 01752600600 | edward.meinert@plymouth.ac.uk | |
| Madison Milne-Ives, MSc | Contact | 01752600600 | madison.milne-ives@plymouth.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Camille Carroll, PhD | University of Plymouth | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Plymouth | Plymouth | Devon | PL4 6DN | United Kingdom |
Only the project leads and associated staff will have access to the research data and healthcare professionals participating in the study will have access only to the data from the PwP and care partners whom they are treating.
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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No blinding will be possible in the study.
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|
| 3 months |
| Patient perceptions of acceptability | Qualitative feedback about acceptability from semi-structured interviews | 3 months |
| Cost impact | Preliminary evaluation of implementation costs; costs required to implement the digital HBC pathway will be compared to the costs of delivering the standard care pathway | 3 months |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |