Acceptability and practicability of self-management for patients with Parkinson's disease based on smartphone applications in China

Abstract

Background China has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson's disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China.Methods We selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires. Results Among the participants, 65.19％ had smartphones. Among these smartphone users, 82.84％ expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013) .Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001). Conclusion In China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.

Rating Scales for Medication Adherence in Parkinson's Disease: A Systematic Review for Critique and Recommendations

“…The MMAS-8 was used by other investigators beyond the original developers and was shown to be reliable and valid in patients with hypertension (a chronic disease that usually requires concomitant use of medications, as in PD), and valid (linguistic and criterion validity) and responsive in PD patients. Though the eight items of the PRO covers some of the components of MA, and despite having been used in six studies with PD patients, [27][28][29][30][31]54 the MMAS-8 has limited clinimetric data available in the PD population. The MMAS-8 is suitable for screening and correlative studies; however, it cannot be recommended for treatment trials until more evidence regarding reliability and sensitivity to change are available for the PD population.…”

“…No scale met the required criteria to be ranked as "Recommended." The Morisky Medication Adherence Scale (MMAS-8), [26][27][28][29][30][31] The Beliefs Related to Medications Adherence questionnaire (BERMA), 32,33 the Beliefs about Medication Questionnaire (BMQ-H), 30,[34][35][36] The Satisfaction with Information on Medicines Scale (SIMS), 37,38 and the Medication Adherence Rating Scale (MARS) 35,39,40 met the criteria of "Suggested;" and the MGL-MAQ, 24,25,34,[41][42][43][44][45][46][47] the Brief Medication Questionnaire (BMQ-S), 23,48,49 the Malaysian Medication Adherence Scale (MALMAS), [50][51][52] and the PD-RX 23 met the criteria of "Listed" (Table 3). The PD-RX 23 it is the only scale developed specifically for the population with PD, but in addition to its clinimetric weakness, it has not been used by any investigator other than the original developers.…”

“…An observational study conducted with 204 PD patients identified that patients using the MA app had higher MA scores according to the MMAS-8. 27 An open-label multicenter randomized clinical trial assessing the impact of using a smartphone-based Parkinson's tracker app to promote MA in a sample of 158 PD patients (64% of dropout rate in the treatment arm and 83% in the control arm) showed that, after 16 weeks patients using the app significantly improved MA when compared to treatment as usual (mean difference: 0.39, 95%CI 0.04-0.74; P = 0.0304). This translated into a 6.6% reduction in low MA category in the Parkinson's tracker app…”